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Incoming DENTAC Personnel (.ppt)
The two most common dental problems are gum disease (gingivitis & periodontal disease) and tooth decay (cavities). Our aim in Army dentistry is to prevent and treat these and other oral diseases, but most importantly, we aim to help Soldiers to become caretakers of their own oral health.
Periodontal diseases are infections of the gums and bone that surround and support the teeth. In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. Gum disease is caused by bacteria in the mouth that infect the gums, causing inflammation around the tooth leading to periodontal disease. When bacteria stay on the teeth long enough, they form a film called plaque, which eventually hardens to tartar, also called calculus. Tartar build–up can spread below the gum line, which makes the teeth harder to clean. Then, only a dental health professional can remove the tartar and stop the periodontal disease process.
Gingivitis can be controlled and treated with good oral hygiene and regular professional cleaning. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include deep cleaning of the tooth root surfaces below the gums, medications prescribed to take by mouth or placed directly under the gums, and sometimes corrective surgery.
Reference: Periodontal Disease. Centers for Disease Control, Division of Oral Health.
Tooth Decay (Cavities)
Dental caries (commonly referred to as cavities or tooth decay) occurs when foods containing carbohydrates (sugars and starches) such as sugary drinks, cakes or candy are frequently left on the teeth. That is because plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars or starches, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and after many such attacks, the enamel can break down and a cavity forms.
Among Soldiers, common reasons for developing decay include poor oral hygiene and a diet that includes frequent use of candy or carbonated or caffeine drinks that are high in sugar. Decay around the edges, or margins, of fillings is also common to older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.
Recession of the gums away from the teeth, combined with an increased incidence of periodontal (gum) disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold.
- Brush your teeth twice a day with fluoride toothpaste.
- Clean between teeth daily with floss or an interdental cleaner.
- Eat a balanced diet and limit between–meal snacks.
- Visit your dentist regularly for professional cleanings and oral exams.
- Ask your dentist about dental sealants, a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.
Reference: Caries (Tooth Decay). American Dental Association.
High Risk Caries Program
The Army’s High Caries Risk Program is a unique program that will improve overall oral health. The High Caries Risk Program customizes dental treatment to the individual Soldier to meet his/her needs. Soldiers receive nutritional counseling, oral hygiene instructions, intensive treatment to help prevent future decay, and treatment for any cavities they have. Soldiers with low caries risk have fewer dental needs, better dental readiness, and spend less time overall at dental appointments, which means more time available to their units. All soldiers are asked to review and sign the High Caries Risk Program Enrollment Form (.pdf file format) during their annual dental visit, if they have not already done so.
Commonly prescribed prevention and treatment modalities used in the HCR program include:
- Fluoride Varnish
- Pit & Fissure Sealants
- Fillings (as needed)
- Antibacterial mouth rinse (as needed for short term treatment of gum disease)
Reference: High Caries Risk Program Benefits (pdf)
Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.
Extraction of wisdom teeth is generally recommended when:
- Wisdom teeth only partially erupt. This leaves an opening for bacteria to enter around the tooth and cause an infection. Pain, swelling, jaw stiffness and general illness can result.
- There is a chance that poorly aligned wisdom teeth will damage adjacent teeth.
- A cyst (fluid-filled sac) forms, destroying surrounding structures such as bone or tooth roots.
Patients should ask the dentist about the health and positioning of their wisdom teeth. The dentist may make a recommendation for removal or send the patient to an oral surgeon for further evaluation.
Reference: Wisdom Teeth. American Dental Association.
page last modified on: 5/7/2013