SeniorEvdokia Chasioti explains why preventive care is the cornerstone of the profession.

Preventive dentistry is the cornerstone of healthy teeth and gums. Daily brushing and dental cleaning are forms of preventive dentistry, which help to avoid enamel wear, cavities, gum disease and eventual tooth loss. By focusing on preventing oral disease, we can maintain oral health and a beautiful smile.

A healthy mouth allows for normal function, gives comfort and plays an essential role to aesthetics. Maintaining a healthy mouth is important because tooth loss has some serious consequences. Individuals who are missing teeth are faced with a serious aesthetic complication, with a compromised function – to the extent that it can affect their speech and nutrition.

A compromised smile affects the way we look and, consequently, the way we feel – it can have serious psychological and social consequences. Neglected oral hygiene can lead to decayed, worn and fractured teeth and can damage the gum and bone that surrounds the teeth. Gingivitis is reversible with effective oral hygiene at home and regular dental cleaning, but left untreated, it will lead to periodontitis.

Prevention is better than cure

Figure 1: Patient with an UR1 central incisor presenting with trauma and supra-eruption
Figure 1: Patient with an UR1 central incisor presenting with trauma and supra-eruption

It is not just about losing a tooth. When a tooth is lost, the stimuli to the bone that leads to bone remodelling and maintaining its volume is lost. The bone supports the lips and cheeks and reduction in bone volume (due to missing teeth) can lead to a detrimental change in a patient’s appearance.

The lips, cheeks and muscles of the face will collapse into the missing bone areas giving a wrinkled look to the face, making the patient look older. The cheeks look loose and the dimensions of the face change. This leads to some particularly serious aesthetic and functional problems.

It is obvious that to achieve a ‘10 years younger’ look, oral health is key and can only be achieved with preventive dentistry and effective oral hygiene at home with the appropriate products.

Having an understanding of the detrimental effects of oral disease will enable patients to comprehend the importance for overall health. Comprehensive research demonstrates that inflammation may be responsible for the association of periodontal disease with heart disease, diabetes, osteoporosis, lung disease and cancer.

Hence, it is critical to determine the history and risk of periodontitis for our patients and address any dental and periodontal problems and, most importantly, prevent those problems with regular dental exams and regular oral hygiene.

Essential education

Figure 2: UR1 central incisor extracted and restored with a new implant-supported crown restoration
Figure 2: UR1 central incisor extracted and restored with a new implant-supported crown restoration

A well-informed patient is a motivated patient. An educated patient is more likely to work closely with me towards the direction of maintaining a meticulous level of oral health, by performing effective oral hygiene at home and attending their dental and periodontal appointments regularly.

It is essential to teach our patients the importance of oral health and how to achieve this. I use a combination of brushing and flossing tips, demos on teeth models and animated videos. Chairside, we all have the perfect opportunity to demonstrate all the means of cleaning – from how to use an electric toothbrush to all the interdental and single-tufted brushes, floss and tongue scrapers. I demonstrate on the model and then I choose the products that best suit the patient and ask them to demonstrate back to me to ensure they understood the techniques and how to use the products.

The majority of periodontal patients suffer from sensitive, receding gums and it is important they use a sensitive clean Oral-B head with their electric toothbrush to avoid further trauma on their teeth and gums. The Oral-B Pro-Expert Sensitive and Gentle Whitening toothpastes help to prevent plaque build-up, and rinsing with mouthwash further prevents plaque build-up and helps kill germs. I also recommend the use of interdental brushes – essential for gum health.

Oral health maintenance

Figure 3: UL6 missing molar restored with an implant crown prosthesis after an internal sinus elevation procedure
Figure 3: UL6 missing molar restored with an implant crown prosthesis after an internal sinus elevation procedure

For the maintenance of oral health and the long-term success of the treatment, I strongly suggest daily removal of plaque from the teeth with brushing twice a day with an electric toothbrush. If the patient presents with teeth sensitivity, gum recession and tooth wear, I recommend a sensitive brush head, such as the Oral-B Sensitive to avoid further trauma on the oral tissues.

The toothpaste I recommend aims to protect against cavities, plaque, gum problems, teeth sensitivity, stains, bad breath and enamel erosion. Through the wide range of products available, I choose the one that best meets my individual patient needs. Rinsing with mouthwash is equally important to help prevent plaque returning and to help kill bacteria.

Additional preventive steps towards meticulous oral health include flossing at least once per day to get rid of food trapped between teeth; interspace brushes for cleaning gaps between the teeth, under bridges, crowns and around implants; and tongue cleaners for fresh breath.

My highest priority is that the well being and happiness of my patients is looked after at all times. The ‘patient journey’ is of major importance to me. I am dedicated and committed to a practice that ensures patients receive the best treatment in a caring, relaxed, stress-free environment, with a goal of recreating stunning smiles using state-of-the-art procedures.