STORY BY: SARAH AGYEKUM (Level 300JNB)
A Dental Surgeon at Knight Smile Clinic/Centre, West Legon, Dr. Felix Addo, on June 22, 2016, revealed what should be known about dental caries when he stated that people only visit the dentist when they feel pain.
According to the World Health Organization (WHO), 60% to 90% of school children and nearly 100% of adults have dental cavities. Severe periodontal gum disease which may result in tooth loss is found in 15-20% of middle-aged adults between the ages of 35-44. Globally, about 30% people aged 65-74 have no natural teeth. Risk factors of dental caries include unhealthy diets, tobacco use, harmful alcohol and poor oral hygiene. 90% 0f the worlds’ population suffer from either dental caries or periodontal diseases. Statistics from WHO 2008 shows that Ghana has 148 dentists which is equivalent to 0.06 dentists per 10,000 patients. 70% of these are based in Accra.
Speaking with GIJ online news, Dr. Addo disclosed that dental caries occurs due to acids produced in the mouth. “Dental caries is a decay of the tooth due to the action of bacteria of food debris in the mouth that produces acids which decay the tooth. Dental caries is also called tooth decay or kaka in our local language” he said.
Dr. Addo mentioned that the main effect of tooth decay, aside the swelling of the gum, headache, effect on social life (not being able to mingle with people and smile), bad breath and death is pain. “The main worry of tooth decay to the patient is pain. This is usually why people visit the dentist. There are patients with holes in their teeth without pain. The holes are evident of decay. However, the decay depends on the extent of the damage. The moment pain sets in, it means the decay has gotten far,” he said.
“Enamel caries with small holes is mostly without pain. When food gets to the enamel, it can be taken out. Mostly, there is no pain. However, when it goes deeper into the dentine, some may feel pain and others, sensitivity. It is mostly not spontaneous. When one chews anything and drinks cold water, there is a likelihood of feeling it. By the time it worsens and gets to the pulp (where the nerves and vessels are), pain sets in; this is where patients will think of seeing a dentist,” he added.
He further explained plague as a mixture of saliva and bacteria in the mouth. This, he hinted that no matter how clean ones mouth is, there are bacteria that occur normally. The bacteria, he said, forms a colony with the saliva and gets stuck to the teeth.
“Plague is usually not so visible yet when it becomes classified, it develops into Calculus. Calculus is the yellowish stain which is formed at the margins of the teeth. Chromogenic material changes the stain to the green and black stains seen. As soon as a black stain appears, the dental caries has occurred,” he added.
According to him, the treatment for dental caries depends on the gravity of the damage which ranges from simple fluoride therapy to the extraction of the tooth.
He stated that a dentist can remove calculus from the teeth and not the tooth paste and tooth brushes: which is why one needs to routinely visit the dentist once every six months. “A dentist can use the ultrasonic scalers to remove the calculus. However, at the stage of plague, an individual can remove the stains. As soon as the plague develops into calculus, toothbrushes and pastes cannot take them off. Only the dentist can remove the calculus using the scaling approach. Ideally, one should brush his teeth twice daily,” he said.
In his view, a dentist may consider removing a decayed tooth when the caries gets into the pulp; where the nerves and vessels are. “A dentist can consider extracting the tooth when the caries gets into the pulp. This is because the pulp is infested at that stage and there is no conventional feeling. However, another option can be used which is the Root Canal Therapy,” he added.
Dr. Addo further mentioned that when a tooth is removed, it is advisable to replace it using the artificial tooth. This, he said, helps prevent the other tooths' from drifting and filling up the space created. Some of the replacements he disclosed are the removable, denture and fixed (the bridge and implant). A patient can remove and wash the removable and denture replaced tooth. However, only the dentist can remove the bridge and implant fixed form of replacement.
According to him, about 20% of the Ghanaian population visits the dentist. Those who give it a try, do so only when they experience any pain in the tooth. He revealed that for the two years he has practiced as a dentist, he has witnessed about six cases of death resulting from dental caries. “Dental caries can cause one to die. Many cases of deaths have been recorded from tooth decay. People don’t pay attention to dental care which results in death. With the molars, there are roots and any damage to it causes swelling. When it spreads into the space, moving along the tissues, then it can move into the neck. When it gets into the chest, the swelling can suffocate the patient leading to Ludwig’s Angina which is an emergency.