The HEALTH | AUGUST, 2018

OBESITY is a major public health concern in both developed and developing countries; with prevalence among adults estimated at 24 per cent worldwide, three per cent for South East Asia and 27.2 per cent for Malaysia. Obesity is a known risk factor for major complex diseases such as diabetes.

“ In dentistry, obesity has been associated with chronic periodontitis( CP; gum disease) in the adult population,” said University of Malaya Faculty of Dentistry Department of Restorative Dentistry Associate Professor Dr Nor Adinar Baharuddin.

“ In Malaysia, the prevalence of severe CP is increasing, estimated at 18 per cent among adults. CP can be successfully treated by means of periodontal therapy. Various adult populations demonstrated that obese subjects have poorer periodontal health and responded less favourably to periodontal therapy. Thus, obesity has been indicated as a potential risk factor for CP and may have a negative impact on oral health-related quality of life.

In University Malaya, the periodontics research team found similar findings. A preliminary epidemiology study showed that about 75 per cent of the obese subjects have CPs. Subsequent study from the same team also found that obesity status is a significant predictor to determine the outcome of periodontal therapy. This means that obese subjects do not respond as optimally to periodontal therapy as compared to the non-obese subjects.

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Gingivitis is superficial and only develops in the soft tissue while periodontitis affects the soft tissue and the hard tissue which is the bone.

University of Malaya Faculty of Dentistry Department of Restorative Dentistry Associate Professor Dr Nor Adinar Baharuddin pointed out that as much as the tooth is concerned, gum also plays an important role in maintaining the good stability and the function of the tooth.

“ Periodontal disease actually is a silent disease, normally left unnoticed until there are major problems.

But, this disease is accommodating. Patients would adapt to this disease, until the tooth is really shaky and they suffer bad breath.

Symptoms

“ Normally, the gums would bleed when brushed. Unfortunately, most patients would brush it off as normal, when in fact, the body is reacting towards it and it needs to be addressed.”

“ Plaque is yet another symptom where there may be a build-up of calculus- dark hard structure around the tooth and in the more advanced disease— chronic periodontitis— where the teeth appears elongated as the gums have receded which causes sensitivity.”

A person may also suffer minor symptoms such as gingivitis— inflammation of the soft tissue— which is reversible.

“ Chronic periodontitis, however, is an irreversible disease involving the loss of bone resulting in the collapse of the soft tissue which makes the teeth looks longer, exposing the dentine as well as the cementum which again results in generalised sensitivity.”

Cause

Nor Adinar explained that dental plaque is the cause.

“ This plaque triggers the inflammation in the gums, making the body respond

“ Periodontal disease actually is a silent disease, normally left unnoticed until there are major problems. But, this disease is accommodating. Patients would adapt to this disease, until the tooth is really shaky and they suffer bad breath.

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Teeth appears to be longer due to receding gum lines.

towards it, which exaggerates the immune response. So, that will trigger the whole disease process.”

She emphasised that everyone can have gingivitis which comes prior to having periodontitis. Nevertheless, not all that have gingivitis will have chronic periodontitis.

“ This disease depends on the immune response of a person.

Some people can have gingivitis from 50 to 70 years of age, because the body is not susceptible to chronic periodontitis. But there are some people who, at an early age may get chronic periodontitis.”

Treatment

Scaling and polishing are basic forms of treatment for cases that involve gingivitis.

“ Scaling means we remove the calculus and the plaque, followed by polishing.”

Home care

Apart from receiving professional care, Nor Adinar advised patients to brush twice a day and to floss as necessary.

DENTAL CARE WITH JILL COOPER

GRINDING is a habit that occurs during sleep and is usually related to stress.

University of Malaya Faculty of Dentistry Department of Restorative Dentistry senior dental lecturer Dr Azwatee Abdul Aziz pointed out that there are also cases where a person clenches their teeth other than grinding them.

“ This puts pressure on your bite, while grinding is the action of sliding your teeth which happens when a person is unconscious or during sleep.”

“ This is mostly related to stress, and if it is diagnosed that the person is really grinding or clenching, a mouth guard can be done. This can be worn during sleep so that it won’ t affect the grinding too much on the tooth. It may also help prevent or slow it down,” she said.

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