Hygiene Tribune Middle East & Africa Edition

hygiene tribune Dental Tribune Middle East & Africa Edition | November-December 20154D < Page 1D > Page 6D duric bacteria (mainly mutans streptococci) metabolizing di- etary sugars to create a low lo- cal pH environment which can de-mineralize enamel. Thus patients whose bacteria war is being won by the bad bacte- ria will have more decay than those where the bad bacteria is kept at lower levels. How can we help? Oral probiotics are able to natu- rally alter the oral ph levels and because they are early biofilm colonizers and non-aciduric, they build a much smaller bio- film. Streptococcus rattus JH145 is a unique strain of streptococ- cus that does not produce lac- tic acid, and has been shown to successfully compete for nutrients and space on tooth surfaces with the native strain of streptococcus that produces lactic acid. The result is a re- duction in decay despite the po- tential presence of sugar (sub- strate) in the oral environment. Gum and Tooth Health What do you make of patients who brush and floss, their plaque indices are down, and yet their periodontal health continues to slump? Can the same be true of these patients? Despite their commitment to mechanically remove bacte- ria, chemically the bad is still winning the war.Research has revealed that even after the ag- gressive process of scaling to clean out the periodontal pock- PRINT DIGITAL EDUCATION EVENTS The DTI publishing group is composed of the world’s leading dental trade publishers that reach more than 650,000 dentists in more than 90 countries. . ets, the future oral health of the patient is determined by the type of bacteria that colonizes first in the base of that clean pocket. If the harmful bacteria are first to colonize, the disease condition will quickly return. If the beneficial bacteria are first, then good oral health will be established and the dental of- fice procedure will have been successful (Socransky and Hafajee, 1992, J. Perio, p. 322).  Pathogenic biofilm has a couple of requisites, and one is a low pH. So a biofilm with early col- onizers that doesn’t make acid has a harder time harboring the bacteria that we associate with dental disease. Harness- ing this pH characteristic of biofilm goes right up into the face of traditional methods - brush ‘n’ floss. Adjusting the pH allows your patients a way to manage their biofilm without having the dexterity and laser- focused education of a dental hygienist. When giving brush ‘n’ floss directions, we end up focus- ing only on the teeth, and we miss the elephant in the room - the tongue. Tongue coating is not innocuous, nor is it only a cosmetic concern. Biofilm on the tongue releases plank- tonic bacteria in what’s called a planktonic storm. A coated tongue sends new biofilm to the rest of the mouth. So it’s time for the tongue to be included in discussions about biofilm management and pro- phylaxis and it is here that pro- biotics plays a very important role due to their activity in all oral biofilm. Probiotic bacteria like Strepto- coccus oralis KJ3, and Strepto- coccus uberis KJ2 colonise su- pra- and sub gingival sites and produce hydrogen peroxide, which aids in inhibition of peri- odontal pathogens. The ability to reduce these types of harm- ful bacteria in return results in a reduction of pathogenic bio- film on the teeth because they can only cause disease when they are in direct contact with the gingival epithelium. If they are in contact with the tooth or surfaces other than the gin- gival epithelium, or if they are freely floating in the mouth, they cannot cause periodontal disease.The patients who suf- fer from refractory periodontal disease, or who have poor re- sults from traditional periodon- tal treatment now have a new conservative approach which might provide them results they were previously unable to achieve with contemporary treatments alone. The story of oral probiotics gets better! This way of biofilm management is not the wave of the future any longer. Recommending oral probiotics with natural strains from healthy mouths may be the ticket for patients who can- not or will not remove their own biofilm to dental hygienist standards. Antimicrobial agents — in- cluding therapeutic doses of systemic and locally applied antibiotics, mouthwashes, sub- gingival irrigants, etc. — will kill probiotic bacteria. This is why they are not used during active periodontal therapy. One of the ideal situations in which oral probiotics are used is im- mediately following successful periodontal treatment. Reduc- ing the repopulation of caries- causing and periodontal bacte- ria gives the patient a fighting chance to remain healthy. Pro- biotics are also ideally used in periodontally healthy patients, especially those with a family history of periodontal disease. The optimal time to take the probiotic mint is in the evening, following the use of all biofilm- control devices. Fresher Breath In general, amino acids are the main substrate for the produc- tion of oral malodorous com- pounds. As freshly secreted hu- man saliva contains low levels of free amino acids, halitosis occurs as a result of bacterial putrefaction by several anaero- bic species found in the oral cavity. The most widely used strategies in the treatment of halitosis are comprehensive oral hygiene, including tongue scraping and brushing, as well as the use of mouth rinses con- taining antibacterial agents. Antibacterial mouthwashes and breath fresheners promote killing up to 99.9% of bacteria and germs in the mouth. These products indiscriminately wipe out both the essential, good

Hygiene Tribune Middle East & Africa Edition

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