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Dental Tribune Middle East & Africa No. 5, 2016

Dental Tribune Middle East & Africa Edition | 5/2016 14 oral health My Teeth are important ByJordan A majority of the people asked, con- firmed that their teeth are more important than other high interest personalcarecategories,forexample haircareandevensuncare. The reason for this is that we need our teeth to be healthy and strong in order to enjoy the things we want to, like eating, throughout our lifetime. Inthepast,itwasanassumptionthat as we age we would lose our natural teeth. That is not the case for today’s older adults who are keeping their natural teeth longer than ever be- fore.Moreandmorepeopleareeven keeping their teeth throughout their lifetime. What many people do not know, is thattheriskofcavitiesincreaseswith age.Oneofthereasonsisdrymouth, a common side effect of many pre- scription medications. About 40 per cent of people take at least one type of medicine that could cause tooth damage . Another reason is that nerves inside the teeth become smaller and less sensitive. By the time you feel pain from a cavity, it maybetoolate. So how can we best take care of our teeth, so that they last our lifetime? The answer lies in daily care and reg- ular visits to the dentist or hygienist. Follow the dentist’s recommenda- tion and brush twice a day, and use, at least once a day, an interdental product of choice to clean where a toothbrush cannot reach. Fluoride strengthens teeth and reduces the risk of decay, so it is important that the toothpaste contains the recom- mended amount of fluoride. Den- tists also recommend a soft tooth- brush that has good reach in order to clean back molars and difficult ar- eas in the mouth properly. Diet and lifestyle also effect teeth and gums, so to stop smoking and minimizing the intake of alcohol and other acid or sugar drinks and food are impor- tant steps to make. By daily remov- ing plaque on and around teeth, as well as along the gum line, teeth and gums have the best chance of keep- inghealthy. There are several factors that affect our brushing results. How we brush and how long we brush are two of the most central. Dentists recom- mend brushing for two minutes to get the best results, but few people actually do this. 50% of health care recommendationsarenotpracticed. People also have a bad conscience when it comes to brushing their teeth . They know they should brush better and put in more effort to keep their teeth heathy for life. Another study shows that men are notably less scrupulous when it comes to oralhygienethanwomen. 73% of women brush their teeth the recommended twice a day versus 62%ofmen.Womenarealsoflossing morefrequentlythanmen. Here are a few suggestions for taking careoftheteeth: - Use a toothbrush that feels com- fortable to hold. There are differ- ent shapes and sizes. In a study it was found that the design of the toothbrush effected the way people brushed and that people had a pref- erence for how they brushed. If you hold the toothbrush in a light grip (not clasp fingers around the tooth- brush in a power grip), and turn the handle a few times when you brush, you most likely prefer a slimmer, precision-style handle. On the other hand, if you prefer a thicker handle you probably have a more static powergrip. -Thesizeoftheheadcomesindiffer- ent sizes and the preference is also very personal. The important thing is that you can navigate the head easily around your mouth in order to reach and properly clean all areas, especiallythebackmolars. - How the bristles are shaped can affect performance. Dentists recom- mend soft bristles that are gentle to teeth enamel and to your gums. It’s important that the toothbrush leavesyoufeelingcleananddoesnot irritatethesoftergumtissue. -It’simportantthatyoudonotshare your toothbrush and keep it hygien- ic between brushing sessions. Keep the toothbrush standing upright and leave the bristles to air dry for bestresults.Iftravelling,keepbristles protected from the other items in thetoiletrybag.Atravelcaporcaseis recommended. Make sure there are hygienicbreathingholesinthem. Keeping our teeth strong and healthy is important and it’s our dailyeffortsthathelpusachievethis. References 1. Qualitative research, TNS Gallup, NorwayandSweden2015 2. Qualitative research, TNS Gallup, NorwayandSweden2015 3.www.betterhealth.vic.gov.au/ health/conditionsandtreatments/ teeth-and-drug-use 4.ADA 5. Gallagher A, Sowinski J. Bowman J et al. The effect of brushing time and dentifrice on dental plaque removal invitro.JDentHva2009:83:111-6 6. DiMatteo MR, Giordani PJ, Lepper HS, Croghan TW. Med Care, 2002;40: 794-811 7. Qualitative research, TNS Gallup, NorwayandSweden2015 8. Mintel rapport “encouraging bet- teroralcareresults”,2015 9. Ergonomidesign study, Sweden, 2004 “My Teeth are important”, is the feedback when asking people about their teeth1 . Interview: “The focus should be on maximum preservation of tooth structure” ByDrDavidAlexander,Singapore With the Minamata Convention on Mercury signed in 2013 and its pro- posed phase-out of mercury-con- taining products, including dental fillings, dentistry has entered a new era in which new and less harmful filling materials than amalgam are increasingly gaining importance. This year at IDEM, an entire sympo- sium will be dedicated to that topic. Scientific programme director Dr David Alexander spoke with pre- senter Prof. Hien Ngo from the Uni- versity of Queensland in Australia about the post-amalgam era and its impactondentalpractice. Dr David Alexander: Why is now the time to be organising such a detailed symposium on dental restorative ma- terials? Dr Hien Ngo: The scope of the Mi- namata Convention is much wider thandentistry.Itsmainobjectiveisto “protect human health and the envi- ronment from anthropogenic emis- sions and releases of mercury and mercury compounds”. In 2014, the FDIWorldDentalFederationissueda policystatementondentalamalgam supportingtherecommendationsof theMinamataConvention,whichin- clude the phase-down of amalgam. As this material has been one of the mainstays of dentistry for over 150 years, this move has huge impact on the way dentistry is practised every day. We need to start preparing to- day. Surely with all the various tooth-col- oured restorative materials available we are already in the post-amalgam era? Youareright,withthewidechoiceof tooth-coloured restorative materials and their improved performance, we are well equipped to enter the post-amalgameraindentistry.How- ever, the call by the FDI and United Nations Environment Programme (UNEP) for the phase-down, rather than the removal of amalgam from our profession, indicated that these authorities realised that amalgam is still an important tool in many parts of the world. This is mainly because of its perceived low cost, long track recordandhightechniquetolerance. There are billions of amalgam resto- rations still in service and the search for the ideal tooth replacement ma- terialisstillongoing. In preparation for the eventual re- moval of amalgam, the FDI policy statement stresses that authorities should work with the dental pro- fession on a comprehensive global dental materials research agenda together with effective preventive strategies. In the post-amalgam era, the profession has to focus on both restorative and preventive ap- proaches to the management of dentaldiseases. Briefly, how did the United Nations treaty on limiting the use of mercury comeabout? It started with the realisation of the negative impacts of mercury on the environment. The UNEP first looked into this issue in 2001. By 2003, it had concluded that there was enough evidence to recommend re- ducing the use of mercury globally. However, by 2009 UNEP realised that there was insufficient voluntary action, so it was decided to step up the pressure with the introduction of a legally binding instrument. This was the birth of the Minamata Con- vention, which was finally signed in 2013. Today, over 128 nations have signedit. As far as dentistry is concerned, what will be the main changes in everyday practice? The main changes include focusing on managing dental diseases, early detection and empowering patients in effective preventive regimes. When repair is required, the focus should be on maximum preserva- tion of tooth structure. This can be achieved only with the use of adhe- sivedentistryandnotamalgam. In order to gain public confidence, dental practitioners should demon- strate and communicate their com- mitment to safe handling practices, effective waste management and safe disposal of dental restorative materials. The public should be edu- cated on the implications of the Mi- namata Convention and the choice of restorative materials should be basedonasoundcost–benefitanaly- sisofeachparticularcase.Inthisnew era, dentistry will be both challeng- ing and fun, and the symposium willprepareparticipantsforthisnew phase. As you already stated, dental amal- gam has been one of the mainstays of dentistry for over 150 years. How can dental professionals acquire the knowledge, learn the skills and train their supporting staff to adopt the necessary procedures so that patients may enjoy the benefits of these mod- ern materials, in most cases, in place ofamalgam? The alternative restorative materials to dental amalgam are not that new; thus, most dental professionals and their supporting staff will already be familiar with these materials, even if they may not be in widespread use in their clinics. New are the features and benefits that the most recently developed materials offer. The sym- posium will place much emphasis on this aspect, especially regarding the clinical techniques. Therefore, the adoption of new techniques, un- derstanding the strengths and the limitations of various materials, and then the training of the wider dental team should not be too challenging. A benefit for every member of the dental team will be seen in patient satisfaction, as the aesthetics and longevity are so much greater now. The symposium will address restor- ing a single tooth, as well as the en- tire dentition, and re-establishing a healthyoralenvironment. What are the major learning out- comesofthewhole-daysymposium? This symposium will enable par- ticipantstounderstandtherationale behind the need to phase down the use of dental amalgam and to gain a detailedandcompleteupdateonthe latest advances in dental materials and the optimal techniques for clini- calsuccess. By the end of the symposium, par- ticipants will have gained practi- cal know-how to deliver effective, evidence-based and patient-centred preventive and restorative solutions intheeverydaypracticeofdentistry. We have assembled a panel of inter- nationally prominent scientists and clinicians to share their knowledge and clinical experience in order to enable a greater understanding of the opportunities for oral health and dental practice in the shift towards thepost-amalgameraofdentistry. By attending the symposium, will dentists be able to gain sufficient knowledge and skills to initiate the changesrequiredintheirpractices? The secret to success in responding to this call to action is to focus on preparing for the new era. This sym- posium is intended to provide par- ticipants with an understanding of therationalebehindthephase-down of amalgam, and participants will gain detailed knowledge on tooth- coloured materials, learn new skills on the selection and application of these, and most importantly be able to communicate the significance of the changes to members of the den- tal team and patients. At the end of the day, participants will feel ready and empowered to embark on this newandexcitingphaseofdentistry. Clearly, the environment is at the heart of the treaty and the conse- quent changes in the practice of den- tistry, but what do you see as other benefits to both the dentist and, of course,thepatient? The risk associated with free mer- cury has been well acknowledged by the dental profession. Waste management and safe handling of amalgam have been observed, and they are well regulated. One can ar- gue that, for the majority of dental practitioners,thetransitiontotooth- coloured restorative materials hap- pened a while back. These materials have much improved performance and they are now very popular. The main objective of this symposium is to bring together a group of excel- lentspeakerstoprovidethelatestin- formationtotheparticipants,aswell as to share experiences and skills. Thelistofspeakersincludeseminent dental leaders, scientists and clini- cians to ensure that each participant willbenefit. Thank you very much for the inter- view. Editorial note: Continue to DTI's Den- talamalgamTopicpagetoreadmore abouttheroleofmercuryindentistry. Jordan POBOX17795,Dubai,UAE Phone:+97148871050 Fax:+97148871060 E-Mail:jordndub@emirates.net.ae Internet:http://www.jordan.no/

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