Evolution of knowledge on dental care
The practice of dental care has deep historical roots. In antiquity, Hippocrates advised using special powders for rubbing in cases of halitosis (bad breath) and treating "black and bad gums." In Ancient Rome and Greece, people used aromatic rinses, wooden toothpicks, scraped plaque off the tongue with a spatula, and cleaned their teeth with brushes featuring abrasives made of red coral and burnt horn. In the Middle Ages, silver and gilded metal toothpicks became widespread.
Interestingly, in the early stages of medicine, the advisability of using toothbrushes was contested. Doctors feared that stiff bristles would abrade the enamel and that a contaminated instrument would become a source of infection. Only the modern stage of dentistry, supported by clinical, biochemical, and hygienic research, has conclusively proven that mechanical brushing is completely harmless and plays a key role in prevention.
Functional significance of the maxillofacial system
Healthy teeth perform not only aesthetic but also crucial physiological functions:
- Facial architectonics: A normal dental arch supports the facial framework. The loss of anterior teeth (canines and incisors) causes the lips to sink inward. Edentulism of the posterior teeth (molars and premolars) leads to shortening of the lower third of the face, sinking of the cheeks, and the formation of a senile expression.
- Phonation: Anterior teeth are critical for proper articulation. Without them, speech becomes indistinct, lisping, and whistling.
- Digestion: The mechanical grinding of hard food is a baseline requirement for adequate digestion and nutrient assimilation.
- Biomechanics and trophics: The act of chewing creates a powerful physiological load. This stimulates blood supply and strengthens the periodontium according to the biological principle "function shapes the organ."
Pathogenesis of diseases and their systemic impact
The basis of prevention is the regular removal of dental plaque using toothpaste and a brush. Mechanical cleaning is accompanied by gum massage, which activates local metabolic processes.
Without proper care, food debris gets trapped between the teeth and along the gum margins. Under the influence of microflora, it decomposes with the release of organic acids that compromise the integrity of the enamel, initiating the mechanism of caries. Simultaneously, dental calculus forms—hard deposits that provoke gum inflammation, root exposure, and tooth mobility.
Carious cavities and tissues affected by periodontal disease become foci of chronic intoxication. Pus and pathogenic microorganisms can enter the bloodstream. Such hematogenous spread of infection can cause secondary lesions in the heart, joints, kidneys, and digestive organs.
Oral microflora
The oral cavity represents an ideal incubator for microorganisms due to high humidity, uniform temperature, lack of light, and an abundance of substrate (food and desquamated epithelium).
The microbiocenosis is represented by casually introduced microbes, an extensive group of resident saprophytes, as well as opportunistic and pathogenic bacteria (staphylococci, streptococci, pseudodiphtheria bacillus).
Normally, labile equilibrium is maintained among all species. However, under the influence of adverse external factors (occupational, domestic) or the accumulation of heavy dental deposits, this balance is disrupted. Resident bacteria, entering into symbiosis, can acquire increased virulence and cause significant harm to the body.
Criteria for choosing a toothbrush
A toothbrush consists of a plastic handle and a head with a working surface. When choosing an instrument, the bristle material is of decisive importance:
- Natural bristles: Hollow on the inside, which makes them a reservoir for the accumulation of microflora. Their tips cannot be polished or rounded, so they often scratch and injure the gums.
- Artificial bristles: Synthetic fibers are stiffer but easily undergo thermal and mechanical processing. Modern technology allows their tips to be rounded, making brushing absolutely safe for the mucosa. It is recommended to use synthetic brushes specifically.
The dimensions of the working surface are also strictly regulated: for adults, the width must not exceed 7.5–11 mm (length 23–30 mm); for children, width 7–9 mm (length 18–25 mm). All hygiene products must comply with sanitary standards and be completely harmless.
Briefly: answers to topical questions
What types of microorganisms make up the normal and pathological oral microbiocenosis?
The oral microflora includes transient microbes, resident saprophytes, as well as pathogenic and opportunistic bacteria. A labile equilibrium of various forms and types of microbes is normally maintained. Gram-positive and Gram-negative bacteria are detected in various oral biotopes, including Streptococcus mitis, Streptococcus salivarius, Veillonella, as well as Streptococcus sanguinis and Streptococcus mutans, which participate in dental colonization. In chronic periodontal inflammation, filamentous Gram-positive, motile Gram-negative bacteria, and spirochetes predominate in the dental plaque; Aggregatibacter actinomycetemcomitans is noted among the highly virulent microorganisms of dental calculus.
What dental indices are used for an objective assessment of oral hygiene status?
For objective diagnostics, qualitative and quantitative assessment of dental deposits, and evaluation of the level of hygiene in dental practice, a number of special indices are used. The main and most common ones are the Fedorov-Volodkina hygiene index, the simplified oral hygiene index OHI-s by V.C. Green and J.R. Vermillion (Green-Vermillion), as well as the Podshadley-Haley hygiene performance index.
Which groups of active ingredients are part of therapeutic and prophylactic toothpastes?
Therapeutic and prophylactic toothpastes contain biologically active substances: minerals and salts, enzymes, vitamins, trace elements, and chlorophyll. These components exert a favorable effect on the hard tissues of the teeth, periodontium, and oral mucosa.
Class and exam questions
Why do dentists recommend toothbrushes with artificial bristles rather than natural ones?
Natural bristles are hollow inside and rapidly accumulate microorganisms. Moreover, their tips cannot be rounded, causing them to injure the gums. Synthetic fibers lack these drawbacks.
How does the absence of teeth affect a person's face?
The loss of anterior teeth causes the lips to sink inward. The absence of molars and premolars leads to sinking of the cheeks, shortening of the lower third of the face, and the formation of a senile expression.
Can poor dental hygiene lead to heart disease?
Yes, carious cavities and periodontal disease form foci of chronic intoxication. Bacteria and pus can enter the blood (hematogenous route) and affect the heart, joints, and kidneys.
What else to study on this topic
- Sanitary and epidemiological requirements for hygiene products (SanPiN 1.2.676-97)
- The system of scheduled dental sanation in the Russian Federation
- Methods of fluoridation and defluoridation of drinking water
- Specifics of using anticariogenic diets
- Principles of organizing health education work among the population
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