Not just tooth decay: What is dental caries, which affects the oral health of over 50 pct of young Indians?

"Oral health has a profound effect on systemic health. Excellent oral health reflects in the aesthetic and functional dentition, allowing individuals to continue their desired social and active role. However, in most low and middle-income countries, with increasing urbanisation and changes in living conditions, the prevalence of oral diseases continues to grow," says Mumbai-based Dr Aisha Ansari, dentist at SL Raheja Hospital.

According to the National Oral Health Policy of India, dental caries, periodontal diseases and oral cancer are among the most common diseases affecting the oral health of a majority of Indians. An oral health survey conducted by the Health Ministry and WHO India in 2007-08 reveals that the prevalence of dental caries ranged between 23 percent and 71.5 percent among 12-year-olds and between 48.1 percent and 86.4 percent among adults aged 35-45 years. A number of factors, including awareness, social and economic conditions, contribute to the burden of oral health diseases in India.

A condition that can be often dismissed as minor tooth decay, dental caries may lead to complex tooth diseases if left untreated. Ansari explains what causes dental caries, the treatment available for it and the importance of paying attention to one's oral health.

When we say oral health, what does it comprise as a whole?

Oral health is a crucial indicator of overall health, well-being, and quality of life. There is a proven relationship between oral and general health. It touches every aspect of our lives but is often taken for granted. Your mouth is a window into the health of your body, and it can show signs of nutritional deficiencies or widespread infection. It encompasses a range of diseases and conditions that include dental cavities, periodontal (gum) diseases, tooth loss, oral manifestations of HIV infection, oral cancer, oro-dental trauma, noma, and congenital disabilities such as cleft lip and palate.

Although oral health problems are rarely life-threatening, they remain a significant public health problem because of their burden due to high prevalence. It is now widely recognised that oral health can have social, economic, and psychological consequences. In other words, oral health can impact an individual's quality of life.

What are dental caries, and what are their common forms prevalent in India?

Dental caries is commonly known as tooth decay and is amongst one of the most widespread diseases globally. Dental caries is defined as an infectious microbiological disease of the teeth that results in localised dissolution and destruction of the calcified tissues. The overall prevalence of dental caries is 54.16 percent. In terms of age, its prevalence was 62 percent in patients above 18 years of age and 52 percent in patients between the ages of 3 and 18. In India, the most common form of dental caries prevalence was in the permanent teeth.

What are the primary oral causes of oral caries in India? Is there any region or age-specific prevalence?

Dental caries has become a leading problem globally, and it is more prevalent in developing countries. Dental caries results when plaque forms on the surface of a tooth and converts the free sugars into acids, thereby destroying the tooth over time. Oral health is an essential component of overall well-being and is often neglected in India. This neglect is the primary cause and reason for developing caries, which when neglected leads to severe consequences and complications. Also, permanent dental caries is most prevalent among people above the age of eighteen.

How dangerous can dental caries get and why is early diagnosis important?

Tooth decay is a pervasive disorder, and it can affect anyone. Tooth decay is a common cause of tooth loss in younger people. Bacteria are generally found in your mouth's saliva and oral cavity. These bacteria are responsible for changing foods, especially sugar and starch, into acids. Bacteria, acid, food pieces and saliva combine in your mouth to form a sticky substance called plaque. Plaque sticks to teeth, building up on teeth within 20 minutes of eating something. If this plaque is not removed, it turns into a substance called tartar or calculus.

Dental caries are rarely life-threatening but leaving it untreated may lead to tooth loss and other complicated tooth diseases. Retaining the integrity of a healthy tooth results in lesser complications and maintaining the form and structural integrity of teeth is very important.

What are the forms of treatment available In India?

Some of the forms of treatment available in India for dental problems, and to educate people about oral health, can be categorized as follow:

• Preventive and Diagnostic Care - this includes X-rays, scans, and cleaning
• Basic Restorative Care - this includes dented fillings, restorations, and root canal treatment
• Major Restorative Care - this treatment provides prosthesis, dentures, implants, bridges and crowns

As per observations, do you think Indians generally do not pay much attention to diagnosis for dental care or visit a dentist regularly?

According to the draft National Oral Health policy 2018, the prevalence and recurrence of oral diseases in India is a ‘silent epidemic'. Every society provides a unique soil for a healthcare programmer to build upon its programs and policies. Indian society is similarly unique in social mindset, prevalent beliefs, and health customs. The absence of scientifically supported background knowledge of a society can severely hinder any attempt of change - whether it is a good or a bad change in society. Indian society's attitude towards dental health is lax and we give it less importance than general health. People's attitude is shaped by their shared beliefs that dental treatment is unbearably painful, and therefore they prefer to live with the pain than to visit a dentist. This perception needs to be changed. Also, the traditional addiction to tobacco in the Indian masses is another issue.

Another factor is the lack of general awareness about oral health and longevity. The scenario in which a patient visits the clinic or nursing care in India is usually the last resort, mainly due to the expensive care because the fees, peripheral charges, and medicines tend to be costly. Most of the time, they wait for the pain to go away on its own or depend on 'desi nuska'. To avoid going to the dentist, patients try using home remedies and local beliefs. Such treatment calls for local herbs, oil, mouthwash, natural remedies, etc. Even after getting a professional care diagnosis, treatment plan, patients often do not follow through with the same. Many quacks in India provide dental care - these can have severe side effects like loss of teeth and even loss of sight. Although Indians generally ignore oral health, the last decade has seen a good rise in oral hygiene. People are now trying to ensure that their teeth remain in good condition and visit a dentist at regular intervals. After all, it is better late than never!

Any dietary or daily care recommendations to prevent dental caries?

Dental caries is the most common disease of the oral cavity. It can be prevented if we maintain good oral hygiene, regularly visit the dentist, have a healthy diet, and avoid junk food or artificial food materials. It is equally important to brush, floss, and use mouthwash regularly. Also, remember to consume fewer food items like chewing gums, sugary items, and sticky foods as they can harm the person's gums.

(Disclaimer: This article is not intended as a substitute for professional medical advice, diagnosis or treatment. Mid-day Online does not in any way endorse the accuracy, completeness, efficacy or timeliness of any advice or line of treatment mentioned in this article. Readers must always seek the advice of a certified medical practitioner and/or a mental health professional before deciding on or starting any course of treatment.)