Hygienicdietary habits

This section covers those data on the frequency and quality of oral hygiene and consistency of diet, time and frequency of food intake.

There is little doubt that the change in lifestyle of civilization was resulting in an increase in the prevalence of dental caries, referring mainly to the increase of the diet of soft foods that contain carbohydrates.

Certain features of sugary foods and the conditions under which they are ingested, are more important in determining the cariogenic potential than amount of sugar (Moynihan, 2005).

The factors that establish the potential cariogenicity of sugary foods are:

• The physical consistency of the diet: food adhesives are more retentive than non-cariogenic.

• Time of ingestion: sugary foods are more dangerous when consumed between meals, as the natural defense mechanisms operate at maximum during meals. The worst time to cariogenic food is just before bedtime, because the mouth is dry by the circadian rhythm of saliva during sleep.

• The frequency: sugar intake reduces the pH of dental plaque that facilitates demineralization and promotes tooth decay, so that the more frequent the intake, more cariogenic foods become.

The severity of the above is that the sugars are rapidly degraded by bacteria in acidic metabolic end products, which will result in a greater demineralization process than remineralization with subsequent carious lesions.

But also, there are certain foods that can protect against the formation of dental caries by the substances that they contain in their structure, either because they are fibrous, fatty or protein, etc. which reduces their cariogenic potential, and when mixed with sugary foods, reduce the potential of the latter, these are called protective foods, among which we mention the cheese. It has been shown to finish a meal with cheese for dessert, reduces the acidity of the plaque and therefore tooth decay (cariostatic).

The cheese prevents enamel demineralization by two different mechanisms: by stimulating the flow of saliva, which buffers the plaque and by increasing concentrations of calcium and phosphorus in dental plaque, which promotes remineralization (Saroglu, 2007).

In recent years, has also increased the use of sweeteners and sugar substitutes; investigations have focused mainly on sugar alcohols (sorbitol, mannitol, maltitol and xylitol), starch hydrolysates (Lycasin), protein (Monellina) and synthetic chemicals (saccharin, cyclamate and aspartic). Unlike sugar, these are poorly metabolized by oral bacteria or metabolized by pathways that lead to acid formation. Even some of them reduce the bacterial metabolism and consequently the development of plaque on the oral tissues. Nutrition education is very important, also correct oral hygiene with effective brushing after every meal is basically in oral health, while considering preventive periodic revisions to the dentist.

The useful life of a toothbrush is determined more by the brushing method that the length of use. Its half-life is approximately three months; however, this estimate may vary due to differences in the brushing habits.

They have developed several methods of toothbrushing and most are identified by a single name like Bass, Stillman, Charters, or by a term indicating the main action to be taken: as spinning or massage.

The objectives of brushing are:

• Remove the plaque and stop the growth of it.

• Clean the teeth of food, debris and stains.

• Stimulate the gingival tissues.

Although the brush is the main mechanical means of plaque removal, often required of dental auxiliaries to remove residual plaque present in the proximal surfaces, among which include: dental floss, interdental cleaners, oral irrigators, mouth rinses buccal interdental sticks, and others (Klaus et al., 1991).

However, the majority of the population is disabled, unmotivated or are unaware of the need to devote time to remove the plaque from all tooth surfaces, or using products not suitable for removing plaque on the site crucial, or both.

To know the habits of the patient is recommended to apply a questionnaire which included a series of questions regarding daily brushing and eating habits, focusing on behavioral risk factors for dental disease. (Fig. 13).

Fig. 13. Filling the questionnaire dietary and hygiene habits
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