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Dr. Tara Baksh (BDS, BSC) General Dental Practitioner of Island Dental Care |
The reason dentists encourage us to brush our teeth at least
twice a day and ideally after each meal is to remove the buildup of plaque from
our teeth. According to the National Institute of Dental and Craniofacial
Research, “Our mouths are full of bacteria. These bacteria, along with mucus
and other particles, constantly form a sticky, colorless “plaque” on teeth.
Brushing and flossing help get rid of plaque. Plaque that is not removed can
harden and form “tartar” that brushing doesn’t clean.” The organization’s site
went on to say that, “The longer plaque and tartar are on teeth, the more
harmful they become. The bacteria cause inflammation of the gums that is called
“gingivitis.” In gingivitis, the gums become red, swollen and can bleed
easily.” Gingivitis is reversible,
however the second stage of gum disease – periodontitis is not.
In periodontitis the gum starts to pull away from the teeth
and form small pockets around the tooth. Bacteria in those pockets around the
tooth get infected and increasingly new forms of bacteria form that over time cause
erosion to the jaw and ligaments that help to hold the teeth in your mouth
naturally. Dr. Tara Baksh a practicing dentist in Grenada is concerned about
the number of patients that come to her office with periodontal disease. This silent disease of the gums can lead to
destruction of the bone of the jaw and ultimately tooth loss. It is called silent because the destruction
can go on for years, without causing pain until the very end when it is too
little, too late. She is concerned that some dentist in Grenada are not recognizing
its signs so by the time the patient come to her office the condition is
already chronic.
“Periodontitis is something that I am seeing a lot of here
[in Grenada] and what does upset me a little bit is that I find it is going
undiagnosed for many years. The problem
with periodontitis is it is called a silent disease. It’s not one where, you
know, you are going to get pain. Yes
there are versions of it that happen very, very quickly but most commonly
periodontal disease happens over years. You’re talking 5 to 10 years in the
making and a lot of people don’t understand that. When they [patients] come to
me they have pain and it’s caused by the periodontal disease. By that time it is well advanced and I am
talking tooth mobile [shaky/loose] that if I could take out if I wanted to or
they have an abscess because the bacteria load is so much - they now have an
abscess. And in cases like that there is nothing you can do but extract the
tooth; because you can’t keep a tooth in there, that’s not supported by bone or
anything. So unfortunately in many of the cases that I see, by the time I see
them they are advanced and they have to end up losing two, three teeth.”
Cancer, HIV/AIDS and diabetic patients are particularly at
high risk for developing periodontitis because their slightly lowered immune
system, the body a longer time to fight off infections in the mouth and so the
disease festers quickly. However the root cause of gum disease is poor dental hygiene.
The lack of brushing and flossing often puts a person at great risk for
developing gum disease. Although
hereditary genetics does play a factor, meaning if an immediate family member
has this particular disease it can make you more susceptible to it, however
with diligent care you may be able to prevent it.
When periodontitis sets in the patient will have to get
their affected tooth or teeth removed and according to Dr. Baksh, dentures are
not always comfortable, “We don’t like to do extractions, because when you do
extractions, you lose your teeth.
What
are you going to eat on? Okay yes, you have a denture. Everyone is like, “Oh
yes, pull out your teeth and get a denture,” but that’s not what you want to
do. Not everybody understands how difficult it is to adapt to this cumbersome
denture in your mouth, and you don’t want to have to do that if you don’t have
to. You want to keep your natural teeth. And then your quality of life goes
down as well.
There are certain foods
that you are not going to enjoy eating anymore. Depending on the type of
denture you have, the roof of your mouth is covered. You can’t feel the texture
of the food, you can’t taste the texture of the food. Food gets stuck under the
dentures. It’s just not nice. You don’t want to [get] dentures if you don’t
have to. So therefore you would want to look after your teeth.”
Dr. Baksh who is part of a group that is developing an Oral
Health Policy for Grenada says there are additional benefits for going to the
dentist twice a year.
She said dentists
can often notice underlying health issues based on the conditions of inner
walls of the mouth, tongue and gums.
For
certain vitamin deficiencies for example the tongue may appear discolored.
Regarding periodontitis, if a dentist notices rapid bone loss they may suspect the
patient has an underline health issue and is unaware, “We as dentist want patients to understand
the importance of coming to the dentist, as recommended, which is twice a year –
every six months. There is a lot of things that we can detect in the mouth
before it actually manifests itself on the body. A lot of patients are pretty
surprised when I say to them, “Do you have this [condition]?” and they haven’t
mentioned it to me. And they would be like, “How do you know that?”” The general
dental practitioner says she can notice if a patient is anemic, has diabetes, Crohn's
disease or even AIDS or HIV. When she notices these early warning signs she
would say to the patient, “I think you should go to your doctor and get a blood
test and make sure all your levels are good,” and just educate them in that
way.
They usually quite surprised that I
can tell these things.”