Eating Just Isn’t The Same With Dentures - Avoid This Silent Disease

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.”