Doctors advise dengue patients to be careful about maintaining oral hygiene

It is estimated that oral diseases affect 3.5 billion people worldwide and untreated dental caries or tooth decay of permanent teeth is one of the most prevalent diseases globally. Poor oral health causes acute and chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth loss, tooth decay and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial well-being. It also affects self-esteem, school performance, and attendance at work or in education.

These observations were made by Prof Tauqir-Ul-Islam, consultant oral & maxillofacial surgeon and head of the department at Liaquat National Hospital, at a public awareness seminar titled ‘Poor Oral Health & its consequences on Community’, organised by the Neurospinal & Cancer Care Postgraduate Institute on Saturday.

He said: “Oral hygiene is a vital part of our daily routine. Oral care not only keeps your teeth looking good and strong, it also has a significant impact on your overall health,” he said. “Decay is the damage caused to the teeth when bacteria in the mouth create acids that harm a tooth, causing a hole or cavity. A tooth has three layers, the deeper the infection, the greater the cavity. There are various causative factors for tooth decay including; lack of good oral hygiene, not brushing and flossing regularly, unhealthy dietary practices, consumption of foods rich in sugar and carbohydrates, not using a fluoride toothpaste, as it helps in creating a protective layer around the tooth and smoking or inhaling second-hand smoke.

“The most important step to prevent tooth decay is to brush twice a day. Flossing to clean between the teeth is an often disregarded step of dental hygiene. Eat nutritious meals and snack smart by avoiding food rich in carbohydrates and sugar.”

Gum disease and bad breath are also caused by poor dental practices. Bad breath could be made worse by the food you take. It can be treated by following healthy dental practices and keeping a tab on the food you eat. Wash your mouth after every meal without fail and ensure regular brushing and flossing. Avoiding smoking is also essential to keep the gums strong and healthy. Mouth sores are also a common oral condition, caused by tongue biting, dentures, hard toothbrush, tobacco etc. They can be treated with medications, avoiding spicy, oily and fried food and simple changing food habits. “However, if it does get painful and doesn’t recover for more than a week, it is best to consult a dentist for regular dental check-ups and to advice you on the right toothpaste,” Prof Tauqir-Ul-Islam added.

Gingivitis is another oral health condition caused mainly because of poor oral hygiene, smoking, vitamin-D deficiency, hormonal changes, viral and fungal infections. The most effective response is adopting a dental cleaning process in order to avoid the progression of the disease.

Guest speaker Dr Namra Saifullah Khan, consultant family physician & chief medical officer at the National Bank of Pakistan, talking about the recent surge of dengue infection in Karachi and its lethal effect on the community, she said oral manifestations of dengue infections are usually seen in more severe stages of dengue infection i.e. dengue hemorrhagic fever, where the platelet count is affected. Gum bleeding is the most common oral presentation and can happen when the platelet count is low. Viral vesicles on lips and within oral cavity as well as metallic taste in the mouth are some other oral presentations.

Good oral care is essential during the infectious period. Several clinical reports observed that patients with dengue fever who experience acute gum bleeding also have poor oral hygiene. This is not surprising as dental plaque and tartar are known to cause gum inflammation and bleeding.

“So, should we stop tooth-brushing or not? For a start, I would recommend gentle brushing twice a day with a soft bristle toothbrush. This is recommended for both adult and children patients with dengue fever. A soft oral foam swab soaked in water or mouth rinse can be used as an alternative. This is particularly useful for patients who are hospitalised and require oral hygiene maintenance by a caregiver. If there is spontaneous or profuse gum bleeding, this may indicate an abnormally low platelet count (a condition known as thrombocytopenia). Here, a prompt visit to your medical physician for consultation is imperative.

“Use of aspirin (commonly used by cardiac patients) and non-steroidal anti-inflammatory drugs (e.g. ibuprofen) should be avoided as these drugs tend to increase bleeding risk,” she further warned.

The chief organizer and medical superintendent of the NCCI, Dr AB Memon, thanked the participants and announced that at the NCCI Hospital, modern dengue, malaria, chikungunya and typhoid fever tests are available at discounted rates for patients affected by floods.