Oral Health

According to the World Health Organisation (WHO), oral diseases affect an approximate 3.5 billion people worldwide and is thus considered to be one of the most common noncommunicable diseases. Oral diseases encompass a range of diseases and conditions that include dental caries, periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, dental erosion and birth defects such as cleft lip and palate. All these diseases can have serious consequences on an individual's general well being and quality of life, affecting. essential functions such as eating and speaking. Other social aspects are also impacted such as self-confidence and the ability to socialise without discomfort and embarrassment.Dental Caries

Dental caries
(also known as tooth decay or dental cavities) is commonly caused by free sugars. Dental caries develops when bacteria (dental biofilm) in the mouth metabolise sugars to produce acid that demineralises the hard tissues of the teeth (enamel and dentine Free sugars include all monosaccharides and disaccharides added to foods and drinks by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates. The lifelong risk of dental caries is reduced if free sugars intake is as low as possible. The protective effects of fluoride (e.g. In toothpaste), can also counter the development of decay, particularly in its early stages. A regular high intake of free sugars, lack of use of fluoride (in toothpaste) and a lack of proper removal of bacterial plaque by toothbrushing and interdental cleaning can lead to caries.

Periodontal (Gum) Disease
Periodontal disease refers to conditions that affects the tissues supporting the teeth. Initially it starts with inflammation and bleeding of the gums (gingivitis) and may lead to the loss of the supporting bone causing tooth mobility and eventually tooth loss. This disease is estimated to affect 1 billion individuals worldwide and is progressive in nature., There are several risk factors for periodontal disease - lifestyle factors, such as smoking and alcohol consumption, some systemic diseases such as diabetes mellitus, metabolic syndrome, osteoporosis, and low dietary calcium and vitamin D and also genetics.

Oral/facial trauma
Oral/facial trauma refers to injuries sustained to the mouth, teeth, and face due to accidents, sports injuries, physical altercations, or other causes. Such trauma can result in pain, bleeding, swelling, and damage to the teeth, gums, jawbone, or other facial bones. Prevention of oral/facial trauma can involve wearing protective gear during sports activities, using seat belts while driving, avoid drink and/or drug driving, avoiding physical altercations, and maintaining good oral hygiene. In case of any trauma, it is essential to seek prompt medical and dental attention to prevent further damage and ensure proper healing.

Oral Cancer
Oral cancer is a type of cancer that can affect the mouth, tongue, lips, gums, or throat. It is often diagnosed in people who use tobacco or alcohol excessively, but it can also occur in those who do not have these risk factors.
According to the Malta Cancer Registry, the prevalence of oral mucosal lesions is low. However, it is important to note that even a low prevalence of oral cancer is a cause for concern, as it can still have serious consequences for individuals affected. 
To reduce the risk of oral cancer, you should avoid tobacco and alcohol use, maintain a good oral hygiene, check your mouth for suspicious changes and visit your dentist regularly for check-ups.

Dental Erosion
Dental erosion occurs when the enamel on the teeth is worn away by acids found in food and drinks. This can lead to sensitivity, discoloration, and eventually, tooth decay. The prevalence of dental erosion is increasing, and it may be related to the high intake of acidic food and drinks.
To prevent dental erosion, individuals should limit their consumption of acidic foods and drinks such as soda, citrus fruits, and vinegar-based dressings. It is also recommended to rinse the mouth with water after consuming acidic substances, and to wait at least 30 minutes before brushing teeth to allow saliva to neutralize any remaining acid. Regular dental check-ups can also help detect dental erosion in its early stages, allowing for prompt treatment and prevention of further damage.

Risk factors associated with oral diseases are:
•    Diet: A diet high in sugars and acidic foods and drinks can contribute to the development of dental caries and erosion.
•    Poor oral hygiene: Inadequate brushing, flossing, and other forms of oral hygiene can lead to the build-up of plaque and bacterial biofilm, increasing the risk of periodontal disease, tooth decay, and other oral health problems.
•    Fluoride availability: A lack of fluoride in the water supply (local water supplies are low in fluoride levels) or in oral hygiene products can increase the risk of dental caries. 
•    Smoking: Tobacco use, including cigarette smoking and smokeless tobacco, is a significant risk factor for oral cancer, gum disease, and other oral health problems.
•    Alcohol: Regular and excessive alcohol consumption can also increase the risk of oral cancer and other oral health problems.
•    Other factors that can impact oral health include genetics, age, medications, and certain medical conditions.
To reduce the risk of oral diseases, individuals should maintain a healthy diet low in sugars and acids, practice good oral hygiene, and use fluoride toothpaste and mouthwash as recommended. Avoid tobacco and alcohol use. Go for Regular check-ups at the dentist and visits to the dental hygienist to remove  difficult-to-reach plaque and calculus. 

Brushing your Teeth
Proper tooth brushing techniques are crucial for maintaining good oral hygiene. 
•    Use 1450ppmF flouride  toothpaste 6+ and 1000ppmF under 6 years. It is important as it helps to strengthen the tooth enamel and prevent tooth decay. 
•    Use a pea-sized amount of fluoride toothpaste on a soft-bristled toothbrush to brush your teeth.
•    Brushing should be done at least twice a day for at least two minutes, covering all surfaces of the teeth, including the fronts, backs, and chewing surfaces, as well as the gums. 
•    Use circular movements and do not apply too much pressure.
•    Do not rinse with water or mouthwash after brushing your teeth, spit out the excess toothpaste instead. This helps to ensure that the fluoride in the toothpaste remains on the teeth, which provides ongoing protection against cavities. 
•    You can use a fluoride mouthwash (in addition to brushing at least 2 times a day) to help with dental hygiene but try to use this at a different time than when you brush your teeth (e.g., after lunch).
•    Wait at least 30 minutes before drinking or eating anything after you brush your teeth or use mouthwash. 
•    Sleep with a clean mouth.

The Health Promotion and Disease Prevention Directorate has published various leaflets on how to best take care of you mouth, they can all be found on our webpage under publications, the list of our publications on this topic include:
Taking Care of your mouth [EN/MT
A Healthy mouth for your child [EN/MT]
Dental care for the older adult [EN/MT]
Diabetes and your mouth [EN/MT
Smoking and your mouth[EN/MT