Majdi & Ghazal

Oral & Dental health

Oral Cancer
 What is Cancer?
 It is an imbalance between cell production and cell loss
 Cells show loss of normal growth control and show invasive and metastatic
potential
 It is a neoplastic disease where normal body cells transform into malignant ones
 Types of tumors:
➔ Benign tumors (‫)األورام الحميدة‬
➔ Malignant tumors (‫)األورام الخبيثة‬
Benign Tumors Malignant Tumors
Grows by expansion and does not infiltrate It sends out processes and destroys
surrounding tissue surrounding tissue
Encapsulated Not encapsulated
Resembles parent tissue Poor resemblance to the parent tissue

Slow rate of growth Relatively rapid rate of growth

No necrosis Frequently show central necrosis

No vascular or lymphatic invasion Invasive activity at the margin
Usually localized Spread locally and/or to distant sites

Does not recur when removed Tend to recur when removed

Does not cause death unless its location Usually causes death unless its growth can be
interferes with vital functions controlled

 Oral Cancer
 Has the same significance of oral diseases
 Happens in any structure of the oral cavity:
1. Tongue surface 4. Gingival tissue
2. Lips 5. Tonsils
3. Cheek 6. Salivary glands

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Oral & Dental health

Tongue cancer Lip cancer Cheek cancer

Gingival cancer Tonsil cancer Salivary gland

cancer

 Oral Cancer symptoms

 Sore or lesion which has not healed within 2 weeks
 Thickening or lump in the cheek
 White or red patches on oral tissue
 Difficulty in moving jaw or tongue
 Numbness or swelling of the jaw
 Sore throat: feeling of something cough in throat
 Chronic hoarseness (‫)بحة الصوت‬
 Risk factors for Oral cancers
 Use of alcohol and tobacco excessively in combination
➔ Chronic alcoholic people have more lesions at the tongue and the floor of
the mouth rather than other locations of the oral cavity
 Overexposure to sunlight
➔ Mainly cause lower lip cancer
 Poor oral hygiene
 Long-term exposure to the chemical carcinogens of tobacco (smoking or
smokeless)

➢ Preventing oral cancer can be done by controlling the previous risk factors
➢ Early detection can save lives by regular dental checkups
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➢ You can screen for oral cancers at home by doing the following steps:

Halitosis
 the word ‘Halitosis’ is derived from:
➔ The latin word halitus meaning ‘breath’
➔ and the Greek suffix -osis meaning ‘diseased’
 So halitosis is: unpleasant odor of exhaled air (Oral Malodor)
 Bad breath must be a health concern because it affects the patients’ self esteem
and their communication with others

 Causes of halitosis
 Xerostomia is the primary cause of Halitosis
➔ Xerostomia results in insufficient oxygenated saliva
➔ This creates a breeding ground for anaerobic bacteria in the oral cavity
➔ pH levels also decreased creating a high acidic condition that helps in the
growth of anaerobic bacteria
➔ These oral anaerobes consume proteins in the form of: (mucus, food
particles and other mouth debrises that are not brushed)
➔ The bacteria that consume oral proteins produce amounts of sulfurous
compounds that smell like rotten eggs or decaying organic matter

Insufficient ↑ breeding of Bacteria Release of

Xerostomia oxygenated saliva + anaerobic consumes sulfur Halitosis
low pH levels bacteria proteins compounds

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Oral & Dental health
 Chronic halitosis is caused by:
➔ The excrement (‫ )فضالت‬of anaerobic bacteria that is facilitated by the
fermentation of peptides and proteins that are found in:
➢ Gingival crevicular fluid
➢ Saliva
➢ Desquamated epithelial cells
➢ Blood

 Oral Causes of Halitosis (90% of causes)

1. Periodontal infections
2. Tongue coating microorganisms (caused by lack of tongue scraping)
3. Xerostomia
4. Faulty restorations: helps in retaining food and bacteria
5. Unclean dentures (not cleaned properly after each meal)
6. Throat infection
7. Carcinomas
8. Cleft palate

 Systemic / Non-Oral Causes of Halitosis (10% of causes)

1. Renal or hepatic failure
2. Carcinomas
3. Diabetes (Special oral smell like acetone )
4. Liver cirrhosis
5. Upper respiratory infections and nasal passages infections

 Professional Diagnostic Approaches of Halitosis

● Halimeter
➔ Portable sulfide monitor used to measure levels of volatile sulfur
compounds (VSCs) in the mouth
● Gas chromatography
➔ used in analytical chemistry for separating and analyzing compounds which
can be vaporized without decomposition
● BANA test
➔ to find the salivary levels of an enzyme indicating the presence of certain
halitosis-related bacteria
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● β-galactosidase test:
➔ to test the salivary levels of the enzyme (β-galactosidase) which was found
to be correlated with malodor

 Self Diagnosis
 Smelling one’s own breath odor is difficult
 Patients often self-diagnose by asking a close friend
 A better way would be to scrape the back of the tongue with a plastic disposable
spoon and smell the drying residue
 Another way to test yourself for halitosis is by doing the following steps:
1. Stick your tongue out as far as possible
2. Firmly wipe your tongue 3-4 times from back to front with a gauze
3. Wait 1 minute then check the gauze, you probably have halitosis if:
➔ You see color ranged from yellowish to brown
➔ You smell odor

 Home tester: an instrument you can use at home to

test for halitosis

 Prevention Methods
 Professional scaling (removing calculus and food debris) at dental clinic by
hygienist
 Brush, floss and use tongue scraper
 Drink enough water throughout the day
 Eat fruits and vegetables: high fiber food keeps your mouth clean and your body
healthy
 Chewing sugarless gum especially after meals: to help regulate the pH of the
mouth and regulate bacterial growth
 Use bacteria-reducing mouthwash

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Oral & Dental health
Cosmetic dentistry
 Cosmetic dentistry: art techniques that can enhance a good smile
 Advancements in art technology and materials are cosmetically used to enhance
teeth appearance in a natural way and make them last longer than they did in the
past
 It is for teeth that are chipped, stained, crooked or have spaces between them

 Why do people seek cosmetic dentistry

 Fractures caused by an accident/ injury
 To improve appearance and maintain self-esteem
 To fix previous or failed cosmetic treatment
 To look younger
Bleaching
 For special events, such as weddings

 Dark Teeth
 A problem that needs cosmetic dentistry
 The color of a tooth can be improved by bleaching
 Bleaching: is a very simple and effective process,
usually carried out by wearing a thin mouthguard
while you sleep that contains an effective material
(e.g. hydrogen peroxide)

 Tooth whitening
 It is actually a bleaching process
 Lightens discoloration of enamel and dentine
 Professionally or at home
➔ Intrinsic stains usually need professional removal
➔ Extrinsic stains can be removed professionally or at home

 Crooked teeth
 Teeth can sometimes be misshapen or twisted
 This can be corrected by: porcelain veneers or lumineers

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■Porcelain Veneers: thin pieces of porcelain used
to recreate the natural look of the teeth while also
providing strength and resilience to the natural
tooth enamel
used to make slight position alteration and to
Porcelain veneers
change teeth shape, sized or color

■Lumineers : same as veneers with few differences:

Ultra thin and highly translucent
they are so thin that little-to-no tooth reduction
is necessary
might be a better long-term solution
Lumineers

 Cosmetic gum surgery

 A surgery that is used to correct a “gummy smile” or
“long tooth smile”
 Gummy smile is when the proportion of teeth and
gum tissue in the upper jaw are not in harmony

 Dental Jewelries
 Implementing oral hygiene is important around them to avoid caries

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