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The Odds of Keeping Teeth – The Rule of Nine

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The Odds of Keeping Teeth – The Rule of Nine

The Odds of Keeping Teeth – The Rule of Nine

January 23, 2006
By: Jean Johnson for Dental1

Teeth are gorgeous in their place, but once uprooted they are like company that has stayed too long. Patients that have to have a tooth extracted often don’t even give a backward glance at the offender once it has unceremoniously wound up on the dental tray next to the forceps and gauze.

But knowing what one’s odds are is often half the battle. Indeed, once people heard that they needed to use fluoride toothpastes, for example, they tended to comply. After all, no one wants to lose their teeth.

The Kuwait Study

In Kuwait the country’s healthcare system includes dental clinics run by the government. Thus, statistics on the dental health of the Kuwaiti population are comprehensive and relatively easy to obtainable, especially if you’re high up in the government.
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Tips for minimizing tooth loss:

Know that any bleeding of the gums is not a good sign. If it persists, treat it like you would an open sore on the foot that does not heal and get professional help.

Dry brush so that you can walk around the house or out into the garden to pass the time while brushing. Then return to the bathroom basin to apply a fluoride toothpaste to protect the teeth and roots.

Floss up under the gum line to remove bacteria that produces plaque.

Wrap the floss around the tooth in order to get both the back and front surfaces..

Consequently, Khalaf Al-Shammari, D.D.S., M.S., who works in Kuwait’s Ministry of Health, joined with colleagues to examine risk factors associated with tooth loss from 1,775 patients who together lost 3,694 teeth.

Al-Shammari’s team published their results in a recent issue of the Journal of Periodontology where they stated that gum disease or periodontitis was the leading reason for tooth loss in those whose records they examined. Patients with periodontitis lost on the average of 2.8 teeth, while those who did not have this type of severe gum inflammation and infection lost only 1.8 teeth.

Comparing rates of tooth loss associated with gum disease in Kuwait with larger trends, Al-Shammari and his colleagues wrote that the statistics were “remarkably similar to most studies performed around the world.”

Risk Factors

Several risk factors, Al-Shammari and associates concluded, were at the root – pun intended – of tooth loss in the group of Kuwaiti patients studied.

1. Age. Specifically, being older than 35 bumped people right up there in terms of risk for losing their choppers.

2. Gender. You guessed it. It’s the guys. Being male increases the chance of tooth loss, although not by a stunning amount. While 27 percent of the women lost teeth because of periodontal disease, 33 percent of the men did. More, men were more likely than women to have lost teeth for any reason.

3. Professional Care. Very obvious here. Those that didn’t manage to darken the door of their dentists wound up seeing them under duress. And the price was at least one missing tooth. Almost 40 percent of the patients studied had never quite gotten around to seeing a dentist or hygienist.

4. Oral hygiene. There’s no way around brushing and flossing regularly, and those that tended to slough off in this area set themselves up for trouble according to Al-Shammari. Only about 16 percent of those in the study reported brushing twice daily, and around 60 percent admitted that they only occasionally or even never brushed their teeth.

5. Smoking. Nicotine that constricts the blood vessels, of course, gets in the way of healing, and thus predisposes patients to periodontitis.

6. Diabetes mellitus. Diabetes is known to wreak havoc with the circulation system, and thus inhibits the body’s natural healing mechanisms. Thus, as do smokers, diabetics already have a strike against them when it comes to staving off gum disease. The researchers write that this association is “well established.” Almost one in five of the patients Al-Shammari et al examined had Type 2 diabetes or adult onset.

7. High blood pressure. Over one in 10 patients had high blood pressure, a symptom that another 2004 study implicated in gum disease with populations of menopausal women. Other than these two studies, however, researchers noted that the connection remains largely unsubstantiated.

8. Rheumatoid arthritis. The Kuwait study demonstrated a strong connection between rheumatoid arthritis and tooth loss. Nonetheless, Al-Shammari states that this correlation “is still not clearly established.”

9. Anterior tooth loss. Finally, findings showed that patients who had lost any of their front, or anterior, teeth were more predisposed to gum disease and thus to further tooth loss.

So there it is. Down and dirty, times nine. The good news is that adopting better oral hygiene habits is within most anyone’s reach.

Brushing a minimum of two minutes morning and night, and preferably after lunch as well doesn’t seem too taxing in the larger scheme of things, especially once the habit gets developed. And following that with a bit of flossing and an appointment with the hygienist now and again just might not push us too far over the top after all. In return, we’ll save a bundle on dental bills, not to mention keep the lovely natural teeth we all arrived with.

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