Commentary
Dental Health in Adolescents
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“Some tortures are physical and some are mental, but the one that is both is dental.”
Proper oral hygiene is not only essential to one’s oral health and comfort, it is also essential to one’s general health. Establishing basic oral hygiene routines and dental care from an early age can not only make for easy habits, but it can also help to ensure that the child’s teeth, mouth and body remain as healthy as possible. This is why dental care for children and adolescents is so very important.
Adolescence refers to the period of accelerated biological growth, changes, and social role transitions that bridges the gap from childhood to adulthood. Teenage years can be a crucial time for influencing the future direction of the child's oral health. This is the time when all adult teeth will be in place and the face and jaws have more rapid development coinciding with the pubertal growth spurt. In this respect, oral health still remains one of the most unmet health care needs of adolescents. Oral disease can have a profound effect on overall health, including pain, missed school, heart disease, etc. The adolescent patient is recognized as having distinctive needs due to:
- A potentially high caries rate
- A tendency for poor oral hygiene, nutritional habits, and routine oral health care access
- Increased risk for periodontal disease and traumatic injury
- An increased esthetic desire and awareness
- Increased risk for periodontal disease and traumatic injury
- Dental phobia
- Potential use of tobacco, nicotine, alcohol, and other recreational drugs
- Desire for oral piercings
- Increased risk of pregnancy or sexually transmitted infections
- Eating disorders
- Unique social and psychological needs
Adolescents are the most intriguing and enjoyable patients. These patients inspire, question the obvious, and take nothing for granted. They want clear communication from adults - plain talk and the truth. Thus, developing successful communication strategies is helpful. Teenagers want to be treated like adults, even though one cannot assume that they have achieved their highest levels of cognitive or moral development. Using a consultative model, in which the specialist communicates with the understanding that they know more, but respect the adolescent’s decisions and parental input thereby treating teenagers as adults, even though they may not yet think as adults becomes a big step in the right direction.
Early detection of oral disease and prevention education in the earliest phases of puberty to pre-empt disease is ideal and therefore recall and checkup becomes an important tool in this regard. It is good to educate patients and their parents even before the signs of oral disease are present. Visual aids and intra-oral video cameras are great tools. Teenagers love technology, so an up-close view of their mouth can be veryhelpful. Additionally, emphasizing that they have the ability to help prevent disease along with supporting them in taking responsibility for self-treatment of gingivitis and caries prevention at home goes a long way. If disease is found, it should be used as a teaching opportunity, not a failure, to support their self-care.
Awareness about proper eating habits and how they can affect oral health is an important aspect in preventing disease. Generally speaking, diet that is high in sugar and starch can present a problem as regards good oral health. Elaboration on exactly how to brush and floss, and with what tools is prime in maintaining good oral hygiene. While brushing and flossing are important, correctly brushing and flossing are even more important. Failing to brush all tooth surfaces or brushing them too hard with stiff bristles are likewise potentially damaging to teeth and surrounding structures.
Academic stress is another common issue that teenagers experience, which can lead to involuntary grinding of teeth while sleeping. Symptoms include difficulty in moving the jaw, a clicking sound when doing so, and/or overall tooth and jaw sensitivity. These symptoms might be early signs of temporomandibular joint disorder (TMJ) - a painful condition that constricts jaw movement - a night guard will prevent the habit.
Many adolescents experience dental issues such as crooked or crowded teeth and/or poor jaw alignment. Aside from a lower self-esteem and social anxiety, these dental issues are a risk for the proper function of teeth as well as for overall dental health. Among today’s orthodontic options, metal braces and clear aligner trays that move the teeth to their ideal position are gold standard.
No teenager wants bad breath and as a parent, leading with this angle, one might get the child to take very good care of their teeth. In addition, to routine oral hygiene, use of sugar-free chewing gum, as well as a tongue scraper can also be a great investment as well. If the child still seems to have chronic bad breath, it could be due to something other than their hygiene (such as an issue with allergies or acid reflux).
Another good tool is aggressive conservative therapy. Earliest possible active intervention of oral disease. Sealants or conservative restorations are placed when appropriate in deep pit and fissure lesions. All carious lesions are restored as soon as possible.
For gingivitis (gum inflammation), which is generalized bleeding upon provocation and/or multiple sites of gingival redness and edema, full mouth debridement with ultrasonic scaler and oral irrigation with chlorhexidine is the treatment modality of choice. This is followed by a six-week re-evaluation. Home use of antibacterial agents such as special toothpastes and mouth rinses are prescribed on a customized basis.
In conclusion, adolescence is a time of identity exploration. As a Pedodontist (Pediatric Dentist), one can support lifelong preventive health decisions and overall well-being, all while enhancing self-esteem of the teen patients. In field of practice, one is constantly learning from each other the best way to do the same.
“The Mouth is the Gateway of the Body, Guard it well”
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