Summer is finally here, and with it comes the long anticipated warm, bright weather. Your patients will have been eagerly awaiting hot afternoons in their gardens, but may not realise the impact this new wave of weather will have on their oral health.
Providing effective support can help patients recognise the good habits they need to reinforce or pick up when the summer sun appears. Whether this is through face-to-face appointments or reminders on social media, spreading the simple messages that can have the greatest impact is key to protecting their oral health.
Beating the heat
In the warmer months, it can be easy for patients to forget to keep on top of hydration. However, considering the impact on salivary production, it’s an important aspect of oral health care. Salivary flow rates decrease in the summer when compared to the winter months, caused by hypofunction of the salivary glands. Whilst this can be caused by anything from anxiety to acute infections, dehydration is the more likely cause at this time of year.
Studies have shown that once exposed to higher temperatures, a decrease in salivary flow rates is almost immediate. In one, patients that were subject to 37 degree temperatures for just 10 minutes, too short a period for dehydration, quickly saw decreased salivary flow. Whilst the UK is unlikely to see consistent weeks of 37 degree highs, it can be recognised that with longer exposures to hotter temperatures, patients are more likely to experience dry mouth.
The nutrient supply within saliva serves to maintain the presence of certain bacteria and exclude others. Saliva performs bacterial clearance, buffering capacities, direct antibacterial activity and remineralisation. When reduced, as seen in the heat, dental caries and infections can develop.
Patients should be reminded to keep hydrated in the summer months, emphasising the effect dehydration can have on their oral health. The ‘Eatwell Guide’ encourages water, lower-fat milks, and lower-sugar or sugar-free drinks (including tea and coffee) to make up daily fluid intake. Avoiding excessive intake of high-sugar fluids, such as juices or some sodas, is key for maintaining dentition.
Catching the sun
Despite the increased risk of dehydration, summer is by no means doom and gloom for dentition. A lack of sunlight has been connected with gum disease, and with approximately one billion people around the world being vitamin D deficient, the summer sun is an opportunity to improve the battle against oral infections.
Through sunlight exposure, 7-dehydrocholesterol in the skin absorbs UV B radiation, and is converted to previtamin D3, which in turn isomerises into vitamin D3. The effects on oral health can be profound. Vitamin D impacts bone and tooth mineralisation, and with unregulated levels patients may develop a rachitic tooth, which is highly susceptible to fracture and decay.
Many studies have also found that the presence of periodontitis is associated with lower levels of vitamin D when compared with patients without the disease. Those with the deficiency have also been observed to experience high levels inflammation, as well as increased bleeding on probing, compared to those with high levels of the vitamin.
Treatments for vitamin D deficient individuals come in the form of supplements, which can often be bought over the counter, and prescription vitamin D. Changes to a patient’s diet may be beneficial, with more fatty fish, egg yolks, and yoghurt being recommended solutions. In the summer, taking advantage of the sun will also be of use, but should be done responsibly with sunscreen and adequate hydration.
Why stop at summer?
Summer will not last forever, but patients must be informed on how best to protect their oral health in the warm weather. Hydration is essential, and safely getting enough sun should be recommended whilst the season lasts, but nothing will beat an effective year-round oral hygiene routine.
Brushing twice daily, with interdental cleaning and using an effective toothpaste is essential, no matter the weather. Consider recommending patients use either of the specialised 100 per cent Natural Baking Soda Toothpaste solutions from Arm & Hammer, available to strengthen either Whitening Protection or Gum Protection. Each solution utilises baking soda, which is alkaline in nature, to help return the oral pH to neutral levels within the mouth. Containing 1450ppm of fluoride, their formulas effectively remineralise and strengthen enamel and remove more plaque around the gumline to prevent infection when compared to non-baking soda toothpastes.
With the warm weather incoming, patients should be aware of the ways the environment can affect them in the short term, and in turn pick up habits that will protect their oral health long into the future.
References available on request.