Health & Wellbeing Service - Manchester

Tooth Decay


  • Brush twice daily with fluoridated toothpaste, last thing at night and on one other occasion
  • Fluoridated toothpaste should have at least 1,350ppm fluoride.
  • Spit out but do not rinse.
  • The frequency and amount of sugary food and drinks be reduced and limited to mealtimes. (DBOH 14)

Periodontal Disease



  • Dental Plaque
  • Bacteria sits at the gum margin, the body’s immunological defence system has to fight to prevent harmful bacteria from penetrating this junction, if it affects it the body’s reaction is inflammation and bleeding - Gingivitis  (SBOHED 09)
  • Many things affect this e.g. a change in hormonal in-balance during pregnancy
  • Other systemic conditions can put people at increased risk e.g. anaemia, diabetes, HIV/AIDS and leukaemia.
  • Certain medications can increase the risk e.g. hypertensive drugs such as nifedopine or immunosuppressive’s  such as prednisalone and Cyclosporine
  • If adequate plaque control is not carried out gingivitis progresses to periodontal disease.
  • Smoking increases the risk of periodontal disease and reduces the effectiveness of treatments



  • Brush teeth systematically twice daily
  • A manual toothbrush with a small head and comfortable handle
  • A powered toothbrush with an oscillating/rotating head
  • Do not smoke.
  • Consider using toothpastes containing Triclosan with copolymer or zinc citrate.
  • Clean interdentally using brushes or floss.
  • Maintain good dietary practices.    (DBOH 14)

Oral Cancer


Key Points:

  • Estimated almost 6,000 new cases in 2012.
  • 1,700 death, incidence greater than cervical cancer.
  • Twice as many males as females affected.
  • Early detection improves survival rate after 5yrs.  (SBOHED 09)
  • Smoking, other forms of tobacco use and frequent alcohol consumption are the main risk factors.
  • White or red patches and oral ulceration present for more than 3 weeks require immediate investigation.
  • Smokers who wish to give up should be given appropriate support to do so.
  • Chewing tobacco common practice amongst Asian communities chewing ‘betal nut quid’, ‘Paan’ ‘Ghutka’ an addictive blend of tobacco and vegetable matter is linked to the high prevalence of oral cancer in Indian subcontinent and Asian communities in other parts of  the world.  
  • There is evidence that if smoking ceases then the risk of developing oral cancer falls
  • Evidence to support the benefit of a higher intake of fruit and vegetables.
  • Higher intake of fruit and vegetables is a good prevention because their vitamin and anti-oxidant compounds (SBOHED 09)



  • Do not smoke.
  • Do not use smokeless tobacco.
  • Reduce alcohol consumption to moderate.
  • Maintain good dietary practices.
  • Increase fruit and vegetable intake to at least five portions per day. (DBOH 14)