Leanne Butts

What is bacterial vaginosis and what are the symptoms?

Bacterial vaginosis (BV) is a common condition of the vagina caused by an overgrowth of various bacteria (germs). It is not just a simple infection caused by one type of bacterium.

- The main symptom of BV is a vaginal discharge. BV is one of the most common causes of vaginal discharge in women of childbearing age. The discharge is often a white-grey colour, and often has a fishy smell. The smell may be most noticeable when having sex. The discharge tends to be heaviest just after a period, and after having sex.
- The discharge does not usually cause itch or soreness around the vagina and vulva.
- Many women with BV do not have any symptoms (up to half of cases). BV may be found by chance when vaginal swabs are taken for other reasons.

Note: BV is not the only cause of a vaginal discharge. Various conditions can cause a discharge. For example, another common cause of a discharge is due to thrush (an infection caused by a yeast called candida). Unlike BV, thrush typically causes a thicker white discharge which tends to cause itch and soreness around the vagina and vulva. See separate leaflet called ‘Vaginal Thrush’ for more detail.

What causes bacterial vaginosis?

Bacterial Vaginosis is not caused by a single bacterium (germ). In BV, an ‘overgrowth’ of various bacteria occurs in the vagina. It is not clear why this happens. Normally, there are various different types of harmless bacteria in the vagina. These bacteria help in the defence against harmful germs (such as candida which causes thrush). In BV, there is a change in the balance of the normal bacteria in the vagina, and certain bacteria multiply and thrive much more than usual. Some bacteria become much more prominent than they normally are.

Doctors describe these changes as “a change in the bacterial flora of the vagina from mainly lactobacillus species to high concentrations of anaerobic bacteria.”

BV is not caused by poor hygiene. In fact, excessive washing of the vagina may alter the normal balance of bacteria in the vagina, which may make BV more likely to develop.

Who gets bacterial vaginosis and how common is it?

About 1 in 3 women have BV at some time in their life. It may be much more common than this as many cases are mild and cause no symptoms. Any woman can be affected by BV. BV is more common in women who have an intra-uterine contraceptive device (IUD). It may also be more common in women who smoke. Hormone changes during your menstrual cycle as well as genetics may also play a part.
Is bacterial vaginosis a sexually transmitted disease?

No, BV can affect any woman, including those who do not have sex. However, BV is more common amongst sexually active women than non-sexually active women. No bacterium is passed on between sexual partners that causes this condition. Sexual partners of women with BV do not need any treatment. However, some cases of BV seem to be sexually ‘related’. It may develop after a change in sexual partner. In these cases, the infection is not ‘caught’ from anyone. But a change in sexual partner may affect the balance of normal bacteria in the vagina. BV is also more likely in women in same sex relationships who have had a change of partner.

How is bacterial vaginosis diagnosed?

The typical discharge and its characteristic fishy smell makes BV likely. In women in a regular, monogamous relationship, your doctor or nurse may be happy to diagnose BV just by your typical symptoms. However, there are some tests available that can help to confirm the diagnosis. Also, if you are pregnant, it is important to make an accurate diagnosis if you have vaginal discharge so that any infection can be treated effectively. This will mean having one or more of the tests below.

Testing the acid level of your vagina

The discharge of BV has a typical pH level (acid/alkaline balance) compared to other causes of discharge. (The overgrowth of the bacteria of BV causes the pH to change in the vagina so that it becomes more alkaline, ie the pH rises.) If available, your doctor or nurse may suggest that they take a sample of your discharge and test it with some pH paper. In addition, if an alkali is added to a sample of the discharge, it often causes a characteristic fishy smell.

Taking a sample (a swab)

To help clarify the diagnosis, your doctor or nurse may also suggest that a sample (a swab) of your discharge is taken from your vagina and sent to the laboratory for testing. Large numbers of various bacteria that occur with BV are seen under the microscope. Your doctor or nurse may suggest that they take more than one swab from your vagina to rule out other causes of vaginal discharge.

What are the possible complications with bacterial vaginosis?

BV and pregnancy

If you have untreated BV during pregnancy, you have an increased risk of developing some complications of pregnancy. For example, early labour, miscarriage, having a low birth weight baby or developing an infection of the uterus (womb) after childbirth.

BV and surgery

If you have untreated BV, the chance of developing an infection of the uterus is higher following certain operations. For example, following a termination of pregnancy or a vaginal hysterectomy. However, antibiotics are given before various operations of the uterus if you have BV. This can usually prevent these infections.

BV and other infections

If you have untreated BV, you may have an increased risk of developing HIV infection if you have sex with someone who is infected with HIV. There is also some evidence that women with untreated BV may be at an increased risk of developing pelvic inflammatory disease (PID). See separate leaflets called ‘Pelvic Inflammatory Disease’ for more details.

What is the treatment for bacterial vaginosis?

Not treating is an option for some women

BV often causes no symptoms, or the symptoms are mild. Also, there is a good chance that BV will gradually clear without treatment, as the balance of bacteria in the vagina may correct itself. So, if you have no symptoms or only mild symptoms, not treating is an option.

However, if you are pregnant and you are found to have BV but have no symptoms, you may still be advised to take antibiotic treatment. The benefits of treating pregnant women with BV and no symptoms is a little uncertain. Your doctor may seek advice from a gynaecologist about whether or not you need treatment.

Note: all pregnant women who have symptoms due to BV should be offered treatment. If you are found to have BV and are undergoing a termination of pregnancy, treatment with antibiotics may also be advised even if you have no symptoms. This is because there is a risk of BV causing a more serious infection of the uterus (womb) or pelvis after the procedure if it is not treated. Some doctors also suggest antibiotics for women who are about to undergo other gynaecological procedures (such as an endometrial biopsy – a biopsy of the lining of the womb) and are found to have BV but have no symptoms.

Metronidazole

A course of metronidazole tablets is the common treatment. Metronidazole is an antibiotic. It clears BV in most cases. Read the leaflet that comes with the tablets for a full list of possible side-effects and cautions. However, main points to note about metronidazole include:

- The usual dose is 400 mg twice a day for seven days. A single dose of 2 grams is an alternative, although this may be less effective and may cause more side-effects. (Note: this single dose is not recommended if you are pregnant.) If you are taking the 7-day course, it is important to finish the course and not to miss any tablets.

- Some people feel sick, and may vomit when they take metronidazole. This is less likely to occur if you take the tablets straight after food. A metallic taste is also a common side-effect.

- Do not drink any alcohol while taking metronidazole, and for at least 48 hours after stopping treatment. The interaction with alcohol can cause vomiting and other problems such as flushing and an increased pulse rate.

- Breastfeeding: metronidazole can get into breast milk, but is not thought to affect breastfed babies. However, to play safe, the standard 7-day course with the 400 mg twice-daily dose is preferred so a baby does not get a large dose. If it is essential to use the 2 gram single dose, then it should be taken after the last breastfeed of the evening (at the start of the overnight breastfeeding break) to limit exposure to the baby.

- Antibiotics used to treat BV may interfere with your contraceptive pill or patch. You should discuss this with the doctor or nurse who is treating you.

Alternative antibiotic treatments

Metronidazole vaginal gel or clindamycin vaginal cream placed inside the vagina can be used if you prefer this type of treatment, or have unpleasant side-effects with metronidazole tablets. The ability of these treatments to clear BV is about the same as metronidazole taken by mouth.

Note: as with metronidazole tablets, you should avoid alcohol while using metronidazole gel and for at least 48 hours after stopping treatment. Also, clindamycin vaginal cream can cause weakening of latex condoms and diaphragms. Therefore, during treatment and for five days after treatment with clindamycin vaginal cream, do not rely on condoms or diaphragms to protect against pregnancy and sexually transmitted diseases.

Other treatments

Overall, there is no strong evidence at the moment that live yoghurt or lactobacillus acidophilus are helpful in treating or preventing BV.

Do I need a ‘test of cure’

Women who are not pregnant

You do not need any further tests (such as swab tests) after treatment to ensure that BV has cleared (a ‘test of cure’) provided that your symptoms have gone.

Women who are pregnant

If you are pregnant, it is suggested that you do have a swab test taken after one month to ensure that BV is no longer present.
Treating recurrences

If you have a recurrence of symptoms and did not have any swab tests taken initially, your doctor or nurse may suggest that they take swab tests now. This is to confirm that it is definitely BV that is causing your symptoms.

BV may recur if you did not complete your course of antibiotics. However, even if you have completed your full course of antibiotics, BV recurs within three months in around 1 in 3 women. If it does recur, a repeat course of antibiotics will usually be successful in treating it. A small number of women have repeated episodes of BV, and need repeated courses of antibiotics.

If you have an intrauterine contraceptive device (IUD) and have recurrent BV, your doctor or nurse may suggest that they remove your IUD to see if this helps to improve your symptoms. You will need to discuss alternative contraception measures with them.

How can I prevent further episodes of bacterial vaginosis?

Most episodes of BV occur for no apparent reason, and cannot be prevented. However, the following are thought to help prevent some episodes of BV. The logic behind these tips is to try not to upset the normal balance of bacteria in the vagina:

- Do not push water into your vagina to clean it (douching).
- Do not add bath oils, antiseptics, scented soaps, perfumed bubble bath, shampoos etc, to bath water.
- Do not use strong detergents to wash your underwear.
- Do not wash around your vagina too often. Once a day is usually enough.

Days to Permanent Bacterial Vaginosis Relief – Review

What is bacterial vaginosis and what are the symptoms?

Bacterial vaginosis (BV) is a common condition of the vagina caused by an overgrowth of various bacteria (germs). It is not just a simple infection caused by one type of bacterium.

- The main symptom of BV is a vaginal discharge. BV is one of the most common causes of vaginal discharge in women of childbearing age. The discharge is often a white-grey colour, and often has a fishy smell. The smell may be most noticeable when having sex. The discharge tends to be heaviest just after a period, and after having sex.
- The discharge does not usually cause itch or soreness around the vagina and vulva.
- Many women with BV do not have any symptoms (up to half of cases). BV may be found by chance when vaginal swabs are taken for other reasons.

Note: BV is not the only cause of a vaginal discharge. Various conditions can cause a discharge. For example, another common cause of a discharge is due to thrush (an infection caused by a yeast called candida). Unlike BV, thrush typically causes a thicker white discharge which tends to cause itch and soreness around the vagina and vulva. See separate leaflet called ‘Vaginal Thrush’ for more detail.

What causes bacterial vaginosis?

Bacterial Vaginosis is not caused by a single bacterium (germ). In BV, an ‘overgrowth’ of various bacteria occurs in the vagina. It is not clear why this happens. Normally, there are various different types of harmless bacteria in the vagina. These bacteria help in the defence against harmful germs (such as candida which causes thrush). In BV, there is a change in the balance of the normal bacteria in the vagina, and certain bacteria multiply and thrive much more than usual. Some bacteria become much more prominent than they normally are.

Doctors describe these changes as “a change in the bacterial flora of the vagina from mainly lactobacillus species to high concentrations of anaerobic bacteria.”

BV is not caused by poor hygiene. In fact, excessive washing of the vagina may alter the normal balance of bacteria in the vagina, which may make BV more likely to develop.

Who gets bacterial vaginosis and how common is it?

About 1 in 3 women have BV at some time in their life. It may be much more common than this as many cases are mild and cause no symptoms. Any woman can be affected by BV. BV is more common in women who have an intra-uterine contraceptive device (IUD). It may also be more common in women who smoke. Hormone changes during your menstrual cycle as well as genetics may also play a part.
Is bacterial vaginosis a sexually transmitted disease?

No, BV can affect any woman, including those who do not have sex. However, BV is more common amongst sexually active women than non-sexually active women. No bacterium is passed on between sexual partners that causes this condition. Sexual partners of women with BV do not need any treatment. However, some cases of BV seem to be sexually ‘related’. It may develop after a change in sexual partner. In these cases, the infection is not ‘caught’ from anyone. But a change in sexual partner may affect the balance of normal bacteria in the vagina. BV is also more likely in women in same sex relationships who have had a change of partner.

How is bacterial vaginosis diagnosed?

The typical discharge and its characteristic fishy smell makes BV likely. In women in a regular, monogamous relationship, your doctor or nurse may be happy to diagnose BV just by your typical symptoms. However, there are some tests available that can help to confirm the diagnosis. Also, if you are pregnant, it is important to make an accurate diagnosis if you have vaginal discharge so that any infection can be treated effectively. This will mean having one or more of the tests below.

Testing the acid level of your vagina

The discharge of BV has a typical pH level (acid/alkaline balance) compared to other causes of discharge. (The overgrowth of the bacteria of BV causes the pH to change in the vagina so that it becomes more alkaline, ie the pH rises.) If available, your doctor or nurse may suggest that they take a sample of your discharge and test it with some pH paper. In addition, if an alkali is added to a sample of the discharge, it often causes a characteristic fishy smell.

Taking a sample (a swab)

To help clarify the diagnosis, your doctor or nurse may also suggest that a sample (a swab) of your discharge is taken from your vagina and sent to the laboratory for testing. Large numbers of various bacteria that occur with BV are seen under the microscope. Your doctor or nurse may suggest that they take more than one swab from your vagina to rule out other causes of vaginal discharge.

What are the possible complications with bacterial vaginosis?

BV and pregnancy

If you have untreated BV during pregnancy, you have an increased risk of developing some complications of pregnancy. For example, early labour, miscarriage, having a low birth weight baby or developing an infection of the uterus (womb) after childbirth.

BV and surgery

If you have untreated BV, the chance of developing an infection of the uterus is higher following certain operations. For example, following a termination of pregnancy or a vaginal hysterectomy. However, antibiotics are given before various operations of the uterus if you have BV. This can usually prevent these infections.

BV and other infections

If you have untreated BV, you may have an increased risk of developing HIV infection if you have sex with someone who is infected with HIV. There is also some evidence that women with untreated BV may be at an increased risk of developing pelvic inflammatory disease (PID). See separate leaflets called ‘Pelvic Inflammatory Disease’ for more details.

What is the treatment for bacterial vaginosis?

Not treating is an option for some women

BV often causes no symptoms, or the symptoms are mild. Also, there is a good chance that BV will gradually clear without treatment, as the balance of bacteria in the vagina may correct itself. So, if you have no symptoms or only mild symptoms, not treating is an option.

However, if you are pregnant and you are found to have BV but have no symptoms, you may still be advised to take antibiotic treatment. The benefits of treating pregnant women with BV and no symptoms is a little uncertain. Your doctor may seek advice from a gynaecologist about whether or not you need treatment.

Note: all pregnant women who have symptoms due to BV should be offered treatment. If you are found to have BV and are undergoing a termination of pregnancy, treatment with antibiotics may also be advised even if you have no symptoms. This is because there is a risk of BV causing a more serious infection of the uterus (womb) or pelvis after the procedure if it is not treated. Some doctors also suggest antibiotics for women who are about to undergo other gynaecological procedures (such as an endometrial biopsy – a biopsy of the lining of the womb) and are found to have BV but have no symptoms.

Metronidazole

A course of metronidazole tablets is the common treatment. Metronidazole is an antibiotic. It clears BV in most cases. Read the leaflet that comes with the tablets for a full list of possible side-effects and cautions. However, main points to note about metronidazole include:

- The usual dose is 400 mg twice a day for seven days. A single dose of 2 grams is an alternative, although this may be less effective and may cause more side-effects. (Note: this single dose is not recommended if you are pregnant.) If you are taking the 7-day course, it is important to finish the course and not to miss any tablets.

- Some people feel sick, and may vomit when they take metronidazole. This is less likely to occur if you take the tablets straight after food. A metallic taste is also a common side-effect.

- Do not drink any alcohol while taking metronidazole, and for at least 48 hours after stopping treatment. The interaction with alcohol can cause vomiting and other problems such as flushing and an increased pulse rate.

- Breastfeeding: metronidazole can get into breast milk, but is not thought to affect breastfed babies. However, to play safe, the standard 7-day course with the 400 mg twice-daily dose is preferred so a baby does not get a large dose. If it is essential to use the 2 gram single dose, then it should be taken after the last breastfeed of the evening (at the start of the overnight breastfeeding break) to limit exposure to the baby.

- Antibiotics used to treat BV may interfere with your contraceptive pill or patch. You should discuss this with the doctor or nurse who is treating you.

Alternative antibiotic treatments

Metronidazole vaginal gel or clindamycin vaginal cream placed inside the vagina can be used if you prefer this type of treatment, or have unpleasant side-effects with metronidazole tablets. The ability of these treatments to clear BV is about the same as metronidazole taken by mouth.

Note: as with metronidazole tablets, you should avoid alcohol while using metronidazole gel and for at least 48 hours after stopping treatment. Also, clindamycin vaginal cream can cause weakening of latex condoms and diaphragms. Therefore, during treatment and for five days after treatment with clindamycin vaginal cream, do not rely on condoms or diaphragms to protect against pregnancy and sexually transmitted diseases.

Other treatments

Overall, there is no strong evidence at the moment that live yoghurt or lactobacillus acidophilus are helpful in treating or preventing BV.

Do I need a ‘test of cure’

Women who are not pregnant

You do not need any further tests (such as swab tests) after treatment to ensure that BV has cleared (a ‘test of cure’) provided that your symptoms have gone.

Women who are pregnant

If you are pregnant, it is suggested that you do have a swab test taken after one month to ensure that BV is no longer present.
Treating recurrences

If you have a recurrence of symptoms and did not have any swab tests taken initially, your doctor or nurse may suggest that they take swab tests now. This is to confirm that it is definitely BV that is causing your symptoms.

BV may recur if you did not complete your course of antibiotics. However, even if you have completed your full course of antibiotics, BV recurs within three months in around 1 in 3 women. If it does recur, a repeat course of antibiotics will usually be successful in treating it. A small number of women have repeated episodes of BV, and need repeated courses of antibiotics.

If you have an intrauterine contraceptive device (IUD) and have recurrent BV, your doctor or nurse may suggest that they remove your IUD to see if this helps to improve your symptoms. You will need to discuss alternative contraception measures with them.

How can I prevent further episodes of bacterial vaginosis?

Most episodes of BV occur for no apparent reason, and cannot be prevented. However, the following are thought to help prevent some episodes of BV. The logic behind these tips is to try not to upset the normal balance of bacteria in the vagina:

- Do not push water into your vagina to clean it (douching).
- Do not add bath oils, antiseptics, scented soaps, perfumed bubble bath, shampoos etc, to bath water.
- Do not use strong detergents to wash your underwear.
- Do not wash around your vagina too often. Once a day is usually enough.

Days to Permanent Bacterial Vaginosis Relief – Review

Controls support, dental care in Sweden is free for children under 20 years of age. As adults, patients can take advantage of the voucher system to quality care at reasonable prices that high cost is always protected.

Recent reforms have made the process of dental care much more open. Suppliers now have to display price lists by comparing its prices with reference prices established by the State. Patients who require extensive treatments to achieve both a treatment plan and cost estimate before starting treatment. And all patients get a copy of your dental findings, which includes tips on dental care at home.

Tips for Brushing

1. Use a soft bristle brush, preferably one with rounded bristles, synthetic. Seek approval of the American Dental Association. Replace your toothbrush every two or three months or as soon as the bristles are worn or bent.

A worn toothbrush will not clean your teeth properly and can actually damage your gums. You should also replace your toothbrush after you’ve had a cold.

2. Make sure your brush is the right size (usually smaller is better than larger ones).

3. Place the bristles at an angle of 45 degrees to the gum line and slide the tip of the brush under the gums.

4. Gently shake the hair or move in small circles over the tooth and gum.

5. Brush the outer surfaces, inside and chewing teeth. For chewing surfaces, use a light and forward.

6. For front teeth, brush the inside surfaces of the upper and lower jaws: Tilt the brush vertically and make several moves up and down the front of the brush on the teeth and gums.

Tips for Flossing

1. Wrap about 18 inches of floss around middle fingers of your hands.

2. Hold the floss tightly, with your thumbs and index fingers and gently guide your teeth. No “snap” the floss as it can cut your gums!

3. When the floss reaches the gum line, curve it into a C shape against one tooth and slide it into the space between the gum and tooth until you feel pressure against the tooth.

4. Gently scrape the side of the floss.

5. Repeat this method on all teeth.

6. Go to a clean area of floss after one or two teeth.

Home Remedies for Dental Care

Various types of fruits like lemon, strawberry, etc. have proven effective in removing stains deposited on the teeth and making it look whiter than ever. All you need do is rub your teeth with lemon or strawberry will disappear. Since these fruits are natures own gift, have no side effects and the effects can be seen from the first day of use.

Once you’ve finished rubbing her teeth for some time to resolve, and then use a toothbrush to brush teeth and rinse your mouth with water.

Another remedy that comes from nature wood ash is used to make teeth white ion beam. This remedy is easy to perform and can get the results sooner. From the past, this technique was used successfully in many villages and other places. What can stain teeth, they all go as soon as you start to brush their teeth with ash wood. This eliminates the discoloration of the teeth.
 

As we all know, Medicare is a health insurance policy for certain categories of people. Such categories include people who are 65 years old or more, people who are older than 65 years having specific physical or mental imparities and people of any age who are suffering from ESRD, End-stage Renal Disease which is basically permanent kidney failure leading a person to seek dialysis treatment.

Before going to what exactly is Medicare supplemental, you must know what the different benefits of Medicare are.  Let us see.

Hospital Insurance: this facility helps a person in covering inpatient care in hospitals and nursing homes. It also helps in rendering skilled nursing facility and different health care benefits.

Medical insurance: This benefit helps in covering doctor’s services, health care in hospital and health care at home.

It also entails certain precautionary services to help in maintaining your health and to manage particular ailments from getting worse.

Medicare Advantage Plan: This is another advantage that provides advantages that are listed under both the above categories. At times, this category offers a few additional benefits like vision, dental, hearing and other wellness programs.

Medicare prescription drug coverage: This is basically a prescription drug choice that is offered by private insurance companies that offer Medicare. It helps in providing the cost of prescription drugs and may also help in reducing the costs of your prescription drugs, thereby helping to protect against higher expenses in future.

Now, Medicare supplemental is an insurance policy that the private insurance companies deal with. This insurance policy intends to fulfill the shortcomings of a standard Medicare Plan. People who meet all the conditions for applying for a Medicare and already hold a Medicare plan are eligible for applying for Medicare Supplemental Insurance Policy.

A standard Medicare Supplemental Plan has to meet the necessary state and federal rules and regulations in order to make it easy for people to buy the insurance. you must understand that a general Medicare plan would not cover all you medical care. A Medicare Supplemental Plan is required to fill in the shortcomings of a Medicare insurance policy.

When you want to get the best possible Medicare Supplemental Policy for yourself, your focus must not be to decide whether to purchase the policy or not, it must be on what type to buy. There are varieties of Medicare Supplemental Policies that are available in the market. One must be thorough with his/ her requirements while deciding to get a Medicare Supplemental. California has a number of private insurance companies that offer excellent insurance packages and programs.

Maintain a hale and hearty smile with a few simple dental hygiene habits. One should not take smile for granted. Maintain a healthy mouth by regularly practicing good dental hygiene habits and treatment problems.

Routine dental care

Clean your teeth on a daily basis and visit your dentist one or two times a year to avoid gum disease and other dental problems.

To clean your teeth correctly, brush them at least twice a day — plus preferably after each snack and lunch— and do floss daily. Also follow these flowing tips:

• You need to use a soft-bristled brush as it’s gentler on the gums.
• Place the brush at an approach against your teeth, and use short back-and-forth movements to clean the teeth properly. Also clean the inside and chewing base of the teeth and your tongue.
• You should replace your brush in every two months.
• When you floss, softly ease the floss among your teeth.

Then pull the ends of the floss alongside the front and back base of a tooth so that the floss types a “C” as it wraps around the tooth. Gently pull the floss from the gum line to the peak of the tooth to scratch off plaque. Remember to floss at the backs of your teeth and to interpret fresh floss among your fingers as you growth through your teeth.

Report problems

In addition to normal care and with dental appointments, call your dentist if you expand any of the following signs and the symptoms of gum disease:

• Red, tender, and if you have swollen gums
• Gums the bleed when you clean them, even if they’re not sore
• Gums that are pull away from your good teeth; you might notice, which your teeth seem longer
• Pus around your teeth and the gums when you push on the gums
• A repeated bad taste from your mouth
• If any Loose teeth
• Changes in the way your top and bottom teeth get in touch, or changes in the sense of your dentures

Good dental hygiene does not need to be difficult. Get in the habit of taking a few simple tips every day and seeing your dentist regularly. You’ll be setting manually up for a brighter smile and for better in general health, too.

One third of people do not consult their dentist every year, so it would visit him once or twice a year. One in three people brushing your teeth at least twice a day, then it should be done three times and spend 3 minutes.

The oral health of the people is good?
Today, one third of people have very good oral health. The child is above the European average. However, it can do much better. Knowing that good oral health is to eat hygiene products (toothpaste, toothbrushes?), there is still room before reaching a good oral health.

How can we improve it?
By promotion, we must give the people reason to be healthy, so they have the desire, the desire to maintain good oral health. To do this, it is necessary to argue on the positive: how to have a social life, love life and how to enjoy the pleasure of the mouth (to eat and drink), if one is not in good oral health dental.

We must restore to the mouth its full value, in terms of sensory, but also medical, because we know that the mouth is at the crossroads of all health.

Many microbes pass through the mouth and many diseases such as diabetes, heart disease or rheumatism, are linked to dental problems.

Dental surgery if needed can be one of the costliest treatment procedures, so to avoid this it is recommended to maintain a good oral hygiene and dental health. If you still need a surgery procedure then you can reduce the cost by choosing a good dental clinic in India. The cost of medical treatments in India is very much less as compared to the European countries.

How to choose your toothpaste?
We must seek the advice of a good dentist. There are plenty of toothpastes and some are adapted to the problems of sensitivity to caries or gum problems. Today, all toothpastes on the market or supermarket pharmacy are of good quality. In addition, they all contain fluoride, as recommended. To choose one for you, the best thing to do is to consult a dentist. He / She alone will recommend the best toothpaste for you.

What action should be taken during the dental care promotion?
During this operation, you just need to do the promotion of oral health and it should be targeted to the people who do not want to even see themselves in a dental office. Even today, many people, almost 40% have not visited a dentist in their last passing year. That’s too much! The majority of these people do not go to an image problem of dental care: fear of evil, not to be listened to, high cost, etc. Yet these reasons are false. But until they reached the door of a dental office, they will not realize it. It is therefore necessary to explain what oral health and acts carried out in practice to play down the dental office and desecrate the dentist.