Category Archives: Dentistry

Dental Fluorosis

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Dental Fluorosis, is an enamel defect caused due to excessive intake of fluoride during the phase of early tooth development, alters the enamel forming cells.

This health condition can affect people of any age group, but is more prevalent among children between the age group of 1-4 years.

In the initial stages, fluorosis appears as white spots. In severe conditions, it causes mottling of enamel, which is severe pitting, cracking of the tooth structure, accompanied with dark brown to black stains.

Severity of dental fluorosis depends upon factors like, amount of fluoride exposure, age of the individual, the host response.

Severe cases of fluorosis can occur if the water is fluoridated much above the recommended level.

Fluorosis is directly related to tooth eruption. More the fluoride intake, more delayed is the tooth eruption, and in turn more severe is the flurosis.

Fluorosis, increases the porosity of the teeth, making them more vulnerable to decay.

 

UNDERLYING PHYSIOLOGY

 

Excessive fluoride intake affects the tooth enamel during the developmental stage.

Enamel consists of hydroxyapatite and carbonated hydroxyapatite; in the presence of fluoride, fluorapatite is also generated.

Excessive fluoride forms white spots, and in severe cases, mottling of enamel.

Fluorsis does not affect permanent teeth. The flurapatite formed is beneficial at this stage. It makes the tooth structure resistant to acid dissolution.

Fluoride consumption can exceed the tolerable limit, if the individual consumes excessively fluoridated water along with other fluoridated products, like toothpastes, or excessive fluoride containing foods.

If the water is fluoridated at 1ppm, then the individual must consume, 1 litre of water, so that a daily dose of 1mg of fluoride is attained.

 

TREATMENT

 

Dental flourosis can be cosmetically treated by the dentist. Initial stages can be solved by Bleaching and Microbrasion. In cases of severe mottling, Restorations or Porcelain Veneers will be ideal.

 

 

Dry Mouth – Causes and Management

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Dry mouth is scientifically called Xerostomia.  It results due to either reduced saliva secretions (hyposalivation), or reduced saliva formation. `

Lack of saliva, can make chewing, talking, difficult. It also increases the probability of tooth decay, because saliva consatntly washes away and neutralizes the acids formed by the action of bacteria on the food remnants. Saliva also helps in remineralizing the lost enamel, hence reversing the decay process.

All tissues and surfaces in the oral cavity, become dry, and the mucosa and the periodontal tissue becomes vulnerable to infection.

 

CAUSES

 

Excessive mouth breathing habit.

Nervousness, anxiety.

Underlying disease which affects the saliva secretion by the salivary glands – SJogrens syndrome, Diabetes.

Dehydration caused by excessive loss of fluids.

Chmotherapy, Radiotherapy.

Medications – Antidepressants, Antihistaminics.

 

TREATMENT

 

First the cause of dry mouth should be identified and treated accordingly to dissolve the problem.

Other symptoms, like restoring the decayed teeth.

Special attention to oral hygiend emeasures.

Preventive measures, like use of sealants, and fluorides to prevent further tooth decay, and can help in restoring the lost tooth structure.

sipping on non carbonated sugarless frequently, inorder to stimulate the saliva secretion from the glands.

Xylitol containing chewing gums can be used.

Pilocrapine can also be prescribed.

Drinking water to relieve the dryness, does not eradicate the problem, unless the cause is dehydration.

Also avoiding intake of tobacco and alcohol.

 

 

 

 

 

 

Tongue Cleaning – The cause of bad breath.

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Tongue cleaning is the most neglected aspect of daily oral hygiene regime. Coated tongue is often the cause for bad breath.

The top sueface of the tongue is not a very smooth surface. It has several elevations and depressions, which are very ideal for the accumulation of debris, and bacterial growth. If left unattended, the bacterial colonies grow, along with abiuld up of food debris, causing bad breath,a nd a condition called Coated tongue, or White tongue.

There are devices available to clean the tonuge. These are called  Tongue cleaners, or Tongue scrappers. Even a toothbrush can be used for this purpose. Any instrument with a rigid design and can flush very well with the tongue surface, is good for tongue cleaning.

 

BENEFITS

Tongue cleaning, elimination millions of bacteria, food debris, and dead cells from the surface of the tonuge.

Many scientific studies have proven, that these organisms, when decay the food particles, form malodrous compounds, mainly Volatile Sulphuric Compounds (VSC) which is the main cause for halitosis, or bad breath.

Tongue cleaning if done on a regular basis, can eliminate the accumulation of anaerobic bacteria, which is the main reason for plaque accumulation, all periodontal problems and gum disease, tooth decay.

 

FACTS

Its a misconception that its the force that helps in optimum tongue cleaning. The most important points to be kept in  mind while performing tongue cleaning, is the motion, and the instruument that you have chosen.

The motion should start from the base of the tongue, slowly, steadily to forwards towards the tip, and the sides. several sweepping motion will be needed to complete the process.

The instrument used, should flush with the tongue surface, and rigid enough against the spongy muscle to conveniently sweep away the debris.

 

SIDE EFFECTS

It has been noted, that in case of excess force, or if  the motion starts much beyond the base of the tonuge, you will experience  a gag reflex. This is a very common phenomenon.

This can be avoided, by relaxing the tongue and the muscles of the throat.

An improper designed tongue scrapper, used aggressively damages the tongue surface especially the taste buds and the papillae present on the dorsum of the tongue. This can be taken care of by learning the right technique to perform the tongue cleaning regime.

 

CONCLUSION

Tongue cleaning alone cannot solve the problem of bad breath. It has to be a part of the complete oral hygiene regime that includes, briushing, and flossing.

If performed regularly, you can maintain a healthy, fresh, odor free and pink coloured tongue.

 

 

 

Implant Supported Dentures – Benefits of Implant Overdentures

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For ages, the edentulous elderly population have been presented with very limited options, which is the traditional complete dentures. But now, due to the fast growing Dental Implant industry, Implant supported dentures, or also called Implant Overdentures, have become the new trend. There are advantages and disadvantages of dental implants and it is best to know about it before treatment.


Most often, a treatment plan for an edentulous patient is made keeping the cost factor in mind. The patient’s desires should be probed, and kept in mind while designing the prosthesis. Some patients have a very strong psychological need to possess a fixed prosthesis. The idea of having a removable prosthesis in their oral cavity, which can slip away, scares them.


On the other hand, there are other class of patients who, are not really concerned if the prosthesis is removable or fixed, unless, their specific need is addressed.


A rule in implant dentistry is to provide the patient with the most predictable, cost effective treatment that will not only satisfy the anatomical needs but also the personal desires.


In a completely edentulous patient, a removable implant supported prosthesis offers several advantages over a fixed implant restoration.


  • The labial flanges, and the denture teeth, in the prosthesis improves the facial esthetics to a great extent compared to customized metal or porcelain teeth, in a fixed prosthesis.
  • The labial contours of the removable restoration replaces the lost bone width and height, and also supports the labial sift tissues.
  • Oral hygiene is not compromised.
  • The prosthesis can be removed at night, which is beneficial for patients with nocturnal parafunctional habits.
  • Fewer number of implants are needed, as opposed to a fixed design.
  • Other complimentary surgeries, like bone augmentation is seldom required, with this prosthetic design.
  • The treatment span is shorter.
  • Comparatively less expensive.
  • Daily home care, hygiene maintenance becomes easy.


Dental Implant Procedure

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Placement of dental implants, is a not a very easy and simple procedure for a dentist. It demands a high degree of skill.


Implant procedure, can be divided into the following phases,


* A thorough treatment planning,


* The implant placement procedure,


* Finally, implant restoration, which is the prosthetic phase.


Surgical planning


A detailed planning of the implant procedure is very important. Normally dentists, rush with the procedure without a definite planning, which leads to irreversible errors. The implant site needs to assessed, for the bone dimension, the bone density in the area. Even anatomic landmarks, needs to be evaluated, like the inferior alveolar nerve, maxillary sinus.

These need to be watched out, for, because they cause a major hindrance in the surgical procedure.

Orthopantamographs, and periapical radiographs are commonly taken prior to the procedure, but sometimes these 2-dimensional images, underestimate the actually bony contours. A 3-dimenaional CT scan, is of great help in such cases. They give the exact width, and length of the alveolar ridge where the implant needs to be placed. The use of  CT scan can increase the overall cost of the treatment.


Sometimes a acrylic stent, which fits well over the adjacent teeth, with drilled holes also help a great deal for the dentist to position and angulate the implant drills. This can be used professionals with less experience, and who are first timers.


Dental Implant Procedure


Traditionally an incision is made on the crest of the edentulous ridge.  Full thickness flaps are reflected, exposing the raw underlying bone. Newer systems these days, also provide with flapless procedures, wherin, flap reflection is not required. Instead a piece of mucosa is punched out. Flapless procedures are controversial. Some believe that, it reduces the recovery time, while some advocate that it increases complication rates, because it is a blinded procedure, and the bone anatomy cannot be visualized. A 3D pre-operative CT scan becomes mandatory.


Keeping the vital structures like the maxillary sinus, inferior alveolar nerve and mental foramen, the pilot drill is bored into the recipient bone. Preparing the implant site, that is the ostectomy, is done in several steps. It starts with using the smallest size drill, and gradually increasing to the desired size. The pilot hole is further expanded using the progressively wider drills. high speed drills, with copious amount of irrigation is necessary to avoid, temperature rise, and bone necrosis.


After placement of the implant body/fixture, the implant screw is tapped onto it, with a precise torque. If its a flap procedure, the flaps are replaced and sutured in place.


Healing time


The exact duration of waiting period, for maximum osseointegration to take place is controversial. In general 4-6 months is ideal for restoring the implant. Immediate loading implants are also available. But again they are controversial. Early loading of the implant can lead to implant failures. Because the healing is not complete, due to which the implant is not capable enough to take up the masticatory loads.


What is a One-stage, and two-stage surgery?


After placement of the implant fixture, a healing abutment or a cover screw is placed which flushes well with the implant surface. On placing the cover screw, the mucosa covers the implant while it integrates, and a second surgery is completed to place the healing abutment.


Two stage surgery is performed, after the healing phase, wherein the overlying mucosa is removed, and the abutment is screwed in.


In carefully selected cases, patients can be implanted and restored in a single surgery, in a procedure labeled “Immediate Loading”. In such cases a provisional prosthetic tooth or crown is shaped to avoid the force of the bite transferring to the implant while it integrates with the bone.

Dental Implants – Advantages and Disadvantages

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Teeth have been naturally designed, to last a lifetime. Unfortunately it isn’t so. With the evolution in dentistry, missing teeth can be replaced. In the past, people with missing teeth had limited options namely, crowns, bridges, and dentures. Today, dental implants and implant over dentures offer an alternative cosmetic solution to most people.


Replacement of missing teeth is important to maintain a healthy balance not only in the oral cavity but also to your general health. Loss of teeth not only impairs the chewing ability of the individual, but also other problems like,


* Movement of neighboring teeth, like tipping


* Crowding of teeth


* Shrinkage of gum tissue


* Disturbed occlusion, due to changed tooth positions, which can also lead to food impaction, dental calculus or tartar formation & bad breath


* Collapse of jaw bone.


Missing tooth, also means missing root. Natural tooth root provides support to the jaw bone, and gum tissue. A dental implant replicates the root of the natural tooth, which fuses very well with the jaw bone, and meets the functional demand, similar to a natural root. This prevents further damage.


Lets have a quick glance at the advantages and disadvantages of  a dental implant,


ADVANTAGES


After the healing process, the dental implant fuses completely with the jaw bone, forming a single functional unit. This increases the chewing efficiency of the individual.

The appearance, function of a dental implant is as good as your natural tooth.

The site, where the implant is placed, further bone loss, and jaw shrinkage does not take place. The bone volume, and dimensions are maintained.

Denture wearers, always dread, that their dentures, might give way while eating or speaking. This is not the case with implants.

Since implants are placed in sites where, teeth are missing, the adjacent teeth are not touched. Neighboring natural teeth need not be altered, which is the case with bridges. This ensures long term stability, and durability.

Oral hygiene and maintenance with dental implants is easy.

Facial appearance is restored, avoiding a sunken face look.


DISADVANTAGES


Dental implant procedures call for a major investments, which is not free of risks.

The entire treatment regime, is time consuming compared to other modalities, like bridges and dentures.

Frequent and several visits to the dentist is needed.

A well kept follow up routine is necessary for every implant patient.

It is technique sensitive, hence the skill of the practitioner is important.

Other complications are common with any other surgical procedures, like pain, bruising, swelling.


Hence, before deciding to undergo the implant procedure, a close and critical assessment of the pros and cons of the same is important.

Dental Implants- Types, Parts & Ideal Candidate

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Tooth loss, is something that none of us look forward to, and the most dreaded. Loss of  a tooth has a considerable impact on the psychology of an individual. The effect is a deep seated one, much more than we can comprehend.

Dentistry offers several options for the replacement of missing tooth, of which dental implants is the most recent and the most considered treatment option.


WHAT IS A DENTAL IMPLANT?

Dental Implant is a  titanium screw or a cylinder, which is available in various sizes, and various biomaterials, and is placed in the edentulous site.  The implant fixture is surgically placed in the jaw bone, and heals gradually by a process called “osseointegration”. This implant fixture replicates the root of the natural tooth. After considerable time has elapsed post healing, a dental prosthesis is placed on the top most part of the implant fixture, which resembles the natural tooth anatomy.


PARTS OF A DENTAL IMPLANT

Implant fixture –

Its an insert that provides firm anchorage for the restoration. It is screwed into the jaw bone, providing a fixed platform, onto which the abutment is screwed. During the healing period, the jaw bone grows into, and around the implant fixture threads, thus strengthening  the jaw bone, and preventing further bone loss, in the edentulous site. Implant fixtures come in various shapes, sizes, materials, and widths.


Abutment –

Implant abutments provide, support to the dental crown. It is the interface between the crown and the implant fixture. It is screwed onto the top most part of the fixture. abutments come at preformed at set angulations, from manufacturers in different platform sizes, or they can also be custom made.


Crown –

Crowns are the top part of the restoration. The part that is visible in the oral cavity. They replicate the original teeth, to provide a biting surface and aesthetic appearance.


WHAT CAN DENTAL IMPLANT DO?

Replace one or more teeth, without affecting neighbouring teeth

support a bridge, and eradicate the need for a removable partial denture.

support a complete denture, which is an implant supported one, hence making it more stable, secure and comfortable for the patient.


TYPES OF IMPLANTS IN USE


Endosteal (placed within the bone) – This type of implant is used as an alternative to bridges or removable dentures. This is the most commonly used implants pattern. It is availbale in various types, including screws, cylinders or blades.


Subperiosteal (on the bone) – These are placed on the bone surface and not within. It is secured, using metal framework’s posts protruding through the gum to hold the prosthesis. these implant are mainly used by those patients, who are unable to wear conventional dentures, and have minimal amount of residual bone height.


IDEAL IMPLANT CANDIDATE


An ideal implant patient is the one who is in good oral and general health. He should not be suffering from any systemic illness, which could compromise the implant procedure outcome.

Adequate bone height and width is mandatory for implant placement. apart from the bone volume the bone quality is also very important for implant placement. Bone density varies in different areas in the jaw. If the bone density is poor, or more porous, which can be evaluated by various imaging modalities, placing an implant becomes doubtful. Nonetheless, these defects can well be reversed by various complementary surgical procedures, like bone grafting, and the treatment plan can thus be well tailored in the best interest of the patient.

Individuals with habits like, smoking, or who consume tobacco in any form, are poor candidates for implant procedures. And they should be well informed about the reduced percentage of implant success in their case.




Teeth sensitivity – Prevention and Management

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Teeth sensitivity, is a very commonly encountered dental condition. The discomfort and pain caused by this condition, actually, makes consumption of hot, cold and sweet food difficult to relish. A right diagnosis and well planned treatment can keep tooth sensitivity at bay.


SYMPTOMS

Teeth become sensitive to temperature changes. most commonly teeth respond to cold food.

If the teeth elicits a pain after a hot stimulus, then it means that, the nerve of that tooth is damaged, and it will need a root canal therapy.

If the pain in the tooth lingers on for several minutes, even after removal of the stimulus, its a sign of pulpal damage, and will need root canal therapy.

sometimes, immediate post-filling, the patient complains of that tooth being sensitive. this is mos commonly seen with silver and composite fillings. the silver in the amalgam restorative material transmits the cold to the nerves. in case of bonded restorations, etching of the tooth surface is done, before placing, and curing the restorative material. This acid etching also leads to teeth sensitivity. But with the entry of the new generation of bonded restorations, this complication can well be avoided.


DIAGNOSIS

The dentist will ask the for the following details,

A detailed, teeth cleaning methods will be asked – an improper brushing technique, along with a hard bristle, tooth brush and an abrasive dentifrice leads to tooth wear and teeth sensitivity.

Dental history – to assess the motivation levels of the patient. presence of long standing deposits, like plaque and calculus can also make the tooth sensitive.

Pulp testing will be done, to check whether the tooth is vital or not. In case of a non vital tooth, which means that the nerve is completely damaged, a root canal treatment is compulsory.

Dietary habits of the patient – consumption of acidic and more citrus food, alcoholic beverages.

teeth examination for signs of decay, gum recession, gum disease, chipped filling.


MANAGEMENT

Teaching the patient the right brushing technique. Giving a demonstration really helps the patient to understand, and emulate the dentist.

If the sensitivity is due to pulpal damage, a root canal therapy puts an end to the agony.

Sensitivity after an amalgam filling, vanishes in few days. So it does not require any further measures.

A high filling restoration can be altered by polishing it.

Tooth pastes that are made exclusively for sensitive teeth can be used, fluoride varnishes are also available. They act by blocking the dentinal tubules. This eradicates pain sensation.

Avoiding acidic products for oral hygiene purposes, for example few flouride rinses are acidic y nature.

Consult a dental professional for periodic oral prophylaxis.



Sensitive Teeth Symptoms & Causes (Dentine Hypersensitivity)

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Sensitive Teeth, also called, Dentine hypersensitivity has been accepted to be among the most painful dental conditions, affecting oral comfort and function.

Earlier, dentine hypersensitivity was considered to be an enigma, since it was frequently encountered, but poorly understood.

Dentine hypersensitivity is defined as, ” a condition, characterized by short, sharp pain arising from exposed dentine in response to stimuli typically thermal, evaporative, tactile, osmotic, or chemical and which cannot be ascribed to any other form of dental defect or pathology.”


TERMINOLOGIES


Dentine hypersensitivity is also referred to as,

Dentine sensitivity

Dentinal hypersensitivity

Cervical hypersensitivity

Root hypersensitivity

Cemental hypersensititvity


Causes of Sensitive Teeth or Dentine Hypersenstivity


  1. Caries
  2. Chipped tooth
  3. Fractured restorations
  4. Marginal leakage around restorations
  5. Some restorative materials
  6. Cracked tooth syndrome
  7. Palatogingival grooves
  8. Gingival recession, with rapid loss of cementum/loss of enamel
  9. Openeing of dentinal tubules due to either, attrition, abfraction, abrasion, erosion.
  10. Parafunctional habits such as bruxism, causes occludsal hypersensitivity
  11. Chewing on coarse diets, or abrasive materials
  12. Vigorous tooth brushing with an abrasive dentifrice
  13. High consumption of citric diet, like, oranges and lemon.
  14. Acidity
  15. Excess intake of alcoholic beverages, soft drinks, yoghurt.


MECHANISMS OF DENTINE SENSITIVITY


The Hydrodynamic theory is the most accepted, which explains the mechanism of dentine hypersensitvity.

according to this theory,


Most pain-evoking stimuli increases the outward flow of the fluid within the dentinal tubules

↓

This fluid movement, inturn, causes a pressure change

↓

This activates the A- delta   intradental nerves, at the pulp dentine border; or within the dentinal tubules.


↓

Pain is elicited.



CONCLUSION

Sensitive Teeth or Dentine hypersensitivity, in terms of symptoms, and localisation of lesions, has all the hallmarks of tooth wear phenomenon.

A great deal still needs to be researched.


Dentists in Yeswanthpur, Bangalore

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Dentists in Yeswanthpur, Bangalore


If you are Dentists in Yeswanthpur, Bangalore and would like to advertise on eDoctor – please use the Contact Form to get in touch with us.

Adding your details on this page is free of cost for Dentists in India.


Web Design for Dentists


We provide web design for Dentists, so if you do not have a website of your own, we can provide you with a superb Dental Web site – please use the Contact Form to get in touch with us. We also, provide Medical Web Design for Doctors.



Dentists in Whitefield, Bangalore

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Dentists in Whitefield, Bangalore


If you are Dentists in Whitefield, Bangalore and would like to advertise on eDoctor – please use the Contact Form to get in touch with us.

Adding your details on this page is free of cost for Dentists in India.


Web Design for Dentists


We provide web design for Dentists, so if you do not have a website of your own, we can provide you with a superb Dental Web site – please use the Contact Form to get in touch with us. We also, provide Medical Web Design for Doctors.



Dentists in Vimanapura, Bangalore

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Dentists in Vimanapura, Bangalore


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Web Design for Dentists


We provide web design for Dentists, so if you do not have a website of your own, we can provide you with a superb Dental Web site – please use the Contact Form to get in touch with us. We also, provide Medical Web Design for Doctors.



Dentists in Vijayanagar, Bangalore

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Dentists in Vijayanagar, Bangalore


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Web Design for Dentists


We provide web design for Dentists, so if you do not have a website of your own, we can provide you with a superb Dental Web site – please use the Contact Form to get in touch with us. We also, provide Medical Web Design for Doctors.



Dentists in Varthur, Bangalore

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Dentists in Varthur, Bangalore


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Web Design for Dentists


We provide web design for Dentists, so if you do not have a website of your own, we can provide you with a superb Dental Web site – please use the Contact Form to get in touch with us. We also, provide Medical Web Design for Doctors.