Showing posts with label Oral health. Show all posts
Showing posts with label Oral health. Show all posts

Thursday, June 30, 2022

What is a Mouthguard?

 

What is a Mouthguard?


A mouthguard is a piece of dental equipment designed to cover your teeth and gums. There are several different types of mouthguards available. Athletes playing contact sports often wear sports mouthguards to protect their teeth, gums, and jaws during practice and games.


You can also wear a mouthguard at night to prevent sleep disturbances, such as snoring. Mouthguard designs can vary widely depending on their intended use. Anti-snoring mouthguards are designed to change the position of your jaw or tongue, keep your airway open, and prevent snoring.


Mouthguards can also be designed to be worn as you sleep to prevent teeth grinding, or bruxism. Bruxism is excessive teeth clenching and grinding that can occur as you sleep, causing jaw pain, neck pain, and noticeable damage to your teeth.


Mouthguards for teeth grinding are typically designed to cover either your top or bottom row of teeth. This added protection can help reduce the damage caused by consistent clenching and grinding throughout the night.


Some people have trouble sleeping with a mouthguard initially, and it may take a few nights to a few weeks to acclimate.


How to Pick the Best Mouthguard for You

With so many mouthguard brands and models to choose from, it can be difficult to decide which one is right for you. Proper fit is perhaps the most crucial factor when selecting a mouthguard, but there are other elements that should be considered. We’ll take a closer look at the most important factors to help you pick the best mouthguard for teeth grinding.


Materials and Durability

Custom mouthguards are often made with two layers. The interior layer is typically softer and made from acrylic or polymer, while the exterior is made from a more rigid material.


The thickness of the mouthguard is usually measured in millimeters, often ranging from 1mm to 4mm. Less expensive models may consist of a single layer and will be noticeably thinner and softer. This may cause the mouthguard to wear out faster when compared to thicker, more rigid models. The severity of your teeth grinding can also impact the overall lifespan of your mouthguard.


Mouthguard Styles

Mouthguards come in several different styles with varying price-points and degrees of customization:


Custom-Fitted: Custom mouthguards tend to be the most expensive, but they may be the most comfortable and effective for many sleepers. They are custom-fabricated to fit the exact shape of your teeth. While this style previously required a trip to the dentist, many companies now offer this service online. You’ll receive a kit to make a custom dental impression that you send back to the company. They’ll use your impression to create and deliver a custom mouthguard fitted to the exact shape of your teeth.


Boil-and-Bite: A boil-and-bite mouthguard offers a simplified version of a custom-fitted mouthguard. This style uses a special thermoplastic that’s moldable at high heat. To create a custom mold, you boil the mouthguard in water to soften the material, run it under cool water, and then bite into it to create an impression of your teeth and gums. Boil-and-bite mouthguards are generally less expensive than custom fit options, but more expensive than one-size-fits-all mouthguards.


One-Size-Fits-All: One-size-fits-all models do not provide a customized fit, but they are typically the least expensive type of mouthguard for teeth grinding. Results may vary when it comes to the comfort and fit of this style.


Fit and Comfort

A mouthguard should fit snugly and comfortably in your mouth in order to be effective. A poorly-fitted mouthguard may prevent some of the damage caused by teeth grinding, but it can also lead to jaw or mouth pain.


Custom-fitted and moldable boil-and-bite models are formed to the specific shape of your mouth and should fit comfortably. When it comes to one-size-fits-all mouthguards, you may need to try multiple models before you find one that suits the shape of your mouth and allows you to sleep comfortably.


Cleaning Requirements

Mouthguards should be cleaned and sanitized regularly.  Each manufacturer will have specific recommendations for cleaning, and instructions should be included with your night guard. If you prefer a low-maintenance option, you may want to examine the cleaning instructions prior to purchasing.


Price

Mouthguards are available in a wide range of price-points to suit almost every budget. Though mouthguards were once considered to be expensive investments, they are more accessible now with the emergence of online companies that offer direct-to-consumer shipping options. Custom-fitted mouthguards typically cost between $100 and $200, while moldable options are generally less expensive.


Mouthguard FAQsWhat is bruxism?

Bruxism is the medical term for teeth grinding and clenching. Bruxism can occur when you’re awake or as you sleep. Physicians consider awake bruxism and sleep bruxism to be two distinct conditions, though they are characterized by similar symptoms.


Overall, sleep bruxism is less common than awake bruxism. However, teeth grinding at night still affects between 15% to 40% of children and 8% to 10% of adults. Sleep bruxism can lead to a number of unwanted symptoms including:


Damage and erosion to the teethHeadachesJaw painClicking of the the joints in the jawTemporomandibular disorders (TMDs)


Sleep bruxism can have a significant impact on your quality of sleep, which may affect your physical health. Since it occurs as you sleep, you may be unaware that you suffer from it.


If you suspect you suffer from sleep bruxism, talk to your doctor or dentist. The presence of common symptoms, such as jaw pain and tooth damage, may be enough to diagnose sleep bruxism. In some instances, you may need to participate in an overnight sleep study to get a definitive diagnosis.


Can I use a regular mouthguard for teeth grinding?

You shouldn’t use a regular mouthguard for teeth grinding, as they are not designed to protect the teeth and jaw from grinding or clenching. Sports mouthguards are usually thick and protect the teeth from impact. They are meant to be used for only a few hours at a time during games or practice, rather than every night.


Mouthguards that are specifically designed for bruxism will protect your teeth and withstand light to heavy teeth grinding. Other mouthguards are more likely to crack, break, or wear down more quickly.


What’s the best way to clean a mouthguard?

The best way to clean your mouthguard is to use the instructions and tools supplied to you by the manufacturer, as this will help prevent damage to the mouthguard. Many mouthguards come with a sanitizing solution for this purpose.


Depending on the mouthguard, you may be able to use standard dental cleaning tools. A gentle but thorough scrub with a soft bristle toothbrush and nonabrasive toothpaste or mild soap can help keep your mouthguard clean between uses.


How often should I replace my mouthguard?

How often you will need to replace your mouthguard will depend on several factors including:


Mouthguard thicknessType of materialsHow severely you grind your teethHow well you take care of your mouthguard


Inspect your mouthguard regularly, looking for any cracks, tears, changes in shape, or thinning. If you experience mild teeth grinding and you take proper care of your mouthguard, it can last several months to a year or longer. Some mouthguards are made from thicker materials designed to withstand severe grinding. If you find yourself replacing your mouthguard frequently, you may want to look for a thicker, more rigid model, or a brand that allows you to buy discounted multipacks.


You may want to bring your mouthguard with you to your regular dental cleaning and checkup appointments, so that your dentist can evaluate your mouthguard for wear and tear.


Can medications cause teeth grinding?

Certain prescription medications may contribute to teeth grinding at night. Sleep experts may not have narrowed down the exact cause of sleep bruxism, but most agree that multiple factors can trigger teeth grinding and clenching as you sleep.


Amphetamines, dopamine-related medications, and selective serotonin reuptake inhibitors are thought to worsen the symptoms of bruxism. Other substances that may contribute to teeth grinding, include tobacco, caffeine, alcohol, and recreational drugs.


Monday, June 6, 2022

What You Need to Know About Bruxism and Teeth Grinding

 


Here's what you need to know about bruxism and what you can do to stop grinding your teeth.


You had a stressful day and you unleashed your tension by grinding your teeth at night, maybe grinding so forcefully that you woke up your partner. And perhaps you paid the price the next day with a headache. Head and facial pain caused by teeth grinding (also called bruxism) is serious and common. While many think of it as a problem that only affects older people, New York City-based dentist Leslie B. Goldfarb, DDS, says people of all ages can develop this habit. “Even children can grind their teeth,” she says.


When you grind, you may be putting as much as 1,200 pounds of pressure on the crowns and roots. That recurring pressure is what can break or loosen your teeth. You can get temporary relief from over-the-counter pain relievers like aspirin or acetaminophen. But that doesn’t get to the root of the problem, especially when you start to get jaw pain. For that, you’ll want to consult with your dentist and make sure you take really good care of your teeth. In the meantime, here are some ways to minimize the daily (or nightly) grind.


Steer clear of stress at the end of the day

Avoid stressful thoughts, activities, and movies in the hours before bedtime. You probably don’t realize it, but just before bed is the worst time to pay the bills, watch Netflix, or talk about your in-laws. If you are bothered by worries, jot down things that you need to address the next day. Then take a long, warm bath before you go to bed. While you’re there, cover your jaw with a washcloth that’s been soaked in hot water. The extra warmth will relax your jaw muscles.


Practice progressive muscle relaxation before you go to sleep, so tension doesn’t lead you to teeth grinding at night. Here’s how it works: When you’re lying in bed, first make a conscious decision to contract, then relax the muscles in your feet. Repeat with your calf muscles, then thigh muscles, and so on, progressively contracting and relaxing each set of muscles all the way up your body. By the time you contract and relax your neck and jaw muscles, you should feel as limp as a rag doll. Also try to avoid eating within an hour of bedtime. Digesting food while you sleep makes you more likely to grind your teeth.


Be guarded

A protective mouthguard made for boxers and defensive linebackers may work for bruxism too. These devices fall into one of three categories: stock mouth guards (which you can find at the local drugstore), the mouth-formed or “boil and bite” type (which are heated in hot water, placed in the mouth and molded to the teeth), and custom-made mouthguards (which give the most protection), according to the American Dental Association’s Council on Advocacy for Access and Prevention. If you buy your own, follow directions on how to mold it to your bite, then wear it to bed at night. The rubbery material will absorb pressure and save your teeth from damage. If you find that the mouth guard keeps falling out, or you wear it right through, talk to your dentist about a customized mouth guard. Try these other surprising DIY ways to stop teeth grinding or bruxism.


Give your jaw a break

During the day, make a conscious point of keeping your jaw relaxed and your teeth apart. As a reminder to yourself, rest your tongue between your top and lower teeth, so if you start to bite down, you’ll really know it. Experts say most people aren’t even aware that they grind their teeth, but those who can break the daytime teeth-grinding habit are less likely to do it unconsciously at night, according to the National Sleep Foundation.


Avoid excessively hard or chewy foods; not only gum and hard candy, but also steak or dried foods that require a lot of jaw action. And if you’re in the habit of chewing on the end of your pencil, try to stop. When you work your jaws during the day, the pattern is likely to continue in your sleep.


Watch what you drink

Keep alcohol consumption to a minimum, or, better yet, stop drinking altogether. This is especially important in the evening. Though sleep experts aren’t sure why, people who drink heavily at night are more likely to grind their teeth when they sleep. Also, avoid caffeinated drinks. Since caffeine is a stimulant, if you drink coffee, black tea, or caffeinated soft drinks, you’re far more likely to grind away.


Get proper nutrition

Did you know that many of the same vitamins and minerals that keep bones strong can also help your teeth? Studies on the elderly given calcium and vitamin D supplements suggest that the nutrients may have helped them to keep their teeth. Specifically, vitamin D might reduce the risk of gingivitis and periodontitis, according to a 2020 study in the International Journal of Environmental Research and Public Health.


Get jaw pain checked out

You may respond to stressful situations during the day by clenching or grinding your teeth at night, without even realizing you’re doing it. This presents a problem, since your teeth are designed to touch briefly when you’re chewing and swallowing—they aren’t built for the punishment of constant grinding. Common triggers are tension and anger. Nighttime grinding can lead to cracked teeth and headaches, as well as the neck and jaw pain called temporomandibular (TMJ) disorders. These 33 tips can make managing stress easier, and give your jaw a break too.


Get regular checkups

Experts recommend that all adults should have biannual dental cleaning by a hygienist, and a biannual oral health assessment by a dentist. “Your mouth is a mirror to your body,” notes Sree Raghavendra, DMD, assistant professor in the Department of Craniofacial Sciences at the UConn School of Dental Medicine in Farmington. Frequent touch points with a dentist will also alert you to grinding activity or bruxism you might not have been aware of, and, hopefully, prevent future damage.


When to call a healthcare professional for bruxism

If you wake up with pain in your jaw, neck, or shoulder, or have morning headaches, tell your dentist or doctor about your symptoms so you can at least try to prevent a dental emergency. This is particularly important if your bedmate reports that you grind your teeth at night. And you need to see an expert immediately if you have a broken tooth from the grinding. For severe bruxism or teeth grinding, you can be fitted with an appliance called the NTI-tss (nociceptive trigeminal inhibition-tension suppression system). It protects you from the damaging and often migraine-producing clenching on back molars. While no one loves going to the dentist, he or she has lots of ways to keep your teeth and gums healthy and your jaw and neck pain-free.



Tuesday, January 13, 2015

Can Xylitol Chewing Gum Protect Your Teeth?

 

You have always heard that eating sugar candy is bad for your teeth. but what if i say "chew some gum and protect your teeth"


Yes you are hearing right, i am suggesting you chewing gum ..but how does it help protect your teeth?..


I am suggesting you to have SUGAR FREE Xylitol containing chewing gums present in the market in various brands.


How does it help?

As I have discussed earlier about the process of Caries/Decay, the organism responsible for decay of the tooth is S mutans.It promotes an acidic environment in our mouths which leaves enamel susceptible to damage, erosion and eventually cavities.


Luckily, nature has provided a cheap, natural and safe remedy for this problem: xylitol. xylitol is a sweet substance commonly found in birch trees and in the fibrous portions of many fruits and vegetables.I want to discuss its application as a cavity fighting agent.


A recent study out of Korea examined the effect on cavities caused by the regular chewing of xylitol sweetened gum.


Two groups of women were assigned to chew either regular or xylitol gum for a period of one year. At ten points during that year, saliva samples were taken from these women and analyzed to determine the amounts of S. mutans.


In the xylitol gum group, the levels of S. mutans decreased consistently as the study progressed.  The researchers also found that the S. mutans produced a lower amount of sticky substances in the xylitol chewers. This is relevant because the stickiness allows for acids to cause more damage to our teeth. The combined effects of  chewing the xylitol gum led to an oral environment that was less prone to cavity formation.


The results of this first study were encouraging. But I wanted to see if this might be a fluke. It seems that it is no


Facts & Figures-

In December of 2008, a review appeared in the Journal of the American Dental Association. In it, the researchers examined the findings of 19 studies relating to the use of xylitol and sorbitol gums in the prevention of tooth decay. Their analysis found that the xylitol gum studies showed the greatest cavity prevention.


Here’s a breakdown of a few different sugar alcohols and their overall preventive effect:

Xylitol Gum – 58.66%

Xylitol & Sorbitol Combination Gum – 52.82%

Sorbitol Gum– 20.01%

Sorbitol & Mannitol Combination Gum – 10.71%


As you can see, the xylitol component appears to be the most important factor in the promotion of oral health.


So how exactly does xylitol help protect teeth? It is believed that it works to starve harmful bacteria, like S. mutans. This leads to a less acidic environment that is less prone to decay and plaque formation.


Calcium added Xylitol gums-

Preventing cavities is a very positive thing. But is there a way to strengthen enamel, if it’s weak to begin with? Maybe so.

A few years ago, scientists in Japan published a study that tested a combination gum that included calcium lactate and xylitol. Their aim was to see if such a gum could actually make tooth enamel stronger.


Volunteers were asked to either a) chew no gum, b) chew xylitol gum or c) chew gum with xylitol and calcium lactate. The voluteers chewed 4 pieces of each gum for 2 weeks. After which, their enamel was measured using an X-ray.


The results showed that the xylitol-calcium gum was about 50% more effective in promoting remineralization than the xylitol-only gum. The authors concluded that, “chewing gum containing xylitol + calcium lactate could enhance remineralization of enamel surface”.

So i suggest having these xylitol chewing gums instead of sugar candies. Care for your teeth they are precious.

Tuesday, April 15, 2014

What is Sialolithiasis –Definition, Pathogenesis, Clinical features, Treatment, Histopathology, Sialography.


Sialolithiasis


Definition- sialolithiasis is a pathological condition, characterized by the presence of one or more calcified stones (sialliths) within the salivary gland itself or within its duct.


Pthogenesis

The exact mechanism of formation of sialolith is not known. It is generally believed that initially a small and soft nidus forms within the salivary glands or its ducts due to some known reasons.


The nidus is made up of mucin, protiene acteria and desquamated epithelial cells.

Once a small nidus frms, it allows concentric lamellar crystallizations to occur due to the precipitation of calcium salts.


The sialolith increases in size with time as layer after layer o salts become deposited , just like growth rings in a tree.


Small sialoliths can be expelled in the mouth with the salivary secretions but bigger sialoliths continue to expand until a duct is completely closed.


It is important to note that the formation of sialolith is more common in relation to the submandibular gland and it’s duct.


Clinical features

Age- Sialolithiasis usually occurs among the middle aged adults, however, some cases are reported in children.

Sex- There is slight male predominance.

Sites- 70% in submandibular salivary gland and its ducts. Parotid gland is next


Clinical Presentation-

  • In many cases sialoliths do not produce any symptoms and are detected only on routine radiographic examination.
  • Chief complain ; intermittent pain, recurrent sumbandibular swelling, discomfort during meals.
  • Pain is drawing or stinging in mild cases but stabing and sharp in severe cases.
  • Stone in the duct can be palpated by bimanual palpation with both the fingers.
  • During examination the flow and clearness of the saliva should be checked.
  • Persistent swelling of the duct due to chronic obstruction by the sialolith eventually leads to chronic sclerosing sialadenitis.
  • Multiple stone or bilateral cases of sialolithiasis can also be seen.
  • Formation of fistulas, sinus tract, ulcerations in the area may develop in chronic cases.
  • Necrosis of gland acini and lobular fibrosis may occur which results in complete loss of secretion from the gland.
  • Parotid stones often cause firm swelling over the ramus of the mandible, the swelling over the ramus of the mandible, the swelling also increases during meals. 


How Sialolithiasis is diagnosed

  • Radilography of sialolithiasis
  • Submandibular sialolithiasis are easily detected by mandibular standard occlusal radiograohs which typically disclose the presence of calcification in the floor of the mouth.
  • Whn a sialolith is located in submandibular gland area then a lateral jaw radiograph will be helpful in location the exact position of the stone.
  • Panaromic radiographs usually detect the parotid gland stones.
  • If only branches of the submandibular gland duct are affected a posterior occlusal film submento vertex and some time a lateral jaw film may be required.


 Sialography of sialolithiasis

  • Sialogrohy refers to the method by which detection of salivary stones within the glad or its duct is done by giving a retrograde injection of a radiopaque dye within the  duct system and obtaining a radiograph thereafter in order to see the size and distribution of the sialolith.
  • Ultrasonograhy and CTscan
  • These are also excellent non invasive technique useful in detecting the sialoliths


Macroscopic appearance

  • On gross examination, sialoliths appear as round or oval rough or smooth solid masses, which vary considerably in their size.
  • These stones are heavily calcified and are often multi nodular although some stones are found in small aggregates.
  • The color of the stone is usually yellowish or yellowish white.

Tuesday, March 11, 2014

Cauliflower Like Growth in Mouth !

 

Cauliflower like growth in the mouth is commonly due to papilloma. It's a benign neoplastic growth which is usually not fatal.


Papilloma definition-  Papilloma is a common benign neoplasm arising from epithelial tissue of oral cavity and is characterized by an exophytic growth of the stratified squamous epithelium.

These lesions  constitute about 2% of all oral neoplasms and it is believed by many investigators that they are caused by the human papilloma virus.


Clinical features

Age: mostly third, fourth and fifth decade of life

Sex: Both sexes are equally affected.

Site: Tongue lips, buccal mucosa, gingiva, hard and soft palate.


Signs and symptoms: Clinical presentation

  • ‘Cauliflower like’growth which is slow growing exophytic and small, it is usually painless unless traumatized. 
  • It has several small finger-like projections on the surface.
  • Size is from millimeter to few centimeter in diameter.
  • The base is either pedunculated or broad based (sessile) but always well-circumscribed lesion.
  • Sometimes it may appear as ovoid swelling with the corrugated surface.
  • The surface of the papilloma is white because of the highly keratinized epithelium.
  • A non-keratinized lesion appears pinkish or grayish in color and it is softer in consistency.
  • Rarely an endophytic papilloma can be seen which grows inwardly.
  • Papillomatosis is a condition in which multiple papillomas are developed inside the mouth.


Histological feature


Proliferating stratified squamous epithelium in the form os multiple fingers like projections

Every single finger-like process has a vascular connective tissue core in cener which conatins few inflammatory cells.


Covered with squamous epithelium which shows hyperkeratosis. and acanthosis.

Although most of the papillary projections are long and finger like there can be small round and blunt projections.

Sometimes there may be a development of superficial ulcerations and secondary infection, because in the oral cavity these lesions are often subjected to trauma.


Differential diagnosis

  • Verruca Vulgaris
  • Focal dermal hyperplasia
  • Verruciform xanthoma
  • Verrucous carcinoma 
  • Fibro epithelial polyp.


Treatment

Surgical excision of the lesion including the base. Recurrence is rare.

What Is Laser Filling For Treating Tooth Cavity

 


Dental cavities are becoming inevitable and dental restorative procedures are become more advanced day

by day. Laser filling is one of such advancement.The most commonly used lasers in dentistry are ND- Yag laser, Helium Neon laser, Ruby Laser.


LASER stands for Light Amplification by Stimulated Emission of Radiation.


In simple language a laser filling is a restorative procedure in which the decayed portion of the tooth is removed with the help of specially designed dental laser and then it is restored with the help of tooth colored cosmetic filling.


Details: 

The objective of any kind of dental filling is same:- Remove the decay and restore the tooth in biocompatible

and functional manner. Laser filling also follow these basic steps.


Step one: Take an X ray of tooth and see that cavity should be small and it should not be close to the pulp (nerve) of the tooth.


Step two: Remove the carious lesion using dental laser. A water jet is continuously flowing while the laser is removing the decayed tooth material from the cavity. This kind of removal does not produce vibration or heat while removing the cavity hence patient comfort is good and easily achieved.


Step Three: After removing the decayed portion of the tooth the cavity is disinfected by using chlorhexidine gluconate  solution. Cavity is irrigated and dried for the filling.


Step Four: A biologically compatible restorative material like light cured GIC or Composite resin is used for filling and binding the prepared cavity. After placing and curing the restorative material normal anatomy and function of the tooth is restored.


Step Five: Occlusion is checked with the help of occlusal bite registration paper and high points are removed.


What are advantages of laser filling


No vibration because no use of drill or burs this makes it more comfortable and  easy for patient.

No Shot of anasthesia is required: Actually it depends upon the pain tolerance of the patients but in most cases no shot is required.

Fast: It really takes few minutes to complete the removal of caries and do the filling.


What are the drawbacks of laser filling


Can't be used in large cavities

Expensive

Can be performed by very few trained dentists ( Lack of availability)

Why Are My Teeth Getting Sensitive

 

Teeth getting sensitive means you are feeling sharp electric like pain on taking cold, sweet or sour food, this kind of pain is short in duration and it subside immediately after removal of stimuli.


If that is what you are experiencing then you are suffering from a clinical condition called as Dentin Hypersensitivity Or Sensitive Dentin.


Teeth crown is made up of outer Enamel layer (Don't have nerves), Dentin layer (have nerve ending in it) & Core of Pulp (nerves and blood vessels). Teeth root is made up of outer Cementum and then Dentin layer.


These enamel and cementum works as insulation to underling dentin from temperature and osmotic stimuli. So now you can figure it out that when ever enamel or cementum is damaged and dentin is expose people start to feel sensitivity while eating cold or sweet food.


Causes of Teeth getting sensitive:


Picture showing Causes of Sensitive Teeth 


Gingival recession or receding gums: This is most common cause of teeth sensitivity gums cover the root which intern is covered by the cementum. when gums recession occurs then root get exposed and by the time when cementum is removed from brushing then tooth become sensitive. Heavy brushing and periodontal disease are two causes or gum recession.


Tooth wear: This is second most common cause: As you know that wear and tear is a natural process but when this process occurs at high speed and your enamel is lost at fast speed then your teeth does not get time to perform any kind of protective mechanisms. Hence tooth become bad before time and you can experience tooth sensitivity. Example of tooth wear- Attrition from teeth to teeth contact ( physiologic), Abrasion ( tooth brush trauma- Pathologic), Abfraction ( combination of both), Erosion ( chemical damage from the acid erosion of the enamel from consuming excessive cold drinks, Gastro esophagial reflux and many more)


Dental decay: Yes decay can also cause teeth sensitivity as decay causes destruction of enamel it exposes the dentin and when ever cold or sweet food comes in contact with that decayed tooth patient may feel sharp pain. which subsides on removal of the stimuli.


Treatments: Depend upon the grade and cause of sensitivity.

Removal of cause and treatment of underlying pathology followed by Desensitizing toothpaste, Desensitizing gel & Professional Dental treatment will completely cure your sensitive Teeth.


You can Check These Desensitizing Tooth Pastes If you want one.

Monday, March 10, 2014

What is Hairy Tongue: Pathogenesis Clinical Features and Treatment


Definition Hairy tongue is an unusual condition which occurs due to hypertrophy of the filliform papilla of the tongue along with loss of normal desquamation process This eventually leads to the formation of a pigmented thick matted layer on the tongue surface heavily coated with bacteria and fungi.


Pathogenesis: Why hairy tongue occur 

Hairy tongue


Normally the keratinized surface layers of the tongue papillae are continuously desquamated thourg

friction of the tongue with food, rough palate and upper anterior teeth. After desquamation tongue papillae are replaced by newer epithelial cells from below.

Lack of tongue movement due to local or systemic disease disturb the regular shedding of the keratin of the tongue papilla especially the filliform papilla.which lengthens and produces a hairy appearance on tongue surface.


Such hypertrophic papillae are often coated with microorganisms and become discolored by retaining pigments from foods, medicines and chromogenic bacteria etc.


Clinical Features of hairy tongue how does it look

  • Hairy tongue commonly affects the mid dorsum of the tongue.
  • Hypertrophy of the filliform papilla produces a thick matted layer on the dorsal surface hairy tongue in extreme cases may produce a thick lathery layer coating on the tongue surface and this condition is often known as early or encrusted tongue.
  • Hypertrophied filliform papilla often brushes sfot palate and produces gagging reflex.
  • Hairy tongue in many cases produces bad breath.
  • There can be irritation to the tongue due to accumulation of food debris and microorganisms.
  • Hairy tongue is considered as mirror of general health. Because it is associated with various systemic disease.


Treatment of hairy tongue.

  • Cleaning and scraping of tongue everyday
  • Application of topical keratolytic agents
  • Consumption of yogurt
  • The effected tongue papilla often rapidly returns to normal when long term antibiotics or oterh drugs are discontinued.



Tuesday, March 4, 2014

What is a Dental Milling Machine

 

Dental Milling Machines are machines used to produce dental prosthesis like crowns and bridges and implant prosthesis by the process of computer added designing and computer added manufacturing process CAD CAM. As the name suggests dental prosthesis are made by milling a block of ceramic or zerconia or metal aloy into desired design.


Use of Dental milling machine have been introduced in 1980 but real use has started from 1990, in early days they have been cumbersome to use and too big to handle, this restricted its use to dental labs.

Dental Milling Machine


Components of Machine- Machine basically includes a Scanner, Computer and Milling Machine.


Scanner which scans the area of teeth and mouth on which prosthesis is going to be build. If scanner is


present at the chair side in a dental clinic then scanning can be done directly in mouth, if scanner is not present chair side then an impression is taken and model is prepared and then scanning is done on the dental model.


Computer and software do all the calculation and designing of the dental prosthesis. It takes the data from scanner and builds a 3 D picture of it then builds a prosthesis on that #D picture this data is then given to the milling machine so that it can start milling and start manufacturing the prosthesis.


Dental Milling Machine is a fitted with small heads which includes different kind of burs or milling points.

these are diamond coated heads of different shapes and designs made for different purposes of milling.


How is it different from older conventional dental crown and bridge prosthesis.

  • Dentist will first examine your mouth and diagnose the disease and problem.  
  • He will treat the defect by removing decay and treating infections by root canal treatment. 
  • In third step dentist will prepare the area for receiving prosthesis. 
  • He may take and impression for making model or he may directly scan the portion on which prosthesis is going o be made.
  • This dental model or scanned data is send to lab where it is feed to computer and then it makes a digital 3 D model of that scanning.
  • digital prosthesis is prepared on that 3D model and then this data is given to the milling machine. 
  • Milling machine prepares the exact replica of the 3D design.
  • This prosthesis is send back to dentist for checking and applying in patients mouth. 


Monday, March 3, 2014

What is a Dental Mirror Used For

 

Dental Mirror is a small round mirror placed on a handle with variable degree of angles to it. These mirrors can have different convergence like concave, flat or convex but mostly concave is used.


What is a dental mirror used for? 

There are three main uses of dental mirror by dentists.


1. Indirect vision- It is obvious to understand that there are lot's of areas in mouth where direct vision is not possible, Either dentist have to bend upside down or patient have to get fully supine and extend back which is very uncomfortable situation for both of them so mouth mirror will help. A dental student will learn dentistry by learning to work in indirect vision using mouth mirror or so called dental mirror, And they really deserve some respect.

What is a Dental Mirror Used For

Indirect Vision & Illumination with mouth mirror Img Via www.hu-friedy.com


2. Indirect Illumination- Same reason given above it is difficult to illuminate every deep and detailed areas of the mouth with dental chair light. So the dental mirror is used for illumination of the particular areas of mouth by reflected light from dental chairs light. Use of concave dental mirror really help in this kind of illumination.


3. Retraction- Retraction in dental surgery means retracting the surrounding tissue like tongue and cheek to expose the areas for proper vision and accessibility for instrumentation. Retraction of cheek and tongue is easy with help of dental mirror,  just place the mirror side of the mouth mirror toward the tissue and pull it away from the site of operation. As the mirror is smooth that is why patient don't feel irritation. A trained dentist will quickly switch between illumination, retraction and vision while doing a dental treatment. Again Respect For These Artists.


There are many ways for gripping and holding mouth mirrors like pen grasp, three finger grasp etc. but that is out of scope of this article, Various types of  mouth mirrors are present in the market today but No4 and No5 are used mostly with concave mirror on it.

So Now yo know What is a dental mirror used for Now share it with your friends using share buttons bellow

You can buy same kind of kit for cleaning your teeth from Amazon here.

Why Are My Teeth Getting Stained ?

 

Question- I go to my dentist regularly and get my oral prophylaxis & cleaning done in every 6 months, My teeth become pearly white after cleaning and their are no stains but they start getting stained in no time ! I can see visible stains after 3 weeks.Why are my teeth getting stained even when I brush properly.


Although teeth staining have multiple causes but the above case is a simple case of poor oral hygiene practice. I'm not saying that the person is not will to keep his teeth clean but he is actually practicing wrong oral hygiene techniques like not knowing proper brushing technique, not flossing and brushing only once in the morning.


Cause of teeth getting stained after scaling and cleaning:

Stained between teeth Img: www.smileartistry.com.au


After professional cleaning surface of your teeth become absolutely clean but as you start eating a soft Dental pellicle start to form on your teeth.It is a protein film that forms on the surface enamel by selective binding of glycoproteins from saliva.


When not cleaned and flossed properly oral bacteria start to make colonies on this pellicle layer and hence they for a layer called as Plaque. This plaque can take the colors of foods and beverages your consume and it looks like a staining on your tooth.when you get your teeth scaled and cleaned at the dentist he removes this plaque. When people does not get this Plaque cleaned and it keep on accumulating it becomes Calculus which is a calcified structure.


Tea Or Coffee: Tea Or coffee contains such kind of plant extracts that have very high tendency of sticking as stains on your teeth. No matter what type pf tooth paste you use, no matter what type of brushing you do, if you are consuming tea or coffee more then once a day every day in a year then your teeth will catch stain.Either get a professional cleaning or change your habit.


Smoking: Tobacco smoke contains nicotine and tar these two ingredients are the main culprit for the smoking stains. tar has a black staining and nicotine has a yellowish staining property. So a smoker will have a blackish and line at the junction of the gums and tooth and yellowish hue on the teeth. Leave the habit, Get your teeth cleaned.


Red Wine- Red wine is made up of grapes which have natural colors these natural colors will bind with the tooth surface and result in teeth staining, but this process is low and mild and occurs to them who consume red wine regularly.


Some Cold drinks and Energy drinks: Cold drinks and energy drinks have coloring agents in them. These agents can deposit on the plaque of the tooth and then get solidify.


Some berries and veggies: I really don't think that veggies should be blamed for the staining of teeth but clinically it have been seen that there are some berries and veggies which have colored juices in them which can stick to the plaque and impart


Solution to Get Rid of Repeated Teeth Staining

Avoid stain producing habits and food.

Brush twice a day with correct brushing technique.

Use floss once a day.

Use inter dental brush to clean gaps between teeth.

Get oral prophylaxis done every 6 months.

Keep oral hygiene good.

What is The Blue Light Dentist Use : Is It Harmful ?

 

What is The Blue Light Dentist Use : Is It Harmful ?

So you have been to the dentist and you saw a wand like thing in dentists hand which he puts in patients mouth then it emits bright blue light with sound of beep !

No need to wonder what is that blue light emitting thing in dentists office.

 I'll Explain what is it, how it works and is there any chance of harm from it.

Blue light that dentists use is called as curing light.


How does blue curing light works ?

Image Via : Wikimedia.orgIt is a gun like machine which have electronic parts inside it. The source of current is the regular 220 volt AC current but a chip inside the machine converts it into much lower DC current and then it supplies it to the light emitting source.( Some guns are battery operated)


The light emitting source is a Quartz Halogen Or LED ( Light emitting diode) attached to the head of the gun. LED bulb have the capacity to produce high intensity of light with very effective use of electricity with least heat production as compared to other bulbs. hence a LED is used. (Don't miss judge it with lasers or any other thing) .


To make an angulated head a fiber optic cable is fitted at the head ahead of the LED bulb, this fiber optic cable can carry light to the head even when angulated at various angles.


Why is the dental curing light blue in color ?

It is mostly blue in color because the light is of longer wavelength which helps in deeper penetration of the light for better curing of the material. The wave length of the light may range from 370 to 510 nm. This light falls in blue spectrum of the VIBGYOR.


What is the blue curing light used for ?

This light is used for setting light activated filling materials.

In Technical Terms- There are dental restorative materials which come in semi solid or powder liquid form when mixed and packed into the cavity they get activated and start setting. Some material are photosensitive- That means setting reaction is initiated after light exposure. Blue curing light is used to cure this kind of dental materials.


Is the blue light harmful ?

No it's not harmful for the tissues inside your mouth or other skin or mucosal tissue, BUT it should never be directed to the eye or in other words you should not look directly into the light, because it have so much of intensity that it may harm retina of eye.


What is a orange colored shield ?

Due to the above cause there is a light barrier or orange color which dampens the light intensity if the operator is working and want to see the field of work.  For patients a orange colored glass will be given, if not given you should better keep your eyes closed.

Wednesday, February 12, 2014

What is Oral Prophylaxis ? Is It Necessary Every 6 Months


What is Oral prophylaxis


Oral prophylaxis in simple words is nothing but a dental procedure by which your dentist or hygienist will clean your teeth using a hand instruments or ultrasonic scaler.

No matter how good you are at cleaning your teeth there is some amount of deposit always left between your teeth and at gum line, this deposits are soft in early stage and called as plaque, as the time advances and cleaning is neglected these soft plaque will change into hard tarter (calculus) which becomes difficult to remove even by brushing. This plaque and calculus give rise to periodontitis and gingivitis (gum infections)


Oral prophylaxis is a preventive procedure with an aim to remove these plaque and calculus so that you should not suffer from any kind of gum infection.


Other benefits of oral prophylaxis- If a patient regularly visits a dentist and get oral prophylaxis done on regular basis then chances of having tooth decay and tooth ache is very less. Why ?


Simple reason; as you will visit your dentist in every six month and get prophylaxis done your dentist will thoroughly check and examine your mouth. If he find out a small cavity he will fill it right at that moment. Usually it takes 6 month for a cavity to form and start bothering you so you can avoid it by visiting your dentist every six months and get oral prophylaxis done.


Other conditions before which you may be advised for oral prophylaxis

  • Before orthodontic treatment - because it's better to start the treatment with cleaner teeth. The brackets will bond properly and chances of perodontitis and gingivitis in during the course of treatment will reduce dramatically.
  • Before any kind of bridge or implant  - Because of the above reason and to reduce the failure rate of the procedure and by plaque and calculus contamination.
  • Before cancer radiation therapy - To reduce the chances or caries and gum infections during radiation therapy of head and neck region. 
  • Before cosmetic dental procedures-  procedures like composite bonding and bleaching will demand a oral prophylaxis before any kind of cosmetic treatment.

How is oral prophylaxis done


  • You will be asked to sit back and relax on the dental chair, If it's your first visit then your dentist will take a detailed medical history of yours. 
  • Dentist will examine your mouth and look for signs of periodontal pockets and gum infections.
  • An ultrasonic scaler will be used to clean your teeth ( it's a hand held devices with a hand piece and pointy tip. 
  • It ejects pressurized water and the tip vibrates in order to remove the plaque and calculus from the teeth surface.)
  • Tricky spots and difficult to reach areas will be cleaned with hand instruments.
  • You will be notified about any cavity of gum problems.

Prophy paste : Image Via :www.zahnarzt-tomovic.de

  • In the end a prophylaxis pasted will be used for polishing the tooth surface. ( a miniature rubber cup is fitted over a hand piece and small amount of prophy paste will be applied on the cup and your teeth will be polished.

  • If done properly it's a painless procedure.
  • Ta Da! you are done and good to go home. Say bye bye to cavities. Thanks to Oral Prophylaxis 
  • Don't forget to get it done every six month if your are not good at brushing and flossing.


 

Tuesday, February 4, 2014

What is Aglossia , Microglossia & Macroglossia

 

Aglossia

Aglossia is an extremely rare congenital defect characterized complete absence of the tongue. This condition is usually associated with other serious developmental defects in the body.


Microglossia 

Microglossia is another rare congenital anamoly in which only a tiny or rudementry tongue has

developed from the cupola. Although microglassias may develop as isolated cases but in most of the cases they occur in association with other anomalies  like oromandibular limb hypogenesis syndrome or hypoglassia- hypodactylia syndrome etc.


Microglassia without limb deformity can occur but they are also associated with some other birth defects such as partial anodontia, sublingual gland hypertrophy and dextrocadia etc.

For obvious reasons patients with microglossia often have severe speech difficulties as well as difficulty in taking food.

As size of the tongue often determines the growth and size of the mandibular arch in case of microglossia the length of the mandibular arch will be smaller due to the smaller size of tongue.


Macroglossia 

Macroglassia is relatively common condition characterized by an increase in the size of tongue.

Macroglossia can be either congenital or acquired in nature


Causes of congenital macroglassia

• Overdevelopment of the tongue musculature

• Lysosomal storage disease

          Hurler syndrome

          Hunters syndrome

          Marteaux-Lamy syndrome

• Downs syndrome

• Beckwith’s hypoglycemic syndrome

• Multiple endocrine neoplasia syndrome


What is relative macroglossia ?

Relative macroglossia is a condition in which a normal size tongue appears to be large. It Is particularly inclosed in small oral cavity. It happens in case of maxxilary retrution or restricted naso pharynx.


What is Apparent Macroglossia ?

Apparent macroglossia I a condition where the tongue appears abnormally large due to poor muscular control of tongue. Although there is no real increase in the bulk of the tongue tissue. Apparent macroglossia is seen in cretinism and happy puppet syndrome.


What Is Pulp Polyp & What Is Treatment of Chronic hyperlpastic pulpitis or proliferative pulpitis

 

Question: I have a soft mass in my tooth cavity which bleeds on touching or eating. The suggested symptoms are of pulp polyp .


Pulp polyp is an unusual type of hyperplastic granulation tissue response in the pulp which is characterized by an overgrowth of the tissue outside the boundary of the pulp chamber as protruding mass.


Clinical Features of pulp polyp

  • Pulp polyp clinically appears as a small pinkish-red lobulated mass which protrudes from the pulp chamber and often fills up the carious cavity.
  • The teeth in which pulp polyp commonly develops are the deciduous molar and first permanent molars.
  • The condition is obviously seen in either children or young adults.
  • The affected tooth  always have large open carious cavity , which is present for a long duration.
  • The pulp polyp bleeds profusely upon provocation.
  • If traumatized the pulp polyp becomes ulcerated and appears as dark red, fleshy mass with fibrinous exudates on the surface.
  • The involved tooth is usually painless.
  • Treatment of Pulp polyp, How to treat it
  • Treatment is done either by root canal treatment or by extraction of the affected tooth.


 Pathogenesis: How any Why does pulp polyp occurs

  • Pulp polyp exhibits an intense proliferation of the pulpal connective tissue and this type of hyperplastic tissue growth depends on several factors, which are as follows:
  • Persistence of balance between injurious  agents and tissue resistance.
  • Presence of low grade sustained inflammation.
  • Pulp tissue should be well vascularized with excellent tissue reactivityThe carious cavity should be young with good body resistance.
  • If all these factors are favourable then a tooth with chronic pulpitis may progress further to develop into chronic hyperplastic pulpitis.
  • However the incidence rate is quite low.


What is Cementoma : Periapical cemental dysplasia signs and symptom, clinical features, radiological feature & histopathlogy

 

Cementoma is a relatively uncommon odontogenic neoplasm, occurring in relation to the periapical bone and cementum at the root apex.


Clinical features

Age- Usually third and forth decade of life

Sex- females are affected far more commonly

Site- Mostly in relation to mandibular anterior teeth, maxillary teeth are also affected in some cases.


Clinical presentation

The lesions are mostly asymptomatic and are detected only during routine dental xarays. These are small and multiple in number and associated teeth are always vital.


Cementoma Radiology

The radiographic  appearance of cementoma varies in different stages of the disease.

In initial osteolytic stage the lesion presents a small well defined radiolucent area near the apex of the involved tooth. The radiolucency s always found to be in continuation with periodontal ligament space.

In the second or cementoblastic stage the lesion appears as a small radiopaque foci.

In the third or the mature stage cementoma is seen as well defined radio opaque mass surrounded by thin radiolucent area.


Cementoma Treatment

No treatment is required or cementoma periodic observation and time to time vitality test of the involved teeth are to be done.



How Do Dentist Fix Cavities: A Complete Patient Guide

 

What is a tooth cavity?

Tooth cavity is a form of infectious disease in which oral bacteria causes the decomposition of left over food debris and this decomposition raises the local ph hence the tooth loses it calcium and minerals from its surface. This eventually results in cavity formation at that point. which increases the food logdment and this vicious cycle goes on until full destruction and infection.


How do dentist fix cavities ?

Step 1 You will be ask about your main complain  which is usually food lodgment without pain.

Step 2 Dentist will take an xary of that particular tooth. Because a small looking cavity may be deep and penetrating inside the tooth. Distance of cavity and decay from he nerve of th tooth is accessed because this will determine what kind of tooth filling can be used to fix the cavity

Step 3 Dentist will discuss about the procedure and kind of tooth filing which can be used in your tooth.

Step 4 If tooth cavity is of moderate depth no anesthesia is required.

Step 5 Dentist will use his drill to remove the decayed portion from the cavity. It literally mans drilling and grinding your tooth to remove the decayed and diseased portion of the tooth.

Step 6 After completely removing the decayed portion of the teeth dentist will isolate the area with cotton rolls to keep it dry during filling.

Step 7 A pulp protecting base filling can be done if your decay was close enough to the pulp (nerve of tooth)

Step 8 Cavity will be filled and condensed with  good quality silver filling or white colored glass ionomer filling or a cosmetic composite filling. What ever you and your dentist choses.

Step 9 Your dentist will keep an occlusal registration paper over your restored tooth and he will ask you to bite on it. This will give him idea about high points. He may ask you that – are you feeling high points on biting in that tooth? Then he will adjust and correct the occlusion of that tooth.

Step 10 Dental assistant will give you Instructions after tooth filling – Not to bite on that tooth for 12 hours after that you can start eating from that side.


Note : If your cavity was deep enough to infect or affect the pulp of the tooth then your dentist may suggest you root canal treatment and capping with that tooth.

Monday, February 3, 2014

What is Aerodontalgia , Barodontalgia or Tooth Squeez

 

Some people may feel pain in there tooth during high altitude flight or deep sea diving (scuba diving) These condition is called as  Aerodontalgia, Barodontaligia or tooth squeez. it  is an unusual type of dental pain which occurs as an effect of change in the altitude.


Barodontaligia: Baro- pressure, Donto- Teeth, Algia- Pain


Most of the time it is seen in military pilots because of rapid changes.In pilots, barodontalgia may be severe enough to cause premature cessation of flights.

Barodontalgia is a symptom of dental disease, for example inflammatory cyst in the mandible.Indeed, most of the common oral pathologies have been reported as possible sources of barodontalgia: dental caries, defective tooth restoration, pulpitis, pulp necrosis, apical periodontitis, periodontal pockets, impacted teeth, and mucous retention cysts. One exception is barodontalgia manifested as referred pain from barosinusitis or barotitis-media. The latter two conditions are generated from pressure changes rather than pressure-related flare-up of pre-existing conditions


Clinical features of Aerodontalgia, Barodontalgia or Tooth Squeez



Barodontalgia Mechanism Via Wikipedia

  • Aerodontalgia affects some person who experience pain in the tooth during high altitude flight or during deep sea diving. 
  • At ground level the tooth is completely asymptomatic.
  • In some cases the pain may not start readily during flight or during diving, instead it may occur few hours or days later.
  • The condition may be related to subclinical pulpitis.
  • Sometimes similar problem may happen in an endodontically treated tooth with improperobturation of the canal. The entrapped air in an improperly obturated canal may expand during flight or driving due to alteration in atmospheric pressure. This applies pressure in periapical nerve bundle and produce pain.

Wednesday, January 15, 2014

How Do Dentist Put You To Sleep In Dental Office


Are you afraid of the dental treatment? Are you planning go for sleep dentistry? Then this article will give you all information about how do dentist put you to sleep in dental office?


What is sleep dentistry?

Actually sleep dentistry is a misnomer because the patient will be sedated rather then sleep. This means that you will be in a state of relaxation and you brain will not respond in the way it responded for the dental phobia prior to sedation.

It's actual name is sedation dentistry. Only way to make a patient completely sleep is general anesthesia which is an uncommon option for general dental treatments.


How do dentist put you to sleep

Their are three pharmacological ways to sedate a patient or to make him half sleep in laymen term.

  1. Inhalation Sedation (Nitrous oxide sedation)
  2. Oral Sedation - Anti-Anxiety Tablets
  3. IV (Intravenous) Sedation Inhalation


Sedation (Nitrous oxide sedation)

Nitrous oxide was discoverd by Humphrey Davy in1772 people first come to know the euphoric and pain reduction capacities of the nitrous oxide by the self experiment of the Humphrey Davy during tooth ache.

In dental office a mixture of 70% Oxigen and 30 nitours oxide is used.

Patient is asked to breath through a mask which supply the mixture.

After 5 to 8 breathing patients start to feel the euphoria like state in which they feel happy! Some patients have also felt giggles (hence laughing gas).

This state of sedation and euphoria allows the dentist to work easily and allows the patient to feel relaxed and calm.

More about Sedation dentistry


Oral Sedation - Anti-Anxiety Tablets

Oral sedation as the name suggests is all about pills that can be used to relax and calm down the patient. It is prescribed to patient before the surgery and you will be asked to take it a night before the surgery or few hours before the surgery.


Most commonly used Oral sedation drug in dentistry is benzodiazepine you may have heard the name Valium or Ativan

There can be two types of the oral sedative agents- 


Sedative hypnotic: Which calm you down and make you feel like sleep


Anti Anxiety: These agents will make yo feel calm and less anxious during the treatment.


Warning! you should not drive vehicle when you are taking these drugs.


Read more about Anti Anxiety Pills


IV (Intravenous) Sedation 

A drug which comes from the anti anxiety family will be used to make you calm and sleepy during treatment.

Mode of administration is Intra venous ie. A needle will be inserted in your veins to give a continuous but controlled supply of the sedative drug.

Effect is profound and controlled but it should be done by a trained and certified person.

Read more about IV Sedation 


How does it feel like when you are in sleep?

Different patient have different experience some feel calm and relaxed, some feel euphoria, some feel half sleep or twilight sleep, some feel tingling sensationg in body. One patient even said he wanted to stay at dentist.

It is point to be noted that complete sleep anesthesia or general anesthesia is rarely used for general dental surgical treatments.