PATIENT EDUCATION


HISTORY TAKING AND GENERAL EXAMINATIONS


As patients we always wonder why the dentist always starts off, asking questions regarding general health and medical problems, rather than directly treat the problem we present with. Question regarding blood pressure, diabetes, prior hospitalization, drugs consumed etc, may sound irrelevant or, if not frightening to us. However this does carry a great deal of significance to the dentist. Correct information regarding our general health is an important factor determining the success of any dental treatment.
Mentioned below is the relevance of a few common medical conditions prevalent among the Indian population, to dental treatment.

Increased Blood Pressure or Hypertension:

   High blood pressure or Hypertension is a condition where the pressure exerted by the flowing blood against the blood vessels is more than the normal range. The normal range for a young patient in 120/80 can increase to 160/90 age advances. Any Blood pressure recorded beyond 160/90 is considered as hypertension. In a patient with high Blood pressure dental surgical procedure which an acceptable amount of bleeding such as tooth removal or gum surgeries can result in increased and uncontrollable bleeding. The amount of bleeding can be frightening to the patient.

To avoid such a situation the patient should religiously control his or her Blood pressure before visiting a dentist for any treatment.

Diabetes mellitus:

It is a common condition seen among middle aged and the older population. Wound created by a dental procedure such as tooth removal in a patient having increased blood sugar, carries an increased risk of infection as well as longer period of wound healing. This can result in pain & discomfort for quite a long period following the procedure. Therefore it a vital to control our blood sugar levels if it is high.

Jaundice:

Any damage to the liver and its related structures, or its functions will show the symptoms of jaundice. Unhealthy liver poses two problems, which concern dental treatment.

There is failure in the breakdown and removal of the drugs taken, before during and after the procedure. This results in poisoning of the body due to increased circulation of the drugs in the system.

Liver produces certain substance, which help in the normal clotting of blood. Thus damage to the liver can also result in increased bleeding.

Therefore it is essential to test the normal functioning of the liver following an episode of jaundice to avoid the above mentioned complication.

Drug Allergies:

Allergic reaction to any drug should be mentioned to the dentist well in advance. Allergic reaction can range anywhere from a simple rash on the body to loss of life within a few minutes after the intake of the drug. If the patient has any fear regarding the medication, allergy tests can be taken to confirm their fear.

Disorder relating to the heart:

 Heart problems such as heart valve disorder, birth defect in the heart, heart attacks etc needs to be seriously evaluated before taking up any dental procedure, which involves bleeding.
For e.g. Dental treatment particularly tooth removal will have to be postponed for a period of six months following an episode of heart attack. The stress experienced during a dental treatment in such a patient is sufficient to trigger off another attack on the dental chair.

The other medical problems other than above mentioned conditions are, Bleeding disorder, Epilepsy, Asthma, Ulcer, Tuberculosis, HIV, Hepatitis, hormonal disorders, Transplants etc.
 
To make a dental treatment safe and comfortable it is absolutely necessary to render full co-operation when questions regarding medical history is put forth .It is our duty to patiently comply to the physical examination and tests requested by a dentist.

IMPORTANCE OF ORAL EXAMINATIONS:

Complete examination of the mouth and the structures present within is a must once every 6 months. When a dentist examines the oral cavity he systematically covers all the structures. He looks for any changes in the size, shape, color & texture of the tissue. Picking up these changes early can at times save our lives.
For eg. Oral Cancer, which develops due to persistent smoking and pan chewing shows change in the inner check, tongue and the gums much earlier than the actual lesion. These changes if picked up early can be treated and restored to normalcy there by preventing the disfiguring and life threatening lesion which is bound to follow.

Similarly, measles can be spotted much earlier by a dentist rather than by a physician. This is because of the small spots or boils called koplik spots, which develop a couple of weeks in advance on the inner cheek.
 
So the next time you visit a dentist allow, him/her to examine the oral cavity completely. 


ROOT CANAL TREATMENT OF MILK TOOTH



Is Root Canal Treatment of Milk Tooth necessary?

There was a time when countless milk teeth were extracted stating that they are just "temporary tooth" or "milk teeth know ,anyhow it is going to fall" and for so many other reasons. But the milk teeth are there for a specific purpose. Each and every milk teeth has to stay for a particular period of time. The change in dietary habits have resulted in a lot of milk teeth getting decayed at an earlier stage than before. These milk teeth have to be preserved whenever possible. They are the natural SPACE MAINTAINERS which are there to preserve the space for permanent teeth. Whenever a milk tooth is decayed badly, where a normal filling cannot be placed root canal treatment has to be considered before removal of tooth is considered.

How many sittings it will require to perform root canal treatment for a milk tooth?

It can be performed in single as well as multiple sittings. The pediatric dentist will decide the best method depending upon the situation.

Is the procedure painful?

No, it is not painful. If necessary the pediatric dentist can anesthetize the tooth and carry out the procedure.

Is the procedure painful?

No, it is not painful. If necessary the pediatric dentist can anesthetize the tooth and carry out the procedure.

After root canal treatment will the milk tooth will fall on its own?

Yes, after root canal treatment the tooth is almost like a natural tooth. It will fall on its own.

After root canal treatment is follow up necessary?

Yes, after root canal treatment the tooth has to be monitored atleast once in every six months.

Is there any way to prevent this?

Yes, and the only way is to detect tooth decay early and treat it. If we detect tooth decay early we can save the tooth by a normal filling. It is better not to wait until pain develops, because once pain develops then preserving the tooth needs extensive treatment like root canal treatment. Hence it is always better to start the FIRST DENTAL VISIT when the first milk tooth erupts into the mouth (between 8-12 months of age). If the first dental visit has taken place at this stage one can completely prevent tooth decay if the parents strictly follow the pediatric dentists instructions.




ROOT CANAL TREATMENT




What is a Root Canal?

To know about a root canal we have to understand the basic structure of the tooth.

The portion of the tooth seen in the oral cavity is called the crown of the tooth and portion which is anchored within the jaw bone is called the root. Depending on the size location and function a tooth may have one or more roots. The tooth has this inner core of soft tissue called pulp. The pulp comprises of all the nerves and blood vessels, which keep the tooth alive. In the crown, the pulp is present within a chamber called pulp chamber and it extends into the root via a narrow tapering canal called root canal. The blood vessels and nerves, which travel through this canal, leave the tooth through a small opening present in the lower end of the tooth ultimately joining with the other major blood vessels and nerves running within the jawbone.

How does the pulp get infected?

Sometimes the pulp inside your tooth becomes inflamed or infected. This can be caused by deep decay, repeated dental procedures on the tooth, a crack or chip in the tooth, or a blow to the tooth .The most common cause is tooth decay.

What happens when a pulp gets infected?

Tooth decay if left untreated spreads into the substance of the tooth ultimately infecting the pulp. Once the pulp becomes infected with more bacteria than it can handle, it begins to degenerate. As with any infection there is formation of pus, which tends to get accumulated at the tip of the roots within the jawbone, forming a "pus-pocket" called an abscess. This abscess not only causes pain and swelling but also affects the jawbone. 

   
What is a root canal treatment?

Root canal is the treatment in which the infected pulp is removed from the tooth and the space occupied by it is cleaned and filled with a special filling material. Even though the pulp has been removed from the inside of the tooth, the tooth is still embedded in a living jaw structure. The root canal tooth will not feel hot or cold. However the tooth would still retain normal sensation to touch or pressure.

Why is a root canal treatment done?

For years, teeth with diseased or injured pulps were removed to prevent or to treat the consequences mentioned above. Today, root canal treatment has given dentists a safe way to save teeth. Based on the results obtained so far it is safe to say that more than 90% of endodontic cases respond to root canal treatment. If carried out.

How is the root canal treatment done?

Contrary to popular belief root canal treatment is not painful .It is carried out under local anesthesia which makes the tooth numb. Only after the dentist has confirmed that the patient has no pain will he /she begin the treatment. The duration of the treatment depends on the amount of infection present. The treatment can be completed in a single appointment or may require more than three appointments.

Root canal treatment has three steps:

1. Access opening: This is the first step where an opening is created in order to reach the infected pulp area using a dental drill. After the access is gained, the infected contents of the pulp chamber are carefully removed using special instruments. An anterior tooth has only root where as a posterior tooth may have more than three roots. There fore it is necessary to remove the infected pulp from all the root canals present in a single tooth.

2. Biomechanical preparation: In this step the hollow space which once contained the infected pulp is cleaned and shaped. Cleaning is usually done with the help of saline water and thin dental files. These files are moved along the surface of the root canal making it large and smooth. This procedure not only removes traces of bacteria from the root canal, but also makes the root canal more receptive to the filling that is to follow.

3. Obturation: Once the canals have been cleaned with the files, the canals are filled with a special filling material. The purpose of this filling material is to seal the canals and prevent future infections inside the tooth.



DIET AND DENTAL HEALTH



The prevention of dental decay begins with cutting down the amount of sugars taken in all forms. Most people think we refer only to sweets as the culprits. But there are other dangerous sugar-containing foods as well

Some of them are:

1. All sugars (including honey)
2. Soft drinks such as colas and
   lemonades
3. Nearly all cereals
4. Cakes, biscuits and puddings.
5. Jam on your bread, marmalade on your toast.
6. Chocolates, sweets and toffees.
7. Peppermint sweets (they are the most dangerous because people believe the peppermint taste to be  ‘medicinal’. These sweets are almost pure sugar).
As has been shown already, both dental caries and periodontal disease are the result of bacterial action, in the plaque, which collects on the teeth and gums.

A chocolate candy bar of about 50 grams may contain the equivalent of ten teaspoons of sugar! A slice of two-layer chocolate cake may be the equivalent of fifteen teaspoons of sugar!

These sugars are not an essential part of a normal diet. Hence reducing the total intake, will not only benefit the teeth, but also the general health. However, it is the frequency of sugar intake, more than the total consumption, which is important in influencing tooth decay. It was shown that the acid formed on the tooth in seconds from sugar might take twenty minutes or more to disappear from the mouth. Thus, small sugary snacks every two or three hours throughout the day will keep the teeth bathed in a dangerous acid state.

If Children must have sweets, they should have them only once a day (preferably during meal time). But it is better to recommend sugar-free snacks. A good list would contain:

Fruits:          Apples, Oranges, Pears, Bananas
Vegetables: Carrots, Celery, Tomatoes, Lettuce, Cucumber, also Nuts, Crisps, Cheese (in cubes), Eggs, Milk, Yogurt.

In this way if we eliminate sugar, we reduce the formation of plaque by  depriving the bacteria of the food, from which they form the acid.

The damage by erosion that, say, lemon juice can do to the enamel will have to be seen to be believed, So avoid frequent tooth contact with lemons, grapefruit, vinegar and other strongly acid substances.

The chemist’s shop may also be a source of danger to the teeth, many cough and throat sweets, lozenges, syrups, and elixirs are loaded with sugar, sometimes up to 50-60 percent. This is to make the product palatable.
 

BAD BREATH



Many people worry about bad breath, either their own or someone else’s. The advertising media have made much of the social stigma arising from ‘offensive breath’ to their own advantage. Bad breath or halitosis may indicate a dental problem, but this may not always be the case. 

CAUSES
 

The odour may be caused by factors in the mouth or by changes occurring in other parts of the body. 


Local factors: 
· Decaying food particles on or between the teeth 
· A coated tongue covered by growing microorganism. 
· Unclean dentures 
· Smell of tobacco 
· Alcohol 
· Gum diseases with pus production involved 
· Healing wounds after a surgery or extraction


Causes arising away from the mouth: 
· Head cold with infected nasal air passages 
· Acute inflammation of air spaces present within the facial  
  bones (often filled with a great deal of pus ) 
· Tonsillitis. 
· Many waste products are broken down from food and drink 
  are excreted through the lungs and this applies to alcoholic 
  drinks as well as pungent foods like onion, garlic etc. 
· Diabetes in which the patient has a sweet acetone breath. 


Bad breath is not a disease; it is rather a symptom, which indicates the presence of disease either within the mouth or away from the mouth. Odours, which may appear unpleasant to many, may not be the same to some e.g. People in the Mediterranean area are accustomed to the  scent of garlic, a scent which many people around the world find obnoxious.



Bad breath, or halitosis, is a very common oral health problem. People of any age may have halitosis, including:


Those who practice poor dental hygiene. 


The elderly, disabled people and young children, who find dental hygiene difficult. 


People who use mouth appliances, like dental braces and dentures. 


Smokers are more prone to halitosis and periodontal disease (another contributor to bad breath). 


People with certain medical conditions, including tooth decay, impacted teeth, abscessed teeth, periodontal disease, alcoholism, uncontrolled diabetes, kidney & liver disease, digestive disorders, sinusitis, throat and lung infections (such as bronchitis), post-nasal drip, allergies and dry mouth. Dry mouth may result from a high-protein diet, non-fibrous diet or medical condition. 


People on certain medications, including certain vitamin supplements, antihistamines, calcium blockers, cardiac medications, blood pressure pharmaceuticals and psychiatric drugs. These substances can inhibit saliva flow or produce dry mouth, which may lead to halitosis. Dry mouth may also lead to excessive thirst and tooth decay – a good foundation for halitosis once again. 


Poor dieters who are dehydrated because of certain foods they eat may have bad breath. Foods that contribute to halitosis include diet soda, onions, spices, garlic, curry, cabbage and coffee. High-protein food debris lodged between the teeth can produce halitosis as well. 


Bacterial Origins of Bad Breath


Researchers have determined that bad breath typically begins when the waste produced by bacteria in the mouth, nose or stomach comes into contact with the air. 


There are numerous nasal triggers for bad breath. Nasal dysfunction, including a genetic abnormality in the nasal passage, may inhibit proper mucus flow. The bacteria found in sinusitis, post-nasal drip and allergies may pass from the nose to the back of the tongue where it can lie dormant due to improper saliva flow or poor dental hygiene. 


When bacterial plaque is not removed from the teeth, the gums or between the teeth, it continues to grow and ultimately may lead to halitosis, tooth decay and gum disease. 




DENTAL IMPLANTS FAQs


What are dental implants?

Implants are manmade substitutes for lost natural teeth. These are titanium metal rods placed into the jaw bone to support a replacement tooth. This acts like the root of a natural tooth. Implants can also be used to support fixed bridges or dentures.

Implant treatment normally has two stages. First, the implant is placed in the jaw. Then, when the gum has healed, replacement teeth are attached to the implant. In some situations it is possible for temporary teeth to be attached to an implant at the time of fitting.

Would implants be right for me?

First, you should decide whether implants could be right for you. Contact us to arrange an implant consultation and discussion and we will let you know the treatment options.

Are implants safe? How long will they last?

Implants are a well-established, tried-and-tested treatment. 90 per cent of modern implants last for at least 15 years.

I have some of my own teeth. Can I still have implants?

Yes. You can have any number of teeth replaced with implants - from one single tooth to a complete set.

Can implants always be used to replace missing teeth?

It depends on the state of the bone in your jaw. Your dentist will arrange for a special radiograph to assess the amount of bone still there. If there is not enough, or if it isn't healthy enough, grafting or placing of bone may be required prior to placing implants in that area first.

Do implants hurt?

Placing the implants requires a small operation. This will be carried out under local anaesthesia itself- the same that is given for removal of teeth. You will not feel any pain at the time, but you may feel some discomfort during the week following the surgery. This is usually due to having stitches in place, and the normal healing process which is relived by the medication prescribed.

Can I have the new teeth straight away?

No. The implants need to bond (integrate) with the bone after they have been placed. This takes at least 3 months in the lower jaw and 6 months in the upper jaw. If you are having one, two or three teeth replaced, you will have a temporary restoration in the meantime. If you have complete dentures, then you can wear them throughout the healing period once they have been adjusted after the surgery.

How long does treatment take?

It takes up to 6 months from the initial assessment to the time when the artificial teeth or dentures are finally attached to the implants. However, if only the lower jaw is involved then it may only take around 5 months.

A lot depends on how complicated your treatment is. Your dentist will be able to give you a timetable once the surgery has been done. In the meantime however, immediate loading teeth or temporary crowns are placed.

Are the teeth difficult to clean?

Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, you'll be shown methods to help keep your implant area clean and healthy.

If I had gum disease when I had my own teeth, will I get it with the teeth attached to the implants?

Only if you don't care for them well enough. If you keep them clean, then you should not have any problems.

Can I take the teeth out if they are fixed to implants?

Most artificial teeth attached to implants can only be placed and removed by the dentist. However, if you have complete dentures fixed to the implants by bars, then you'll be able to take them out for cleaning.

Do I have an implant for each missing tooth?

No, unless you're only having a single tooth replaced. Normally, four to six implants are used to replace all the teeth in one jaw, as each implant can usually support two teeth. For a few missing teeth, two or three implants may be sufficient.

What happens if the implant does not bond (integrate) with the bone?

This happens very rarely. If the implant becomes loose during the healing period or just after, then it is easily removed and healing takes place in the normal way. Once the jaw has healed, another implant can be placed there. Or, the dentist can make a bridge, using the implanted false teeth that have 'taken'.

Is the treatment expensive?

Unfortunately, yes. However, in many situations, the cost of the treatment is only a little more than the cost of more conventional treatment with crowns and bridges.

There are advantages to it, too. An implant to replace a single tooth avoids the need to cut down the teeth either side for crowns to support a bridge. Also the implants serve a lifetime and not only till your adjacent teeth remain healthy like in bridges. Moreover, with age as all other teeth are lost, the implants already present can be used to provide fixed complete dentures. Normal dentures often mean you can't eat or speak well, due to the dentures moving about. But teeth attached to an implant don't cause this problem. Also, the implants integrate into bone preventing bone loss unlike crowns and bridges, thus delaying the signs of aging.

WISDOM TOOTH REMOVAL


Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth. Wisdom teeth are the four permanent adult teeth located at the back corners of your mouth on the top and bottom. These teeth are considered as the hardest ones.



Wisdom extraction may be done for several reasons. The wisdom teeth may come in creating an issue for surrounding teeth pushing them out of the way or dispositioning . This can cause a type of domino effect with the rest of the teeth in the mouth including making the front teeth appear very crowded. This is one reason that extraction may be elected. Additionally, the wisdom teeth can do damage to the surrounding gums given how they come in. They could tear the gum and cause sores. This could ultimately lead to infection of the gum, tooth and/or jaw. An abscess may occur needing the tooth to be removed.

The wisdom teeth extraction procedure usually involves an incision to open the gum, and sometimes a small portion of the bone may need to be removed to provide access for the wisdom teeth removal. The wisdom teeth may also need to be divided into segments so it can be removed safely and easily. Perfect wisdom teeth technique and a lot of experience is a must for these surgical procedures. The incision in the gum may then need to be closed with stiches (these are dissolvable in our practice). The patient is always well monitored during the wisdom teeth removal surgery, and a set of instructions are given and discussed for the post-operation recovery period.

The main symptoms that leads to wisdom teeth extraction are:
1.infection in the mouth
2.facial swelling
3.pain
4.swelling of the gumline in the back of the mouth

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your Oral and Maxillofacial Surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.

The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged. Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished. Restrict your activities the day of surgery and resume normal activity when you feel comfortable. Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.






SNACKS AND YOUR TEETH

 Sugar Snack facts:Snacks containing sugar increases a child’s risk of developing cavities. Each time your child eats sugar, plaque in the mouth combines with sugar to produce acid. These acid attacks on the teeth over time can destroy the tooth structure

Your child needs to eat a variety of foods: grains, milk and milk products, meat, vegetables and fruits. Try to avoid establishing a “sweet tooth” by limiting foods high in sugar.

Tips to better oral hygene:Snacks containing sugar increases a child’s risk of developing cavities. Each time your child eats sugar, plaque in the mouth combines with sugar to produce acid. These acid attacks the teeth & over a period of time can destroy the tooth structure

Your child needs to eat a variety of foods: grains, milk and milk products, meat, vegetables and fruits. Try to avoid establishing a “sweet tooth” by limiting foods high in sugar.

• Cut down on high sugary snacks and offer your child snacks which are low in sugar such as vegetables, cheese etc. These do not promote tooth decay.

• Cut down on the sugary and sticky food stuff and snacks. With frequent snacking, the acidity of the mouth stays high. This exposes the tooth to acid for extended time periods. Frequency of snacks will increase the risk of developing cavities more than the amount eaten at one sitting.

• Avoid soft, sticky sweets that lodge in and between tooth surfaces, such as toffee, dried fruits, etc. Sticky foods are retained in the mouth longer and as a result, the acid which destroys the tooth is produced for a longer period of time. The consistency of the snacks increases the risk of developing cavities more than the amount eaten.

• Natural sugars (found in breast milk, fruit, milk, bananas) have the same effect on your child’s teeth as refined sugars (found in soda pop, ice-cream, cake). Healthy foods should not be avoided, however, brushing afterwards is important in the prevention of tooth decay.

• Don’t give your child sugar-rich foods that stay in the mouth and prolong the acid attack, such as gum, hard candies, lollipops, etc.

• If you do serve sweets, serve them with meals. Increased saliva flow during meals helps neutralize the effects of sugar.

• Brushing and flossing after snacks and meals is important in preventing cavities. 

DENTAL HEALTH AND DIABETES

Diabetes Mellitus is a condition whereby the sugar (glucose) from food is not used by the body. The reason the body is not able to use the sugar could be due to one of the following:


Type I Diabetes: The body does not produce enough insulin ( a hormone that is needed to absorb glucose)


Type II Diabetes: The cells in the body don’t interact with the insulin.


Therefore, the type of diabetes an individual has will dictate how it can be controlled. Those people who do not produce enough insulin can receive insulin injections. Individuals whose cells don’t react with the insulin can try to control their diet and the types of food they eat (reduce the amount of sugar and fat)


A disease such as diabetes affects the entire body including the mouth. Here is some information in a question and answer format that may shed some light on how diabetes affects the teeth, gums and breadth.


Q: Are diabetics more at risk for getting cavities than non-diabetics?


A: Not necessarily. If the condition is monitored and controlled the diabetic is at no greater risk for getting cavities than a non-diabetic.


If the condition is not controlled and the diet consists of foods high in sugar and starch, the diabetic’s chances of getting cavities will increase. It is understood that diabetics sometimes eat smaller meals, requiring more meals per day. This means frequent doses of sugar (in various forms) throughout the day. A diabetic needs to ensure he/ she brushes teeth after every meal and flosses daily.


Some diabetics have noted their mouths feel dry. If this is the case, then the risk of cavities is definitely increased. Normally, saliva washes over the teeth collecting some (not all) sugar and is then swallowed. Without enough saliva in the mouth, sugar is allowed to remain on the teeth. This allows the sugar an opportunity to cause decay.


Q: What can gum disease mean for a Diabetic?


A: Diabetics are known to have a decreased dental healing response. Gingivitis is an infection within the gums caused by bacteria found in plaque. A diabetic’s body doesn’t respond as quickly to fight this type of infections as a non-diabetic. If the infection persists it can become worse leading to the infection of underlying bone that anchors the teeth in place. It has been shown that diabetics who keep their condition under control have a better chance of combating infections than those who are poorly controlled.


In addition to controlling the condition of diabetes, the importance of maintaining good oral health is essential. Brushing and flossing help to reduce plaque and bacteria that cause infection and thereby decreasing the risk of gum disease.


Q: Will a Diabetic lose their teeth sooner that a non-diabetic?


A: Many factors contribute to the loss of teeth in someone who has diabetes. A poor healing response combined with gum disease and the destruction of bone anchoring the teeth in place may result in teeth that become loose and eventually fall out. Although diabetics have no control over their response to infection, they can practice good oral hygiene habits (brushing and flossing). Removing plaque will reduce or eliminate infection. Ensuring the diabetes is controlled (taking insulin, altering diet) is also a way of decreasing the risk of tooth loss.


It should be noted that a diabetic may have excellent oral hygiene and still suffer from gum disease and bone loss. If this is the case, additional measures can be taken. A dentist can recommend a special prescription mouthwash which kills various bacteria in the mouth that contribute to gum disease. Your dentist can write the prescription. Diabetics should be encouraged to ask their dentist any questions they have regarding their oral health status.


Q: Many Diabetics have unpleasant “Fruity – Sweet” smelling breadth. Is there anything they can do about it?


A: Unfortunately, no. The “fruity-sweet” breadth is caused by the disease itself as a result of the body’s natural defense against decreased glucose use. There are some methods of masking the odor, but they are only temporary and do NOT eliminate the problem. Some things that may help are:


Chewing gum (make sure it’s sugarless)
Using a mint flavored mouthwash
Brushing frequently


While there are many other concerns that people with diabetes may have, these are the basics pertaining to the oral health. If you have any questions that have not been answered, or would like more detail, please don’t hesitate to contact your dentist. 






IMMEDIATE IMPLANTS DETAILS

Dental ImplantS are artificial tooth roots on which a crown can be placed to maintain esthetics and chewing function. As over time people loose their teeth due to dental decay, gum diseases etc. and their chewing ability generally goes off, and then they look for different tooth replacement options. A few decades ago we had only removable dentures as an option then came fixed bridges and now the latest thing is dental implants. In removable dentures the patient acceptance was very low, in fixed dental bridges we had to grind the adjacent teeth. In dental implants treatment procedure as they are made up of titanium and they function as artificial roots we have eradicated previous problems people face over time. 
When ever a dentist puts an implant – he checks the general and dental health of the patent. Dentist will get some investigations done like an O.P.G. x-ray, a C.T.Scan for jaw bones your blood analysis and also the bone quality check up too. If any pre-existing dental condition is there it will be treated first prior to the implant surgery. 

Procedure for Implant Placement – 

The dentist will give you local anesthesia and will reflect the gum tissue, then will drill a hole in your bone where dental implant has to be placed. After preparing the site well an implant will be placed and secured with in the bone. Once the surgery is over a time period is given to the implant to get integrated with the bone. For Conventional implants time is 3 to 6 months depending upon the bone condition. For Immediate implants we can put the crown with in 2 to 3 days. 

Low Cost and best price of dental implant dentist treatment procedure in India – 
At dental implant centers in Chennai and dental implant clinics in India, best implant dentist in Chennai  and India offers best price low cost and affordable dental implants treatment procedures as compared to dental implants treatment in Thailand, dental implants treatment in Hungary, dental implants treatment in London, dental implant treatment in U.S.A. 
Generally the cost of implant in India ranges between 15,000 to 45,000 INR. Depending on which system the person is interested in. As a general cost – this cost can go as high as 60,000 to 70,000 INR. This steep increase in price is associated with the dental health of the patient as he may require - bone grafting – sinus lift – gum surgery procedure – prior or during the dental implant surgery in Chennai and India. 

The overall cost of dental implant treatment will include – initial dental implant Consultation, X-rays for dental implants, Blood tests , cost for the dental Implant in India, any Additional Surgery as bone grafting etc, Type of Abutment used Type of Crown that will be place on implant. 

So for people who are considering this treatment as tooth replacement option, they should inquire about the full cost involved before finalizing the treatment. 
All implant surgeries in Chennai and India are done under strict sterilization and sedation to minimize any pain or discomfort. 
All dental implants used at centers in India are CE and ADA certified. 




TOOTH REPLACEMENT

Bridges • Dentures • Implants

WHY REPLACE MISSING TEETH?
Your teeth work together like a finely tuned machine, and losing even one tooth could be the start of serious problems if it isn’t replaced promptly.  This booklet shows you what can be done to fill in the gaps in your smile.
BRAND – NEW

TEETH

Tooth loss has many causes: decay, gum disease, and injuries are the most common.  Missing teeth detract from your appearance and make eating and speaking more difficult, and the strain on your remaining teeth invites more tooth loss.  The common options for preventing these problems are bridges, dentures, and implants. 
EFFECTS OF  TOOTH LOSS 
Teeth shift so that the upper teeth no longer mesh with the lower ones.  Chewing is difficult as well, and teeth may be sore. 
Plaque builds up more easily as teeth crowd together, increasing the risk of decay and gum disease. 
If back teeth are lost, lips and  cheeks can sink into vacant spaces, making you look older. 
BRIDGES
Bridges are tooth replacements attached to adjoining natural teeth.  They’re best for people with a few missing teeth.
Fixed Bridge
  • A fixed bridge consists of one or more artificial teeth set between crowns placed over adjoining natural teeth.  The dentist shapes the natural teeth to receive the crowns.
               
The two most common kinds of bridge are fixed bridges and Maryland (bonded) bridges.  Both require that the adjoining teeth be healthy and have good gum and root support.  Bridges take two or three visits to put in place and can be removed only by your dentist.

IMPLANTS
Implants, artificial tooth support surgically set in the jaw, can be used to replace any number of missing teeth.  This procedure is best for adults who experience discomfort with conventional dentures but who have healthy gums, adequate bone to support the implant, and a commitment to oral hygiene.
Implants usually require outpatient or office surgery and take from three to nine months to complete.
  • A metal post is surgically set in the jaw; an artificial tooth is attached to the post (above).  If the jawbone has deteriorated, a metal frame may be fitted over the remaining bone to hold the posts.
Maryland (Bonded) Bridge
• A Maryland (bonded) bridge consists of one or more artificial teeth between metal clasps.  The anchor teeth are reshaped slightly, and the clasps are bonded to them.
 
          

DENTURES 
A denture is a set of removable artificial teeth that rest directly o the gums.
Partial dentures are best for people with several teeth missing and whose adjoining teeth are too weak to hold a bridge.

Full dentures replace all the teeth on a jaw.  They’re best for those who have lost all their upper or lower teeth because of such problems as decay or gum disease.
           
Partial Dentures
  • Partial dentures are artificial teeth attached to a framework Clasps fit onto adjoining natural teeth.
         
Full Dentures
  • Full dentures consist of a plastic framework (resembling natural gums) into which artificial teeth are set.  The dentures fit directly on the gums.
HOME CARE
Taking Care of Your New Teeth 
  • Brush and floss regularly.  All tooth replacements are potential food and plaque traps, so good dental habits are more important than ever.  Use a special toothbrush with a small, tapered head to reach hard-to-clean areas.  Your dental professional can recommend one.
  • Rinse your mouth with water after every meal, and if you wear dentures, rinse them out too.  Rinsing will prevent food from getting trapped in or around your fixture.
  • Ask your dentist or hygienist about alternatives to using floss if you can’t floss properly because of age or a handicap.
  • Clean dentures thoroughly every night.  Your dentist or hygienist can recommend a cleaning solution, but be sure to rinse it all off before putting the dentures back in your mouth or before storing them.
  • Store dentures overnight in a moist denture box to keep them from drying and warping.
  • Keep your mouth clean as well as your dentures.  Brush your gums and the roof of your mouth with a soft brush (whose bristles can be further softened in a warm-water soak).  You’ll clean away food particles and keep your gums healthy.








TOOTH REPAIR


Fillings • Crowns • Root Canals


DO YOU HAVE A TOOTH THAT NEEDS
Fixing? If one of your teeth has been damaged by decay or an injury, prompt repair will prevent bigger and more painful problems later on. This booklet will show how your dentist can restore your tooth to working order.

THE BIG FIX 
Tooth repair can make the difference between saving and losing damaged tooth. Dentists can repair a tooth that has decayed or been injured and can restore it to its normal function. The three most common procedures are fillings, crowns, and root canals.
Decay in the tooth enamel
Decay that has weakened tooth structure 
Decay that has infected the pulp champer, which contains nerves and blood vessels
 
FILLINGS 

When decay creates a cavity in a tooth, the dentist usually fills it with durable material-most often gold, a composite resin (a tooth-colored plastic), or a metal alloy called amalgam.

Visits needed: One.

Durability: The lifespan of a filling depends on its location, the material used, and the care you give your teeth. Gold can last from five to more than 20 years: amalgam or a composite resin can last five to 15 years.

How Teeth Are Filled 
  • The dentist drills out the decay and shapes the tooth to hold the filling
  • The hole is then filled with the most appropriate material for the cavity’s size and location in the mouth. 

CROWNS 

A crown is cover for a tooth that’s been weakened by decay (right) or by recurrent fillings. A crown may also be required after a root canal or when a tooth has broken or cracked. The most common material used include gold, porcelain, and metal alloys.

Visits needed: Two

Durability: Crowns can last from five to more than 20 years, depending on the material used. Gold is the most durable.

ROOT CANALS 

If a tooth’s which contains nerves and blood vessels, becomes infected or damaged because of deep decay or an injury, root-canal treatment may be the only way to save the tooth. The procedure cleans out the pulp chamber and repairs the damage.

Visits needed: One to three, depending on the condition of the pulp. If the tooth is abscessed (meaning the pulp has died and the infection has entered the bone anchoring the tooth), the infection may have to drain before the empty root can be filled.

Durability: The material used to fill the root canal will probably last the rest of your life. But you may eventually need to have the filling or crown replaced. 
  • During your first visit, the dentist removes the decay and a small amount of enamel (slightly more than the thickness of a dime) from the surface of the affected tooth. He or she then shapes the tooth into a base for the crown to fit over. An impression is made of the tooth so that the crown will be exact fit. A temporary crown is then put on.
  • After the affected tooth has been numbed, the dentist makes an opening in the top of the tooth to reach the pulp chamber. The pulp is then removed and the chamber and root(s) are rinsed out.
  • On your return visit, the permanent crown is cemented on the tooth. This visit generally takes just a few minutes and may not require anesthetic.
  • Once the pulp chamber and root canal system are clean and free of infection, these areas are filled with a rubberlike material. Finally, the tooth is crowned or filled (shown) to seal the opening to the pulp chamber.

HOME CARE 
Taking care of Repaired Teeth
FOR FILLINGS 
  • Avoid hard or chewy foods for 24 hours if you’ve had an amalgam filling. It may continue to harden during this time.
  • Eat normally if you’ve had a composite-resin or gold filling, it’s as hard as it’s going to get when you leave the dentist’s office.
  • Call your dentist if a filling falls out or feels loose. 

FOR CROWNS AND ROOT CANALS 
  • Don’t be surprised if your tooth is sensitive for a few days if you’ve had a crown or root canal done. A crowned tooth may be temporarily sensitive to heat and cold, and a tooth that has had a root canal may be tender because the surrounding tissue is inflamed. Over –the-counter pain relievers can reduce discomfort following a root canal.
  • Floss around the edges of your crown. The tooth may be protected by the crown,, but the gumline and adjacent teeth are still susceptible to trapped food and plaque buildup, which can result in gum disease or additional decay.
  • Call your dentist if a crown falls off or feels loose. 



     


What you need to know about

ORTHODONTICS 

Simple answers to frequently

Asked questions about

WHAT IS ORTHODONTICS? 

The process of straightening teeth, is called Orthodontics. It may be loosely defied as the science of moving teeth, straightening irregular, crowded or improperly placed teeth. Dentists who are specially qualified in this area of expertise are referred to as Orthodontists. 
WHO REQUIRES ORTHODONTIC TREATMENT? 
Anyone with malaligned or irregular teeth, buck teeth, crowded teeth, overlapping teeth, rabbit teeth or ones with gaps in between may require orthodontic treatment.
WHY DO TEETH BECOME IRREGULAR? 
There are numerous reasons for malaligned or irregular teeth. These are briefly:
  • Small jaw 
  • Thumb-sucking 
  • Bad lip and tongue habits 
  • Other habits like breathing through the mouth, nail biting 
  • Incompetent lips 
  • Injury / accidents 
WHAT DOES TREATMENT INVOLVE? 
This is done commonly by fixing braces to teeth and straightening them out.
WHY DO SOME PATIENTS HAVE TO EXTRACT TEETH AND SOME NOT? 

In some cases a patient may need to get some teeth extracted in order to fix the braces. Teeth are only removed after serious consideration. However, if the patient is referred to a qualified orthodontist at a young age and the problem is not severe, then the entire treatment may be carried out without tooth removal. It is critical therefore to visit a dentist at the earliest sign of irregular teeth so that he may refer you to an orthodontist.
IS THE TREATMENT VERY PAINFUL?

The treatment is certainly not painless, but the pain is mild and lasts from 3to 7 days after a visit to the Orthodontist. After this, there is no pain. During subsequent adjustments or wire changes, there may be mild pain.

Recent advances in Orthodontics have made treatment far more comfortable. The braces become a part of you, just like a pair of spectacles. 
CAN I CONTINUE TO EAT MY FAVOURITE FOODS?

DO I HAVE TO MODIFY MY DIET?


You can continue to eat your favourite foods but they will have to be prepared specially. Your food will have to be softened. Or cut into small pieces, or he well-cooked before eating. Ice creams and colas may be had as usual but corn will have to be sliced off the cob, hard fruits will need to be sliced, nuts and chikki ground and chocolate must not be eaten after refrigeration.

Foods that are best avoided are popcorn, sticky chocolates, hard nuts and fruits, hard crusts and chewing gum. These food can break or loosen your braces making you uncomfortable and can delay treatment. 
HOW SHOULD I CLEAN MY TEETH NOW? 
Brushing with braces on your teeth requires a little more effort than, if you didn’t have any.
  • Use a soft bristled toothbrush or an orthodontic toothbrush 
  • Brush twice a day in gentle circular motions with special emphasis to dislodge food that is lodged between teeth and the braces. Use a mouthwash to rinse additionally. 
  • Never allow plaque or food to accumulate on the teeth and braces. 
WHAT ELSE DO I HAVE TO DO DURING TREATMENT? 
You may have to wear small elastic bands which you change regularly. Some treatment requires a retractor or head gear, a lip bumper and other functional appliances which your orthodontist will show you how to use. Report any untoward change or damage of the braces immediately.
DOES THIS TREATMENT AFFECT MY PERFORMANCE AT SCHOOL / WORK/ SPORTS? 

Not at all. You will only need to take reasonable care of your braces during contact sports like boxing, football, hockey, cricket etc. to prevent damage to the braces and injury to the teeth and lips.

Take this simple quiz 
1. Pick the odd man out!
You don’t need Orthodontic treatment if

Your teeth are

Irregular / Crowded / Overlapping/

Have gaps / Back teeth / Rabbit teeth /

Discoloured

2. The chief causes of irregular teeth that

Will require orthodontic treatments are

Small jaws / Thumb sucking / Nail biting /

Injury / Accidents / incompetent lips /

All of these 

3. The things I give up during treatment are:

Pop com / Hard & sticky chocolates /

Chewing gum / Hard nuts & fruits 

The correct answers are
1. Discoloured

2. All of these

3. All of these 






How can I care for my child’s teeth?


When should I start caring for my child’s teeth? 
As soon as your baby’s teeth appear, you should clean them with a wet piece of gauze or damp washcloth after feedings. When the rest of the teeth have come in, brush them gently with an extra soft, baby tooth brush like My First Colgate toothbrush. It helps to have your child lay his head in your lap so you can see the teeth better when your brush.

Remember that the teeth of babies, who sleep with a bottle of milk, formula or fruit juice in their mouth can suffer from decay known as Milk Bottle Tooth Decay. So the bottle should be removed as soon as the feed is over and do not use the bottle as a pacifier.
Why are milk teeth so important?

Even though primary (milk) teeth eventually fall out, they do serve a very important function. Besides helping in chewing, speech and good looks. Milk teeth reserve space for permanent teeth, so if a tooth is lost too early, new teeth could grow in crooked. If the milk teeth are well looked after, then it is more likely that the permanent teeth will grow in their correct position.


There are many ways to help prevent early decay, beginning with regular checkups. But if a cavity does develop in a milk tooth, be sure to have it filled. And if your child accidentally knocks a tooth out, place it in cool milk or the baby’s saliva or water and get to the dentist within half an hour so it can be replanted in your child’s mouth. This should be followed even for permanent teeth.
When should I make my child’s first dental appointment?

When your child is about a year old, it’s time he or she sees a dentist. Early visits can prevent minor problems from becoming major ones, and even though you are checking your child’s teeth, you may not recognize a problem. Don’t wait until there is a decayed or injured tooth to introduce your child to a dentist; make the first visit a positive one.
YOUR CHILD’S FIRST DENTAL VISIT. 
  • Familiarize your child with the dentist and dental office by taking him or her along with you; letting your dentist know in advance allows time for them to get acquainted.
  • Your child may enjoy a “ride” in the dental chair; perhaps your dentist will use the dental mirror to show your child his or her teeth
  • Be low key about the visit; your child has no reason to be afraid unless it’s suggested.
  • Take cues from the dentist who’s experienced at dealing with children, and don’t expect perfect behaviour from your child. 
How can I teach my child proper dental care? 
Imitation is the best way to teach your child how to brush and floss. Children as young as 2 or 3 can learn to brush by watching you, although you should follow up with a thorough brushing of their teeth. 
Get the children into the habit of brushing at least twice a day with a good toothpaste and toothbrush which gives maximum benefit to children. Parental supervision is however essential upto age 6 to prevent/minimise swallowing of toothpaste & teach the correct technique of brushing. Ensure that children rinse & spit after brushing. Parents should also floss their toddlers teeth. By the age of 10, children should be able to floss by themselves. Most of all, sure to praise your child for clean teeth, a nice smile and good oral health habits?
How can we help avoid cavities?
Out of all age groups, children are most susceptible o cavities. It’s critical that they brush twice a day and floss daily to remove plaque, the colourless film of bacteria that forms on teeth and leads to tooth decay and gum disease.

A well balanced & nutritious diet promotes good oral health. However try and reduce ‘between-meal’ snacks specially of foods which contain sugar or carbohydrates in order to inhibit acid formation in the mouth. Do not get into the habit of giving your child a sweet to stop a tantrum or as a reward.

And remember, regular dental checkups are the key to healthy oral development. 
YOUR CHILD’S THUMBSUCKING. 
  • Thumbsucking is a natural occurrence for many babies and new-borns and they derive satisfaction from it. During the first year of life, thumbsucking should not be discouraged. 
  • If thumbsucking continues beyond four to five years of age, consult your dentist. If the habit is allowed to continue, it can lead to crooked teeth (Malocclusion). 
Children need healthy teeth for chewing speaking clearly and looking good. With the advancements in dentistry and oral care products, today’s generation has a better chance than ever to grow up with strong, cavity free teeth.

Parents, too, play an important role in a child’s dental development, because better oral health for your child begins with you. 
BRUSHING THE CORRECT WAY :
1. Hold the toothbrush just under the gum line at an angle of 45° Gently jiggle the brush or move in tiny circles over the teeth and gum.  Repeat for each tooth.
        
        
2. Use tip of toothbrush to brush behind each front tooth, both top and bottom. 
3. Brush the insides of each tooth using the same jiggling action in step I. 
        
        4. For the chewing surfaces, use a light back and forth motion. 
5. Floss your toddler’s teeth regularly.  Floss is wrapped round the middle fingers and then gently eased between the teeth with the aid of the forefinger and thumb.  By the age of ten children can begin flossing by themselves. 
        
Finally, massage your gums with your fingers after brushing and gently brush your tongue too.  Do not use metal tongue cleaners. 
Brought to you by Colgate under its “Young India” Dental Health programme in the interest of patent education and better dental health. 




DENTAL BASICS


 Brushing • Flossing  • Dos and Don’ts

HOW LONG WILL YOUR TEETH LAST? 
Your teeth are meant to last a lifetime, but they still need proper care to prevent such tooth threatening problems as decay and gum disease.  Read this booklet to find out how to care for your teeth so they stay healthy, strong, and attractive.
BACK TO BASICS
Thanks to fluoridate water and toothpastes, better nutrition, and improved dental care, Americans’ teeth are healthier than ever.  But that doesn’t mean you can neglect yours.  Tooth decay is still the number-one cause of all tooth loss, and gum disease is responsible for most tooth loss in adults 35 and older.  The best way to prevent these and other problems is to master the basics of daily dental care, especially the proper ways to brush and floss.  
BRUSHING
 Brushing removes food particles and plaque from your teeth, making them look clean and freshening your breath.  Brush at least twice a day with a fluoridated toothpaste that has the American Dental Association (ADA) seal of acceptance.  Use a brush with soft, rounded bristles and replace it every three months.  Follow these steps to clean all surfaces: 
1. To clean the outer surfaces, tilt the brush so its bristles point toward the gumline. Use gentle side-to-side strokes, moving across your teeth in a circular motion.
               
            
2. To clean the biting surfaces of the olars, hold the brush flat.  Gently scrub your teeth by moving the brush back and forth.
3. To clean the inner surfaces of your back teeth, hold the brush horizontally and use the same gentle back-and-forth strokes.
                
                
4. To clean the inner surfaces of your front teeth.  Hold the brush vertically and use gentle up-and-down strokes.
FLOSSING 
Brushing does most of the work in keeping your teeth clean, but it can’t reach plaque and food particles between teeth and under the gumline.  Daily flossing will keep plaque from building up in these hard-to-reach areas.
 There are two types of floss: waxed and unwaxed. Use which every you prefer. To make sure you floss all your teeth, start behind the upper and lower molars at one side of your mouth and work toward the other side. Follow these steps:
1.      Break off about 18 inches of floss and wind most of it around your middle fingers.  Hold it as shown above.
             
                
2.      Slide the floss between teeth using a gentle sawing motion until it reaches the gumline. Curve the floss around the tooth and gently slide it into the space between the gum and tooth.
3.      Scrape the sides of the tooth by moving the floss away from your gums.  Unwind clean floss as you work.
             
 HOME D CARE 
Dental Dos and Don’ts 
  • Use fluoride. Fluoride strengthens tooth enamel and helps prevent the bacteria in plaque from causing cavities.  Some drinking water is fluoridated, and toothpastes and mouthrinses with the American Dental Association seal of approval contain adequate amount of fluoride.
  •   Eat a balanced diet, including fruits and vegetables, careals, dairy products, and meat.  Calcium is essential for strong teeth and bones.  Good sources include milk, cheese, yogurt, and tofu.
  • Cut back on sugary and starchy foods, which can cause tooth decay.  Beware of the hidden sugars some processed foods, such as peanut butter, ketchup, canned vegetables, and nondairy creamer.
  • Don’t chew on hard substances, such as ice or popcorn kernels, or grind or clench your teeth.  These habits can damage tooth enamel.
  • Don’t smoke or use chewing tobacco, which can stain your teeth, contribute to gum disease, or cause oral cancer.
  •  Don’t drink too much coffee or tea, and avoid foods that may stain your teeth.
  • See your dentist at least every six months for a general checkup and professional cleaning.




Tooth Decay

What you need to know about - Tooth Decay
Simple Answers To frequently  Asked questions About Tooth Decay
WHAT IS TOOTH DECAY?
            

Tooth Decay describes the condition wherein the tooth, under a variety of harsh conditions, breaks down leading to the formation of a cavity.  It starts with a hole/opening in the enamel.  If this is not treated, it progressively reaches the deeper sections of the tooth, where the pulp and the nerves are causing the tooth to become sensitive to a variety of stimuli, a variety of gum problems such as inflammation and swelling, pain, and ultimately tooth loss.

Tooth decay is a common dental ailment that may occur at any time or time or age.  However, since the onset of tooth decay is strongly related to the unregulated consumption of sweet foods and beverages; it tends to affect the young and adolescents more than any other age. One form is diagnosed in nursing infants and is referred to as nursing caries.
ISITVERY COMMON?          
WHAT IS ‘BABY BOTTLE TOOTH DECAY’?
 
 
A serious form of tooth decay affects nursing infants and is called ‘Nursing caries’ or ‘Baby bottle tooth decay’.  In infants who are nursed continuously with a bottle/formula milk/ pacifiers; the milk is retained in the mouth as the child falls asleep with the bottle.  This milk is an excellent nutritive media for a variety of gems present in the mouth.  The milk is broken down by the germs to form harsh acids which lead to the formation of a cavity on the tooth. 
 
WHAT ARE THE CAUSES OF TOOTH DECAY?
          
1.   POOR ORAL HYGIENE: Irregular & improper brushing, not flossing between teeth, not rinsing with water or mouthwash after meals speed up the process of tooth decay.
2.   UNREGULATED DIET OF SWEET FOOD AND DRINKS: Periodic snacking on aerated drinks, jam, marmalade, even potato chips can lead to the formation of acidic by – products which damage the surface of the tooth enamel.  This is the reason why most young children adolescents suffer from tooth decay.
3.   BAD OR WORN OUT DENTAL FILLINGS: Tooth decay might develop again from exposed tooth surfaces.
WHAT CAN I DO IF I HAVE TOOTH DECAY?
If you have developed black or brown spots of decay on your teeth either in the fissures or on the smooth surfaces and it is associated with discomfort and /or sensitivity to hot and cold and / or frank pain, it is likely that you have tooth decay.  Your dentist will evaluate you comprehensively and based on his clinical and radiographic findings he will do one of the following:
             
1.      Make an opening in the crown and remove decay, shape the cavity and fill it with a tooth coloured filling or an amalgam filling. This could also be done under local anaesthesia.
          
 
 

2.
      If the dacay is very deep and the pulp (never, root canal) is involved in the decay process he will, under local anaesthesia go deeper into the pulp chamber, remove the pulp and the nerve, render it free of infection, do a root filling and later put an amalgam or a tooth coloured filling. Subsequently he will put a veneer or a crown on the tooth as the case may be.
PREVENTION IS THE BEST
CURE FOR TOOTH DECAY.
Certain Preventive measures are known to reduce the risk of tooth decay.  You must practice these good dental habits: 
BRUSHING
Brush your teeth twice a day.  Hold a soft a brush at the gum line at a 45° angle.  Brush in a circular motion to massage the gums and an up-down motion to dislodge plaque.  Do this gently on the outer as well as inner surfaces of teeth.
Dentists recommend using a toothbrush with soft bristles and a small head.  Replace your toothbrush every 3 months or as soon as it loses it’s original shape.  Once a brush loses its shape, you require more pressure for the same cleaning action.  This extra pressure is damaging to gums as well as the protective enamel layer. 
CHOOSE THE RIGHT TOOTH BRUSH
FLOSS
 Floss daily to remove plaque from between teeth.  Take about 18” of floss and wrap most of it around your middle finger and the rest around the middle finger of the other hand, leaving a 2” length between them.  Using your thumb and forefinger, gently scrape the side of each tooth away from the gum. 
RINSE
Rinse your mouth with water thoroughly after each meal.  Rinse for a minute everyday with mouthwash. 

D I E T

 
Reducing the frequency of in take of sweets during the day, decreases the number of ‘acid attack’ by the digestive breakdown of these foods in the mouth.  This prevents further damage to the tooth. 
 
Expectant mother must be particularly careful with their diet and must make sure that it contains all the necessary nutrients and vitamins [described below] since the foundation of a child’s teething is laid early in the second trimester [3 to 6 moths] 
 
A balanced diet that includes all food groups such as fresh fruits, vegetables, bread, cereals as well as other grain products, Dairy products such as milk, cheese, yogurt; meat, poultry, fish provides the essential nutrients required for dental growth. 
Take this simple quiz 
1. Most effective method of preventing dental decay in general population is:
  • Oral prophylaxis
  • Fluorides
  • Diet Counselling
  • All of these 
2. Regular visits to the dentist should be
Scheduled according to:
  • 6 Months interval
  • Ages 3, 7, 10, and 13 years
  • Patients need
  • Annually. 
3. Difference between  a child’s toothbrush
And an adult’s is that the child’s toothbrush has
  • Smaller diameter bristles
  • Softer Bristles
  • An angled head 
The Correct answers are
1.      Fluoride
2.      6 months interval
3.      Smaller head size





What you need to know about

Gum Disease 
Simple answers to frequently asked questions about

Gum Disease

WHAT IS PERIODONTAL DISEASE? 

A disease which affects the gums and other supporting structures of the teeth is known as Periodontal disease. It is commonly known as gum disease. The early

Stage of the disease is referred to as Gingivitis and is characterised by inflammed gums which bleed easily. In the more advanced stage, the disease affects the bone and other supporting structures and is known as periodontitis.

WHAT CAUSES GUM DISEASE? 
Diseased mouth
Healthy mouth

The early stage of gum disease, gingivitis, starts with plaque. Plaque is a soft, sticky colourless film of bacteria that constantly forms on teeth. If you do not clean your teeth properly, the plaque builds and enzymes that can irritate the gums. Gums can become red, swollen, sensitive and can bleed on provocation.

WHAT HAPPENS IF GINGIVITIS IS NOT TREATED?
In time, the build-up of plaque can move below the gum-line. This causes an inflammation which form pockets, that is, a space between the teeth and gums. It also destroys the underlying bone. This advanced stage is known as periodontitis. As more bone gets destroyed, the tooth can loosen and eventually fall out or may need to be removed.

WHO CAN GET GUM DISEASE? 
Although periodontal diseases can occur at any age, they usually affect adults. As many as 90% of people above 40 years suffer from some form of gum-disease, making it the leading cause of toothloss in adults.

HOW DO I KNOW IF I HAVE IT?

Some early warning sings of impending gum disease are:

Gingivitis                   Red, swollen or tender gums. Gums that bleed while brushing,

Periodontis               Gums separated from your teeth. Pus between teeth and gums.

                                    Change in the way teeth fit together. Loose or shifting teeth.

                                    Bad breath or bad taste.



Should you notice any of the above sings and symptoms, visit your dentist immediately. It is prudent to meet your dentist at least twice a year thereafter.
HOW CAN I PREVENT GINCIV IT IS? 
  • The only, effective way is to prevent build-up of plaque. Brushing and flossing twice a day & after meals can control plaque build-up
  • Eat a balanced diet, especially one rich in dietary fibre. Fresh fruits and vegetables, milk and fish are recommended.
  • Visit your dentist at least twice a year. He is trained to recongnise early symptoms of gum disease and offer curative procedures. 

SO GUM DISEASE IS CURABLE! 
Yes, Early gingivitis is usually completely reversible. Your dentist will treat the disease through professional cleaning and scaling to remove plaque. You must follow that up with certain preventive measures that prevent the resettling of plaque at the gum-line:

Advanced gum disease, now referred to as periodontitis, may require surgery to help save teeth. Only very advanced stages are incurable.

HOW DO I PREVENT THE ONSET OF

GUM DISEASE IN THE FIRST PLACE! 


Certain preventive measures are known to prevent the re-settling of plaque at the gum-line and therefore, reduce the risk of gum disease. You must practice these good dental habits:
BRUSHING 
  • Brush your teeth twice a day. Hold a soft brush at the gum line at a 45* angle. Brush in a circular motion to massage the gums and an up-down motion to dislodge plaque. Do this gently on the outer as well as inner surfaces of teeth.
  • Replace your brush every 3 or 4 months. 
FLOSS 

Floss daily to remove plaque from between teeth. Take about 18” of floss and wrap most of it around your middle finger and the rest around the middle finger of the other hand, leaving a 2” length between them. Using your thumb and forefinger, gently scrape the side of each tooth away from the gum.
RINSE

Rinse your mouth with water thoroughly after each meal. Rinse for a minute everyday with mouthwash. 
Take this simple quiz 
1. Prevention of gum disease is achieved by
  • Regular and effective brushing
  • Flossing in between teeth
  • Rinsing
  • All of the above 

2. One of the main causes for the onset of gum disease is
  • Plaque build-up
  • A damaged toothbrush
  • Chewing hard foods. 
3. Gum disease appears in 2 stages:
  • Early gingivitis and then periodontitis
  • Periodontitis followed by advanced gingivitis.
The correct answers are 

1. All these

2. Plaque build-up

3. Early gingivitis followed by advanced periodontitis
 


What you need to know about

Oral Cancer
Simple answers to frequently Asked questions about 
Oral Cancer
WHAT IS ORAL CANCER? 
Oral Cancer is a disease that starts as an uncontrolled growth of cells in the mouth. It leads to disfigurement of the face, debility of body and eventually death.

SOME KINDS OF ORAL CANCER
IS IT VERY COMMON? 

Oral Cancer is the most common of cancers in India with as many as 64,460 cases reported each year. That makes it as common as cancer of the lungs, breast or cervix. As much as 7% of all cancer deaths in males and 4% in famales have been reported to be due to oral cancer. The figure continues to rise rapidly because of bad oral habits such as chewing of gutka, tobacco, and smoking among 
WHAT ARE THE EARLY WARNING SINGS? 

A white or red patch in the mouth or on the tongue, a painless ulcer which doesn’t heal for over two weeks, difficulty in eating, drinking and speaking are some of the early sings of oral cancer. If these symptoms appear, you must see your dentist immediately. 
CAN I EXAMINE MYSELF? 
Yes, you can, in fact it is strongly recommended because early detection can greatly increase the chances of a complete cure.
  • Stand in front of a mirror in good light.
  • Open your mouth wide. Look for small lumps or swelling, ulcers, a red or white patch.
  • If you have dentures, take them out and inspect your mouth.]
  • Inspect the lips with your mouth both open and closed.
  • Stick your tongue out and inspect the margins, as well as below the tongue. 
If you see something that is unexplained, visit your dentist immediately.
WHAT ARE THE EARLY CLINICAL INDICATORS? 

A good dentist is trained to recognize the clinical symptoms of an early oral cancer:

Leukoplakia

It is a raised white patch, which is associated with the constant chewing of tobacco and gutka. 2.8% of oral Leukoplakia results in cancerous growths.

Oral submucous fibrosis
It is the inability to open the mouth and / or a burning sensation which affects 9 per 10,000 Indians.

Lichen Planus
It is a skin affliction occurring in the mouth. It can be caused due to stress and diabetes.

Anaemia
It is a deficiency of iron very common in India, which can lead to the development of oral cancer.

CAN ORAL CANCER BE CURED? HOW? 

If detected early, oral cancer is curable. The smaller the ulcer or affliction, the better the chances of cure.

Treatment involves the surgical removal of the afflicted parts followed by radiation. Chemotherapy is rarely advocated. Cancer of the lip shows 85% cure-rate. Other oral cancers if detected early and treated promptly, may prolong the life of the patients, by as much as 20 years.

HOW TO AVOID ORAL CANCER? 

Since oral cancer is very common in India, extra precaution is suggested. 
  • Avoid bad oral habits like chewing tobacco, gutka and smoking. These bad habits increase your chances of getting oral cancer dramatically.
  • East a diet rich in fiber, fresh fruits and vegetables, fish and dairy products such as butter milk.
  • Visit your dentist twice a year.
  • Brush twice a day and maintain good oral hygiene. 

Take this simple quiz 
Pick the one out:

1. The common clinical condition that may transform into oral cancer is….

Leukoplakia / Arthritis / Lichen Planus / Submucuos Fibrosis. 
2. The early warning sigins of oral cancer include:

Red & white patch / Discoloration of lips / Non-healing ulcer / Difficulty in opening the mouth. 
3. The chief causes of oral cancer are…

Chewing Gutka, Paan, Tobacco, Smoking Chewing Bubble Gum, Bad oral hygiene. 
The Correct answers are 
1. Arthritis

2. Discoloration of lips

3. Chewing Bubble Gum. 




Dental Veneers 

Dental Veneers are thin, individual hand crafted wafers of porcelain or plastic, which can be bonded to your teeth to change their shape, color or alignment. Often an alternative to crowns, dental veneers look completely natural and are made of a very durable ceramic material that actually strengthens your tooth! It is very common for people to have imperfect teeth, either oddly shaped teeth, chipped teeth, crooked teeth, teeth with small holes in them, or an inappropriate sized tooth or teeth that have an odd appearance. Dental Veneer solve such irregularities and create a durable and pleasing smile.

There are two tooth veneers procedures available that correct discoloration of the teeth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and they will recommend the most appropriate tooth veneers procedure for you.
Porcelain Veneer Procedure

Only the teeth that show are veneered and this procedure can be carried out on both the upper and lower teeth. Teeth are prepared for veneers by lightly buffing to allow for the small added thickness of the veneer. Veneers are created from an impression taken in your cosmetic dentist's office. Your custom veneer is then placed directly onto your tooth with water or glycerin to verify their perfect fit and the shade or color. The color cannot be changed after the veneers are adhered to your teeth. The tooth is then cleansed with chemicals to achieve a durable bond. Once the glue is between the veneer and your tooth, a light beam is used to harden the glue/cement. Usually porcelain veneers require two visits and also require a dental laboratory to create the final tooth restoration piece.

Composite Veneer Procedure

Composite (direct) veneers are usually performed in a single visit to your cosmetic dentist. The procedure is an application of a bond and enamel directly to the tooth's surface.

Advantages & Disadvantages of Dental Veneers

Advantages Dental Veneers: 

Typically costing less than dental crowns, dental veneers won't stain, making dental veneers a very popular solution for many people seeking that perfect smile. The primary advantages are the beauty and durability of the material. Veneers last from ten to fifteen years, and come in colors that will brighten dark teeth without the worry of them changing color. Because porcelain doesn't stain like composite resin, it remains attractive for a much longer period of time, making veneers a very popular solution for many people seeking that perfect smile. In addition, gum tissues tolerate porcelain well, thus reducing the likelihood that gum problems will develop. An advantage of veneers over crowning is that you will keep more of your original tooth.

Dental veneers are typically done in only two one and a half hour long appointments, and can actually strengthen your tooth. Following the two visits there is no additional maintenance, other than daily brushing and regular check-ups. You will have a brighter whiter smile which will improve your confidence in many different aspects of your life.

Disadvantages Dental Veneers:

It normally takes a week or two to adjust to any change in the size, spacing or shape of your teeth. While very little tooth is removed in most cases, there are times when more tooth must be removed and this increases the risk of trauma to the tooth. The amount of tooth to be removed for the veneers should be discussed with your cosmetic dentist beforehand.

Dental veneers are very reasonable facsimiles of natural teeth, but not perfect replacements for natural teeth. It's common to see slight variations in the color of veneers upon very close inspection, as with natural teeth.






Dental Jewellery

Tooth Jewellery Skyce - (The million-dollar smile) 

Everybody needs a little extra sparkle in his or her life from time to time. Teeth jewellery, non-invasive tooth decoration, is a brilliant way to add sparkles to your smile and stand out of the crowd. Skyce'TM is one of many such products that present the perfect way to get exactly that.

Tooth jewellery is much in demand these days in cosmetic dentistry. Most are making this style statement not only to surprise friends with a sparkling crystal glass design, or something in gold with a twinkle of ruby or diamond, but also add zing in life. These tiny little designs are great fun, and because there's no drilling involved, they won't harm your teeth.

If you want to make an oral fashion statement, there are safe ways. One is to use "Twinkles" - decorative appliqu├ęs that are bonded to teeth by the dentist, in the same way as orthodontic brackets. The procedure is very simple and usually takes about 10 to 15 minutes. They can be left in place for years if desired, but are removable, and do not damage the tooth. They're also a lot cheaper. Besides maintaining the health of your teeth, you can

Choices and Facts: 
Doesn't cost a fortune 
  • Lots of fun designs to choose from 
  • Teeth jewellery is available in two colours: "crystal" and "sapphire blue" 
  • 'Twinkles' designs in 24k gold - with or without ruby and diamond 
  • No drilling, so the jewel does not damage tooth tissues and has no side effects 
  • Mostly jewels are applied to the labial surfaces of upper anterior teeth 
  • It can be easily removed without any damage to the tooth structure. Further, tooth jewellery can be fixed again at a later stage. 


 
 




 





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