Thursday, March 31, 2022

CORONA and DENTAL 2 : Oral signs and symptoms in COVID-19 patients

The occurrence of oral signs and symptoms in COVID-19 patients, including dysgeusia, petechiae, candidiasis, traumatic ulcers, HSV-1 infection, geographical tongue, thrush-like ulcers, among others

Other oral manifestations of the case included recurrent herpes simplex, candidiasis, and benign migratory glossitis.
Different sites of the oral cavity where virus and its receptors are detected include periodontal tissue, buccal mucosa, tongue, salivary glands.


TRANSMISSION from infected Patients 
COVID 19 & ORAL CAVITY
1. Non Specific Stomatitis
2. Dry Mouth
3. Traumatic lesion
4. Odontogenic infection
5. Herpetic stomatitis
6. Petechiae
7. Oral mucosa bleeding 
8. Oral candidiasis
9. Edema
10. Sialorrhea
11. Varicose vessels






COVID 19 & ORAL CAVITY - ORAL CARE MANAGEMENT AND CLINICAL OUTCOME


 








References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319209/

2.https://www.cdc.gov/pcd/issues/2020/20_0266.htm

3.https://link.springer.com/article/10.1007/s11282-020-00497-0

4.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753817/

5.https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3556665

6.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280113/

7.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261657/

8.https://www.ada.org/en/publications/ada-news/2020-archive/september/hpi-poll-dentists-see-increase-in-patients-stress-related-oral-health-conditions

9.https://en.wikipedia.org/wiki/Coronavirus

10.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462545/

Acidic Teeth/ Transparent Teeth

Question: My teeth are becoming transparent. I have stopped bad acidic food. But what do I do more and how I make them solid again? So they don't start decaying at young age.


Tooth starts becoming transparent due to the high consumption of 
coke, fizzy drinks, acidic drinks, citrus fruits or in medical conditions like people with high acidity, GERD, and others.
 
Over the period of time, first layer, Enamel (white layer) starts to get removed and the second layer Dentin (yellow layer) starts exposed. 
Then the patient complains of generalized sensitivity (hot, cold, sugary food products and drinks) and they always get relief by using desensitizing toothpaste.
Tooth starts to appear
Glossy, Shiny, Yellow more, 
Flat surface, Sharp edges of the tooth(which can create ulcer on the side of the tongue, cheek).
In dental terms, it is called DENTAL EROSION.

It is advisable to completely stop acidic food.

Also, take Antacid medication or drink if you have acidity.

What you can do to Save teeth from Acidity


1. Start eating raw fruits (non citrus) and vegetables.

2. Advice to take Sugar free Chewing gum because it increases salivary production and Saliva protects from Erosion.
3. Stop applying Baking soda/ powder, Slice of lemon directly on the tooth surface, it will further damage the tooth and make it more sensitive.
4. Do not brush immediately after having any fizz drinks/ citrus fruits. Wait for an hour or so.
5. Sharp edges on the tooth need to reduce down.
6. Start taking antacid tablets or liquid to control acidity.
7. Take supplemental B12 tablets.

The teeth which are reduced once cannot be made the same again but you can make them not fall again or go beyond this level.
In extreme cases, where even desensitizing toothpaste is not able to control the sensitivity, where the tooth erosion is so high that the patient is having extreme pain and sensitivity to hot, cold, sugary, sour food products or drinks, then, in that case, you need to get it treated. 
Either simple Filling will close the exposed tooth structure or RCT followed by the crown will be done.  

For not decaying if you have acute carious activity in your mouthFor that
  •  If you do not have fluorosis then Choose FLUORONIDATED TOOTHPASTE 
3m clinpro 5000 1.1% toothpaste (it's more expensive than the other toothpaste available on the market)


or Enafix toothpaste.

 
Reduces risk for cavity and makes enamel strong. FLOURODINATED TOOTHPASTE decreases enamel solubility by acids and also improves remineralization.

Also
1. Correct brushing technique (Type of Brush, Angulation of Brush, Timing of Brushing, Movement of Brushing is equally important). 
https://www.youtube.com/watch?v=MvRI4mlhOFo

3. Use of Mouthwash like chlorhexidine, hydrogen peroxide, or betadine or salt water rinses

4. Use of Interdental Brushes/Toothpicks


5. Gum paints like Stolin. Metrohex plus gel for gum care.

6. Fluoride application every 6 months from a nearby Dentist.

7. Tell your Dentist to take 5 x-rays (upper/ lower right and left back teeth from canine to the last molar) of yours every quarterly or 6 months or yearly (depending on the caries activity level) quarterly left-back and keep a track of caries activity.

8. Brushing at night is super important, no matter what you eat or drink. Mouthwash cannot be a substitute for brushing. Brushing is a must. You can do Clean Brushing (without toothpaste). 
https://www.youtube.com/watch?v=LEqDNAJbwmY

9. Restrict eating toffee/ chocolate/ milk/soda/pizza/burger/chewing gum/or any food or drink in between your meal.

10. Stop habits like drinking coke, lime, any fizzy drinks, tobacco, paan, smoke, and similar.

You need to reduce the bacterial load in your mouth, as soon as you do it you will see a change.

Get your fillings completed before it reaches deep. It will save not only your tooth from getting super decay but also save your money which you will be spending on the future high-end treatment.

Wednesday, March 30, 2022

Bruxism/Teeth Grinding/ Worms Connection?

 

Question : I have bruxism problem during sleep. I grind teeth while asleep. I heard that this problem can occur due to a worms as well. So I am taking albendazole for worms first before visiting dentist. I wanna ask how to take albendazole. Do I need to chew it or do I need to take it with water and swallow it?




Bruxism reasons could be

1. You grind your teeth at night, which you may not be aware of

2. Lot of stress

3. Anger issues

4. Habits like nail biting, tongue thrust and other

5. Cervical

6. Nerve related 

7. Imbalaced bite

8. You are eating only from one side or eating on one side more than the other.

9. Genetically

10. Wisdom teeth

11. Teeth conditions

Do you have headaches when you wake up? If the answer is yes then the Chances are higher of bruxism/ Teeth Grinding

In general solutions could be

1. Getting a Night guard

2. Splints

3. Deprogrammer

4. Balancing the occlusion

5. Occlusion Appliances

and many more

also, you can take a muscle relaxant and one anti-inflammatory for the time being
follow up is a must in cases like this.

Worms have nothing to do with bruxism or vice versa. Instead, you must get a dental check-up and an Occlusal Night Gaurd.




Teeth Whitening : Yellow Teeth

 

QUESTION:


Can you suggest better ways


 to whiten teeth? If it has to


 be get done by doctor how


 much does it cost and what 


are its side effects?

 


Yellow teeth could be due to many reasons
topmost are

1. You might take some medication.
2. You are not brushing at night / in the morning / or using datun or using red paste.
3. Genetically
4. Water in your area 

5. Smoking stains
6. Tobacco/ Paan Chewing/ Gutka Habits

and there are many other reasons.


For whitening your teeth

Toothpaste available

- Glizer Dr. Reddy 
-Colgate white sparkle /visible white 
Teeth whitening chemical is kept less in toothpaste, you might see results with these toothpaste if you brush with them three times a day
Regular use of such toothpaste can make your teeth sensitive to hot and cold, can also abrade your teeth.
Also, such toothpaste doesn't give the desired results.
The benefits are long-lasting, it is handy, with less chemical use you can get pretty ok looking glowy teeth.

But if you want extreme results then In-office dental whitening is the best.

Mouthwash available

Hydrogen peroxide mouthwash 3: 1

Home Whitening Kits are available (for this you need to visit a dentist)

also most effective is in office teeth whitening (dentist visit)

In office teeth whitening-office
One appointment procedure
per session is of 20 minutes will cost 4000 / 6000/ 8000/12000/15000/20000/25000/30000 (all depending on what whitening system is used, what material is used, and the percentage of material used)
The procedure is done completely in-office only.


Cost also depends on the area and the experienced dentist
More posh the area is more will be the charges
More experienced the dentist is more will be charges and less will be complications.

Side effects could be
1. Time-taking procedure.
2. Techniques sensitive
3. Sensitivity after teeth whitening
4. Not indicated in patients with hypersensitivity
5. Chemicals can burn your gums if not protected.


Patient's case
Stains- Smoking Stains/ Lack in Oral Hygiene Practices.
2 sessions 15 minutes each
First Cleaning of teeth, Polishing, Then Teeth whitening is done.
One appointment Procedure.

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Pull Your Tooth or Save It? Which is Best? | Tooth Dicey?

QuestionIs it better to have a tooth repaired or pulled?

 You need to understand it this way

Why You should get your tooth repaired?


  1. A natural Tooth is a natural tooth.
  2. Natural tooth maintain the gum tissue just like that even after 10–20 years.
  3. Natural tooth maintain the bone level the way it is today.
  4. Replacing a Natural tooth is time taking procedure.
  5. Replacing a natural tooth is a painful, stressful, and most importantly expensive affair that does not guarantee the maintenance of gum and bone the same way as it was doing before.
  6. Let us imagine you got your tooth pulled out. Now you need at least a month to let it heal and then decide the treatment plan.
  • In that one month, your neighboring teeth migrate to that space. Your opposite tooth moves towards the space. The more time you take to get an artificial tooth, more is the chances of migration.
  • You must be thinking so what !!!!…..ok let me tell you ….If your neighboring teeth migrate to that space, they will be coming out of their own socket, creating small space at sides of them leading to food lodgement complaint, tooth before and after that moving tooth will get carious over the time, imbalanced occlusion/bite ( can lead lead to Headache, TMJ disorder, pain that side of the face, pain on opening and closing mouth).
  • pulled tooth space will be completely closed then you cannot let it replace as well.

7. Artificial tooth is an artificial tooth. PDL Fibre attachment of the natural tooth with bone gives the natural tooth an edge over choosing artificial tooth.

you have limited options for fixed teeth and that is IMPLANT. Sorry to say, IMPLANT FAILS TOO.

Another option is the removable tooth, but over time it resorbs bone and gum tissue. and plus the tension of pulling it out and putting it in every time is one added headache.

8. Let me explain the expensive part

Natural tooth repairing could be

  • Filling - that will cost around 2000/ 3000/4000 max 6000
  • RCT - will cost around 2500/3500/5000/7000/10000…or more
  • then after RCT you might need a cap - that'll be around 3500/5000/8000/12000

Replacing a natural tooth with fixed teeth

  • implant- 30000/40000/50000/ 80000or more per implant

Replacing a natural tooth with Removable teeth

  • 3000//5000/10000/15000/25000 + disadvantage of bone and gum loss over the time.

9. If your natural tooth can get infected so is your artificial tooth.

10. Medically/ Physically compromised patients.


Why you should pull it out ?

1.Tooth is grossly carious,

2. Root piece is left in the mouth

3. Tooth is mobile,

4. Cannot be saved with a root canal.

5. Patient not willing

6. Patients who are medically not fit, Physically not well.

7. Before Radiotherapy

8. Financially cannot afford.

9. After Treatment, the tooth is again showing pus, swelling formation, pain.

10. If the tooth is fractured.



The choice is yours at the end of the day.

But Saving your natural tooth should always be your priority. But if your case lies in 

Why you should pull it out then in that case You must not remain adamant about saving it. Better to get it out and must replace it either with fixed or removable as early as possible.

A natural tooth is a Natural tooth no matter what. Nothing can replace a natural tooth.

As a Dentist, I feel it gives me a boost to save the tooth when the patient is willing 200% to save the tooth despite knowing the prognosis of the tooth and do not want to pull the tooth out at any cost, in those cases, I also give out 210%  effort to save the tooth.


Toothache Question

  My mother 54 years old is having toothache and so she took sporidex af 750 that the dentist prescribed one year back. Astonishingly she go...