Wednesday, April 27, 2022

Is It a Cavity or Stain? How to Find Out

 Question for today is -

Why doesn't my dentist fix the little black dots and black lines on my teeth? Aren't these cavities?



If your food is getting stuck in the Black Line or Black Spot and It is present on the surface like in this 1st picture




Then more likely it is a CAVITY due to caries.
The dentist confirms the Cavity which is present on the Black Line or Black Spot by probing the surface of the tooth.

If Probe goes inside the Line or Spot and food particle comes with the probe then definitely it is a cavity due to caries and it needs immediate attention of the dentist.

Black Stains are Superficial, These stains are due to plaque formation. Plaque is a white, sticky biofilm which is formed every day.

Black or Brown Stains like those present in the picture
on teeth which could be present due to many reasons.

Topmost reasons are
-Tea, Coffee
-Smoking, Tobacco Habits
-You might have taken some medication, (antibiotics tetracycline and doxycycline can affect enamel formation in children under the age of 8, tetracycline, Antihistamines, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, beta-blockers, heart rhythm medications, and diuretics, Cancer medication, etc.)
-You are not brushing at night / in the morning / or using datun or using red paste.
-Genetically
-Water in your area
-Improper Teeth Alignment and so your brush is not able to clean those areas.

Now you have to see in your tooth.


If your food is getting stuck in it, more likely it is a cavity, you need to get it filled.
If your food is not getting stuck then it is Stains that you can easily remove with a toothbrush, then those stains are more likely black/brown stains and do not require filling.

Tuesday, April 12, 2022

Is dental crowning after a root canal necessary?



Read this

by John I Ingle - “crowns should be placed on endodontically treated posterior teeth that have occlusal intercuspation with opposing teeth of the nature that places expansive forces on the cusps. Since crowns do not enhance the clinical success of anterior endodontically treated teeth, their use on relatively sound teeth should be limited to situations where esthetic and functional requirements cannot be adequately achieved by other more conservative restoration”


Meaning in simple terms



If RCT is done In Posterior teeth i.e 2 Premolars and 2 Molars and

if they have opposite teeth, then you must get a crown after the Root Canal, otherwise due to force by opposite tooth RCT treated tooth will fracture, and then it will be a waste of your time, money, and doctor’s time.

if there is no opposite tooth then you should not because then there will be no force on the RCT treated tooth.

In case of RCT in Anterior teeth i.e canine, lateral incisor and central incisor. There is no need for a crown in them until and unless there is esthetic demand by the patient or functional demand by your teeth.


Little bit about who is John Ingle?



Dr. John I. Ingle, is best known as author of ENDODONTICS, a leading text in the field, first published in 1965. Dr. Ingle obtained his dental degree from Northwestern University in 1942. In 1957 Dr. Ingle standardized the size and shape of endodontic instruments, an international standard that remains today.  He has published over 80 scientific articles in the dental literature and has lectured extensively throughout the world.



https://www.platinumdentalcentre.co.in/post/is-dental-crowning-after-a-root-canal-necessary

Thursday, April 7, 2022

How to properly take care of your teeth?

 Question: How do you properly take care of your teeth?


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.

What to do After Tooth Removal ?

Question:

What are the precautions to take after tooth extraction?


Immediately after extraction till 24 hours
.

The next 24 hrs are extremely important because your activity will decide whether your healing will take place on time or not, whether your healing clot will stay or get removed.

  • Keep pressing the cotton ball for an hour.

  • After an hour, remove the cotton ball and have a cup of vanilla/ chocolate ice cream, not butterscotch, only a cup and not a stick of ice cream.


  • For the next 24 hours No spitting. Take saliva inside. NO SPITTING.

  • Take soft, cold food and water only.
  • Apply Icepack.

  • Do not brush. No Toothbrushing.

  • Do not drink anything from a straw, if you want to drink coconut water, take it in a glass and then drink.

  • No fizz drinks.

  • No Hot food or water items.

  • Do not wrap a cloth around your face.

  • Do not sleep on that side.

  • Do not place a blanket or bedsheet on your face.

  • No Smoking, Alcohol, Tobacco chewing.






















  • Take medication as prescribed.

  • Do not try and use your tongue and finger to touch the extracted socket.

  • Stop talking for an hour and speak less for the next 24 hours.

  • Take a rest and also you can continue your daily activity.

  • Do not take stress or tension.

Anything you do wrong in the immediate next 24 hours, your healing clot will get dislodged, chances are that there will be an infection and result in a DRY SOCKET


.

After 24- 36 hours

  • All the normal activities can be started.

  • Start warm saline rinses i.e add a pinch of salt in half glass of warm water and do rinses at least 4–5 times a day.

  • Take medication as prescribed. Don’t try and outplay the dentist by thinking now you are not having pain so why should I take anti-inflammatory and antibiotics medication, Please.

  • No Smoking, Alcohol, Tobacco chewing at least for 7–14 days.

  • Do not try to use your finger and tongue to touch the extracted socket.

  • After having food, do rinse your mouth with a warm saline rinse or you can also do betadine rinses in a 1:3 ratio.

If you Feel you have pain after 3–5 days after tooth extraction, then surely it is a Dry Socket and for that, you need to visit the dentist.

The Dentist will Irrigate and put medication in the socket.

You will need to keep visiting 3–4 times to change the dressings.


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.




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...