Dental Myths – By Dr. Manasa

Denths: Separating Fact From Fiction, Finally!

Over the years, dentistry has evolved from an imprecise practice based on folk cures to a structured medical discipline that relies on science and technology.

Although modern dentistry has come a long way, there are still many dental myths that are passed on by word of mouth. Here is the truth about some common dental misconceptions:

Myth: If there is no visible problem with my teeth, I don’t have to see a dentist.

Fact: Just because your teeth look healthy doesn’t mean that it is a good idea to skip going to the dentist. You should visit your dentist twice a year for a routine examination and dental cleaning to make sure that your teeth stay healthy and that any dental problems are treated before they become serious.

Myth: My parents had good dental health so I don’t really have to worry about mine.
Fact: Though genetics may play a small role in determining your dental health, it is mostly up to you to take good care of your teeth and gums to keep them healthy in the long term.

Myth: Brushing my teeth more than once a day can harm my teeth enamel.
Fact: Most dentists recommend using a soft toothbrush to avoid being overly rough on gums and teeth. If you do so, you shouldn’t run into any problems brushing twice a day or — if possible — after each meal.

Myth: Chewing sugar-free gum after a meal is just as effective as brushing.
Fact: While chewing sugar-free gum after meals can help clean your teeth and freshen your breath after meals, it is no replacement for thoroughly brushing and flossing to remove dental plaque and debris.

Myth: I shouldn’t brush my teeth if my gums are bleeding.
Fact: Bleeding gums  are often caused when dental plaque or food debris is not properly removed by regular brushing and flossing. If you notice that your gums become more prone to bleeding, it is a good idea to thoroughly and gently brush and floss them at least twice a day. If the bleeding continues, visit your dentist.

Myth: If I have a toothache, placing an aspirin tablet next to the tooth will relieve pain.
Fact: At-home toothache remedies won’t correct your dental problems. Putting an aspirin tablet in direct contact with the soft tissues of your mouth will not help relieve a toothache, and can lead to painful chemical burns — don’t do it!

Myth: Teeth whitening will damage my enamel.
Fact:Teeth whitening has gotten much safer as new technological developments in both over-the-counter and in-office products have evolved. In general, if you follow directions and consult your cosmetic dentist about possible dental treatment options, you should have nothing to worry about.

Myth: It isn’t really important to take care of my child’s baby teeth because they are going to fall out in a few years anyway.
Fact: Not only is it a good idea to start teaching your child about good oral hygiene at an early age, neglecting to take proper care of their baby teeth can cause problems with their bite or permanent teeth if they fall out too early.

Myth: All dental procedures must be avoided during pregnancy.
Fact: Although certain procedures, such as X-rays or dental surgery, should be avoided during pregnancy, regular dental treatments should continue as usual.

How to maintain Good Oral Health – By Dr. Nivedita

Proper brushing takes hardly two minutes which is just 120 seconds ! Most of us do not spend that time to brush. To achieve desired result of clean oral cavity, use small circular motions with the toothbrush brostles angulated ar 45º towards the gum – line and clean each section as follows

  • Clean outer surface of lower teeth and then inner surface of lower teeth.
  • Clean outer surface of upper teeth and then inner surface of upper teeth.
  • Clean the chewing surfaces.
  • Brush your tongue too to prevent bad breath.

 

 

 

Tilt your brush at 45º angle against the gumline and sweep or roll the brush away from the gumline using a circular motion

 

 

 

 

 

Gently brush the outside, inside and chewing surface of  each tooth using short back-and-forth strokes.

 

 

 

 

 

Clean the inside surfaces of the upper front teeth by titlting the brush vertically with small up and down strokes .

 

 

 

Clean the inside surfaces of lower front teeth by tilting the brush vertically with small up and downstrokes.

 

 

 

 

 

Gently follow the curves of your teeth.

 

Kind of toothbrush to use

It is better to use a soft bristle too brush and small headed as it is easy to use in the hard to reach areas . Many people prefer powered toothbrush as an alternative. It can be helpful for those who have difficulty in brushing or people with manual dexterity.

When to change the toothbrush?

If the toothbrush starts to wear off or if its 3 months which ever comes first.

How to floss?

Proper flossing removes plaque and food particles in places where a toothbrush cannot easily reach — under the gum – line  and between your teeth as plaque build-up can lead to tooth decay and gum disease, daily flossing is highly recommended.

To receive maximum benefits from flossing, use the following proper technique:

  • Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with
  • Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
  • Gently curve the floss around the base of each tooth making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue
  • Use clean sections of floss as you move from tooth to tooth
  • To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth.

EFFECTS OF MISSING TEETH – By Dr.Manasa

The problems caused by missing teeth :

It is easy to think that losing a tooth is not going to cause you any problems. But unfortunately the long-term consequences of tooth loss can be quite serious.

When you lose a tooth you may wonder what to do next. One of your thoughts is likely to be, why replace it?

Effects of Missing Tooth / Teeth:

  1. Difficulty in speech
  2. Difficulty in eating food / chewing. Thus, affecting the general health.
  3. Change in facial profile
  4. Bone loss in the area of missing teeth , gradually remaining teeth can become loose
  5. Difficult to clean and more at risk from decay.
  6. SHIFTING OF TEETH: Although the teeth are firmly attached to the jaw bone, they can nonetheless shift and move over time if a missing tooth / teeth are not replaced. This issue of shifting can be accelerated significantly with one or more missing teeth. The gap(s) create vast spaces into which adjacent teeth can shift. This shifting creates more space for other teeth to shift and, in a domino effect, the entire bite can be impacted,teeth may become tilted and crooked.

                                     

  1. BITE IRREGULARITIES: Missing one or more teeth can cause bite irregularities that impact the health of your remaining teeth, your gums, your head and neck, your jaw muscles and your jaw joint (temporomandibular joint). The manner in which the chewing surfaces of your teeth come together determines occlusion(your bite). Missing teeth can lead to shifting of the teeth, which can drastically impact how your teeth come together when you bite.

An improper bite (malocclusion) can lead to a variety of problems, including things like headaches, muscle pain, unnatural wearing of the teeth,tooth loss , sensitivity and evenTMJD. Orthodontics can help to correct malocclusion, but it can be an expensive and lengthy treatment process.

Missing teeth can actually affect your overall health and the health of your mouth. We tend to think about teeth as individual units, but in fact they make up a complete system. Teeth work together in harmony, and problems can occur when they don’t.

Hence, it is always advisable to immediately replace the missing tooth / teeth.

LASERS IN DENTISTRY – By Dr.Manasa

HARD TISSUE LASERS : IMPROVING  RESTORATIVE DENTAL TREATMENT

LiteTouch Er:YAG laser (AMD LASERS)

                                   

Patients often avoid dental care due to the fear of pain that they perceive they will feel either related to the local anesthetic injection or during drilling to remove caries.

Additionally, the vibration and sound associated with the dental handpiece during caries removal increases patient stress while in the chair for needed treatment. This may lead to treatment avoidance until the actual intraoral pain surpasses the feared pain of treatment. Providing a more comfortable experience for the patient aids in patients accepting and following through on dental care at an earlier stage.

A hard tissue laser allows the practitioner to remove carious tooth structure while preserving healthy enamel and dentin for truly minimal invasive dentistry. The more of the native tooth structure that can be preserved, the better the long-term prognosis

 

Caries noted in the distal pit of a first molar.

Preparation following caries removal with the LiteTouch Er:YAG hard tissue laser demonstrating a minimally invasive preparation performed without the need for local anesthetic ready for restoration placement.

SOFT TISSUE LASERS :

Laser Soft-tissue Procedures

Soft-tissue lasers can be used for gingival contouring, leveling, troughing, gingivectomy, other periodontal procedures.Exposure of unerupted teeth, operculectomy, frenectomy, treatment of oral aphthous ulcers,soft-tissue incision, ablation and removal of soft-tissue lesions.

Laser gingival troughing also offers excellent hemostasis, and the removal of soft tissues such as fibromas or frenulae can be easily accomplished with minimal collateral damage, again with excellent hemostasis.

Diode lasers (i.e. Picasso, AMD LASERS, Indianapolis, IN) are designed for soft tissue applications. These allow the practitioner to remove gingival tissue to expose root caries, esthetically recontour gingival tissues, to treat periodontal pockets and a range of other applications that present daily in the typical practice.

 

  FRENECTOMY DONE USING SOFT TISSUE LASERS

 

 

Advantages of lasers in dentistry :

  1. Excellent hemostasis
  2. Good visibility with pen-style holder
  3. Efficient and effective soft-tissue removal
  4. Safe around implants
  5. Typically requires no/topical anesthesia
  6. No periodontal pack or suturing is required
  7. Reduced post-operative pain
  8. Reduced gingival recession following margin exposure
  9. Reduced swelling and discomfort.

SPACING BETWEEN YOUR FRONT TEETH – By Dr.Manasa

HERE IS THE SOLUTION…

Spacing between your upeer front teeth (MIDLINE DIASTEMA) is a common dental aesthetic concern.
People loose their confidence to smile and find oneself unattractive because of midline diastema.

What causes the diastema?

1.Physiological tooth development.
2.A diastema also can be caused by an oversized labial frenum. The labial frenum is the piece of tissue that normally extends from the inside of your upper lip to the gum just above your two upper front teeth.
3. Genetic

How is diastema treated?

 

1. Orthodontic treatment to move the teeth and close the diastema.
2. Use porcelain veneers, very thin pieces of porcelain bonded to the outside of the teeth.

3. Crown and bridge work or replacement of teeth with implants (adults only).
4. Composite restoration to close the gap.

BABY BOTTLE TOOTH DECAY – By Dr.Manasa

What is Nursing bottle caries/ Baby bottle tooth decay ?

It is tooth decay occuring in Infants and children till the age of 71months. Hence also reffered to as Early childhood caries.
Upper front teeth are commonly affected.

Why and How does nursing bottle caries occur?

Nursing bottle caries occur due to frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby.

 

 

It is a disease that can begin with cavity-causing bacteria being passed from the mother (or primary caregiver) to the infant. These bacteria are passed through the saliva. When the mother puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.

 

 

If your infant or toddler does not receive an adequate amount of fluoride, they may also have an increased risk for tooth decay.
At risk are children whose pacifiers are frequently dipped in sugar or syrup. Giving an infant a sugary drink at nap time or nighttime is particularly harmful because the flow of saliva decreases during sleep.

How to prevent Nursing bottle caries?

Think baby teeth are temporary, and therefore, not important? Think again. Baby teeth are necessary for chewing, speaking, and smiling. They also serve as placeholders for the adult teeth. If baby bottle tooth decay is left untreated, pain and infection can result. Severely decayed teeth may need to be removed.

 


If teeth are infected or lost too early due to baby bottle tooth decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. In addition, the chances that adult teeth will end up being crooked are greatly increased.

The good news is that a few simple steps can help stave off baby bottle tooth decay. They include implementing good oral hygiene at an early age. Here’s how:
• Wipe the baby’s gums with a clean gauze pad or washcloth after each feeding.
• Begin brushing your child’s teeth, without toothpaste, when his or her first tooth comes in.
• Clean and massage gums in areas without teeth.
• Floss once all the baby teeth have come in.
• Make sure your child is getting enough fluoride, which helps lessen cavities. If your local water supply does not contain fluoride, ask your dentist or doctor if you need to use a supplement.
• Avoid feeding sweets and orther sugar products in-between meals.
• Avoid overnight bottle feeding of milk/liquids such as sugar water, juice or soft drinks. Infants should finish their bedtime and nap time bottles before going to bed.
• Schedule regular dental visits by your child’s first birthday. Dentists also offer special sealant coatings, which can help prevent tooth decay in children.

Treatment of Nursing bottle caries :

Treatment varies based on your child’s age and the severity of the condition. At the earliest signs of a problem, you and your child’s dentist can work together to formulate an approach to management and treatment.

White spots on a tooth’s surface are early symptoms of baby bottle tooth decay. At this stage, fluoride treatment or placing fluoride varnish can be done to remineralize all of the teeth. This treatment actually reverses decay in its earliest stages by helping to rebuild the surface enamel. Your child’s dentist might also recommend fluoride supplements.

If decay is spotted at later stages, fluoride treatments will no longer be sufficient. Symptoms of more severe decay include:

  • Brown or black spots / cavities on the teeth
  • Bleeding or swollen gums
  • Fever, swelling or irritability, which could indicate infection

Bad breath
If your child shows any of these symptoms, it’s imperative to see a dentist as soon as possible.
Dentist will carry out extensive restorative treatment for the affected teeth and place stainless steel crowns / remove (extract) badly decayed teeth follwed by space maintainers depending upon the severity of affected teeth.

Bruxism/ Teeth Grinding – By Dr. Nivedita

What is teeth grinding?

Bruxism / teeth grinding is a condition in which people grind, chew or clench their teeth either while sleeping or while the are awake.

People with severe bruxism can fracture dental fillings or cause other types of tooth damage. Severe bruxism has also been blamed for some cases of temporomandibular joint dysfunction (TMD), mysterious morning headaches and unexplained facial pain.

Causes of bruxism

  • Psychological/ physical
  • Stress
  • Improper teeth alignment
  • side effect of some pschiatric medications

Symptoms

  • Grinding sound at night noticed by people who sleep with a person with bruxism.
  • A dull morning headache
  • Chronic pain in the face
  • Tight muscles especially in the morning.
  • Damaged teeth, fractured fillins and injured gums.

 

 

 

 

 

 

How to find out?

Questions will be asked about your current life stresses, your general dental health and your daily medications. He or she also will want to know whether you routinely drink beverages containing alcohol or caffeine, because both of these chemicals seem to increase the tendency to grind your teeth.

If you share your bedroom, the dentist also may want to ask that person about your sleep habits, especially about any unusual grinding sounds heard during the night.

Careful examination of your mouth and jaw will be carried out as well as for any obvious dental abnormalities, such as broken teeth, missing teeth or poor tooth alignment. If your dentist suspects that you have bruxism that is related to dental problems, he or she may conduct a more detailed assessment. In addition to checking your “bite,” the dentist will examine your teeth and gums for damage caused by bruxism. The dentist will also take a series of mouth X rays.

If your child grinds or clenches his or her teeth, discuss the problem with your family dentist. Although many children eventually outgrow bruxism, even short-term tooth grinding can cause damage to your child’s permanent teeth.

Expected duration

Usually children between 3 to 10 years of age who have bruxism will spontaneously stop by the age of 13. Yet considerable precautions need to be taken to preserve the tooth structure.

In teenagers and adults, the duration depends on the cause. If its due to stress the habit will not go away unless the stress factor is removed and in case of dental related problems, it will stop when the problem is corrected.

Prevention

If the cause of bruxism is stress you need to get help by professional counselling and find a way to manage the stress and relax If your bruxism is related to stress, you may be able to prevent the problem by seeking professional counseling or by using strategies to help you learn to relax. Also, try cutting down on stimulants such as tobacco and caffeine.

In both children and adults, tooth damage related to bruxism can be prevented by wearing a night bite plate or a bite splint (a dental appliance worn at night to stop teeth grinding).

 

Bad Breath (Halitosis) – By Dr. Nivedita

What is bad breath ?

Bad breath, also known as halitosis, is breath that has an unpleasant odor. This bad breath can be persistent or periodic as well depending upon the cause.This odor is due to the millions of bacteria present in the mouth particularly back of the tongue. The mouth’s warm, moist conditions make an ideal environment for these bacteria to grow. Most bad breath is caused by something in the mouth.
Some types of bad breath are considered to be normal such as morning mouth which is caused due to dry mouth as the saliva that washes away the decaying food and odors during the daydiminshes in the night. The dead cells adhere to the tongue and inside of cheeks. Bacteria use these cells for food and expel compunds which leave a foul odor.

What causes bad breath?

  • Poor oral hygiene
  • Respiratory tract infections
  • Infections in the mouth
  • Xerostomia ( dry mouth )
  • External agents
  • Systemic illness

Symptoms

Often people may or may not know if they have a bad breath unless and until told by someone else.

How to find out?

A dentist or physician may notice the patient’s bad breath while the patient is discussing his or her medical history and symptoms. In some cases, depending on the smell of the patient’s breath, the dentist or physician may suspect a likely cause for the problem.

Your dentist will review your medical history for medical conditions that can cause bad breath and for medications that can cause dry mouth. Your dentist also will ask you about your diet, personal habits (smoking, chewing tobacco) and any symptoms, including when the bad breath was noticed and by whom.

Your dentist will examine your teeth, gums, oral tissues and salivary glands. He or she also will feel your head and neck and will evaluate your breath when you exhale from your nose and from your mouth. Once the physical examination is finished, your dentist may refer you to your family physician if systemic problems are the most likely cause.

Prevention

Bad breath caused by dental problems can be prevented easily. Daily maintenance calls for brushing your teeth, tongue and gums after meals, flossing, and rinsing with mouthwashes approved by the American Dental Association (ADA). Regular visits to the dentist atleast twice a year should be made for dental examinations and for professional teeth and gum cleaning.

Bad breath also can be combated by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles. Other products that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, raw carrots and celery.

 

Treatment

The treatment of bad breath depends on its cause.

Knocked out or Avulsed tooth ! – By Dr. Annie Roselin

Children are more prone to injury while playing sports , fights or  fall . In addition to the pain and trauma , tooth loss will cause more mental trauma to the kid . Knocked out tooth , called as Avulsed tooth by  the dentists is one of the serious emergencies faced by the permanent teeth.

If you encounter a child with avulsed tooth , don’t panic. Calm the child , search for the tooth and pick it by holding the crown ( white tooth ) portion . Do not touch the root portion .

If the tooth is dirty, rinse it in milk ( if available ) or tap water gently for 10 seconds. Do not wipe it with cloth or hands. Try to put the tooth back in position and ask the child to bite on a handkercheif . In most cases , it will slip into right position , but remember not to force the tooth . Consult your nearby dentist quickly for further treatment.
If the tooth cannot be positioned , place it in the child’s mouth between the cheeks and teeth .

If the child is not mature enough to handle the tooth without swallowing it , keep the tooth in a wet medium like milk , saliva, coconut water or green tea. The best medium to transport avulsed tooth is HBSS ( Hank’s Balanced Salr Solution) but it is often not available . If these are not available simply place the tooth in running water and rush to your dentist as soon as possible .!

 

What your dentist will do ?


Your dentist will clean the infected area and reposition the tooth in correct position and splint it with adjacent teeth using composite or wire and will start root canal treatment right away or wait. However , the treatment will differ if the tooth or the bone around it is broken . The dentist will require a follow up in a week’s time or after 2 – 3 weeks and thereafter once in 6 months to ensure that tooth is re implanted successfully


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