Tuesday, 16 July 2013

Teeth Cleaning

How Do Dentists Clean Your Teeth - Scaling and Polishing or Teeth Cleaning Process

Do you want to get your teeth cleaned but you are scared or curious about the procedure then sit back and relax I'll explain every detail to you
Teeth cleaning is a layman term which is used by common people but when you enter a dental clinic your dentist or hygienist will use a term called as scaling and polishing or oral prophylaxis for the same process, Don't panic they will only clean your teeth and nothing else.

Now let's discuss the procedure
Teeth cleaning can be done by an authorized dental hygienist or a dentist in a proper controlled and sterile environment of the dental clinic.
When you reach dental clinic, First you will be questioned about your health history and other dental and medical health problems.
If they see no health related problem which is related to the outcome of the procedure then they will make you lie down on a dental chair with semi supine or supine position.
There are two type of methods to clean your tooth
1. Manual instruments- These are hand held stainless steel instruments with minute heads for cleaning various surfaces and interdental reas of tooth. These instruments are called as Perodontal scalers.
2. Ultrasonic scaler- this is an advanced way of cleaning teeth, this equipment have interchangeable tips which vibrates and causes dislodgment of any debris on the teeth.
What ever is the method objective of teeth cleaning is same:
Removal or plaque, calculus and food debris from the tooth surface and interdental area.

1.Hand instruments-
Hand Scalers
If your dentist is using hand held periodontal scalers then it will take more time, He will adapt the instrument on the tooth surface and then give a stroke to remove the plaque or calculus, He will repeat this process on all the teeth and on all the surface of the tooth. even between the interdental area of teeth. He may irrigate the area with chlorhexidine mouth wash. This process is usually painless if done properly. 
After Scaling is completed he will use a prophylaxis paste to clean and polish the tooth surface, this paste is loaded on a rubber cup which is mounted on a handpiece like device. The polishing cup will rotate and polish the tooth surface.
2.Ultrasonic scalers-
Ultrasonic Scaler
If your dentist is using ultrasonic scalers then you may find the process done faster, Ultrasonic scaler is a kind of machine which produces vibrations at a controlled frequency, This vibrations are transmitted to the tip of the instrument. when this tip comes in contact with the tooth surface it removes any kind of calculus or palque from the tooth surface.
This machine is much easy and fast to handle. If done correctly it will produce no pain and no side effects or harm.
Polishing is done after teeth cleaning in same manner as above mentioned.
If you have lots of debris and if your oral hygiene condition is bad then dentist may take multiple visits for the teeth cleaning.

Removable Dentures

What Are Dentures Made Of

You want to know what dentures are made up of this means- You may be wearing a denture or you just have some curiosity to know. What ever may be the cause I'll tell you the answer in very detailed manner.
Dentures ( I'm here talking about the Removable Dentures what old people wear not fixed one) can be defined as removable dental prosthesis with artificial teeth attached to the denture base that replaces the masticatory surface and associated structure of a mxillary or mandibular dental arch.

Earlier when advanced materials were not discovered dentures were made of  vulcanite, vinyl plastics, Type IV Gold. Chrom Cobalt alloy and Porcelain. But now advance materials are discovered which are more life like and more biocompatible. 

If I tell you in one line- Dentures are made of Arcylic Resins 
Denture base resins come in two forms which are mixed at the time of denture fabrication of denture- Powder form and Liquid form

Powder form contents-
  • Main component - Polymethylmethacrylate.
  • Initiator- Benzoyl peroxide or disobutylazonitrate.
  • Pigments- Mercuric sulfide, cadmium sulfide.
  • Opacifiers- Zinch or Titanium oxide.
  • Dyed organic fiber- Nylon or acrylic fibers to produce effect of minute blood capillaries.
  • Plasticizer- Dibutyl pthalate.
  • Inorganic particles- Glass fibers or zirconium silicate.

Liquid Form Contents-
  • Main component- Methylmethacrylate
  • Inhibitor- Hydroquinone
  • Accelerator- N,`N-dimethylparatoulidine
  • Cross linking agent- Glycol diethacrylate 
Denture teethDenture teeth are also made up of acrylic resin but they are company made and prefabricated. Lab technician just applies the dentist recommended teeth according to the case.


Gum Health

Gum Infection Symptoms that indicates- You need a Treatment

 Gum infection is one of the commonest problem in humans and in 90% of the cases it occurs due to bad oral hygiene, but there are many factors like medical conditions, food habit, medicine we use; which are also responsible for it.
In medical terminology Gum infection is called as Gingivitis or Periodontitis depending upon the severity of condition.
So today we will learn to recognize gum infection symptoms because 40% of people can’t recognize they have gum infections until it gets very bad.
You may like to have a mirror with you while reading this, to check the symptoms one by one.

11 Gum Infection Symptoms you must know about

1.Bleeding gums-

This is the first symptom of gum infection, people first see this kind of symptom while
brushing their teeth, person suffering from gum infection will see blood in tooth paste foam when they spit in sink or while eating hard food. Bleeding occurs from the junction of the gum and tooth, even a slight irritation of gums will induce bleeding.

2.Redness of gums-

Normal color of gum is pink but in gum infection cases redness of gums can be seen, at first the redness is around the margins of the gum but it may become diffused later on, in acute conditions you will see marked redness combined with gum bleeding. This redness may be seen around single tooth or it can be seen generalized in all the gums. This redness is sign of inflammation and goes after treatment.

3.Bluish or purple gums-

In some cases when the infection becomes chronic; the color of gum changes from red to bluish purple this is sign of venous engorgement of the blood vessels in gums whenever you seen such kind of coloration of gums it’s time to go to your doctor.

4.Bad breath- This is second most common sign of gum infection after bleeding gums, those people who
have bad breath are prone to have gum infection, bad breath signifies high level of bacterial grown in your mouth and hence a compromised oral health. Best way to test bad breath- lick your wrist and wait for some time then smell that area f your experience fowl smell then you are suffering from halitosis.

Want to know How to get rid of bad breath or Halitosis

5.Swollen and spongy gums-

This is the point when patients really start to notice the problem. Gums become swollen and puffy, its surface loses stippling and becomes smooth, when swelling enlarges then ulceration may develop over them, ulceration are due to mechanical trauma while eating. Swelling may be over one tooth or it may be generalized.

6.Recession of gums-

This symptom indicates that gum infection is in the advanced state of its development, in this symptom the gums leave it natural position and move down toward bone this may expose the roots and may form gaps between the teeth. This occurs due to loss of underlying supporting bone. Some time it may be associated with single tooth and some time it is generalized.

7.Bad taste in mouth- advanced gum infection causes pocket formation at the junction of the tooth and gum, these deep pockets harbor bacteria and debris these pockets may result in exudates formation and these exudates result in bad taste.

8.Sensitivity- This gum infection symptom indicates serious problem. Gum recession will results in exposure of root surface which intern results in sensitivity, tooth will look longer then it usually are and patient may feel sharp pain like feeling while having cold stuffs.

9.Tenderness & pain- In advanced stage of gum infection pain can be experienced by the patient this pain can be from gums and some time the tooth associated with the infected gums will become symptomatic and it will become painful.

10.Ulcerated gums- If ulcers can be seen on the gums that means acute form of gum infection. If gum ulceration is generalized then it indicates some serious oral disease, get it checked.

11.Hyper salivation or pasty saliva- As your gum infection get established for long time it may result in increased salivary flow this is a usual sign of infection in mouth, in chronic cases saliva becomes pasty.

Conclusion: A Research by National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland says that there is lack of awareness of Gum infection symptoms in patients and there is lack of interest in assessment of the problem by the general dentist. This problem can only be prevented and cured with the help of individual and professional effort.


Dental Braces

Braces are indeed the solution for you, your orthodontist will prescribe an appliance specific for your needs. The braces may consist of bands, wires, and other fixed or removable corrective appliances.

Generally, there are three types of braces:

  • Brackets: Made of stainless steel or clear or tooth-colored ceramic or plastic, brackets are bonded to the front of each tooth. Ceramic or plastic brackets are often selected for cosmetic reasons. Plastic brackets, however, may become stained and discolored by the end of treatment. Another disadvantage of ceramic or plastic brackets is that they cause more friction between the wire and brackets, which can increase treatment time.
  • Lingual-type brackets: These are brackets that attach to the back of teeth, hiding the bracket from view.
  • Traditional bands: These are the generally outdated "full metal-mouth" look, which consists of the use of metal brackets soldered to metal bands that wrap around each tooth.
Newer "mini-braces," which are much smaller than traditional braces, may be an option for some. Your orthodontist will discuss the various types of available braces with you and determine which might be the best option for you.

How Do Braces Work?

In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction. As the teeth move, the bony tooth socket reabsorbs and changes shape as pressure is applied.
Braces are made up of the following components:
  • Brackets are the small squares that are bonded directly to each tooth with a special dental bonding agent or are attached to orthodontic bands. Brackets act like handles, holding the arch wires that move the teeth.
  • Orthodontic bands are stainless steel, clear or tooth-colored materials that are cemented with dental bonding agents or cement to teeth. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more cosmetically appealing options but are more expensive than stainless steel. They are not used in all patients. Some people have only brackets and no bands.
  • Spacers are separators that fit between teeth to create a small space prior to placement of orthodontic bands.
  • Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Arch wires can be made of metal or be clear or tooth-colored.
  • Ties are small rubber rings or fine wires that fasten the arch wire to the brackets. They can be clear, metal or colored.
  • A buccal tube on the band of the last molar holds the end of the arch wire securely in place.
  • Tiny elastic rubber bands, called ligatures, hold the arch wires to the brackets.
  • Springs may be placed on the arch wires between brackets to push, pull, open or close the spaces between teeth.
  • Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (A headgear is another tool used by orthodontists to aid in correcting irregularities of the teeth; see below)
  • Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit of individual teeth.
  • Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct bite discrepancies and also to create room for crowded anterior teeth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap.

Oral Surgery

What is Marsupialisation Or Partsch Operation - Indication, Advantages, Procedure 

Marsupialisation or Partsch operation is a conservative surgical procedure for management of cysts in oral cavity and other parts of the body.
A cyst is a sac like pathology which can develop in any part of the human body. When a cyst grows to such a big extent that complete removal of the cyst will result in permanent structural and functional loss then marsupialisation is advised.
Procedure in layman terms- The roof of the cyst is removed and the cavity is evacuated the cyst lining may be left intact at that movement but cystic contents are removed and the cyst is left open. Edges or the border of the cyst are stitched with the normal outer epithelium.
This technique relives the intra cystic pressure and reduces size of the cyst and promotes healing. This procedure also reduces the chances of the reccurrency.
After some time when there is enough healing and cyst have been reduced in size then cystic lining can be removed or any kind of cyst removal surgery can be performed, following which the cyst is closed.    
Partsch was the person who invented this technique hence the name Partsch operation is applied.

Indications for Marsupialisation-

When cyst cavity is so big that complete removal of cyst will result in excessive structure loss.
  • When cyst is in proximity with vital structure which will get harm if complete cyst is removed.
  • When cyst have tendency of high recurrence.
  • Those cyst which have character of high volume intra cystic liquid production.
  • Compromised cases which does not advocate for complete removal of the cyst.
  • Usually used in bartholin cyst. and large dentigerous cyst.
  • Conservative operation so it will conserve soft tissue and bone structure.
  • Success rate is high.
  • chances to damage to adjacent vital structures is reduced.


Tooth Fillings

What Are Tooth Fillings Made Of - Things About Tooth Filling You Never Knew 

 Tooth fillings have been an ancient type of dental treatment, although it have been developed and procedure have been made more advanced in the mean time.

In layman term it is called as tooth filling but in dental terminology it is called as dental restoration; It tells us about the objective of the procedure, The objective is to remove the decay and then restore the functional as well as aesthetic requirements of the tooth.
Let's see what type of materials are been used for the filling of the tooth. I'm listing the filing materials in chronological manner from oldest to newest.

Direct filling Gold- gold is the only type of restoration which i used in pure metal form. It is used
to fill small cavities and it is claimed to be most long standing and permanent type of filling. 24 carats pure gold is used for filling the cavities.

It comes in different forms like Gold pallets, Gold foils, Powdered gold. It is outdated due to it's high cost and technique sensitiveness .

Dental Amalgam- (Silver filling)- Dental amalgam alloy is a type of filling material in which two or
more metals are mixed together to form a solid stable restoration, Mercury in liquid form and Silver powder in solid form is is used. Silver powder with other alloys(Tin, Copper, Zinc) is collectively called a silver amalgam alloy.

Dentist will remove the decay and prepare a desired  shape of the cavity to accept the restoration. Then mercury and silver amalgam powder are mixed with the procedure called as Trituration. A soft mass is developed and condensed in the cavity.

Dental Cements-  Lots of dental cements have been developed by the time and they have been used of various purposes in dentistry like Temporary filling, Permanent filling and for fixing the crowns and bridge. I am listing some selected dental cements although n numbers of cements are available.

Zinc Oxide Eugenol- Used for Temporary restoration, Used as thermal insulating base under
metal  restoration, Pulp capping, Cavity Liner, Root canal sealant, surgical dressing.

Zinc Phosphate Cement-Luting(sticking) agent for restorations, Intermediate restoration, Insulating base bellow metal restoration.   [picture not given]

Glass ionomer- one of the most popular dental cements in present world. White in color and
comes in different shades, contains fluoride and have excellent tooth bonding capacity, high strength and wear resistance have made it a good posterior and well as anterior restoration material.

Composite Resin- This is one of the cutting edge technology in which more then one kind of materials are mixed together to make a composite which is superior in quality then both of the parent materials.
Dental composite is used for cosmetic fillings, bonding and restoration of chipped tooth, and a core in post and core build up.

The list of dental filling materials is endless so I have mentioned some popular materials.

What is Pericoronitis

Pericoronitis is an acute infection which causes swelling or inflammation of gums and surrounding soft tissues of a partially erupted tooth. Pericoronitis usually occurs in lower wisdom tooth area. Wisdom teeth usually erupt in late teens. When there is not enough space for wisdom tooth to erupt, then tooth becomes impacted.  Wisdom tooth may be partially or completely impacted. A flap of gum tissue is created in partially erupted wisdom tooth where food impaction can occur. Soft tissue flap covering partially impacted tooth is known as operculum. Entrapment of food below operculum or injury by the opposing tooth on operculum can lead to Pericoronitis.  When the flap becomes inflamed and swollen, then it is known as Pericoronitis. Pericoronitis can also occur in relation to completely impacted wisdom tooth or partially impacted wisdom tooth.

Signs and Symptoms of Pericoronitis

  • Gum tissues in relation to partially impacted tooth become swollen and inflamed.
  • Gum tissue will appear red and pus will discharge from gums in relation to tooth. Pus can result in increase in bulk of flap and can interfere with jaw closure.
  • Lesion will be extremely tender and painful and pain may also radiate to ear, throat and floor of mouth.
  • Bad taste and bad odor is present from oral cavity.   
  • Patient will have difficulty in swallowing and will have difficulty in closing the jaws. Pain will aggravate on biting from opposite tooth as it will cause trauma to the flap present around the affected tooth.  
  • Swelling of cheeks may also occur in Pericoronitis.
  • Swelling of lymph nodes (Submandibular lymph nodes) and jaw muscles spasm may also occur in Pericoronitis.
  • Fever, increase in number of white blood cells (Leucocytes) and malaise indicate sever infection.

Diagnosis of Pericoronitis

Pain, swelling and redness in relation to partially erupted tooth will diagnose Pericoronitis.

Treatment of Pericoronitis

Treatment of Pericoronitis depends on many factors. Treatment depends on:
  • Severity of swelling which is present
  • Whether  the involved tooth is to be extracted  or not and
  • Whether systemic complications are present or not.
Debridement of area is done by cleaning the area. Flap is raised and pus and debris is removed by rinsing with water after giving topical anesthesia to the patient. If severe acute symptoms are present, then antibiotics are also prescribed to the patient to reduce the infection.
Patient is instructed to do hourly rinses with solution of tea spoonful of salt in glass of warm water. Patient should take more of fluids and should maintain good oral hygiene to avoid any food accumulates in wisdom tooth area. Patient should brush and floss properly to avoid any food deposits. Food deposits will aggravate the pain. Pericoronitis infection can regress in duration of 5-7 days. If tooth doesn’t erupt completely, then food accumulates will keep depositing below the gums and can cause Pericoronitis to recur.
Operculectomy that is surgical removal of flap over partial erupted tooth can also be done in case of Pericoronitis.      
Dentist may or may not remove the involved tooth. Dentist will do examination and will make out that whether tooth can completely come or not.  If the tooth can erupt completely without any complication, then dentist may not do tooth extraction. 
If tooth is to be retained and is not to be pulled out, then surgical procedures using periodontal knife or electro-surgery may also be required. After giving anesthesia to the patient, to remove the tissue, wedge shaped cut is made on gums. Periodontal pack is given after tissue removal.

Pericoronitis Home Remedy

  • In initial stage of Pericoronitis, patient can do rinses with solution of tea spoonful of salt in glass of warm water. Rinse with this solution 2-3 times a day.
  • Patient should brush his teeth after meals to remove the left over food particles in mouth. Food particles present over involved tooth site will aggravate the pain. 

Prevention of Pericoronitis

To prevent chances of Pericoronitis, patient should maintain good oral hygiene by brushing and flossing regularly. This is done to avoid deposits under gums. If Pericoronitis reoccurs, then flap of gum tissue is removed by the dentist. Flap of gum tissue may grow back again and in that case, extraction of wisdom tooth is required. 

When to Consult an Oral Surgeon

If symptoms of Pericoronitis are present, then patient should visit his oral surgeon. If patient’s wisdom teeth are erupting, then he should visit his dentist twice a year for examination.

Complications of Pericoronitis

  • It may become localized in form of pericoronal abscess.
  • Cyst formation can occur in case of partially erupted vital tooth.
  • Pericoronitis can cause difficulty in swallowing if it spreads to back soft tissue.
  • Peritonsillar abscess formation, cellulitis, Ludwig’s angina are infrequent but can occur as a complication of Pericoronitis.