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Choosing Right Type Of Braces

Sun, 06 Jul 2008 01:34:49 GMT

Once a diagnosis is made, the orthodontist can then decide on the right kind of treatment. In some cases, a removable retainer will be all that's necessary. In other rare cases (especially when there is an extreme overbite or underbite), an operation will be necessary. But in most cases, the answer is braces.Braces simply do the work of alignment.

Braces straighten teeth because they do two very important things: stay in place for an extended amount of time, and exert steady pressure. It's this combination that allows braces to successfully change the arrangement of teeth in a patient's mouth, periodically adjusted by the orthodontist.The type of braces you get depends on a number of factors:

The extent of your treatment, such as:

The severity of your bite or tooth crookedness problems
If extractions are necessary
If jaw surgery is necessary
If headgear or other special appliances are necessary
The amount of time you will need to wear braces
The preferences of your dentist or orthodontist
How much you are willing to pay
How long you will be in braces to correct your problems
What you, yourself desire?. Would you feel embarrassed in metal? Are you only willing to straighten your teeth if Invisalign is used? Do you prefer the look of ceramic or sapphire? Or don't you care, as long as the outcome is good.

TYPES OF BRACES

Ceramic and "Tooth Colored" Braces

Clear Inspire Sapphire Braces

Invisalign Braces

Lingual (behind-the-teeth) Braces

Metal Braces (including Self-Ligating Braces and Viazis Braces).

The most practical and widely used braces are the metal ones but for cometic purposes people use the other ones.

METAL BRACES

Stainless (Metal) Braces are the most popular type of braces due mainly to its rugged functionality and manageable cost. Most patients request COLORED ties. At each appointment you may have your colors changed. You can look forward to making a fashion statement after each visit. The patients allergic to this kind of material are in good times of many other options available today.

DAMON BRACKETS

In terms of popularity these are next to metal braces. It is an invention of dentist DAMON DWIGHT .These braces are popular as they work on sliding door technology called self litigation. The braces have wire which by its back and forth motion are more comfortable due to less friction. these braces take less time and number of adjustments.

CERAMICBRACES
Ceramic brackets are made of a high tech glass-like composite material developed as a spinoff material by the NASA space program. They are very strong and generally do not stain. These are the type of braces many celebrities had worn/wear. Adults like to choose ceramic because they "blend in" with the teeth and are less noticeable than metal and dont make our smile look metallic. A clear or tooth colored tie is used with ceramic braces. Most family and friends will not even notice your braces. Ceramic braces are guaranteed not to stain by the manufacturer, barring some foods, coffee, coke, curry, smoking etc and are expensive.

SAPPHIRE INSPIRE! BRAND BRACES

Inspire are made of pure monocrystalline sapphire and are very translucent. They are very strong and do not stain. It will more or less disappear if your teeth are already very white. The pros and cons for Sapphire brackets are the same as those for Ceramic brackets.

TRADITIONAL SILVER BRACES

These are the most common and most popular style of braces. The brackets are state of the art and provide the most efficient & precise movement of the teeth and can be decorated to reflect each person's sense of style and personality! You can try new color combinations and patterns as per your preferences and computer color planner results.

GOLD BRACES

Discover a new element in orthodontics...GOLD! These are similar to stainless steel braces with the exception of being gold-plated. The classic beauty and elegance of gold is now available in orthodontic braces. Adults choose to use gold braces because their beauty is more than skin deep. Gold turns the everyday appearance of regular braces into an exciting fashion statement. There are also gold wires available for this type of orthodontic appliance.

INVISALIGN BRACES

Invisalign Braces are great for people who do not have severe problems. The treatment trays are computer-fabricated by Align Technologies, the company that makes Invisalign. The "braces" consist of strong plastic trays that are custom fabricated especially for you, as everybody has a unique jaw structure. But the patients with severe malocclusions, the better option would be to wear traditional metal braces. Your orthodontist only has some control over your Invisalign treatment. It is best to get Invisalign done by a trained orthodontist
So, if your orthodontist says that you are not a candidate for Invisalign, you should probably believe it! If he or she says that Invisalign will work for you, then go for it! The cases are replete with people who have had very successful Invisalign treatment and who have been very happy with the results. These braces are indeed invisible; this appeals to adults; no irritation to gums; they do not stain.

LINGUAL BRACES
Lingual braces are placed behind your teeth. These are also called invisible braces, as they are virtually invisible to other people. Usually, lingual brackets are made of metal. The Orthodontist is specially trained in this kind of appliances.

Some of the points taken note of are that the adaptation period is 3-7 days; patient may hurt or feel irritation of tongue; chewing adjustments/difficulty towards hard food; mild speech disorder with brackets in the upper arch; these are expensive in comparison to traditional braces; The obvious benefit of this type of treatment is that no one will know that you are wearing lingual braces unless they look inside your mouth! For more information about lingual braces.

Types And Techniques Of Frenectomy

Fri, 01 Aug 2008 09:49:56 GMT

Before we get into understanding the types and techniques of frenectomy, it is very important to know what is frenectomy. Frenectomy is a surgical procedure wherein a thin layer of tissue called frenulum or frenum observed on various parts of the body is removed. So far as the dental area is concerned, frenectomy is either performed inside the middle of upper lip , which is called labial frenectomy, or under the tongue, called lingual frenectomy. Frenectomy as it is a very common dental procedure in dental world and is performed both on children and adults.

Labial frenectomy is very common with patients undergoing denture treatment in order to get the proper fit of dentures or patients who have tissues attached to centre of upper lip and causing recession of gums or gap between the upper front teeth called central incisors.

In the case of lingual frenectomy, the dentist removes the tissues / lingual frenum developed too close to the tip of the tongue which is either causing speech problems or hindering the development of teeth. Lingual Frenectomy is quite common in the case of children diagnosed withtongue tie / clipping of tongue problem.

Here is some more details of labial and lingual frenectomy. In case the readers have some more questions, dedicated dentists on our panel will be more than happy to offer free dental advice online.

Standard Frenectomy - An incision is made across the base of the frenum at its attachment to the incisive papilla.The dissection is carried down to the periosteum,and the incision is then extended along both sides of the frenum to its attachment on the labial mucosa. The specimen is placed on traction and excised from the lip. This results in a bell shaped defect. Relaxing incisions are made at the mucogingival line. The labial flaps are advanced. The diamond shaped defect is allowed to heal.

Laser Frenectomy - The lip is streached to delineate the frenum using a carbon dioxide laser,the frenum is outlined. Then the band is excised to the periosteum. Relaxing incisions are made at the mucogingival line. Hemostsis is achieved by defocusing the beam.

Mandibular Labial Frenum - The midline mandibular labial frenum is normal. But when it attaches on the interdental papilla ,between the lower incisors, it creates an adverse periodontal environment. This leads to food and plaque accumulation. The patient may develop chronic inflammation, a periodontal pocket and a recession of the attached gingival. Failure to eliminate this abnormal frenum pull may lead to bone loss and mobility of the lower central incisors.

Techniques

Excision -The frenum is excised. The wound edges are undermined, relaxing incisions are made and wounds closed. (As shown in the diagram)

Excision and Z-Plasty Closure - The band is excised and the wound closed using a “Z” Plasty rotational flaps

Lingual Frenum or TongueTie - A prominent lingual frenum, attached high on the lingual alvelor ridge, is seen commonly in infants. This causes decreased tongue mobility and the fear of future speech impairment. The lingual frenum becomes less prominent during the first 2-5 years of life. Children in mixed dentition may complain of difficulty moving their tongue. A lingual frenum with high attachment on the alveolus may contribute to gingival inflammation and recession in relation to the central incisors. Lingual frenectomy is performed more commonly for one of the above reasons than for speech articulation problems.

Techniques

Excision and V-Y Closure - The frenum is cut from the attach menton the alveolar ridge. Then a traction is applied with forceps. Parallel incisions extending along the floor of the mouth and ventral surface of the tongue are made and the band of tissues is removed. Relaxing incisions are then made at a junction of the floor of the mouth and the ventral surface of the tongue converting a straight line defect to a ‘V’. The defect is then closed as ‘Y’ with 4-5 chromic catgut sutures. This process accomplishes excision of the frenum and simultaneous lengthening of the lingual sulcus.

Excision and Z-plasty Closure - An alternative is frenectomy with single or multiple Z-plasties to lengthen the ventral surface of the tongue.Two large triangular flaps are created on the ventral surface of the tongue. The flaps are transposed as ‘Z’ plasty. This improves the tongue’s mobility without endangering the submandibular ducts.

Laser Excision - Tongue Tie may also be corrected using Carbon dioxide laser. Traction is applied to the tongue to identify the frenum. With the laser set at 7watts in the pulsating mode, the frenum is outlined. Then, using a continuous mode, the frenum is excised. Relaxing incisions are made at the junction of the floor of the mouth and the ventral surface of the tongue. Hemostasis is achieved by defocusing the beam and lasering the bed.

Do's And Don'ts After Tooth Extraction

Sun, 06 Jul 2008 01:36:53 GMT

Whenever any surgery / Tooth extraction takes place the first thing we want is to let it heal properly ,quickly and smoothly. As a common practice, most of the dental surgeons have standard post surgery instructions printed which are handed over to the patient. One must follow these instructions given by the dentist. Apart from those instructions there are few things which need to be taken care post extraction.

Try to take some rest. You may feel great but don’t exercise at least for a day.When taking rest,keep your head lifted on a pillow.

Let the clot be formed on the tooth extracted site , which covers it and allow it to heal. Bite on the gauze piece, which the dentist has put on the extraction socket, minimum for an hour. Don’t chew on that gauze piece but put a steady pressure. This will help in stopping the bleeding and formation of clot which acts like a cork on the bottle. Change gauze after every half an hour depending on the amount of bleeding. If clot is dislodged,the nerve endings are exposed,nerves and capillaries spasm and constrict,limiting essential blood supply which causes delay in healing. If the bleeding doesn't stop one should try putting a wet tea bag in the site, as tannic acid present in black tea helps stop bleeding.

Don’t spit minimum for 24 hours because it can dislodge the clot. If the clot is dislodged you can have very painful condition known as dry socket. Afterwards one should spit 3-4 times in a day so that no food is lodged near the area where the tooth is removed. Dentist may advice CHLOROHEXIDINE mouth rinses as they kill bacteria.

Don’t smoke for 48 hours. The chemicals in the smoke can effect the clot and hence the chances of developing dry socket.

Don’t take solids till the numbness is there. When you start feeling your jaws you can start taking solids.

Take your medicines as prescribed by your dentist. Don’t skip the medicines. If antibiotics are given they should be taken regularly. Pain killers and anti-inflammatory drugs help in reducing the pain and swelling. If the pain continues even after two days and bleeding starts then you should call your dentist.

Avoid sucking of any type-SMOKING, SIPPING, EATING HARD VEGETABLES. Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. Avoid hot drinks, spicy foods, sodas, etc.

If you are daring enough to avoid these instructions, you may be a strong contender for some complications.

WHAT COMPLICATIONS CAN BE THERE AFTER EXTRACTION?

Bleeding
Infection
Dry socket
Jaw fracture
Sinus perforation
Broken Bone Fragments (Sequestrii)
Part of the Tooth Left (Retained Roots)
Osteonecrosis

Bleeding : If one follows the instructions of the dentist after extraction to take rest and to keep the gauze piece for 1 to 2 hours after extraction then the problem of bleeding is not there. The patients who are taking anticoagulants like Heparin or Coumadin or the patients who have bleeding disorders like hemophilia should give the history to the dentist. The patients who are taking aspirin or nonsteroidal analgesics have increased bleeding time.

Infection : Infection is the most common complication after extraction. Our mouth Is full of bacteria. One cannot sterilize it. Dentist decides whether to give antibiotics after the extraction or not. Normally for the simple extractions antibiotics are not required but if patient has pain and swelling or pus then it is better to go for preventive antibiotics. Bleeding continuing after 48 hours, acute pain and swelling are very common signs of infection after the extraction and the patient must visit the dentist in such circumstances to avoid further complications.

Dry Socket: It is the most dreaded and painful condition which can happen after extraction. For a day or two after extraction the patient is fine, and then he has acute pain and becomes very restless. Patient complains of bad taste in the mouth. It is more common after the extraction of lower teeth than the upper teeth. It can happen even after the simplest extraction.

Jaw Fracture : It can happen but very rarely and that too in lower jaw. The dentist who is doing the extractions knows that how much pressure has to be put to pull out the tooth. But sometimes dentist before doing the extraction see the x-ray and tell the patient that the bone structure around the tooth has become fragile and chances of fracture are there. In such cases patient and the dentist are prepared beforehand to manage the situation.

Sinus Perforation: The back teeth are in close proximation with the sinus. Sometimes if you see the x-ray it looks as if the roots of the back teeth are virtually in the sinus. It never happens. There is always a thin bone separating the sinus from the roots of the teeth. But sometimes during extraction the piece of the bone comes along with the sinus. This normally happens when the tooth is close to the bone because of infection. In that case perforation occurs. If perforation occurs you cannot suck because in that case the air will rush from the nose to the sinus and through perforation to the mouth. If the perforation is small the patient complains of bleeding from nose. If the perforation occurs then the patient should follow certain instruction like:

Do not suck anything till the extraction socket heals.
Do not do anything which will dislodge the clot. If the clot is not disturbed then no complication arises.
Do not smoke at least for a week because the chemicals in the smoke either dissolve the clot or dislodge it.
Do not blow up the balloons or anything else, it will disturb the clot..
Avoid aerated drinks instead you can take fruit juices.
Don’t sneeze, it sneezing will surely dislodge the clot.

If the perforation is big and it does not heal by itself then another surgical procedure is carried out in which tissue graft is put to close the perforation.

Treatment Of Thumb Sucking

Sun, 06 Jul 2008 01:25:12 GMT

Thumb Sucking in children usually starts at the age of 6months, at times before birth. Children have a natural tedency to suck. This habit may involve sucking of thumb, digits or pacifiers. Children develop this habit to suck whenever they are hungry, tired, restless, bored or sleepy. 90% children stop by the age of 3-6yrs. If it continues beyond that it needs to be treated.

For the treatment to be successful, one should first make the child awared of the consequences thumb sucking might have.

The treatment plan can be broadly divided into the following:

Psychological Therapy

Screen the patient for the underlying psychological disturbances that sustain a thumb sucking habit. Once psychological dependence is suspected, the child is referred to professionals for counseling. Dont start the treatment if the child is undergoing emotional turmoil such as loss of favorite toy, of a pet etc.
Thumb sucking children between the ages of 4 and 8 years of age need only reassurance, positive reinforcement and friendly reminders. Awareness of the habit can be accomplished by emphasizing the positive aspects of habit cessation. Various aids are employed to bring the habit under the notice of the child such as study models, mirrors, etc.
Children and parents are informed about existing dentofacial deformities and the long-term risks of a sustained habit. Patients should be presented with positive mental and visual images of the dentofacial ideals expected from habit cessation and subsequent orthodontic treatment.
During the treatment adequate emotional support and concern should be provided to the child by the parents.
Destructive approaches in the form of nagging, shamming and belitting ought to be strictly avoided.
Constant reassurance and encouragement should be provided to the patient to gain his confidence.
The use of positive behavior modification techniques and even hypnosis has been effective in digit habit therapy. When the habit is discontinued, the child can be rewarded with a favorite new toy or special outing.
Engage the child in activites he/ she enjoys so that he forgets to suck.
Talk openly (if he understands) to your child about the speech and dental consequences.
Praising the child in front of others for his efforts to stop his habit and asking him to encourage others to do so.

Dunlop’s beta hypothesis:

He believed that if a subject can be forced to concentrate on the performance of the act at the time he practices it, he can learn to stop performing the act. Forced purposeful repetition of a habit eventually associates it with unpleasant reactions and the habit is abandoned. The child should be asked to sit in front of a mirror and asked to suck his thumb, observing himself as he indulges in the habit.

Reminder therapy:

This can be divided into the following

Extra oral approaches:

It employs hot tasting, bitter flavored preparations or distasteful agents that are applied to finger or thumbs. For example, Cayenne pepper, quinine, asafetida. This is effective only when the habit is not firmly entrenched.

Thermoplastic thumb post was devised by Allen in 1991 where a thermoplastic material was placed on the offending digit. A total of 6 weeks of treatment time was required for elimination of habit.A thumb post is placed over the thumb with wrist bands covering the wrist.These bands come in various colors so that the child feels great wearing them.

Intraoral Approaches

Various orthodontic appliances are employed to attenuate and eventually break the habit.

Removable appliances used may be palatal crib, rakes, palatal, arch, lingual spurs.

Hawley’s retainer with and without spurs. Fixed appliances such as upper lingual tongue screens appear to be more effective in breaking these habits. If the child has made appreciable changes in his habit by 3 months, the appliances can be safely removed for a testing period. If gross signs of anxiety are aroused e.g. bed wetting, bad dreams, etc, the appliance should be removed.

Mechanotherapy:

Fixed intra-oral anti thumb sucking appliance:

Most effective mechanical deterrent to thumb sucking is an intraoral appliance attached to the upper teeth by means of bands fitted to the primary second molars or the first permanent molar. A lingual arch forms the base of the appliances to which are added interlacing wires in the anterior portion in the area of the anterior part of the hard palate. It works by preventing the patient from putting the palmer surface of the thumb in contact with the palatal gingival, thereby robbing the pleasure of sucking.

Blue grass appliance:

Haskell (1991) introduced this appliance, for children with a continued thumb sucking habit, which is affecting the mixed or permanent dentition. It consists of a modified six sided roller machined from Teflon to permit purchase of the tongue. This is slipped over a 0.045 stainless steel wire soldered to molar orthodontic bands. This appliance is placed for 3-6 months. Instructions are given to turn the roller instead of sucking the digit. Digit sucking is often seen to stop immediately. .

Quad helix:

This appliance prevents the thumb from being inserted and also corrects the malocclusion by expanding the arch

Examination Of Thumb Sucking Patient

Sun, 06 Jul 2008 01:25:12 GMT

Examination of a thumb sucking patient by the dentist involves taking history from the patient and/or parents involving complete knowledge of behaviour, habits and intensity of problem. It includes physical examination of the feature and intra oral examination of the patient. The complete process of this examination has been classified as under:

History of the Patient

· Determine the psychological component involved

· Question regarding the frequency, intensity and duration of the habit.

· Enquire the feeding patterns, parental care of the child.

· The presence of other habits should be evaluated.

· The diagnosis of a digit habit can also be obvious when the child is actively performing the habit. However, during a dental appointment a child may seldom indulge in his habit.

EXTRA ORAL EXAMINATION

Various key areas to be noted include the following:-

· The digits:

Digits that are involved in the habit will appear reddened, exceptionally clean, chapped and with a short fingernail i.e. a clean dishpan thumbs. Fibrous roughened callus may be present on the superior aspect of the finger. The habit is also known to cause deformation of the finger.

· Lips

Upper lip may be short and hypotonic. Note the position of lips at rest whether they are held together or apart. The position of the lips during swallowing should also be observed. Chronic thumb suckers are frequently characterized by a short, hypotonic upper lip. Relative tensions of the upper and lower lips also play a role during swallowing. Upper lip passive or incompetent during swallowing. Lower lip is hyperactive and this leads to a further increase in the proclination of upper anteriors due to its thrust on these teeth.

· Facial form analysis:

Check for mandibular retrusion, maxillary protrusion, high mandibular plan angle, and profile.

When swallowing, the patient is observed for presence of a facial grimace or an excessive mentalis muscle contraction, a normal placement of the tongue against the teeth and palate and whether the pattern of speech of the child is essentially normal. Facial profile is either straight or convex.

· Other features:

Features caused due to the presence of other habits along with thumb sucking. Associated symptoms that should be watched for during the initial examination are habitual mouth breathing and tongue thrust swallow, particularly in children with anterior open bite. Active thumb suckers also have a higher incidence of middle ear infections and frequently have enlarged tonsils accompanied by mouth breathing. Features of secondary habits have to be noted.

INTRA ORAL EXAMINATION

· Tongue:

Examine the oral cavity for correct size and position of the tongue at rest, tongue action during swallowing.

· Dento alveolar structures:

Individuals with serve finger or thumb sucking habits, where the digit applied an anterior superior vector to the upper dentition and palate, will have flared and proclined maxillary anteriors with diastemas and retroclined mandibular anteriors

Other intraoral symptoms will include a high probability of buccal crossbite, particularly in those children who suck their digits with a pronounced contriction of their buccal musculature and a tendency to narrow palates.

Observe the symmetry of incisal position of upper central and lateral incisors. Asymmetry indicates that the child sucks the right or left thumb or finger by preference. Measure dimensions of over-et and open bite if present.

· Gingiva:

Look for evidence of mouth breathing; gum line etching, decayed or excessive staining on the labial surface of the upper central and lateral incisors.

· CLINICAL FINDINGS:

A digit sucking habit can present without ill effects. However various malocclusions can occur in the primary and permanent dentitions.

The type of malocclusion produced by digit sucking is dependent on a number of variables (Nanda 1989)

Position of digit.
Associated orofacial muscle contractions
Mandibular position during sucking
Facial skeletal pattern
Intensity, frequency and duration of force applied.

COMMONLY OBSERVED CLINICAL PROBLEMS:

Maxillary Anterior Proclination and Mandibular Retroclination.

When a child places a thumb or finger between the teeth, it is usually placed at an angle so that it presses lingually against the lower incisors and labially against the upper incisors. This direct pressure is responsible for the displacement of the incisors. There can be variation depending on which teeth are affected, how much, which teeth are contacted, and the number of hours per day of sucking and the magnitude of pressure. Intermittent vigorous sucking does not cause as much malocclusion as that seen in a habit of 6 hours or more, especially as seen in children who sleep with the thumb or finger between the teeth all night long.

The anterior open bite:

This type of malocclusion arises due to a combination of factors. These are:

1. Interference with normal eruption of incisors due to an interposed thumb.

2. Excessive eruption of posterior teeth due to separation of the jaws, which alters the vertical equilibrium on the posterior teeth, 1 mm of elongation posterior, opens the bite by about 2mm anteriorly.

· Constriction of Maxillary Arch:

This may be because of the failure of the maxillary arch to develop in width due to an alteration in the balance between cheek and tongue pressures. If the thumb is placed between the teeth, the tongue must be lowered, which decreases pressure by the tongue against the lingual surfaces of the upper posterior teeth. At the same time, cheek pressure against the teeth is increased as the buccinator muscle contracts during sucking. Cheek pressures are greatest at the corners of the mouth and this probably explains why the maxillary arch tends to become ‘V’ shaped with more constriction across the canines than the molars.

· Posterior Cross Bite:

This occurs as a consequence of constriction of the maxillary arch. The unbalanced muscle forces on the maxilla exerted by the cheek muscles are unmet by the pressure from the lingual musculature which are normally present. While this results in a maxillary constriction, there is no restriction to the mandibular growth eventually leading to a cross bite.

Importance Of Teeth

Fri, 25 Jul 2008 03:26:03 GMT

To have beautiful smile, one should have beautiful set of teeth and that can be achieved if you know the importance of your teeth. The teeth help us to:-

Chew our food properly which is essential for body growth and health.
Speak properly – Few alphabets can not be spoken properly if we have crooked teeth or missing teeth e.g. “T” sounds as “D” if teeth are inclined towards inside.
Look beautiful – Teeth give shape to our face. If one looses few teeth, the face starts looking sunken.
Look confident – If one has beautiful set of teeth then one is confident and smiles often.

THE TWO SETS OF TEETH

In one lifetime we have two set of teeth i.e. one set of milk teeth and one set of permanent teeth. Milk teeth are 20 in number and permanent teeth are 32 in number. Milk teeth start erupting from the age of six months and by the age of 2.5 years to 3 years all milk teeth are in the mouth. Permanent teeth start erupting at the age of 6 years till the age of 13 years. Only the last molars come at the age of 18 to 25 years.

The tooth has two parts. One part is visible outside in the mouth and is called crown. The other part which is embedded in the bone is called root. The outmost layer of the crown is called enamel which is the hardest part of the body. Then comes the dentin in which we can feel hot and cold sensation and afterwards comes the pulp which has the blood and nerve supply of the tooth.

TYPES OF TEETH

The different teeth are given different names and they have different work to do.

Incisor – Front 4 upper and lower teeth are called incisors. These teeth help in incising the food.
Canine - Corner tooth, which is sharp and helps to shear the food is called canine. There are 2 in the upper arch and 2 in the lower arch.
Premolars - These are also called bicuspids or small molar. They come after canine. They are 4 in upper arch and 4 in lower arch.
Molars - These help in mastication of food. They are 6 in upper arch and 6 in lower arch. The last molars are also called as wisdom teeth.

Understanding Wisdom Teeth

Mon, 18 Aug 2008 21:26:58 GMT

Wisdom tooth is known as Mandibular Third Molar. Wisdom tooth is located distally away from second molar. In permanent dentition, no other tooth is located posterior to Wisdom Tooth i.e. it is the last tooth. One gets 4 wisdom teeth and every quadrant has one wisdom tooth. Wisdom teeth usually fully grow in the mouth between the ages of 16-25 years with 17-21 years band being most common. Wisdom Tooth drives the name of wisdom tooth by relating it with this age as it is generally believed that one gets wisdom by this age and therefore it became the saying that when these third mandibular molars grow in, one gets the wisdom thereby leading these teeth to be called as wisdom teeth. As stated above, commonly we have 4 wisdom teeth but sometimes one or two wisdom teeth don’t grow in. This is called as Hypodontia. Also in some cases, there is extra tooth i.e. the number is more than 4, in that case it is called supernumerary tooth.

Wisdom teeth (Third Mandibular Molars) straightway grow in as permanent teeth and in baby teeth there are no third mandibular molars. The wisdom teeth act the same way as other molars, with principal functionality of grinding during mastication of food i.e. chewing of food. In current times the growing in of wisdom teeth creates many problems for a person because over the centuries, the eating habits of man have changed from raw food to well cooked food, which requires much less effort to chew and due to this fact of evolution of man, the jaw size has decreased. This decreased jaw size creates problem for the wisdom teeth to grow in because of reduced space for their eruption and due to this they put pressure on the front molars by pushing them. This pushing adversely affects the other teeth which lead to pain and swelling. This condition is called impaction of wisdom teeth and to get rid of these problems, the dentist’s advice the patients to get them extracted.

Impaction of Wisdom Teeth

A wisdom tooth is treated as Impacted in condition when it does not have enough space to grow in and remains buried in the gums due to decreased jaw size. The impaction of Wisdom Teeth is of different types. These are stated as under:

Mesioangular Impaction – This type of impaction is most common. This condition occurs when the wisdom tooth is angulated towards the midline.

Vertical Impaction – Wisdom tooth is called as vertically impacted when it is straight but does not have sufficient space to erupt. This is second most common type of impaction for wisdom teeth.

Distoangular Impaction - This condition occurs when the wisdom tooth is angulated towards the back of the teeth. Distoangular wisdom tooth is easy to extract in maxilla but difficult in the mandible.

Horizontal Impaction – When the wisdom tooth is lying horizontally at 90 degrees towards the root of second molars, it is called to horizontally impacted. This type of impaction of wisdom teeth is least common.

Bony Impaction - If the wisdom tooth has insufficient space to erupt and is completely inside the bone it is called as bony impaction of wisdom tooth.

Soft Tissue Impaction – When the wisdom tooth grows out of bone but has not come out of soft tissue then it is called Soft Tissue Impaction of Wisdom Tooth.

Pericoronitis

This is another condition related with wisdom tooth is Pericoronitis. It happens when wisdom tooth is not fully erupted and the gum tissue is covering the occlusal surface (chewing surface). This soft tissue flap is called as Operculum. It is very difficult to clean the tooth with the operculum as the food gets impacted in it causing the infection in the gum around the crown of the tooth. This infection of gums is called as pericoronitis. This is a common problem which gets exaggerated by biting from the opposite tooth as it causes the trauma to the operculum. In the event of persistence of this condition, the dentist recommends the extraction of the wisdom tooth. The most common symptoms of pericoronitis are the swelling, redness of the area, difficulty in opening the mouth, bad taste, smell and pain that can go till neck. If left untreated it can cause severe infection.

Safe Medicines During Pregnancy

Sun, 06 Jul 2008 01:32:22 GMT

It is a common belief that expecting mothers should avoid taking medicines but the fact is not absolutely correct. Whenever a dentist performs some procedure, the dentist recommends certain medicines like pain killers, antibiotics etc. The following details should help the expecting mothers in clearing most of their doubts about medicines which can safely be taken during pregnancy.

PAIN KILLERS

Dental pain is the main symptom and to relieve that dentist has to prescribe the painkillers to the expecting mother. Acetaminophen is considered to be safe throughout the pregnancy. If necessary the nonsteroid pain killers like ibuprofen is safe till 32 week s of pregnancy. But sometimes the pain is severe so narcotics i.e. codeine has to be prescribed they can be given for short duration like maximum for a week. Narcotics are quickly flushed out of baby’s system by the mother’s metabolism. The baby may be bit sleepy when the expecting mother is on narcotics but there is no side effect. Still before prescribing narcotics patient’s obstetrician can be consulted.

ANTIBIOTICS

When the patient has some kind of dental pain ,it is due to some infection. So the dentist has to prescribe the antibiotic along with the painkiller. If the patient has to undergo the procedures like extraction or root canal treatment , even then the antibiotics have to be prescribed. The pencillins and cephalosporins are considered safe during pregnancy if the patient is not allergic to them. Dentist avoid prescribing tetracycline to the pregnant patient as it is known to stain the teeth of the baby which is known as tetracycline staining. Erythromycin is also safe during pregnany if the patient’s stomach can tolerate it. If the patient has severe infection like abcess formation then metronidazole can also be prescribed. Metronidazole also known as flagyl is safe during pregnancy.

FLUORIDE

Whether fluoride should be given to the expecting mother or not is a big controversy. The optimum level of fluoride makes the teeth resistant to the acid attack but at the same time high level of fluoride is harmful for not only the teeth but for the bones also. So we avoid giving fluoride during pregnancy whatever is available through water is sufficient.

ANESTHETICS

The procedures like extractions and the root canal treatment which are considered safe during pregnancy needs anesthesia and the safest is local anesthesia. Dentists avoid inhalation anesthesia or intravenous anesthesia during pregnancy(because of increased risk of miscarriage in first trimester ). All local anesthesia like lidocaine ,lignocaine, novocaine are considered safe. They are normally used without epinephrine. Epinephrine is a vasoconstrictor and its main function is to increase the time period so that the anesthesia lasts for a longer period . If the dentist think that the particular patient require anesthesia with epinephrine then patient’s obstetrician can be consulted.

Why do we need to BRUSH our teeth?

Sun, 06 Jul 2008 01:20:24 GMT

We all must have noticed a soft sticky layer forming on our teeth everyday. This layer is called PLAQUE. It is mainly formed of food debris and bacteria. Brushing teeth removes plaque and gives us clean teeth, gums and a fresh breath. For healthy teeth and gums it is mandatory to have good oral hygiene and for that brushing should be perfect.

Most dental problems are because of improper brushing technique. One may be brushing 3to4 times a day, but if brushing technique is not proper, there will be food lodgment in between the teeth resulting in oral hygiene. That is why learning proper brushing technique is very important.

HOW TO BRUSH?

There are different brushing techniques but most commonly used tech for adults is BASS and for children it is FONE’S tech.

BASS METHOD OF BRUSHING

In Bass method brush is placed at 45 degree to long axis of tooth.

In this brushing technique bristles are forced in the area between the two teeth and the junction of gums with the teeth. Then teeth are brushed with short back and forth strokes with vibratory action

The eating surface is brushed with short anterior and posterior strokes.

This brushing technique is used for routine use.

FONE’S METHOD OF BRUSHING

This brushing technique is effective for young children.

In this brush is firmly placed against teeth and gums at 90 degree on the outer surface.

Brush is moved in rotary action while teeth are closed. This brushing technique is very easy for the children to follow.

FREQUENCY OF BRUSHING

We often ask this question that how many times do we need to brush out teeth. It should be individualized on basis of

Rate of plaque formation

Caries risk

Gum diseases

It is the quality of cleaning, not the frequency which is related to disease. But brushing twice a day, once at bed time and once in the morning is recommended.

EFFECTS OF INCORRECT BRUSHING

Lots of PROBLEMS can be there because of incorrect brushing like –

gums can be receded because of which teeth look long and root is exposed. .

gums can get irritated and start bleeding

tooth staining

bad breathe called as Halitosis

periodontal problems

abrasion(wear) of the teeth takes place

teeth become sensitive to hot and cold sensation

bone loss leading to mobility and ultimately tooth loss

HOW OFTEN BRUSH SHOULD BE CHANGED?

On an average it should be changed after 3 months, when the bristles start wearing off.

It should be changed after cold and flu

We get indicator tooth brushes in which central tuft is dyed with food colorant (blue). When blue color fades, it indicates time to change the brush.

IS BRUSHING IMPORTANT FOR CHILDREN?

Many people have a belief that it is not important for small children to brush. But its not correct. It is equally necessary for children to maintain a good oral hygeine as it is for adults.

The best technique for children is FONES. Parents should encourage their children and keep a regular check about their brushing habits. Small size attractive brushes are available for children.

Types Of Dental Fillings

Sun, 06 Jul 2008 01:34:09 GMT

Dental fillings are divided into various types

DIRECT RESTORATIONS- They include the type of filling materials that are placed in the prepared cavity in a single visit. The materials included in this are resin composites, silver amalgam, glass ionomer cements, temporary filling materials etc.

INDIRECT RESTORATIONS- They include the filling materials that require more than 1 visit to be placed in the cavity. On the first day of appointment, the dentist prepares the tooth and makes an impression to record the details of the tooth to be restored. It is then sent to the dental lab. In the next visit, the material is placed in the prepared tooth. These include veneers, inlays, onlays, crowns and bridges fabricated with gold, base metal alloys, composites.

DIRECT RESTORATION

SILVER AMALGAM

Silver amalgam is undoubtedly the most commonly and widely used filling material. A properly handled silver amalgam produces a restoration that lasts for many years. It is used mostly in posterior teeth.

ADVANTAGES

Material is easily handled and manipulated
Widely used in many different types or sizes of cavities
Used as retrograde fillings
Least technique sensitive
Minimal expansion or contraction at the time of setting
Optimal compressive strength
Economical
Hardness is comparable to that of dentin and enamel
Biologically stable
Durable
Single appointment placement
Easily repaired

DISADVANTAGES

Poor aesthetics, so is not recommended for anterior teeth
Extensive cavity cutting is required
Mercury toxicity
Low tensile strength
Base is required under the filling as silver is a good thermal conductor
Poor edge strength
Qalvanic current can be produced if any other metallic filling is done in the teeth that come in contact
Amalgam blue, blackish appearance of few restored teeth
Some patients complain of hot and cold senstivity after the filling
Shows marginal breakdown

CAN BE USED IN

In patients of all ages
Stress bearing areas
In small to moderate size cavities
In patients with poor oral hygiene
When moisture control is a problem
In low economic status patients
As a foundation to metal ceramic, cast metal restorations

CONTRAINDICATIONS

Anterior teeth
Patients who have history of allergy to mercury or any other component
Silver amalgam contains silver alloy powder and liquid mercury. The silver alloy powder has constituents like silver, tin, copper and zinc. Amalgam is of 2 types Admixed alloyand Single compositionalloy. It has also been divide into High copperalloy and Low copper alloy, depending upon the amount of copper present in it

RESIN COMPOSITES

Composite resin is presently the most popular tooth colored filling material. Composite material is a compound of two or more different materials with properties superior or intermediate to those of the individual component. The various components of a composite resin are resin matrix, fillers, coupling agents, coloring agents.

The resin matrix initially used was Bis GMA(Bisphenol Glycidyl methacrylate). Now, UDMA( Urethane dimethacrylate) and TEGDMA(Triethylene glycol dimethacrylate) are also being used.

Fillers used are quartz, silica, tricalcium phosphate, zirconium dioxide. They provide strength, hardness, rigidity to the material.

Coupling agent binds the resin matrix to the filler particles. Organic silanes are commonly used coupling agents.

Coloring agents used are aluminium oxide, titanium dioxide.

Composites are divided into 3 types depending upon the size, amount and composition of the inorganic filler. These types are Conventional, Microfilled and Hybrid.

Placement of a composite filling requires an etchent (like phosphoric acid) and a bonding agent.

Various advances have been made in composites, these are Flowable composites, Packable composites, Antibacterial composites, Laser curing composites.

FAILURES OF COMPOSITE RESINS

discoloration of the fillings, specially around the margins
recurrent caries
marginal fractures
gross fracture of the restoration
failure in maintaining proximal contact
post operative senstivity

HOW TO AVOID THESE FAILURES

complete removal of dental caries
complete etching
proper isolation while placement of the restoration
uniform and single coat of bonding agent
avoid bulk placement of composite material
avoid contact with fingers or gloved hands
proper curing of composite
keep cavity as small as possible
avoid sharp internal line angles
use small increments
composite at bevelled areas should be polished properly

GLASS IONOMER CEMENT (GIC)

The glass ionomer cements have evolved as a hybrid of Silicate cements and Polycarboxylate cement.

It is available in powder and liquid form.

The powder contains silica, alumina, aluminium fluoride, calcium fluoride, sodium fluoride, Aluminium phosphate.

The liquid contains polacrylic acid, itaconic acid, maleic acid, tricarballylic acid, tartaric acid, water.

The powder and liquid are mixed on a paper pad in the ratio 3:1 and then placed in the cavity formed.

TYPES OF GIC

There are 4 types pf GIC- Conventional, Hybrid, Tri-cure and Metal reinforced.

ADVANTAGES:

aesthetic

good adhesion to the tooth

releases fluoride, so anti carcinogenic

high retention

biocompatible

good marginal seal

requires minimal cavity preparation

DISADVANAGES:

soluble

water affects the setting reaction

abrasive

not as aesthetic as composite resins

USES OF GIC:

used both in deciduous and permanent teeth

class V and class III cavities

abraded or eroded areas

root caries

rampant caries, nursing bottle caries

luting or cementing in veneers, metallic and nonmetallic inlays nad onlays

protective liner under amalgam, composite

core build up

retrograde fillings

splinting of periodontically weak teeth

a traumatic restorative treatment

repair of perforations in tooth

Various modified forms of GIC are available now like Metal modified GIC( miracle mix, glass cermets), Resin modified GIC, Compomer(polyacid modified composite resins).

INDIRECT RESTORATIONS

INLAYS AND ONLAYS

An Inlay is an intracoronal cast restoration designed mainly to restore occlusal and proximal surfaces of the posterior teeth without involving the cusps of the teeth. They are custom made to fit the prepared cavity and then are cemented in that place. Its placement usually takes two appointments. During the first visit, an impression is made of the tooth and a temporary inlay is placed. The impression is then sent to a dental lab, which will make the inlay according to a particular tooth. On the second appointment, the temporary inlay is removed and permanent placed on the tooth.

An Onlay is a combination of intracoronal and extracoronal cast restorations when one or more cusps are covered. It is a more extensive reconstruction and indicated in areas where lots of tooth structure needs to be restored. It is made in the same way as an inlay and then the permanent onlay is securely bonded using high strength dental resin.

INDICATIONS

extensive tooth loss

teeth having periodontal problems also

endodontically treated teeth

for correction of occlusion

retainers for fixed prosthesis

teeth having fracture lines in enamel

patients with good oral hygiene

CONTRAINDICATIONS

developing or deciduous teeth

high caries index

dissimilar metals

high plaque index

Porcelain inlays and onlays are highly recommended for anterior teeth since they are aesthetic and natural looking as compared to metal fillings. They are long lasting once bonded to the tooth surface and cover large decayed areas.

Gold inlays and onlays are used in posterior teeth.

DIRECT FILLING GOLD

Gold foil is one of the earliest available dental filling materials.

Its available in various forms like gold foil sheets, pellets, ropes, laminated foil, platinized foil, mat gold, mat foil, powdered gold.

INDICATIONS

incipient carious lesions

eroded areas

vent holes in crowns

cavities on cusp tips

CONTRAINDICATIONS

teeth with large pulp chambers

periodontically weak teeth

large carious lesions

aesthetic areas

low economic status patient

not possible to maintain complete isolation

Caring for Teeth With Braces

Sun, 06 Jul 2008 01:34:49 GMT

When you have braces you have lot of things in the mouth. You have brackets, wires, rubber bands, elastics which all causes the impaction of food particles in the mouth. It becomes very difficult to keep the mouth clean so if you want to maintain the good oral hygiene you have to take really good care of the teeth. For that special orthodontic brushes can be used which are very effective and teeth should be brushed thoroughly after every meal. If one has a high caries index and if the orthodontist recommends then one can use the fluoridated mouth rinses. Mouth washes not only mechanically cleans the teeth but as they are fluoridated so chemically also they act upon the teeth and make it more resistant to the acid attack which is produced by the bacteria and causes the caries. Initially when the braces are put, one is very uncomfortable as they not only cause pain but hurt a lot also. Pain is because the wire is causing the movement of the teeth by putting pressure on the teeth, but one becomes used to it in couple of days. Initially till our lips and the cheek become used to the brackets and the wire they produce sores and it really hurts. For this the dentist gives the wax which can be put on the particular area which is hurting and for the sores one can use the gels prescribed by the dentist. So initial week or two is quiet a trying period but after wards one becomes used to all the things but the care for teeth should not be overlooked.

What happens when the braces are removed?

Who so ever go for the braces have the crooked teeth and really look forward for the day when the braces are removed? Most of them wonder how they will look after wards. They really wonder what will happen on the day the braces are removed. They are quiet apprehensive as during the treatment period even if you take very good care of teeth you end up having stains on the teeth. The fixing material used for fixing the brackets is also visible sometimes. One also wonders whether removing the braces will be painful or not. The answer is, removing the metal braces is neither painful nor time consuming. But if you have ceramic braces the removal process is long and it is sometimes painful for the patient as there is a chance that it will break during removal as the ceramic is brittle by nature. About the stains and the fixing material the dentist do professional cleaning and polishing of the teeth after removing the braces and that will take care of every thing. After cleaning and polishing the dentist takes the x-ray and the impressions of the teeth. Impressions are taken to see the end result, to keep the record and for getting the retainers made. X- Ray’s are taken to see the condition of the wisdom teeth. Some times if dentist feel that the wisdom teeth can adversely affect the teeth and can cause the movement of the teeth, he can recommend them to get it extracted.

After the removal of the braces the treatment does not end here. To prevent the newly moved teeth from moving and to give them time so that they adapt themselves to the new position, the retainers are given. They are the most important part of the treatment. If the retainers are not worn the teeth can shift back and whatever time ,money, efforts and the hardships one has endured to have well aligned teeth, will go waste. The retainers can be removable or fixed and the duration for which they have to be worn also varies according to the case. Some times few have to wear it for few months while others have to wear it for few years. For first 6 months the retainers has to be worn day and night except while eating and afterwards they have to be worn only at night

When one starts with the treatment it looks quite difficult and sometimes one gets frustrated looking at the mouth full of brackets, rubber bands or wires but you should remember that you are not the only one and with passing of each day your time with braces is decreasing and eventually they will come out and you will have beautiful smile

Treatment Of Mouth Breathing

Sun, 06 Jul 2008 01:21:18 GMT

For the treatment of the mouth breathing there are few considerations which should be considered. If we take into consideration these factors the treatment can be a success. These are:

Age of the child: Before starting with the treatment the age of the child should be taken into consideration. Most common cause of mouth breathing is the enlarged adenoids and the narrow nasal passage. With age there are chances that adenoids shrink and the nasal passage becomes wide and the child starts breathing through nose.

Treatment of mouth breathing:

As discussed earlier before starting the treatment the cause and the degree of mouth breathing should be ascertained. That is whether the mouth breathing is obstructive or habitual and whether it is total mouth breathing or the partial.

Physical exercise- child is asked to do the deep breathing exercises. These are done in the morning and at night. The child is asked to inhale through the nose while taking the arms up . After holding the breath for few seconds the child should exhale through mouth and bring the arms down.

Myofunctional therapy: in case of mouth breathers the most common problem is the hypotonic and short lip that is why the lip seal is not established and the child keep on breathing through mouth. To increase the tonicity of lips few myofunctional exercises are recommended. These are:

During day time hold pencil between lips
During night tape the lips together with surgical tape in habitual mouth breathing
Hold a sheet of paper between lips
Patients with hypotonic upper lip stretch upper lip to maintain lip seal.
Button pull exercise– a button is taken and thread is passed through it. Patient is asked to place the button behind the lips and pull the thread while restricting it from being pulled out by using lip pressure.
Tug of war exercise--- involves two buttons, with one placed behind the lips and other is pulled by the other person.

Appliance therapy:

If it is established that the cause of mouth breathing is not obstructive but t is habitual then the best way is to stop the air to enter the mouth. For that a appliance is given called as oral screen or the thin rubber membrane is given. They are worn at night and they cover the outer surface of the teeth and the gums extending into the vestibules. Initially the holes are made in these so that the patient does not have difficulty in breathing.

E.N.T. check up: before starting with the treatment E.N.T. check up is mandatory to ascertain that the cause of moth breathing is habitual or obstructive. If the child has nasal obstruction and he breathes through mouth because of obstruction then before starting with the treatment obstruction should be treated otherwise the child will face lot of problems and the treatment will be a failure.

Dark Gums Can They Be Made Natural Pink

Sun, 06 Jul 2008 01:20:46 GMT

Smile looks beautiful if one has beautiful teeth with natural looking pink gums. But that is not always possible. The color of the gums generally matches with the color of the skin. The western people have fair complexion and generally the color of the gums is also pink. On the other hand dark skin people have dark gums. In India the complexion of the people is towards brownish side so the color of the gums also varies from pink to dark brown. Sometimes all the gum tissue is not of dark color but it shows dark patches. So the degree of discoloration and the intensity varies from individual to individual.The good news is that Dark or pigmented gums are not an indication of a disease. If one has dark looking gums that does not mean that one has unhealthy gums.

WHAT IS THE CAUSE OF DARK GUMS

Now the question arises how it happens. It is seen as the genetic trait and is medically known as Racial or Physiological Gingival pigmentation. The main culprit behind this is the black pigment known as Melanin. The production of melanin increases manifolds in the presence of sunlight. At the same time it is more in the persons having complexion towards darker side. The individuals who are involved in outdoor activity tend to have darker gums. Even the children who are more active outdoor and at the same time have gummy smile are more prone to have dark gums. Once the gums become dark during the childhood they tend to stay that way. The gums around the teeth tend to become dark but the part of the gums which is hidden under the lips has natural pink color.

TREATMENT OF DARK GUMS

Treatment of the dark gums is possible. The blackness of the dark gums is merely superficial. When the outer dark colored layer is removed, the pink aesthetic looking gums appear. The most popular effective and simple method of removing the darkness of the gums is the surgical removal of the outer layer of the gums which gives the dark color to the gums. The procedure though surgical is a painless outdoor procedure carried out under local anesthesia. In this procedure the outer layer of gum epithelium is removed with a layer of underlying connective tissue. After the removal the connective tissue which is left to heal by secondary intention. The new epithelium which is formed is devoid of dark pigmentation. The positive results can be seen within one to two days. After this procedure 20 to 30% of the pigmentation returns after 5 to 6 months and then stays as such. If few precautions like not exposing oneself for long hours to sunlight are observed then the gums stay pink and there is marked improvement in aesthetics. This surgical procedure can be repeated if the gums again become dark and looks bad.

Problems Encountered With Retainers

Wed, 27 Aug 2008 19:49:52 GMT

Basically there are two types of retainers –fixed and removable. In fixed type of retainer a wire is bonded on the inner side of the teeth towards the tongue and it stays there. Fixed retainers can stay in place indefinitely and dentist prefers to give fixed retainers in which the chances of relapse are high. But in case of fixed retainers you should visit your dentist regularly to make sure that they do not get loosened. You have to take real good care of your fixed retainer as they are the source of tartar build up.

The removable type can be removed. But initially they have to be worn full time except while eating after that they can be removed and can be worn only at night. The most common type is the Hawley retainer, which is made of a metal wire that surrounds the teeth and keeps them in place. It is anchored in a specially-molded, sometimes brightly colored acrylic form that sits in the palate or floor of the mouth. Top and bottom retainers are usually made as necessary.

Problems encountered with retainers

Initially after the removal of braces you are given retainers you will encounter certain problems like

You will not be able to speak properly but reading loudly or speaking loudly for one day will take care of that problem.

You will have lot of saliva in the mouth, even this problem will be gone by the end of first day as you become used to the retainer.

Some times the retainers do not fit properly or they cause tissue soreness in that case fix the appointment with your dentist and he will fix the problem

Some people develop the habit of flipping the retainer with the tongue. This habit should not be developed as this will loosen the retainer and the chances of retainer breakage are there.

How to take care of retainers

The retainers come with the retainer case. If you want to keep the retainer clean and fresh then scrub them clean gently using mild detergent and warm or cool water. Do not use very hot water as it can wrap the retainer

Complications and Care After Root Canal Therapy

Sun, 06 Jul 2008 01:33:43 GMT

These days dentists prefer doing single sitting root canal treatment in which, after the diagnosis is made, in single visit the root canal treatment (RCT) is completed. After the root canal treatment the patient can have few problems like:

Pain in the tooth: There can be pain after the affect of numbness is over. One can take a pain killer which is normally prescribed by the dentist. If pain is acute and there is swelling then one should consult the dentist. Mild soft tissue inflammation is there which causes irritation but it subsides within a week after the root canal treatment.

If the pain starts after few months of root canal treatment and there is difficulty in chewing then the dentist has to be consulted because some times the infection is left or the filling is not done properly and it causes the pain. In such cases some times re treatment is recommended. But the diagnosis has to be made after taking the proper history, clinical examination and with x-rays.

Fracture of the Tooth: It is advisable to go for crowning of the tooth after the root canal treatment as the tooth becomes brittle and is prone to fracture. The crown will save the tooth structure and gives natural feeling.

Discoloration of the Tooth: After the root canal treatment as the tooth looses its vitality, it becomes discolored. This discoloration can be taken care of either by bleaching or the crowning.

The dental files or other instruments used in the cleaning and shaping of the pulp space might break down but these can be removed by a specialist Endodontist. Leaving them in the canal can cause problems like root canal failure by incomplete filling of the root canal or even act as a source of infection later.

Incomplete filling or missing a canal while filling may act as a source of retained infection or new infection. All this leads to treatment failure and aggravates the complications.

Certain bacteria are not responsive to root canal treatment to a great extent enhancing the problems.

Whether all the teeth which have pain can be saved by the root canal treatment?

The answer is No, for the success of root canal treatment the careful selection of the case is very important. All the teeth can not be treated by root canal treatment. There are few conditions in which the teeth can not be treated with root canal treatment:

When the tooth in question does not have adequate bone support. If the bone supporting the tooth shows resorption and it is mobile then that tooth cannot be saved by root canal treatment.

When the tooth which has to be treated by root canal treatment has inadequate tooth structure and can not be restored after wards

When the general resistance of the patient is poor in that case root canal treatment is not indicated.

If the root is fractured then also the tooth cannot be saved by root canal treatment.

Procedure For Apexification

Thu, 28 Aug 2008 07:59:26 GMT

Frank in 1966 was one of the first to describe the clinical methods using calcium hydroxide paste & camphorated monochlorophenol (CMCP),to stimulate root closure.

The procedure for Apexification is

The tooth is isolated with rubber dam, & access is gained into the pulp chamber.

Using large reamers & files, remove the debris from the coronal half of the pulp & establish the file length radiographically.
Clean the canal, irrigate it & then dry it with a paper point. Repeated gentle use of sodium hypochlorite assists debris removal.
Seal a pellet of CMCP in the pulp chamber with a provisional restorative material.
On recall, in 1 to 3 weeks, remove the restoration & clean the canal.
Take care to avoid any instrumentation of the walls of the dentin near the apex.
Mix a paste of calcium hydroxide & CMCP on a glass slab. Carry the paste to the canal & force it into the apex with a larger plugger or cone-shaped instrument. The objective is to fill the canal completely. Obtain a radiograph to check the accuracy of the root canal filling.
On a 6 month recall, you should see radiographic evidence of an apical closure.
When you have accomplished apical closure, the root canal filling is completed.
If apexification has not been completed, repeat the cleaning & insertion of a calcium hydroxide & CMCP paste.

Apexification pre-treatment showing open apex

Calcium hydroxide placed in the pulp chamber following removal of pulp

Check X-ray-Apical constriction formed by 12-13 months.

Post-treatment obturated with gutta percha

Treatment evaluations of Apexification

The first evaluation may be done after 3 months. Radiographs may show hard tissue deposition, but such evidence is not considered reliable. It is necessary to test the quality of apical barrier with a size 35 file.

If the 3 months radiograph shows little or no apical changes, reschedule the patient for another 3 months recall. There is no need to change the calcium hydroxide if it appears to occupy the root canal space adequately, & if the coronal temporary seal appears satisfactory.

The follow-up evaluation is repeated every 3 months until successful apical bridging has occurred. This may take as little as 3 months or as long as a year or more, depending on the degree of apical destruction & the ability of the apical tissue to repair.

Obturation of the root canal

Because the root canal wall does not change during apexification, the shape of the canal will remain the same after the apical barrier has formed, namely a reverse taper. These canals are probably best suited for obturation by a thermoplasticized technique.

Dental Hygienist Salary

Mon, 07 Sep 2009 03:12:46 GMT

What is the average salary that a dental hygienist receives? The median salary that a typical dental hygienist will receive is $70,000 in the United States. The pay scales for dental hygienist will be affected based on the employer that you work for and the credentials of the employee. The more expertise the dental hygienist gains more will be the salary too.

Research based on the salary that a dental hygienist can fetch shows that it is dependent largely on the number of years of experience that they have. A dental hygienist with less than a year’s experience can get anywhere between $20 to $37 per hour where as one with less than four years experience can make an hourly rate of $25 to $35. If the dentist has an experience of between 5 to 9 years than the hourly rate will be $27 to $37, for experience of ten to nineteen years is $28 to $37 and for one with more than 20 years of work experience the rate is $29 to $38.

The salary of a dental hygienist will also vary based on the state that they work in. In a state like Houston dental hygienist will earn on an hourly rate $30 to 36, in Chicago $32 to $ 38 and in Portland $32 to $37. The least hourly salary rate that a dental hygienist can get is in Rochester at $ 24 to $ 29 and the highest salary being in Seattle at $39 to $45. Hence, on an average a dental hygienist can make anywhere from $18 to $40 per hour in salary.

Dental hygienists take care of the sanitation and safety requirements of a dental office and also help the dentist on side chair while the dentist is conducting procedure and also operate the machinery at dental office.

The salary of a dental hygienist also depends upon his / her manual dexterity and communication skills as dental hygienists have to work very closely with the dentist and dental assistants. need to explain the procedures thru their clinical knowledge. The dental hygienists who know how to clean and polish the teeth, examine the patients teeth and gums and other not so complex dental procedures are going to be an asset to a dentist and hence such dental hygienists are bound to get better salaries. The better they are in such jobs, the more salaries they command.

As more and more of old dentists are getting retired, the scope of dental hygienists is growing because dentists of today want the dental hygienists to perform the routine clinicaland preventive jobs and themselves focus on advanced or complex work in the time they save by hiring a good dental hygienist ad earn more revenue. This shift is resulting in beter job prospects and salary for dental hygienists.

The increasing demand for dental hygiene and dental care amongst youngsters as well as aging population has made dental hygienist as one of the fastest growing profession as a career with a growth of 30% through year 2016.

A dental hygienist salary depends on several other variables that need to be taken into consideration. However, the salary of a dental hygienist has been increasing over the number of years at quite a substantial rate. Many dental hygienists are employed at several dental clinics on a part time basis and this enables to earn an income from more than one source. This largely increases their overall take home salary per month.

A dental hygienist will be paid either on an hourly basis, daily or on a commission. The average dental hygienist salary is based on the geographic regions that dental hygienist operate in, the employment office and the amount of experience that they carry with them.

An average dental hygienist pay is quite impressive as the bottom 10% earns about $18 per hour and the top 10% earn more than $38 per hour. The average salary rate for a dental hygienist is at about $30 per hour.

The pay of the dental hygienist largely depends on two factors which are the state or province that they practice in and the number of years of experience that they have. It also depends on the specific offices that they work in and the overall dental hygienist educational degrees to their credit. If a dental hygienist specializes in a particular niche then their salary earnings will be certainly more. Specialization in the form of further dental degrees will enable them to earn above the median range of dental hygienist salary.

What are Treatments Of Gum Disease

Sun, 06 Jul 2008 01:20:46 GMT

Periodontal disease refers to a more aggravated version of gingivitis. This is characterized by dental holes that can be found in the gums caused by tartar and other more aggressive bacteria that until harm the dental health of the patient. Poor oral hygiene coupled with irregular visits to the dentist as well as absence of dental care may cause the bacteria to grow and metastasize to the periodontal membrane thus causing periodontal disease. To be able to treat this condition, you must take the following steps in order to combat the said condition.

Non-invasive therapy can help treat the disease especially if it has been diagnosed in the earlier stages. Scaling is one form of non-invasive therapy where in the surface of the gums as well as the spaces in between and under will be cleaned out of tartar. This will rejuvenate the gums to its former health.
The next step is to undergo root planning. This is done after the dentist has cleaned out all the plaque and bacteria in your mouth. A systematic cleaning of the adjacent area is now performed. This is to allow healthy growth of gums for recovery and to remove all excess bacteria within the mouth.
It is also recommended that you take some form of dental medication to supplement the procedures that you have to undergo in order to cure the periodontal disease. An example of medications that you should take is the enzyme suppressant that will control your enzyme production in order to protect your gums from unwanted bacterial invasion.
Consider surgical options. You should consider surgical options if the diagnosis points to the fact that the receding of your gum line exceeds five millimeters. Ask your dentist about the best way to go in terms of surgery.
Soft Tissue Grafting - This is done if the gum line recedes excessively so much so that your teeth already a fierce longer than normal. The dentist or periodontist will have to implant soft tissue to facilitate the growth of the gum line.
A Bone Grafting procedure is also needed if the bacteria caused by periodontal disease reaches the bones’ and damages it further. Bone grafting is the process of rebuilding bones using organic or synthetic sources. Organic meaning it comes from the patient’s own structure. The latter means that it comes from external sources such as animals.
As a last step, it is recommended that the patient does his best to take care of his dental hygiene right in this own home. Brushing your teeth regularly and using toothpaste that is high in fluoride as well as antimicrobial mouthwash is strongly recommended in order to prevent the growth of bacteria within the oral cavity.

Maintaining good oral hygiene is truly important when it comes to preventing dental diseases such as the periodontal disease. It is our duty and responsibility to take care of our dental health so that we will not have interpersonal relationships problems in the future.

How Do Braces Work

Sun, 06 Jul 2008 01:34:49 GMT

The facts about working of the braces have always been on the minds of the persons, thinking about undergoing the correction of the deformities of their teeth by the use of the orthodontics branch of dentistry. Let me tell you that even though our teeth are one among the strongest things in the world, force applied over a planned duration of time can move them easily. The orthodontic braces work by applying particular value of force which is sufficient to apply the force on the teeth to align them properly in shape and to correct the deformities which act as a hindrance to a beautiful smile. The arch wires placed in the slots of the brackets a part of braces which are bonded securely to the teeth with the use fluoride releasing glue in place of the earlier used wire bands. The fluoride glue is very useful in reducing the amount of caries. The arch wires adapted on to the braces help in the application of forces, which lead to mainly five kind of tooth movement.

First being rotation which is one of the toughest types of tooth movement when force is applied on the mid-point of the root of the tooth.
Translation which is also called as the bodily movement of the tooth.
A combination of bodily and the spinning or rotational movement of the tooth is one of the most simple and common movements of the teeth.
Intrusion or the movement of the teeth towards the bone is a part of orthodontics.
Extrusion known to be the simplest movement of the teeth is movement of the teeth out of the bone.

Braces which are used in the field of orthodontics consist of the following parts

Brackets which are made up of metal or ceramic and they are attached to each tooth.

A glue (especially fluoride containing glue) or metal band is involved which helps in the attachment of the bracket to the tooth.

An arch wire which is the main component of application of the force on the teeth is places in the bracket.

One of the latest advances today is the nickel titanium wires activated by heat which react to body’s natural temperature. The temperature of the body causes the causes the wires to produce a gentle but constant force. These new advances reduce the frequencies of adjustments and orthodontist visits. The nickel titanium wires activated by heat are more efficient than the stainless steel wires and are quite popular among the young orthodontic patients and also the pain associated with them is less as compared to stainless steel wires. Arch wires have a very efficient property of elasticity and then there are nickel titanium wires with the property of shape memory that is they tend to get back to the same shape as they were before bending also so they want to retain their normal straight shape. The wires commonly used these days are the twist wires having resemblance to a small cable. The wants to remain straight even after it is put into your mouth to keep the braces in place in your mouth. The mouth temperature is 20-25 degrees more than the room temperature, this enhances the tendency of the wire to be stiff and in the process provides the forces necessary for bringing about the biomechanical process of bone remodeling and make the orthodontic tooth movement possible.

Ligature wires or elastic rings (o-rings) are used for binding the arch wire with the bracket firmly. The ligatures are adjusted and if needed are changed at each follow up visit. But recently used self binding brackets don’t need adjustments.

The movement of the teeth is caused by the pressure applied on the brackets and the teeth. Springs and rubber bands are also used to exert force in required amount and direction in some cases. Braces are the components exerting constant force over a period of time leading to the movement of the teeth in the required particular directions. The use of extra oral appliances like the head gear may also be needed in some cases especially the adults to complete the treatment in said form and time.

The teeth are surrounded by the gum tissue all around and the periodontal membrane is present around the root portion of the teeth and alveolar bone surrounds the root portion of the teeth and periodontal membrane joins the cementum of the tooth with the alveolar bone.

The pressure applied by the braces on the teeth causes the stretch of periodontal membrane on one side and compression on the other side of the periodontal membrane. The process scientifically called as bone remodeling leads to growth of bone in the new position.

Movement of the Teeth via the Process of Bone Remodeling

Bone is a tissue made up of cells called as the osteoblasts or the bone forming cells and the osteoclasts or the bone eating cells, both of which are involved in the process of bone remodeling i.e. a biomechanical process which makes bone stronger by bone deposition in stress bearing areas and bone is made weaker in areas of no load by bone resorption. The osteoclasts or the bone dissolving cells are responsible for bone resorption and osteoblasts or the bone forming cells are responsible for the bone deposition process and both combined together lead to bone re-modeling. The bone density is increased by this process.

The teeth are placed in the bone and are the roots are connected to the bone is periodontal membrane and the force applied by the arch wires pushes the tooth in the desired direction and creates stress in this periodontal membrane. The stress produced in this ligament leads to compromised blood supply in it and the biological response leads to bone remodeling which causes bone resorption by osteoclasts on one side and bone deposition by osteoblasts on the other side. The bone resorption is possible in two different ways known as the direct resorption from the cells lining the alveolar bone and indirect resorption or the retrograde resorption from the activity of osteoclasts in the surrounding bone marrow. The retrograde resorption takes place in case of excessive stress for a longer time which causes diminished blood supply of the periodontal ligament and necrosis after that. This necrosis or hyalinization leads to resorption of a larger area then deposition which is also referred as negative balance by the orthodontists occur whenever there is the application of the force to produce indirect resorption. The acellular periodontal ligament undergoes retrograde resorption under the effect of the desired stress on the enamel of the teeth for the desired amount of the teeth. Deposition of bone is also very important as without it tooth movement is not possible. If bone deposition does not occurs on the side opposite to that of tooth movement there would occur gaps on that side and teeth will become loose. These gaps make the tooth movement difficult and hamper proper treatment. A patient should understand the concept of the bone deposition and bone resorption. All these movements occur due to the compression and biological changes in the periodontal ligament all due to the forces applied.

The periodontal ligament acts as a joining b/w teeth and surrounding alveolar bone. Pressure created b/w the periodontal ligament and the alveolar bone leads to the production of osteoclasts and one lysis occurs and normal gap is created b/w the teeth and the alveolar bone. The tension created in the ligament on the distal side of the teeth causes the osteoblasts to make new bone in the direction opposite to that of the tooth movement and re- establish the normal gap b/w the teeth and the bone. The force required is only a part of the maximum. Then there are the brackets and the arch wire are the creators of the artificial force which sustains the pressure. The process of force transmission is complete with the placement of the arch wires in the braces placed on the teeth. This transmission leads to the transfer of force from the braces to the teeth and cause bone remodeling to take place and move the teeth in new functionally and aesthetically desired orthodontic positions.

The process of bone resorption caused by the osteoblasts takes about 72 days to get completely going and bone deposition process by the osteoblasts takes about 90 days to start the action in full swing. The stabilization of the result achieved takes about 10 months which makes it necessary to wear the retainer to avoid relapse to the old uncorrected or some in b/w undesirable position after the completion of treatment.

The movement seen in the tooth is about a millimeter in a month which is accounted by the orthodontists but it can vary from individual to individual, depending upon the type of treatment, the type of movement and correction needed and also the type of appliance and technique used. An understanding is required.

Now after this knowledge on the working of braces one can easily go ahead with procedure of wearing braces to have a wonderful smile.

Why Do We Need Braces

Sun, 06 Jul 2008 01:34:49 GMT

The basic makeup of every tooth in your mouth is the same, and they all grow out of the same place i.e. from down within the jawbones, which are surrounded by the gums. Although some people's adult teeth grow out from the gums at the right angle and with the right spacing, many people's teeth don't.

And in some cases, a person's upper jaw and lower jaw aren't of the same size. When the lower half of the jaw is too small, it makes the upper jaw hang over when the jaw is shut, resulting in a condition called an overbite. When the opposite happens (the lower half of the jaw is larger than the upper half), it's called an underbite.All of these different types of disorders go by one medical name: malocclusion. This word comes from Latin and means "bad bite." In most cases, a "bad bite" isn't anyone's fault; crooked teeth, overbites, and underbites are often just like brown eyes or big feet are inherited traits.

Malocclusion can be a problem because it interferes with proper chewing — crooked teeth that aren't aligned properly don't work as well as straight ones. Because chewing is the first part of eating and digestion, it's important that teeth can do the job. Teeth that aren't aligned correctly can also be harder to brush and keep clean, which can lead to tooth decay and cavities. And finally, many people who have crooked teeth may feel self-conscious about how they look; braces can help them feel better about their smile and whole face.

If a dentist suspects that a kid or teen needs braces or other corrective devices, he or she will refer the patient to an orthodontist. Orthodontists are dentists who have special training in the diagnosis and treatment of misaligned teeth and jaws. Most regular dentists can tell if teeth will be misaligned once a patient's adult teeth begin to come in, sometimes as early as age 6 or 7 and the orthodontist may recommend interceptive treatment therapy. Interceptive treatment therapy involves the wearing of appliances to influence facial growth and help teeth grow in better, and helps prevent more serious problems from developing.Some teeth may grow in crooked or overlapping. In other people, some teeth may grow in rotated or twisted. Some people's mouths are too small, and this crowds the teeth and causes them to shift into crooked positions.

Understanding Retainers After Braces

Wed, 27 Aug 2008 19:49:52 GMT

When one has crooked teeth or malaligned teeth one pt for the orthodontic treatment. Your dentist after taking proper history and making the diagnosis puts braces on your teeth. The treatment continues for 1 to 3 years depending upon the case to case. When the teeth come I proper position the dentist removes the braces and gives the retainers.

What are retainers - Retainers are custom made acrylic appliances which are given after the braces are removed to keep the teeth in their new moved position. They can be used for correcting minor orthodontic problems. They are made of clear acrylic or plastic with wire which covers the outer surface of the tooth.

When and for how long the retainers should be worn?

Retainers should be worn immediately after the braces are removed. Initially for about6 months they should be worn all the times except eating food and then gradually the time of wearing the retainers is decreased and it has to be worn only at night. In some cases where the malocclusion is very severe, the retainers have to be worn through out the life at night.

What is the function of retainer?

Retainers help to keep the teeth in their new position to which they are moved after the orthodontic treatment. The braces straighten your teeth but the teeth are not settled into the new position until the bone, muscles and the tissue around the teeth adapt themselves according to the new position of the teeth.

What happens if retainers are not worn?

If retainers are not worn ,the teeth which are straightened by the braces try to go back to their original position and again you will have malaligned teeth. In such cases the braces has to be placed again and the whole procedure has to be repeated. If the retainers are not worn for few days and the retainer which is given to you by your dentist does not fit , this should be reported to your dentist immediately. The dentist will try to solve this problem giving another set of retainer depending upon the condition.

Various Stages of Cold Sore blister

Fri, 20 Mar 2009 01:16:34 GMT

The first cold sore symptoms are hardly even noticed. Dryness, irritation, tingling and burning are felt in the area of fever blisters in the beginning. This marks the first stage of the cold sores as the virus is heading towards the outer surface layer of the neural tissue cells.

The cold sore appears in the region within twelve to thirty six hours. The patient will see the swelling at the fever blister site along with the development of little, hard and pimple-like protuberances that are highly painful. Fever, headaches and a general feeling of tiredness is common to notice at this stage. Lymph glands present under the jaw also begin to swell. Your tiny hard elevations now swell, burst open and coalesce to make up a huge open up ulcer. Fever, running nose and head pains are other common symptoms associated with this point of the stage. This part is the most painful time of this stage. All this constitutes the second stage of the cold sore. The lymphatic nodules are quite well edematous as felt under the surface of the lower jaw which might be quite painful.

A clear fluid drains down the cold sore along with the cold sore virus. This stage is highly contagious and infectious now. This stage is the called the third stage or the most contagious stage and occurs before the healing process starts.

Few days later the cold sore will start the healing process marked by the development of a crust over it. Still painful and breaking of the scab and touching the sore can be very painful. The symptoms like headaches, fever and edematous lymph glands start healing by now. Itching and irritation of the cold sore are still experienced even though the healing process continues.

Usually the crust formed will fall off in a couple of days. Even after the new skin is revealed after the scab falls off the cold sore but still healing continues underneath the new skin which is a constant source of tingling and redness present in the area for another week or more. This stage of the cold sore is still infectious and can cause them to re-occur very fast. The body temperature and the head pains are nearly gone by this time. The swollen lymphatic nodules are greatly decreased by this time.

While still in the final stage of their life cycle the fever blister can tend to come back. This time is perfect to use your best cold sore treatment at this stage. The fever blisters can easily spread from one person to another or from one part of the body of the infected person to another site in the same patient.

Pay attention and be careful as the cold sore virus is very infectious from the first irritation the complete absence of the fever blister signs and symptoms.

Home Remedies For Dental Problems

Fri, 01 Aug 2008 19:15:08 GMT

There are various dental problems which one can have. The pain, bleeding gums, canker sore, gum infection, loose tooth or bad breath these are some of the common dental problems. One should know some home remedies before one can visit the dentist. Rather I would say that person should take care of the teeth so that most of the dental problems can be avoided. Like if one keep doing warm saline rinses along with proper brushing and flossing at home, the chances of developing gum infection and bleeding gums become less. Even the chance of having bad breath is less. Here we are going to discuss some home remedies for commonly occurring gum diseases.

Home Remedies for Gum Infection

Common cause of gum infection is the deposition of plaque on the teeth which keeps on irritating the gums causing the gum infection. In this there is bleeding from gums along with pain and swelling and if the condition persists then one can easily loose the tooth. It is always advised to take good care of teeth and gums by doing regular brushing and flossing but if one has gum infection then the following home remedies can be tried:

One can do warm saline rinses 2 to three times a day. It is the best home remedy for infected gums. The salt should be one tea spoon fl in 8 ounce of luke warm water

One can apply Aloe Vera o the effected part.

Doing gurgles with water in which salvia is boiled is also effective.

It is said that chewing basil leaves in the morning with empty stomach is very good not only for gum infection but also for the throat infection.

Home Remedies for Bad Breath

This is the most common and most embarrassing condition. One who has bad breath really wants to get rid of it

Deposits on the tongue are one of the major causes of bad breath. One should regularly clean the tongue with the tongue scrapper or the brush to clean the deposits present on the tongue.

The persons who have dry mouth usually have the problem of bad breath because in the dry mouth case the cleansing action of the saliva is missing. They can chew the sugarless chewing gum to increase the salivary flow. Some special chewing gums have anti odour ingredients which are also very useful.

Chewing fennel seeds, parsley or cinnamon sticks are also considered to be quite effective for bad breath and is a good home remedy.

Using antimicrobial mouth wash before going to bed at night is also effective against the bad breath.

If one is a denture wearer whether it is full or partial, one should clean it properly. They can be washed with mild detergent.

One can boil 4 to 6 leaves of fenugreek seeds in a glass of water and can use it as the mouth wash. It really helps. This can be used twice a day for minimum 7 days to get the best results.

Home Remedies for Loose tooth

If the tooth is very loose and the bone support is not there then it cannot be saved. If the mobility is slight and it is due to gum infection then doing warm saline rinses and after that massaging the gum with some good gun paint helps. If the gum paint is not available ten one can use mustard oil with a pinch of salt to rub that area. This should be done at least twice a day.

Home Remedies for Bleeding Gums

Bleeding gum is a very common dental problem and it s the sign of infection in the gums. It is also the symptom of gingivitis and it is mainly due to the poor oral hygiene. There are few home remedies for bleeding gums. These are –

Brush your teeth daily minimum two times a day. Once in the morning after breakfast and once at bed time after dinner. You should also floss your teeth regularly so that the food impaction is not there.

Do warm saline rinses two to three times a day. You can use 2 % hydrogen peroxide diluted with water in the ratio of 1:4 as the mouth wash.

You can use baking soda with water. Apply it on the gums and then brush your teeth. Baking soda helps in decreasing the number of microbes in the mouth.

Some times the problem of bleeding gums is because of vitamin-C deficiency. It is also called as scurvy. In this case consume citrus fruits. Lemon water without sugar is also good.

Because of its good healing properties one can use aloe on the gums and teeth.

One can add a drop of tea tree oil in the tooth paste to prevent the occurrence of gum disease.

Home Remedies for Mouth Ulcers - Canker Sores

There is no treatment for canker sores as they are self limiting and they heal with in 7 to 10 days. But we can do certain home remedies so that the pain caused by them is reduced and the chances of infection are not there. These are:-

Do not eat any thing which will irritate the ulcers. Try to take something liquid or semisolid.

One can apply Aloe Vera juice as it has excellent healing properties.

One can use the mouth wash which is made by boiling the salvia.

Eating kiwi fruits are supposed to have the healing effect on the ulcers. It is said that one should eat three kiwi fruits a day.

One can do warm saline rinses as it will reduce the chances of secondary infection

Applying honey on the ulcer also helps. Honey is also applied on the gums of the baby when the baby is having irritation on the gums due to teething.

It is said that when one has ulcers in the mouth eating tomatoes help. One can even take tomato juice.

Home Remedies for Teeth Whitening

Some times the yellow teeth are natural like the normal color of the teeth is yellow and with age also the teeth become yellow as the dentine which is below the enamel is yellow in color as compared to the enamel. Enamel forms the outer cover of the tooth and is white in color. With age the enamel wears off and the teeth they started looking yellow. It is difficult to whiten them. But some home remedies for otherwise stained teeth are

Brush and floss your teeth regularly

Avoid taking the things which stain your teeth like red wine, cola, coffee, tea.

One can use lemon to clean the teeth as it has the bleaching effect.

One can brush with the mixture of hydrogen peroxide and the baking powder.

Fruits like apples have the natural cleansing action. So they should be consumed.

Home Remedies for Dental Pain

When one has dental pain; the best alternative is to visit the dentist immediately. But sometimes it is not possible as mostly the dental pain starts in the middle of the night and at that time little knowledge about the home remedies really help. So for temporary relief one can try few home remedies.

Clove oil application gives relief but while using clove oil one should be extra careful because excess clove oil can cause the ulceration of the gums. The other alternative is to use clove as such. It is quiet effective.

Turmeric powder is considered to be good antibiotic and it also give relief from pain. Put some turmeric powder on the cotton swab and press it into the cavity. It definitely gives temporary relief.

The juice of garlic is an effective anesthetic. when there is toothache just peel a clove of garlic and press it against the effected tooth. It gives relief.

If the tooth pain is after extraction or some dental surgery ,one can try few home remedies for that like

Dip tea bag in the iced water and apply it on the affected area. It gives relief.

The paste of black pepper and basil leaves in equal amount applied on the effected area gives relief. It hastens the healing also.

These are the few home remedies for dental pain, which one can try for temporary relief but one should not avoid visiting the dentist as only the dentist can diagnose the problem and do permanent treatment.

Ways Of Tooth Extractions

Sun, 06 Jul 2008 01:36:53 GMT

There are various procedures of tooth extractions depending upon the case to case. The dentist decides the best way after clinical examination and taking x-ray to see the position and condition of the tooth to be extracted and accordingly decides whether the tooth can be extracted simply or some surgical procedure for tooth extraction has to be adopted.

Simple Extractions

In simple tooth extraction cases, after giving the local anesthesia, the tooth is extracted / pulled out with the dental forceps. No afterward complications are expected if patient follows the post tooth extraction instructions given by the dentist.

Surgical Extractions

Unfortunately all the teeth cannot be pulled out easily. In some cases the tooth is damaged to that extent that nothing is visible above the gum line or in some cases due to infection or root canal treatment the tooth becomes so brittle that the crown breaks as soon as it is held by the forceps leaving behind the root part. In such cases surgical extraction has to be done. In this type the incision is given in the gums and the flap is raised to expose the embedded part of the root of the tooth which is then removed. But sometimes bone has to be cut to fully remove the roots of the tooth.

Impacted Teeth Extractions

Impacted teeth are those teeth which are embedded and do not erupt in the oral cavity. These teeth create lot of problems and have to be extracted. Most commonly seen impacted teeth are the third molars (wisdom teeth). The impaction can be soft tissue impaction or the bony impaction. If it is soft tissue impaction then the incision has to be given in the soft tissue above the tooth and then like simple extraction it can be pulled out by using the forceps. But if it is bony impaction then the bone has to be cut and sometimes the tooth is also sectioned. The impaction can be vertical, horizontal or angular depending about the angle of the tooth.

What is a Dry Socket?

Tue, 19 Aug 2008 03:03:54 GMT

Dry socket is a condition in which the clot which covers the extraction site either gets dislodged or gets dissolved leaving the bone naked. This bare bone is exposed to bacteria in the saliva and the food which the patient consumes the bone becomes infected and becomes very painful. It gives very bad odour. This pain is deep pain and patient cannot pinpoint the site of the pain.

How to prevent dry socket?

The incidence of dry socket can be prevented by taking certain precautions like:

Using Chlorhexidine mouth rinses 24 hours after the extraction, thrice a day. The rinses should be done gently so that blood clot covering the extraction socket is not dislodged.
Patient should not smoke minimum for 48 hours after the extraction.
Patient should follow all the post extraction instructions
If dentist feels and prescribe the antibiotics, patient should take them regularly.
Patient should try to maintain good oral hygiene.

Treatment for the Dry Socket

If the patient has dry socket he should visit the dentist. In dry socket antibiotics are not of much help. The dentist cleans the area and gives a packing which almost at once relieves the pain . first packing relieves the pain for 1 2 to 24 hours, after that the procedure has to be repeated. Second packing relieves the pain for longer duration. After three or so packings, the wound starts healing from inside out and the bone is covered, then it can be left open to heal.

Cost of Root Canal Treatment

Sun, 06 Jul 2008 01:33:43 GMT

The cost of root canal treatment depends upon various factors like whether it is a back or front tooth or a front tooth, whether it is done by a general dentist or a root canal specialist also known as the endodontist.The front teeth have one root and the procedure is less time consuming as compared to the back teeth which have two, three or even four roots and therefore the process becomes tedious and more time consuming so the cost also increases.

Overall root canal treatment for a front teeth would cost anything b/w $360 to $700 and for a back teeth would range b/w $600 to $910.The cost also varies with the technique used whether manual hand files or drill driven files for preparing a root canal of a tooth.

The fee charged by an endodontist will be greater than the fee charged by a general dentist. Endodontist typically treats the most difficult cases esp. root canal re-treatment cases which mostly needs some hand from expertise and root canal failure or complicated cases. The fees of an endodontist reflect a charge they take for a high level of expertise and quality services they offer. On an average an endodontist could easily charge you 30% to 50% greater fees than the fees charged by a general dentist. However in most of the cases your dentist will be confident enough to carry and does perform the procedure well and would know best when to take the advice of the specialist. Also your dentist would be more accommodating with scheduling, billing, and insurance considerations than an endodontist.

When The Tooth Needs To Be Extracted

Sun, 06 Jul 2008 01:36:53 GMT

Extraction of the tooth means pulling out the tooth. Earlier dentistry was nothing except filling the teeth or extracting them. But now a days , until it is absolute essential the tooth is not pulled out. Normally the dentist tries to save the tooth but sometimes it has to be extracted.

There are various situations where extractions are indicated. These are:

When the tooth is damaged to the extent that it cannot be repaired
When the tooth is mobile and there is bone loss
Sometimes the tooth is extracted for orthodontic purposes
Sometimes the milk tooth does not fall itself and permanent tooth starts coming above it in such cases the milk tooth is called retained tooth
Tooth which is associated with some cyst or tumor or when it is impacted , means tooth does not have enough space to come out

Sometimes tooth has to be extracted when the treatment to save the tooth is expensive and patient cannot afford it.

Dental Assistant Salary

Mon, 07 Sep 2009 03:12:46 GMT

The salary that a Dental Assistant draws on an hourly basis on an average is about $13.50. The annual wages for most Dental Assistant in the United States stands approximately at about $31,500 to $45000. This kind of salary can be yours if you choose to further your education and become a Dental Assistant. It will certainly allow you and your family a better life based on the salary and the job security that comes with this profession. If you want to go ahead with a long time career option as a Dental Assistant then you will certainly be interested to find out the amount of money that you can make. This fact can be a great motivator and deciding factor for a person to continue in that profession.

Let us consider what a Dental Assistant makes on an average. In order to determine this there are several factors that play a role. It majorly depends on your education and expertise. These two factors might bring about quite a bit of variation in the salaries drawn. The amount that you make as a Dental Assistant also depends on the state and province that you practice in. Say if you are in California or Texas or in an urban or rural area, then your salary will vary accordingly.

As a generalization, out of all the Dental Assistants survey about 50% of them earn between $29,000 and $36,000. The niche top 10% earns over $39,000. These are the Dental Assistants who have years of experience and enhanced educational qualifications to support it. On an average the Dental Assistant ends up earning $12 if he/she is straight out of college and with enough experience to back them up they can go on to earn $20 per hour.

The differences in the cost of living bring about a difference in what the Dental Assistant can earn in different states. This also depends on the demand for them and versus the supply of qualified Dental Assistants. There can be also some local factors in play to determine the salary of the Dental Assistant like in any other profession, such as how populous is the state, how many people opt for oral hygiene care.

Let us look at the figures per state:

· California – $12.96

· New York – $14.92

· Illinois – $14.86

· Pennsylvania – $13.13

· Georgia – $14.66

· Ohio – $13.27

· Virginia – $14.49

At the same time the salary will also depend on the city that the Dental Assistant operates in.

The salary for some of the largest and most populous cities is:

· Las Vegas – $15.49

· Chicago – $14.59

· Atlanta – $14.93

· Tulsa – $13.74

· New York – $17.00

· Houston – $12.33

· Charlotte – $16.42

The salary drawn by a Dental Assistant within a state will also vary.

Having said that, these are the average figures and more experience, expertise and education that the Dental Assistant has to back them up the higher will be the earning potential for them.

Effects of Mouth Breathing

Sun, 06 Jul 2008 01:21:18 GMT

The mouth breathers breathe through mouth instead of nose. They keep there mouth open. It affects the dentofacial structure. The teeth and the gingiva are affected and the same time patient has the speech problem. There are different causes of mouth breathing. In some is the cause is obstructive that is they start breathing through mouth because there is some obstruction in the nasal passage like enlarged adenoids, deviated nasal septum. Some times even after the removal of obstruction child keeps on breathing through mouth then that habit becomes habitual. The mouth breathing habit if persists affects the dento facial structures. These are

Effect on the facial form it is seen that the children who breathe through mouth due to the hypertrophied lymphoid tissue show more vertical growth. They have long faces and sometimes it is called as Adenoid faces. There faces have typical long and narrow appearance with narrow nose and nasal passage.

Affect on the teeth and the arches mouth breathers they keep the mouth open so the flaring of the upper teeth is seen. We can see the open bite that means the upper front teeth do not cover the lower front teeth. Patient breathes through mouth so the tongue is positioned downwards to make the airways. This causes the imbalance in the forces and the narrow maxillary arch causing the posterior cross bite.

Incidence of caries in mouth breathers there is the increased incidence of caries as the mouth remains open and there is dryness. The front upper teeth are affected the most.

Effect on the lips the mouth breathers have the flaccid and the short upper lp as the lips are not used to close the mouth they become short and flaccid. It is not that every person having short upper lips is a mouth breather. The lower lip is curled up and appears voluminous. The upper lip being short and incompetent the upper teeth show more. Normally the part of the upper teeth and the gums is covered by the upper lip while smiling but in case of the mouth breathers even the gums are visible during smiling giving the smile which is called as the Gummy Smile.

Effect on gingiva in mouth breathers the gingiva is inflamed. This condition is called as the Moth Breathing Gingivitis. Most affected is the gingival tissue of upper front teeth. The gums become inflamed and hyper plastic because the mouth remains open and they are constantly having the affect of air drying. The salivary flow is also decreased causing the heavy deposit as the self cleansing effect of the saliva is reduced. The gingiva has the classic rolled up appearance. There is bone loss and the pocket formation in the inter proximal area if proper oral hygiene is not maintained.

Effect on speech in mouth breathers’ speech can also be affected if the cause of nasal obstruction is not removed. The mouth breathers have the nasal accent.

Other effects the mouth breathers have the expressionless face. The activities of the muscles differ in the mouth breathers and the nose breathers. Mouth breather have the frequent attacks of ear infection i.e. otitis pedia also.

Average Cost of Braces for Teeth

Sun, 06 Jul 2008 01:34:49 GMT

Once you feel that you need braces to get your teeth aligned you must ask your regular dentist or ask your friends to recommend one to you. It is better to start the treatment as soon as possible. The longer you take to decide to opt for the treatment the more are the braces going to cost you. It is easier to work on children’s teeth then those of adults and hence less expensive too.

Do not jump at the first thing that your dentist tells you. If you want a good deal and affordable braces do your homework well enough. Get at least two options as this will let you know whether you are getting the best and most affordable of braces. Both the dentist must give you a similar answer. Keep in mind that first consultations are usually free and no obligation.

How much do braces cost the patient? It costs them anywhere up to around $5000 for both the upper and lower teeth and entails two years of treatment. This will vary slightly depending on the specific service that you might require. There are private orthodontist who charge on a higher scale when compared to the dental schools. Of course they work under the watchful eye of their professor.

If you are looking for affordable braces then you have several options, you just need to search them out. Some dental chains offer lower prices for orthodontic work done by a certain group of dentists. Some dental plans offer discounts on the new work on your teeth. Check with your insurance plan as usually orthodontic treatment is not covered especially a treatment that is in progress.

Think of the braces that will be best suited for you taking your lifestyle and other expectations into consideration. The braces will certainly make you feel and look beautiful. They will do wonders for your smile remaining intact and your teeth healthy. However, the average cost that you will have to pay for the braces will vary depending on several factors. This will include the severity of the problem, the time needed for the overall treatment and the region that the teeth need to be straightened or aligned at.

Normally, braces come within the range of $5000 but it is worth every cent the way you will look long after. Your teeth will be aligned and straight using the latest technology.

However, finally what you end up paying is determined by what condition your teeth are in and how badly their position affects chewing and speaking. You will come out of this procedure with a beautiful and perfect smile for certain.

Affordable braces can be yours depending on various factors. Let us look at those factors:

§ A dentist will charge up to $5000 where as an orthodontist will charge about $5600. This is based of course on the level of expertise and experience that the doctor has under their belt. If they have had extensive training in this particular field then you will end up paying more.

§ The cost differs from person to person too. Adults’ braces are priced higher than for children. The reason behind this is that the materials used are less and they need to be worn for a short period of time.

§ The cost of the braces is determined by which area you have the treatment done it. The greater the number of people wanting this service less will be the price for them.

§ Braces cost lesser in some countries than in others. So if you are looking for lower range braces look for dentists on the Northeast, Midwest and South territories as they are less expensive than those on the Canadian and Pacific side. In places such as South America, some parts of Europe and Asia you will certainly be able to get affordable braces.

§ Look for regions that are not very pricey. For instance in Arizona you can get braces for as little as $3700 whereas the same in Cleveland can be got for $2500 and in Chicago for $5500. So, if you find out about the kind of braces offered and the cost in different regions you will end up with a pair of affordable braces for sure.

§ Prices of braces in urban areas are about $200 higher than those in the suburbs. If you were to have the treatment for braces done in rural areas than the cost will fall further by $500 to 700. The quality of equipment could be one of the reasons or just the plain factor of real estate prices. Hence, check before you opt for the treatment and the equipment used.

§ Braces come in different types and kinds. Metal braces are less costly than the ceramic ones. Metal braces will cost you about $400 less than the ceramic ones. The ceramic braces look natural and hence are more aesthetic to look at. Invisalign braces can cost you about $6200 because of the features that it offers you.

Previously, patients only had metallic braces but now they have clear and ceramic to choose from too. Hence the price will certainly differ. Metal braces are generally the most economical option in braces. Whereas the tooth colored ceramic braces blend in with your teeth and are not conspicuous. Clear braces made of mono-crystalline sapphire are see-through and as natural as they can get. These will cost you approximately $200 more than the metallic ones.

Ensure that you shop around for a good orthodontist or dentist for the treatment as this is a specialized field and you want to come out of the treatment with the smile that you always wanted.

To conclude, the price of braces vary greatly and can start of with as little as $2700 and can go up to even $10,000.

Ensure that you check for details, ask as many questions as possible and then finally decide on the right kind of affordable braces for you. You will be left smiling beautifully forever.

Diagnosing Need For Braces

Sun, 06 Jul 2008 01:34:49 GMT

Braces are a subject of Orthodontist. Not everybody is recommended to go for braces. A orthodontist needs to undergo certain steps to diagnose whether one needs braces.

First of all an orthodontist will look at the teeth closely in order to determine if braces are needed. Overlapping teeth that crowd each other are difficult to clean, even for a dental hygienist. Adults may want to correct the problem with braces, not just for cosmetic reasons, but to keep teeth as healthy as possible. Teeth that overlap are difficult or even impossible to floss properly, especially for children. Plaque builds up between teeth, causing decay.

Then the orthodontist checks for signs of an overbite in order to determine if teeth need braces. If the front teeth protrude over the bottom teeth, not allowing the teeth to align when they are clenched together, this may be an overbite.

Thereafter your orthodontist will test to see if there may be a possible underbite as another way to determine if teeth need braces. In this case, the bottom teeth will protrude, extending forward beyond the upper teeth. If the teeth can't be clenched together evenly on top and bottom, this may indicate the need for braces or possibly some other form of dental care.

Finally your orthodontist will determine if teeth need braces as early as possible. While adult dental problems can be treated with braces, it's usually easier to start care early in life. Proper alignment of teeth can help prevent tooth decay and gum disease. Getting braces to correct the alignment of teeth can improve the ability to chew properly, thus aiding in healthy digestion.

First the orthodontist will need to reach a diagnosis before deciding on treatment. Reaching the diagnosis means making use of several different tools, including X-rays, photographs and impressions. The X-rays give the orthodontist a good idea of where the teeth are positioned and if any more teeth have yet to come through the gums. Special X-rays that are taken from 360 degrees around the head may also be ordered; this type of X-ray shows the relationships of the teeth to the jaws and the jaws to the head.

The orthodontist may also take regular photographs of the patient's face to help him or her understand these relationships better. And finally, the orthodontist may need an impression made of the patient's teeth. This is done by having the patient bite down on a mushy material that is used later to form an exact copy of the teeth

Can Braces Stain Teeth

Sun, 06 Jul 2008 01:34:49 GMT

Firstly, if you have decided to wear braces you are certainly concerned about the way your teeth look. Also, once you have braces you must be extremely cautious about maintaining oral hygiene or else your teeth will develop stains that might be difficult to get rid of. It is not the braces which cause the stains but the lack of maintaining good oral hygiene with braces which cause the staining.

Always brush your teeth after meals. Brushing will enable you to un-lodge any food particles that have got stuck in between your teeth and braces. This will avoid any tooth decay and staining of your teeth.

Dentists also recommend that you floss your teeth as flossing will get out the particles that you can’t see but are there nevertheless. This will further reduce the chances of you staining your teeth. Also, use a fluoride mouth rinse.

When you have braces on avoid foods like curry, coffee, tea, red wine as they can create stains and when your braces come off the area covered with the braces won’t be stained and all the remaining area will be. This will certainly not be a very pretty sight to look at.

Even whilst you are having your braces treatment you could consider having your teeth cleaned professionally by a dentist. This will ensure that all the stains are kept at bay from your teeth.

People opt for braces because they want to improve their smile and the way they look. When you remove your braces and you notice stains on them then you can go ahead and have your teeth bleached. Whitening of the teeth works well on moderate stains and restores stained teeth to their white color once again.

You could also try some over the kitchen counter remedies such as using baking soda, salt and lemon juice to scrub the stains off your teeth. These will be easy to get and have no detrimental effect on your teeth.

Once again the braces do not cause the stains on the teeth rather if you maintain good oral hygiene and take care not to consume the things which are difficult to clean; the teeth can not be stained. The problem of staining the teeth with Invisalign is less as to maintain the oral hygiene with Invisalign is easy. You can remove them, brush your teeth and can put them back. With ceramic braces during treatment if you consume the things like curry, red wine, beverages like tea, coffee or coke it can stain the rubber bands which are used to ligate the wire with the bracket and it looks very unaesthetic. For this the bands are changed in every visit or use the bands with darker shade so that the staining is not visible.

The Average Cost Of Dental Implants

Sun, 06 Jul 2008 01:36:12 GMT

The older we get we are bound to lose our teeth because of disease, accidents or the wear and tear of life. After we lost our teeth we realize the crucial role that teeth play in our lives. They affect the way we look and in turn it enhances or lowers our self esteem and confidence. Missing teeth will make you look older than what you are and do nothing for the way you eat or chew. It can be extremely embarrassing to smile and bare gaps and missing teeth rather than a pearly row of straight white teeth. All these factors gave birth to the dental implant procedures.

Dental implants are the need in the patient to replace and restore their missing teeth with something as close to natural teeth as possible. The latest dental implants not only look good, but also feel and perform just like normal teeth you are born with. They are the epitome of aesthetics, usability and functionality all mixed into one. Dental implants are far better than traditional dentures. They are stable and fixed permanently hence no shifting. They are user-friendly and help your jaws, gums and bones remain healthy.

Now, you might wonder that dental implants certainly sound like the top of the shelf procedure then what is the cost involved. How much will I have to shell out in order to get all of these benefits? The cost of dental implants varies depending on the number of missing teeth, the dentist who is attending to you and the area of town or country or the world that you undergo this treatment. There are several factors and variables involved in this which can determine the cost of the dental implants.

However, if you were to look at the median range then dental implants will set you back by $2000 to $4000 and can even go up to $14000 in some cases. Moreover, the exact cost is hard to pin point as it will differ from patient to patient based on their individual needs and the materials used.

Before, you begin the treatment that is the time for you to determine the cost of the dental implant that you will incur. Talk about this with the dentist or the dental associates. Discuss the various dental implant options and the cost that are involved. What are the payment options that you have? Financing companies do take into consideration any advanced dental treatment that you might have to undergo. Third party finance companies offer credit and dental offices also offer installment plans for dental implant treatments.

There are places where the dental implant will approximately cost you about $1500 per tooth. There might be additional costs involved too such as preparing the jaw bone to accept the implant. This can increase the cost. Many dentists go on to offer you a discount if you go in for more than one dental implant at a time.

The factors that determine and affect the cost of the dental implant are the number of times you will have to visit the dentist. This will include the fees and the services offered for every sitting and stage of the treatment.

The first visit is for the dentist to estimate about the treatment, the appropriate dental implant and the time scale that it will take. This first visit is either free or considered to be a consultation or could be covered by insurance. Some patients might require bone grafts which can go on to cost you a further $750.

If you were to consider the break-up of costs for dental implants then:

Bone grafts - $750

Implanting the titanium post into the jaw - $1000- 2000

Attaching the implant - $600 – 800

The crown or the false tooth - $800 – 1000

The cost of the implant will rise or fall based on the location of the tooth. Whether, it is at the back of the lower jaw which is difficult to reach, nerves in the area that need expertise. Implants which have unusual sizes or special coatings are several dollars more than the normal ones. Mini implants used to fill up narrow spaces in between teeth cost about a third of the full dental implants for several missing teeth.

Unfortunately, dental implants are not covered by any insurance company as it comes under the purview of cosmetic surgery. However, there are several financing and payment plans to help patients pay for the cost of dental implants. There are some companies that offer you payment plans with no interest if you were to pay up the principal amount within 3 to 18 months. There are credit companies that charge a 12 percent interest for repayment of principal amount of over a period of 2 to 5 years. There are flexible accounts which may allow patients to keep aside money to cover dental implants cost.

If you look at dentures and bridges these are covered by insurance companies. Now, before you rejoice, these are the kind that requires more maintenance and repairs in the long run. Whereas dental implants are permanent no hassle once they are fixed.

There are several different kinds of specialists to work on restoring your missing teeth and dental implants. There will be dentists who provide you with cosmetic dentistry and have receive only a few days of training in implants whereas on the other hand you will have prosthodontists who specialize in this field and have received over three years of training. The amount of training, experience and expertise that the dentist has will affect the cost greatly. The quality of the procedure, materials used, the dental clinic, the dental team and the centralized location will all add on to the cost. The patient must be clear about the stages of the treatment and how much could be the additional cost beyond the particular figure quoted and for what. This way there will be no unpleasant surprises for the patient later on.

The factors that determine the cost of the dental implants are:

§ Materials used – the dental implant prosthesis is determined by the companies that manufacture them. There is not much price variation here.

§ Imaging – the X-rays and CTs add to the cost. Although this makes the procedure modern and accurate, it even makes it expensive.

§ Laboratory – the work done to make the final preparations for the crown

§ Patient’s condition – this takes into account the age, oral hygiene and the jaw bone as this will determine if any further treatment is needed before or after the dental implant.

§ Expertise/service charges – the time that the dentists spends in treating you and how much value would s/he place on the time spent. Expertise and knowledge comes at a certain cost.

Foods with Braces

Sun, 06 Jul 2008 01:34:49 GMT

The orthodontic treatment is almost incomplete without the use of braces but before the result of the treatment is out, the patient has to face the problem of managing and adjusting with the braces especially in the first few days. Eating food with braces is one major field of concern with the patient of orthodontic treatment. Since the orthodontic treatment is a very expensive procedure and also it is tough in regards of physical restraints, therefore taking care of the braces is very important. The braces should be taken care in regards to cleaning and also the kind of food items to be taken with no harm to braces. Certain food items should be avoided to decrease the number of sudden visits for repair of broken and lost braces to the orthodontist. Braces being fragile can be easily damaged.

Braces can be easily destroyed by chewing hard and solid foods. To crunch ice even from a drink, to eat or chew on a hard sweet candy or even chips can easily damage a bracket. The orthodontic bracket can easily be dislodged and break by eating hard bread and also tough pizza crust. Even healthy food like apples, guavas, carrots etc can also damage the braces although otherwise being nutritious foods for health.

Food Items to be Avoided While Wearing Braces

While having braces one really wonders about the type of food with braces to be taken. Here are certain foods with braces which should be avoided.

Hard and sticky candies such as lollipops, fruit roll ups, hard corn chips, airheads, licorice, caramels, candied apples & jolly ranchers should be avoided as the food with braces.

Gums make a very injurious food with braces. Any kind of gum can get caught in the wires and bend the wire. The undesirable bend caused whish the dentist has not placed can lead the teeth to move in the wrong direction.

Ice cubes, nuts of any kind, hard fruits like guava, apple etc, hard pretzels and popcorns should be avoided as these are harmful food with braces people and can cause maximum damage.

People with braces should rather should prefer healthy snacks like bananas, grapes and fruit pastes as food with braces to replace favorite unhealthy and harmful hard foods.

Foods can be sliced and broken up before eating to make the process easier and make them as the food of choice for people with braces.

Fresh corn should be cut off the cob first and can be used as the food for people with braces.

Carrots and other raw vegetables and also the chicken can be cut into small pieces and separated from the bones and eaten ( when caught in wire these food particles are a source of bad breath and constant irritation to the gums )

Even the hard crusty pizzas, bread toast can be taken in pieces.

Certain habits like biting finger nails, chewing on clothes, chewing on pen, pen caps, pencils and opening bottles with teeth, donot go with braces and hence should be should be avoided.

Also carbonated soft drinks are not considered as good food with braces as it can cause damage to the tooth enamel so the use of these drinks should be restricted to once a week. The stains caused by the acids in these aerated drinks cause permanent stains and scars on front teeth which occur along the gum line and are visible only when the braces are removed. Proper brushing is required especially after consuming something, also water pick can be used to clean the stuck food particles and the plaque on the teeth , teeth whitening procedures can be followed in case of permanent stains after the braces are removed. Fruit juices, milk and water are better choices.

Common sense should be used when deciding the food to be consumed while wearing the braces that will be compatible with them and make the treatment to finish on time. Broken or lose braces will only extend the time of treatment. So the choice of food with braces is very important.

Recommended Foods with Braces can be grouped in various categories like:

Milk and Various Milk Products

Drinks with milk as the base as it is the best food with braces people.
Curd (yoghurt) which is smooth and without hard pieces. The hard pieces can also be broken down into smooth paste with the help of a blender and can be consumed as the food by he people with braces.
Also available are various types of soft cheese as the food with braces individuals which can be nicely cherished in different forms.
Various types of pudding and custard are also available.

Breads and Baked Foods

The bread to be consumed has to be free of whole grain, seeds or nuts and if the person likes whole bread it should be smooth and even the crust can be removed before eating as the food with braces people.
Soft cakes and pancakes including muffins without hard pieces and nuts is also a good choice of food with braces people.
The corn and flour is made into soft mixture into micro-wave.
Even other soft crackers and wafers can be cherished as the food item with braces patients.

Grains and Meat Products as the Food with Braces Individuals

Pasta and noodles along with cooked rice and even the rice water is healthy and less damaging food with braces people.
Quinoa , bulgur and kasha can also be eaten
Meat cooked to a soft core, meat loaf and barbeque cooked soft meat can also be consumed.
Meat balls and chicken salad along with thinly sliced meat
Small shredded chicken nuggets can be consumed.
Tofu can be easily made and consumed in different forms
Soft cooked fish, fish sticks, crab cakes and other seafood delicacies cooked to a soft core like tuna and salmon can be cherished.

Soups which do not contain hard chunks can be consumed which will not harm the braces and is the good choice of food items with braces.

Vegetables comprising boiled mashed potatoes, soft cooked beet roots, potato pan cakes, salsa and mashed beans, leafy vegetables like cauliflower and spinach can be had. Cole slaw is also good. Potato or boiled salads along with avocadoes can be consumed as the good food items with braces.

Fruits that get ripe and mushy like bananas, seed less grapes etc and fruit juice along with fruit smoothies are healthy choice of food with braces people.

Fruit shakes, protein shakes and milk shakes can be cherished.

Ice creams without any nuts or crusts and soft cakes can be enjoyed. Most cold drinks like cold coffee can be had avoiding excessive caffeine and acidic drinks. Cheese cakes, puddings and custard can be eaten.

Suggested Breakfast Time Foods for People with Braces

Mashed eggs, mashed cheese, frozen cheese blintzes, hot cereals and pan cakes can be consumed. Muffins but without any hard chunk along with some fruit juice can be had. Matzo cooked along with eggs and butter served with sugar. Bread and butter or bread and jam or fruit sauce and milk is good.

Suggested Lunch for People with Braces

One can consume macaroni with chopped ramen noodles along with cheese. Even egg, tune fish and chicken or meat salad can be taken. Soups both vegetarian and non vegetarian can be taken. Any dish like beans and cheese dish can be taken as long as it is shredded into small pieces and is without any nuts or chunks and has only soft consistency.

Suggested Dinner for People with Braces

Meat pieces chopped into small pieces and pie can be taken. Fish can be enjoyed best being simmered and slightly steaming. Fried rice both vegetarian and non vegetarian including chicken and meat can be had the only criteria being the pieces should be small and soft. Even pastas and barbeque chicken can be cherished.

So we see when there is so many food items for the individuals with braces to eat and only certain precautions to take and food items to be avoided it is not a difficult task to wear braces and still not go on dieting. So enjoy eating to a beautiful smile.

Options For Tooth Colored Braces

Sun, 06 Jul 2008 01:34:49 GMT

In case one wants to go for tooth colored braces due to cosmetic reasons then there are few options available as tooth colored braces. These tooth colored braces are no doubt costies than the conventional metal braces. If however money is not a deciding factor for choice of braces then one must ask the dentist for these options before deciding the braces.

The tooth colored braces include

Ceramic braces
Plastic braces
Clear inspire Sapphire brace
Ceramic Braces

These are generally made of composite materials and are highly aesthetic as they blend with the tooth color. They usually do not stain but the ligature wires used can stain if you take lot of curry, coffee or smoke. They are strong enough to withstand the forces put on them to bring about the desired tooth movements without fracture. The ceramic braces are more comfortable as compared to the metallic braces as they don’t irritate the gums. The main advantage of ceramic braces is that it is very esthetic as compared to the metallic braces. But it has its own disadvantages. As the ceramic is brittle no doubt the ceramic braces are strong but at the same time they are fragile. They can break or chip easily as the material does not have the elasticity and when they chip the sharp edges can hurt the lips. The second disadvantage is that the ceramic is harder than the enamel so if it is put on the lower teeth it can wear off the upper teeth as they come in contact with the upper teeth.

Staining of the ceramic braces is another disadvantage which should be considered. The ceramic braces stain and look very unaesthetic so while having ceramic braces one has to be very particular what to eat. One should avoid the food which can cause staining of the braces. The person should also try to maintain very good oral hygiene.

The treatment time also increases with the ceramic braces as the teeth they remove slowly as compared to other braces.

The other problem with ceramic braces is encountered when one has to get them removed. It takes longer to remove the ceramic braces than the metallic braces. Some times it becomes painful also.

Plastic Braces

These are a cosmetic alternative to the metal braces, typically made from plastic alloys. Clear elastics are used with these braces. These tend to be most brittle making them more susceptible to fracture.

Clear Sapphire Braces:

These are made up of pure monocrystalline sapphire. These are very transparent thus very aesthetic. They are strong and don’t stain easily. They are the best option if your teeth are very white.

LINGUAL BRACES

These are placed on the lingual (inner) aspect of the teeth so practically invisible to other people and do not show in photographs making them highly acceptable. These are usually made of stainless steel thus tend to irritate the tongue and there is difficulty in speaking initially. They are highly expensive and cannot be used in all cases. An orthodontist specially trained in it can only do lingual orthodontic treatment. Another disadvantage is the longer treatment time.

INVISALIGN

These ‘braces’ consist of strong computer fabricated computer trays especially for you. They are invisible, easier to clean, don’t irritate the gums and don’t stain at all. Apart from these advantages few disadvantages of the Invisalign treatment are that they can only be used to treat minor or small malocclusions, very expensive and treatment time is prolonged. Also in some cases usual braces are required initially.

Root Canal Re-Treatment

Sun, 06 Jul 2008 01:33:43 GMT

Even when pain and/or swelling which are signs of infection are present, the majority of cases of root canal treatment failure can be successfully treated in the technologically advanced world of today. By the improved researches and the clinical trials the dental professionals have developed a lot better concepts, materials, and techniques. Also now the quality of education and exposure has produced better trained general dentists and even many specialists in the field. All these factors help in providing better care to the patient. Some of the advances which have improved the quality of work and proved to be a help for both the dentist and patient are:

Magnification glasses, fibred optic lighting system and headlamps have greatly enhanced the vision and therefore the produce a greater treatment success.

Ultrasonic devices allows the dentist to more efficiently and accurately remove old root canal materials and other intra-canal hindrances so that a success can be achieved even with most difficult root canal failure cases.

Improved instruments, better materials and medicatements for disinfecting, filling and repairing root canals and innovative new technologies have lead the dentists and the patient to get re-treatment done for the majority of the root canal failure cases.

The dentist are now able to treat the root canal cases with better diagnosis and visualization thanks to the new technology of Computer digital radiography. Also the radiation exposure has been greatly reduced due to this.

Root canal re-treatments available these days are of two types:

Non-surgical endodontic re-treatment

Surgical endodontic re-treatment

Today, well-trained general dentists and root canal specialists alike can most of the times perform non – surgical endodontic root canal re-treatment which is very cost effective, time saving and quite predictable as compared to other treatment alternatives like extraction. But at times the root canal failure case cannot be re-treated by non-surgical methods. In these cases it’s important to use surgical endodontics to re-treat a root canal failure case preferred over extraction.

Non-Surgical Root Canal Re-Treatment Method

The main aim of Non-surgical endodontic procedure is to save the endodontic ally failed tooth. But at times a patients crown given on the tooth requiring re-treatment needs to be removed. In some cases access can be made possible through the existing crown. The access opening as done in fresh case will give the dentist a non-surgical access to the root canal of the tooth through the top surface of the tooth. When the access has been effectively gained the procedure may further involve the following steps:-

Locating and treating the earlier missed or undetected canals.

Removing the earlier filled material from the root canal space. Drills or chemical agents can be used to remove the existing filling.

Post and core removal or any broken instrument from the pulp space.

Improving the quality of already present root canal treatment

Making way through the blocked canals and by-passing canal ledges.

Treating if any mechanical and pathological perforations of the root present.

Once these objectives are achieved, the root canal space is cleaned well, re-shaped, completely disinfected and finally sealed with complete accuracy. A protective restoration can then be placed in the end to restore the proper tooth form, function and aesthetics.

Surgical Root Canal Re-Treatment Method

Surgical method of treating a root canal failure case involves raising a small flap adjacent to the involved tooth in order to gain entry and treat the root canal infection. Surgical line of root canal treatment is a minor in office procedure done under local anesthesia. When the infected area is exposed the dentist performs curettage (the removal of diseased and infected tissue by scrapping or scooping). This is usually followed by the apicoectomy procedure in which the infected root portion esp. the root tip is removed. A small filling is then placed from the root end side to seal the left healthy part of the tooth root. Surgical root canal therapy tends to give a good long term prognosis if the entire infection can be effectively eliminated.
Unfortunately at times the re-treatment efforts may not be possible or cost-friendly and extraction may be the only alternative. But to save a previously endodontically treated tooth which is failing is usually possible and predictable, being the most conservative option for the patient.

Understanding Abscessed Tooth

Thu, 28 Aug 2008 01:16:21 GMT

Localized collection of pus in the alveolar bone at the root apex of the tooth with extension of the infection through the apical foramen into the periradicular tissue.It may be

Acute Apical
Acute Gingival
Chronic Apical
Gingival
Periodontal
Phoenix

The abscessed tooth can be there because of many reasons. The most common is because of dental caries. Gum problems and the trauma can also cause abscessed tooth.

CLASSIFICATION OF ABSCESSED TOOTH

Depending upon the symptoms and the cause the abscessed tooth can be divided into two groups

Acute alveolar abscess

Chronic alveolar abscess

SYMPTOMS

Acute Alveolar Abscess As the name implies the symptoms are very acute initially there is

Tenderness

Severe throbbing pain with soft tissue
Swelling
As it progresses
Swelling becomes more pronounced
Tooth becomes elevated & mobile.
Patient presents with inflammation, swelling, pain, fever and malaise. in case of children prompt treatment is important as children are prone to dehydration especially if they are not eating well due to pain and swelling. Untreated leads to infection in bone

Chronic Abscess

Due to long standing ,low grade infection of the periradicular bone

Seen when there is continual discharge through the formation of the sinus tract.

GENERAL SYMPTOMS
- Slight rise in body temperature.
- Chills, malaise & headache
- Lymphadenopathy
RADIOGRAPHIC CHANGES

These are minimum in case of acute form-due to short period of time & as it is confined to medullar bone only. Whereas in case of chronic, better defined radiographic lesion is seen.

TREATMENT

Treatment of acute alveolar abscess
- Acute symptoms can be relieved by using antibiotic therapy.
- Relief of the symptoms is more efficient if drainage is also established.
- Drainage may be established through the pulp chamber of tooth or the associated gingival or by extraction of the tooth.
- Should pain occur during the excavation of tooth structure to establish drainage, The discomfort can be lessened if the tooth is stabilized by the dentist’s fingers.
- Warm saline mouth rinses often aid in localizing the infection & maintaining adequate drainage before endodontic treatment or extraction.
- Plenty of fluids intake and the rest is recommended.
TREATMENT OF CHRONIC ABSCESSED TOOTH

In case of chronic abscessed tooth a radiograph is recommended to ascertain whether the particular tooth can be saved by the endodontic treatment like root canal therapy or it has to be extracted.

How to Clean Stains After Braces

Sun, 06 Jul 2008 01:34:49 GMT

Before the advent of modern dentistry what dentists used was cement to hold the braces to the teeth. The cement if not cleaned up properly did leave stains on the teeth. However the latest cements that are used are mostly stain free and even if they are the dentists ensure that they do a good clean up job afterwards to leave your teeth sparkling white.

The latest types of braces require you to have the best of oral hygiene if you don’t want your teeth to be stained after the braces have been removed. All the plaque, tartar or food particles that might have got trapped in between the teeth and the braces need to be removed with due care. If this is not done then the front enamel of the teeth will get stained and it might never be brought back to its previous color. In fact, the most common reason for teeth to be stained after a braces treatment is that the patient did not use the adequate prescribed dental hygiene. The dentist will stress on your brushing your teeth and even demonstrate the technique the reason being the stains will only be noticed once the braces are off. Unfortunately, once the enamel of the tooth is affected there is nothing much you can do.

Your dentist will suggest that you polish or whiten your teeth. These are techniques that will restore your teeth to its original color or lighten the stubborn stains.You could also remove these stains by using off the counter whitening toothpastes and brushing the affected areas for at least ten minutes in the morning and at night. There are certain foods such as coffee, tea, smoking that are known to stain teeth hence avoid them. Try to use salt with your toothpaste as it is known to be a lightening agent.

Do not forget to rinse your mouth every time that you eat something. That will flush out the trapped particles. Some dentists might provide you with a concentrated fluoride treatment to be able to remove the harm done by decalcification to your teeth. There are teeth whitening strips that are available that will help to remove the stains of your teeth quickly and noticeable difference will be there within a few days of using them. However, if you have lots of buildup of plaque and tartar then they will not be that effective.

Your best bet is to diligently make your toothbrush and toothpaste your buddies. The moment you brush regularly you will notice that when your braces are removed you really do not have to worry about the stains. This is a better option than trying to whiten them later on using professional help or in-store products.

There are cosmetic dentists who offer a process called tooth bonding which will fist remove the dark spots and next use a composite bonding material to cover them up. There is also a Zoom whitening bleach treatment which will make your white teeth appear all the more whiter than before.

Orthodontic Brackets

Sun, 06 Jul 2008 01:34:49 GMT

BRACKET It is defined as a device that projects horizontally to support auxillaries and is open on one side usually in vertical or horizontal

Brackets are the passive components of fixed orthodontic appliance therapy.Brackets act as handles to transmit forces from active components (archwire) to teeth.They have one or more slot to accept archwire.

According to type of slot

Ribbon arch

Edge wise

According to mode of attachment

Weldable brackets

Bondable brackets

According to material used to fabricate the bracket

Metallic

Ceramic

Plastic

According to slot size:

0.018’’× 0.025’’

0.022’’× 0.028’’

EDGE WISE BRACKETS

Used in edgewise and straight wire technique.

They have horizontal slot facing labially.

They provide greater control over tooth movement and do not permit tipping of teeth.

RIBBON ARCH BRACKETS

They are used in Begg fixed appliance therapy.

They possess vertical slot facing occlusal or gingival direction.

Slot is narrow mesiodistally.

This is used with round wires to bring about tipping of the teeth in labiolingual as well as mesiodistal direction.

BONDABLE BRACKETS

Brackets which are directly boded over the enamel are called bondable brackets.

Undersurface of bondable brackets have meshwork or grooves to help in interlocking with the adhesive.

WELDABLE BRACKETS

They are welded or soldered onto the bands which in turn are cemented around the teeth.

They have metal flange which can be welded to the band.

METALLIC BRACKETS

Most commonly used are stainless steel brackets.

But due to allergic reactions to nickel content, titanium brackets are also available

Advantages of metallic brackets

They can be recycled

They can be sterlised

They resist deformation and fracture

They exibit least friction at wire-bracket interface

They are not very expensive

Disadvantages of metal brackets

Non-esthetic

Tend to get corrode and cause staining of teeth.

CERAMIC BRACKETS

Introduced to orthodontics in late 1980’s

Made of aluminium oxide or zirconium oxide.

Advantages of ceramic brackets

They are dimensionally stable and do not distort in the oral cavity.

They are durable and resist staining in oral environment.

Disadvantages of ceramic brackets

They are very brittle and therefore fracture or crack when undue forces are applied.

To compensate it’s brittleness their size is increased which tend to increase their bulk.

They exhibit greater friction at wire-bracket interface

PLASTIC BRACKETS

Introduced during early 1970’s

Usually made of polycarbonate or modified form of polycarbonate.

Available in tooth colored or transparent forms.

Disadvantages of plastic brackets

Tend to discolor particularly in patients who smoke or drink coffee

They offer poor dimensional stability

Their slot tend to distort

The friction between bracket and metal archwire is very high

LINGUAL BRACKETS

These are modified brackets bonded to lingual surface of teeth.

These are similar to conventional metallic brackets, but treatment mechanics involved in lingual orthodontics differ from standardized labial brackets.

INVISALIGN BRACES

Invisalign is a series of clear, removable aligners that both orthodontists and dentists use as an alternative to traditional metal braces

Advantages

The most obvious advantage of the treatment is cosmetic: the aligners are completely transparent, therefore far more difficult to detect than traditional wire and bracket braces..

The aligners are marketed as being more comfortable than braces.

Due to the removable nature of the device, food can be consumed without the encumbrance of metallic braces.

Aligners avoid many of the side effects of traditional fixed appliances, for example the effects on the gums and supporting tissues. The aligners give less force per week and less pain than do fixed appliances (traditional metal braces). Fixed appliances are adjusted approximately every six weeks and apply greater forces.

Aligners should be removed to eat, drink, to clean the teeth, or to have them checked by the clinician. (It is acceptable to wear aligners while drinking water.)

Computerized treatment planning is compulsory as part of the Invisalign protocol. As with other forms of orthodontic treatments that incorporate a computerized plan, this allows the prospective patient to review the projected smile design, learn how long the treatment is likely to take, compare different plans, and make a more educated decision about whether or not to use Invisalign.

Invisalign treatments have been claimed to be quicker than traditional orthodontics.

Disadvantages

The product also has potential disadvantages: the very fact that the aligners are removable means they are not continually correcting the teeth.

Unlike traditional fixed braces, they are largely dependent on a patient's habits and their consistency in wearing the aligners.

The success of the Invisalign aligners is based on a patient's commitment to wear the aligners for a minimum of 20-22 hours per day, only removing them when they are eating, drinking, or brushing their teeth.

The system is also somewhat expensive, as conceded by the Align company, and can be more expensive than traditional wire and bracket systems.

The aligners must be removed for eating. They and the teeth should be cleaned before re-inserting afterwards. This can be troublesome for people who are constantly snacking and may mean the patient has to clean their teeth up to six times daily.

By their very nature, Invisalign aligner trays are not as proficient as fixed braces at moving teeth in the vertical dimension. severe skeletal problems are also difficult to treat.

Unlike traditional braces, if a patient grinds or clenches his or her teeth during the day or while sleeping, the aligners can become damaged

The aligners are constructed of implantable grade polyurethane, there may be cases of allergic and toxic sensitivity reactions to Invisalign

TREATMENT

Diagnosis and treatment plan. Then, impressions and pictures teeth will be taken for digitization purposes.

The impressions of teeth will be digitized in order to work with a computerized 3-D image of teeth. Then, planning of tooth movements throughout the entire treatment timelineis done. Patient will be able to see a virtual representation of teeth before, during, and after completion of the Invisalign process
customized aligners are created with advanced technology to wear at each stage of treatment. While the number of aligners varies for each individual situation, a full set of treatment typically includes 20-30 aligners per arch.patient should wear aligners at all times, with the exception of eating and drinking, in order to complete treatment in the timeline determined doctor. During the entire treatment process, patient will be able to watch his teeth gradually moving into place. Aligners are changed after every two weeks.

Problems after Removal of Wisdom Teeth

Mon, 18 Aug 2008 21:26:58 GMT

There are certain problems related to removal of wisdom teeth, which the patients who undergo the surgical extraction of wisdom tooth have to face. These problems are not complication but are general ones which almost every body has to face. However if the patient is aware of these problems before hand then it becomes easier for them to minimize their effect and also helps mentally for the patients. These problems can sometimes lead to complications if not addressed properly like severe infection in the extraction site. However one can meet all the problems effectively by carefully following the instructions of dentists.

Bleeding

The most important thing after the extraction of wisdom teeth is the formation of clot at the extraction site. Till then the bleeding and oozing of blood from there is common. This bleeding can occur up to 3 days after the removal of wisdom tooth; however after 3^rd day its quantum goes down and should be very less or barely noticeable. Till the bleeding is continuing, one should avoid vigorous rinsing of the mouth as it can dislodge the colt formed at the extraction site. One should gently start doing warm saline rinses 2-3 times a day after 24 hours of extraction of wisdom tooth as it helps in faster healing of the wound. These should be continued till the healing is completed. This should stop the bleeding. But sometimes it does not stop. In such cases one can take sterilized gauge piece and gently bit down on it with equal pressure. This helps in stopping the bleeding. This should not be overdone as this can irritate the wound. After biting down for half an hour, when gauze piece is changed, there should be noticeable reduction in the bleeding. Another more effective way is to take iced tea bag instead of gauze piece as the tannic acid in the tea bag helps more in reducing the bleeding from wound. All the steps help in reducing the bleeding and oozing. However where in spite of all these steps it does not stop or reduce after one day then one should contact the Oral Surgeon as this is not normal and good and there can be some other reason for the same. During the period of formation of clot in the exposed extraction site of wisdom tooth and coupled with presence of bacteria in the mouth, one can have bad smell coming from there shortly after the surgery. Further this can be accompanied by bad tasting fluid seeping from extraction site. This bad smell and fluid can continue upto maximum 2 weeks after the surgery. All these increase the importance of follow up appointment with dentist within 7-10 days of surgery. During this visit if the dentist feels that the infection has set in the extraction socket then he gently uses a plastic syringe without the hypodermic needle and fills it with a mixture of equal parts of hydrogen peroxide and water or Chlorhexidine Gluconate which also comes in the form of a mouth wash, into the sockets to remove any food or bacteria that may have collected in the back of the mouth.

Infection

This is the most common complication after extraction. Our mouth is full of bacteria. One cannot sterilize it. Dentist decides whether to give antibiotics after the extraction or not. Usually for the simple extractions antibiotics may not necessary but in the case of patient having pain and swelling or pus then the dentist prescribes the antibiotics as a preventive measure. In cases where bleeding continues after 48 hours along with acute pain and swelling, there could be infection after the extraction. In such cases the patient must contact dentist to avoid further complications.

Swelling

Swelling is another common problem after the extraction of wisdom tooth. Rather the painful swelling is a good sign and is indicator of normal progress of healing process of wound. There is no fixed time frame for its duration and level of severity. These can be different from person to person. To reduce the amount of swelling one can do cold fermentation with ice. It should be done for 20 minutes and then take break of 20 minutes. Do this for one hour within 12 hours of surgery. Do not do hot fermentation. The post operative instructions of the dentist explain all this including the start and reduction of swelling. Normally it takes 7 days for swelling to subside and if this does not happen within this expected time then one should call up the dentist to checkup. In cases where swelling once goes away and then sets in again, this can be due to infection in the wound.

Dry socket

Dry Socket is also one of the most common complications of wisdom tooth extraction. It is a very painful condition. In dry socket condition the pain is acute and it does not subside even after taking pain killer tablets and to complicate further food gets impacted in the socket. It happens when the blood clot formed over the extraction site gets dislodged or does not form or falls of prematurely. Dry Socket is not an infection rather it is a condition. This happens when the post extraction instructions given by the dentist are not followed by the patient. Smoking, drinking with straw, sucking, spitting or blowing nose dislodges the clot. Females taking contraceptives have higher risk of getting dry socket due to the high level of estrogen. Further sometimes sneezing, musical instruments played with mouth also can disturb the clot due to change in pressure in the mouth. In the cases where the patients are smokers or in the case of complicated extractions involving lot of effort on the part of dentist for cutting the bone or in the case of patients having previous history of dry socket, the chances of their having dry socket are higher than others. When all the symptoms are present and the patient suspects of having dry socket then he should contact the dentist. The dentist will clean the extraction socket and induce fresh bleeding for formation of clot. In case of infection, the antibiotics are prescribed along with pain killers.

Nerve Injury

When the wisdom tooth is extracted by the dentist/Oral Surgeon, they have to be cautious so that to avoid the injury to nerve as these can be in close proximity to the tooth being extracted. The nerves of major concern are Inferior Alveolar Nerve and Lingual Nerve. The importance of these nerves is as under:

Inferior Alveolar Nerve – This nerveenters the mandible at the mandibular foramen and exits the mandible at the sides of the chin from the mental foramen. This nerve supplies sensation to the lower teeth on the right or left half of the dental arch, as well as sense of touch to the right or left half of the chin and lower lip.

Lingual Nerve – This nerve branches off the mandibular branches of the trigeminal nerveand courses just inside the jaw bone, entering the tongue and supplying sense of touch and taste to the right and left half of the anterior 2/3 of the tongue as well as the lingual gingiva. Such injuries can occur while lifting teeth but are most commonly caused by inadvertent damage with a surgical drill. Such injuries are rare and are usually temporary. Depending on the type of injury they can be prolonged or permanent.

Best Way to Whiten Teeth after Braces Removal

Sun, 06 Jul 2008 01:34:49 GMT

Viola! You have finally got your braces removed and what you see in the mirror are teeth that have been aligned in a straight row. You never imagined that your teeth could be this straight. But, you see some stains on your teeth and they don’t look as white as you would want them to.

So, what do you do now? Let us look at the various options that are available to you.

First of all get a cleaning of your teeth done at the dentist. This will remove all the accumulated tartar and plaque on your teeth and show them up a shade two whiter than before. If you want to have your teeth bleached wait for at least a month after the braces have been removed as the teeth can be in a weak state before that. When the dentist is removing the braces ensure that all the substance that allows it to stick on to your teeth is removed too. If this is not done properly then you will be left with stains.

You could ask your dentist for the Zoom whitening treatment. This is extremely popular and effective. It costs one about $350 but it is worth every dime spent on it as your teeth come out sparkling at you back from the mirror.

You might also want to consider laser treatment for the whitening of your teeth but it is extremely expensive.

There are Crest white Strips which you could try to give you white teeth. These strips are able to remove all the yellow and stains off your teeth and leave them the way you were born with.

There are also dentists who use whitening gels and trays. You will be given this tray to take home along with you and use it for two to three months. You will certainly notice a change in the color of your teeth.

After you have used these methods the best thing to adopt is diligence and consistency in your oral hygiene habits. Brush your teeth regularly and try to reach for places that are unreachable. Floss your teeth and use a mouth wash as a rinse. Stains tend to build up over a period of time especially due to neglect. Once you don’t allow them to build up you will not need to necessarily worry about them.

Happy smiling!

What Is Flossing

Sat, 26 Jul 2008 00:41:01 GMT

Dental FLOSS is the most important thing, next to brushing, for maintaining a good oral hygiene. This is an effective method for removal of plaque and debris from in between the two teeth, where a tooth brush may fail to reach because of tight contact between the two adjacent teeth. So it can also be referred to as an inter-dental cleaner. Most dentists agree that the combination of brushing and flossing is the most effective way of removing plaque from all surfaces of the teeth.

TYPES OF DENTAL FLOSS

Dental floss is available as a multifilament nylon yarn. It is further divided into various types according to its form and material, the various types are as follows-

Twisted or Non Twisted

Bonded or Non Bonded

Waxed or Non Waxed

Thick or Thin

TECHNIQUE OF FLOSSING

18 inches (approx.) of floss is wrapped around the middle finger of the right hand .The rest is used to secure floss to the middle finger of the left hand .

The floss is passed over the tips of the thumbs keeping them one inch apart.

The floss is passed gently between each pair of teeth in a gentle sawing motion; it is then curved into C shape around the tooth and is rubbed up and down.

The similar method is followed for other teeth.

The next length of the floss is taken when the present one gets soiled or frayed.

Flossing can be made easier by using floss holders. Floss holder has one or two forks that are rigid, to keep the floss taut when penetrating into tight contact areas. On these forks the mounting of the floss is easy and they hold the floss firmly in place.

F shaped and Y shaped dental floss wands

These F and Y shaped wands are specialized plastic wands used to hold the floss. This makes it easier to use the floss on all the surfaces of the teeth where it may be difficult for our finger to reach.

Care After Wisdom Tooth Extraction

Mon, 18 Aug 2008 21:26:58 GMT

Following are the instructions which need to be followed by patients to avoid the complications after extraction of wisdom teeth and for faster healing.

Rest - Try to take some rest. You may feel great but don’t exercise at least for a day. When taking rest, keep your head lifted on a pillow

Do Not Chew from Extraction Side - Chewing of food from the side of extraction should be avoided as this can irritate the extraction wound which can cause bleeding and dislodgement of the clot and the infection. It is instructed to take liquid or semisolid diet.

Spitting - Do not spit for minimum for 24 hours because it can dislodge the clot. If the clot is dislodged you can have very painful condition known as dry socket. Afterwards one should spit 3-4 times in a day so that no food is lodged near the area where the tooth is removed.

No Smoking for 48 Hours – In smoking sucking action is involved and this can cause the dislodgement of the clot and can be the major cause of the dry socket which is a very painful condition.

No Sucking - Avoid sucking of any type. Do not drink anything with straw for 48 hours.

Avoid Eating Hard Foods - Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. Avoid hot drinks, spicy foods, sodas, etc. Remember to take plenty of fluids.

Brushing - It is advised not to brush your teeth for the first 8 hours after surgery. After that one may brush one’s teeth but very gently, avoiding the area of surgery.

Warm Saline Rinses & Mouth Wash - Use of any kind of mouth washes or rinses should be done for first 24 hours as it can cause the dislodgement of the clot which is very essential for the proper healing of the extraction socket. After 24 hours one can use warm saline rinses or the mild antiseptic mouth wash as prescribed by the dentist. Warm saline rinses and mouthwash should be done gently and not vigorously.

Take your medicines as prescribed by your dentist. Don’t skip the medicines. If antibiotics are prescribed then they should be taken regularly. Pain killers and anti-inflammatory drugs help in reducing the pain and swelling.

Types Of Dental Implants

Sun, 06 Jul 2008 01:36:12 GMT

Dental implant is the device with which a single or multiple missing teeth can be replaced even if support is not there. In this the support is taken from the underlying bone instead of the adjacent teeth unlike fixed bridges. Even complete dentures can be given above the implants even if the severe bone loss is there.

Basically there are two types of dental implants. In some the implants are put inside the bone but some times the thickness or height of the bone is insufficient, so implants can not be put inside the bone. In that case some times implants are put on the bone. The basic two types of dental implants are

1) Endosteal or Root Form Dental Implant

2) Subperiosteal Dental Implant

Endosteal Implants of dental implant is put directly in the bone. It is the most common type of dental implant used in dentistry. It is also called as the root form dental implant as in this type of dental implant the part which is placed inside the bone acts as the root of the natural tooth. They are available in different width varying from 3.2mm to 7mm and are available in different lengths varying from 10mm to18 mm. The width and length is decided by the dentist depending upon the width and the height of the bone and the type and the number of teeth to be replaced. The process of putting the dental implant is two step procedures. In first step a hole is drilled in the bone according to the size of the implant and then the root part of the dental implant is inserted. Then the gums are sutured above this and patient is asked to wait for 2 to 3 months in which recall evaluation is done to see whether the implant has properly fused with the bone or nor. The process of fusing the implant with the bone is called as the osseointegration. When the dentist is sure that the osseointegration is complete then the second step is done. In which a small incision is given in the gums were the implant is put. The implant is exposed and the abutment part is attached. After this the dentist takes the impression and gets the crown made which is fused o the implant. Some dentist likes to put the Endosteal dental implant as the one step procedure. In one step procedure the only difference is the part of the implant o which the abutment is placed is kept above the gum margin. So that when the healing is completed and the abutment has to be attached then the second incision is not given to expose the dental implant as it is already above the gum margin. Now which procedure should be done depends upon the dentist. Some are comfortable with the two step procedure and some are happy with the one step procedure. The success and failure of the implant does not depend upon this.

Some times when the dentist feels that the bone height is not ideal he do some special surgeries before giving the dental implants these are

Bone Grafting - in this if the height of the bone is insufficient then bone is taken from some other part like jaw or the hip bone is used. Some times synthetic bone graft material is also used.

Tissue Regeneration - A artificial membrane can be placed near the bone edge to enhance the proper healing after the bone graft.

After these surgeries when the bone height and thickness is ideal the Endosteal dental implant is put.

Subperiosteal Dental Implant – Some times the bone structure is badly atrophied. Not only it is atrophied but the bone structure is limited to the extent that bone grafting can not be done. In that case subperiosteal bone graft is given which is individually made and is very light weight. It is a metal frame work which has multiple posts which come out of the gm tissues and is put on the remaining bone. The dentist has to decide where it can be put depending upon the site and the condition of the bone. It can be used to replace the multiple teeth or even complete denture can be given above this. After it is put the natural bone and the tissue covers it and give it extra stability.

Ramus Frame Implant - Some time when the lower jaw bone is severely resorbed and is unable to give any kind of retention then there is another alternative known as Ramus frame implant. It is in between the Subperiosteal and the plate form. These are prefabricated and can be moulded according to the anatomy. It is given on both sides on the ramus of the bone posteriorly. The part which shows the opening is inside the bone but the metal bar is outside in the oral cavity towards the tongue and holds the denture.

Intramucosal Implant – This is another type which is not used very often known as Intramucosal Implant. It is used to give extra retention and stability to the removable dentures. In this a mushroom shaped attachment is attached on the gum side of the denture and it fits in the indentations which are made I the soft tissue it increases the retention of the removable dentures.

Dental Implants come in different shapes and textures.

Materials for Dental Implants

Different materials are used for dental implants but in dentistry most commonly used dental implant is of Titanium as it is most compatible witht he dental tissues and inert. The various materials used for dental implants are as under.

Titanium
Tantalum
Alloys of titanium/ aluminium/ vanadium
Cobalt,/ chromium/ molibidnum
Aluminium oxide
Carbon
Silicon rubber
PMMA( polymetyhl methacrylate)
Polyetyhlane

Components of Dental Implant

Body
Cover screw
Healing abutment
Abutments
Impression posts
Laboratory analogs
Waxing sleeves
Prosthesis retaining screws

Functions of Dental Implant

Implant Body - It is a portion of implant system within the bone.

Cover Screw - It seals the occlusal surface of the implant during osseointrgration( the interface between the alloplastic material and the living tissue)

Healing Abutment - It is a cover attathed to the implant which is used to maintain the opening through the tissue until the restoration is completed.

Abutments - They are the components of the implant system that screw directly into the implant.There are diiferent types of abutments available like standard,fixed, angled, tapered and nonsegmented.

Impresssion Posts - They are the component used during the impression procedure to transfer the position of the implant to the cast.

Lab Analog - Made to represent exactly the top of the implant fixture in the laboratory cast.

Waxing Sleeves - They are attatched to the abutment by the relating screw on the laboratory model.

Prosthesis Retaining Screw - Screw used to secure a screw- retained metal framework.

Human Dentition

Wed, 29 Oct 2008 05:14:36 GMT

The human dentition consists of two sets of teeth. One is the set which one starts getting as infant and one is which one starts getting from the age of 5-6 years. The first set of teeth also called as milk teeth or primary teeth or decidous dentition gives ways to permanent teeth. The complete details are as under

PRIMARY OR DECIDUOUS DENTITION OR MILK TEETH

SECONDARY OR PERMANENT DENTITION

Primary teeth or baby teeth or deciduous teeth are called the first baby teeth of a child (sometimes also called milk teeth). The number of baby teeth is 20. They are ten in each jaw but much less than the number of the adult teeth. The primary teeth are replaced at a baby's later age by a set of 32 permanent

Primary Teeth Eruption - Baby Teeth Chart

Around the 8th week after conception, oval-shaped tooth buds start to form and harden in the embryo's mouth. Although the baby teeth aren't visible when a child is born, both the primary and permanent teeth are partially formed below the gums. The tooth crown develops first and after it is fully grown, the root begins to develop. Then between about six months and 1 year old, the deciduous teeth begin to push through the gums. This process is called baby teeth eruption or teething. A child gets his first complete set of primary teeth by the age of 3. The first baby teeth to erupt are usually the two lower front teeth.

The baby teeth chart shows the average age that each primary tooth is expected to erupt. But not all baby teeth follow these rules. Some infants may have their first primary tooth (usually one of the bottom middle teeth) erupted as early as 3 months. Others may reach their first birthday or more without getting their first deciduous tooth. If there is no sign of teething by this age you should ask for a pediatrician's advice. That kind of late development of primary teeth is more common in premature babies. In some rare cases (1 every 2.000) infants are born with one or more teeth (called natal teeth) or may have teeth emerge within the first month (called neonatal teeth). A dentist should evaluate the teeth's condition, as they could be loose, interfere with feeding or irritate the baby's tongue.

TOOTH MORPHOLOGY OF PRIMARY TEETH

The primary teeth are 20, ten at every jaw, 8 incisors, 4 canines and 8 primary molars. The deciduous teeth of the primary dentition are smaller than the teeth of the same type in the permanent dentition, but they generally resemble in form.

PERMANENT HUMAN DENTITION

The eruption of permanent teeth starts around the age of 6. From then until the child becomes twelve years old, all the primary teeth loosen and come out while the permanent teeth come through in their place. Up to the age of 13 years the 28 out of 32 permanent teeth will appear.

The full dentition of adult human teeth is completed much later. The 4 last adult teeth, one at the back of every side will appear between 17-21 years. That's why they are called wisdom teeth Grown-ups have a set of 32 permanent teeth, of four different teeth types.
Sixteen at the top and sixteen at the bottom jaw:

8 Incisors,

4 Canines,

8 Premolars

12 Molars

The dentition plays a vital role in a person’s physical as well as mental health because the tooth play a key role in a persons appearance so it becomes very important for maintaining good oral health. Tooth care should start at an early age and parents should make it a habit to avoid caries from nursing bottle caries stage onwards Child should be made to undergo fluoride treatment for prevention of caries. Pits and fissure caries should be looked into dealt with to avoid further damage using pits and fissure sealants etc.

What Are Composites

Sun, 06 Jul 2008 01:34:09 GMT

Composites are resin based tooth colored filling materials which can be bonded to the tooth. Earlier very few materials were available, when one has to go for the filling. It used to be either silver or gold restorations. These materials have very unaesthetic looks, especially if the front tooth has to be filled. When one has to choose the restorative material, number of factors are taken into consideration. Like

The tooth which has to be filled e.g. if front tooth has to be filled we only consider the tooth color materials which give esthetic looks so in that case composite is the option.
Type of cavity i.e. the cavity is big or small.
Properties of the material like whether the particular material is indicated for the specific cavity
Cost of the filling material –some materials are expensive and some are cheap. Silver amalgam filling is cheaper than the composite filling.

Types of composite filling- on the bases of how they can be used the composite fillings are divided into two types

Indirect type- this is used for making composite inlays or onlays and the composite veneers. In this is first of all impressions are taken to make the mold of the tooth cavity in which filling has to be done. It is fabricated outside the mouth in the lab and on the next appointment it is fitted in the patient’s mouth. This is comparatively expensive ad time consuming as the patient has to come minimum for two times. But strength wise the properties are better than the direct technique. Normally inlays and onlays are made when the cavity size is big.

Direct type- in this the filling of composite is done directly in the patient’s mouth. This is done in the single visit. It is indicated in closing the gaps (distema) in the front teeth.

Teeth after silver filling Teeth after composite filling

Front teeth with cavity Front teeth after composite filling

Composites are available in many shades so according to the color of the tooth shade is selected to give esthetic results. Composites are resins which have light sensitive agent in t. this can be cured with the light to make it hard. Before putting the resin in the cavity the area is treated with a agent that is called as the etching process. After that the bond is applied which is cured by the light above this the composite is placed and is cured with light

Why Are Teeth Stained After Braces Removal

Sun, 06 Jul 2008 01:34:49 GMT

Lots of people who have braces are worried that when they will remove those braces their teeth will be stained. Usually the stains left behind are if you don’t brush properly or regularly. Do not forget to brush your teeth vigilantly reaching to the farthest of crevices so that you are left with teeth that look real good. Food can get easily trapped in between the braces and leave stains behind. Even after taking regular care you still find that your teeth are stained after you have had your braces removed you can have them polished and whitened by the dentist.

Braces are of several kinds. Invisalign braces will not stain your teeth at all. In case you have other kinds of braces you can do everything in your might to keep the stains under control by maintaining a severe check on your teeth hygiene. Brush, floss and mouth wash everyday religiously. Later, when your braces are removed you won’t have much of a stain on them. Your dentist might also bleach your teeth which will make the stains disappear permanently. And all you will be left with are a straight set of whitest of white of teeth which might be mistaken for pearls.

If your teeth were really clean and white when the braces were put on and you did not maintain the same brushing technique whilst the braces were on then when they are removed you will have white and yellow spots on your teeth. Just brush nice and hard and try to remove those stains. However, stains really don’t happen to a lot of patients who wear braces. In case of removable braces you are at an advantage as they can be removed to clean your teeth well enough.

At times the food particles that aren’t reachable and get trapped underneath the teeth beneath the braces leave stains that are quite stubborn. The white stains caused like this are initial carious lesion known as incipient lesions. If one does not take care then this can cause the decay of the tooth but if one brush properly twice a day with fluoridated tooth paste then these lesions can be remineralized. If one wants to avoid having stains after the braces are removed then the best thing is to maintain very good oral hygiene by brushing properly so that no food particles remain trapped between the teeth and the braces and t floss the teeth properly otherwise you can have the stains which gives very unaesthetic look. It is not always that the stains are there because of decay but sometimes it can be because of the remnants of the glue which is used to glue the bracket on the teeth. One should not be worried about them as the can be easily removed by cleaning and polishing. Normally when the braces are removed the dentist does the cleaning and polishing of the teeth so that all the extrinsic stains can be removed.

One question mostly asked by the patients is that if they want to go for the whitening of teeth like bleaching can they get it done with braces? Will not get the answers is no. as the area of the tooth covered by the bracket will not get bleached and the tooth will give blotchy appearance when the braces are removed. The area which is bleaches will be whiter and the area where the brackets are put will be paler. So if one wants to go for whitening of the teeth that should be done after the removal of the braces.

Accelerated Orthodontics

Sun, 06 Jul 2008 01:34:49 GMT

In easier and simplest of the terms accelerated orthodontics also known as the “ high speed braces “ or the “ six month braces “ means fast orthodontics i.e. it is a relatively faster way of moving the teeth into the desired position then the conventional orthodontics. While the traditional method of treatment took around one to three years to move the teeth in desired position accelerated orthodontics can do the miracle in just three to eight months only.

Actually in today’s world many techniques can be used instead of orthodontics like veneers, crowns, bonding and bridges etc. all of which can give us a beautiful smile without wearing the braces and the latest in fashion is accelerated orthodontics even if braces are unavoidable. Mostly accelerated orthodontics is common among adults usually above 25 years of age as they have the problem with wearing the braces especially for long years concerned mainly with looks of the braces and other personal reasons. So the procedure of high speed braces that is accelerated orthodontics helps to achieve a better aesthetics and a great smile in much less time than the conventional orthodontic treatment. The six month braces or we can say accelerated orthodontics can be effectively used as the treatment option for the repositioning of the front teeth to give a beautiful smile wherever orthodontics is the suggested mode of treatment, so accelerated orthodontics should be discussed with the cosmetic and aesthetic dentist along with the options of dental veneers and bonding of teeth.

The most important and main advantage of accelerated orthodontics is that it takes much less time than the conventional methods and also there is very less damage of the bone. Also less root resorption of the teeth is seen. But the biggest disadvantage of accelerated orthodontics being it being relatively a newer procedure not many dentists are aware or well trained with the process of accelerated orthodontics. The case of crowed teeth is one tough challenge to correct with the accelerated orthodontics and the dentist should be highly skilled to carry out the procedure of accelerated orthodontics well otherwise failure and worsening of the cases is also seen.

To be more precise this procedure of accelerated orthodontics does not offer treatment of all the orthodontic problems and there are certain orthodontic cases which need the extended or the conventional long or one to three year orthodontic treatment. Actually speaking these six month braces that is accelerated orthodontics are used as an alternative treatment to the porcelain veneers and by the patients who want to give themselves a beautiful smile by straightening their teeth but want to avoid wearing the conventional braces for a period extending in years.

Before the accelerated Orthodontic treatment

After 7 months of accelerated Orthodontics

Truly speaking high speed braces or accelerated orthodontics is known to be a very controversial procedure. The time of the treatment in accelerated orthodontics depends on the kind of technique used and the amount of space the teeth needs to be moved along with the decided goals of the treatment and above all the patience and the co-operation of the patient. Six month braces or accelerated orthodontics is a minor procedure carried out in the office and is related to the straightening, closing of the spaces and spacing including the re-alignment of the front teeth. The procedures of accelerated orthodontics are carried out under local anaesthesia by a group of specialist trained in particular for accelerated orthodontics. Carried out by highly skilled professionals the treatment of accelerated orthodontics gives no more pain or discomfort to the patient then the normal in office cleaning and scaling procedures for the teeth. Already proved techniques of orthodontics and periodontics are used for the procedure and only minor itching is experienced in the gums in the beginning as the teeth are moving much faster in accelerated orthodontics than in the conventional orthodontic treatment. The treatment involves the procedure of decreasing the width of the teeth to create space for the correction of the crowding seen in the front teeth of the patient to enhance the smile. In some cases though the crowding is corrected by reducing the size of the teeth, it might be unavoidable in some cases to relieve crowding without the procedure of extraction. Brackets which self-ligate are used in the procedure of six month braces or accelerated orthodontics but many do not support the theory. The treatment with six month braces that is accelerated orthodontics mostly involves some periodontal surgical procedures within one week of placement of the braces. Minor discomfort can be felt for a few days in the procedure of accelerated orthodontics but it is much less painful than the conventional orthodontics.

The follow up visits in case of accelerated orthodontics are the same as we do in traditional long term orthodontic treatment need to be made for any adjustments if needed and the orthodontist might provide you with retainers occasionally to retain the result achieved with the six month bracesor accelerated orthodontics.

Talking about the cost of the treatment of accelerated orthodontics the procedure is carried out by a team of specialists so the cost of the treatment of accelerated orthodontics will vary depending upon the type of treatment done and the fees charged by the concerned specialists in your area. Although the cost of six month braces or accelerated orthodontics is almost similar to the traditional procedures, the advantage is that much less time is taken for treatment. Any additional procedure like the application of braces behind the teeth that is the lingual braces will increase the cost of the treatment. Insurance companies mostly do not cover the procedure of high speed braces or accelerated orthodontics so be extra careful while planning the treatment even from an insurance company. The cost of the high speed braces or accelerated orthodontics ranges from about $10,000 and $15,000 depending on the procedure adopted and the specialist involved

A procedure called as the periodontically accelerated osteogenic orthodontics also called PAOO for short is where the gum specialist that is the peridontist and the oral surgeon creates grooves with special instruments and then fill these grooves with the bone graft material. The entire procedure is done under local anaesthesia only. The main point in doing this procedure is that the when the bone begins to heal back it becomes so soft that the teeth can be moved in the bone much faster with the applied braces then the conventional method of orthodontics and this causes the treatment of accelerated orthodontics to be completed in few months rather than years.

Also to be mentioned is that earlier bovine bone and also bioactive glass was used as the bone graft material used for the healing and strengthening of the bone but studies have shown that patients own bone is the best material for the procedure of accelerated orthodontics. The patient’s own bone when used encourages the formation of new and healthy bone in the area of bone grooving and is also very safe and free from transmission of disease. The chances of graft rejection are also negligible when it is taken from the patient’s own body. So patient’s own bone is the best used as the bone graft material these days for the success of six month braces or accelerated orthodontics.

The braces used in accelerated orthodontics can be ceramic, metal and lingual braces like used in conventional orthodontics.

So get ready to experience a wonderful new smile with a fraction of time you would have never imagined before with the use of accelerated orthodontics. Keep smiling.

Does Smoking Cause Stains on Teeth with Braces

Sun, 06 Jul 2008 01:34:49 GMT

You will notice that smokers usually have teeth that are yellowish because the nicotine in cigarettes tends to stain teeth. Now in case a smoker wears braces then the place where he has braces will remain a lighter shade of yellow and the other teeth will get further stained by nicotine. This will look really ugly as his teeth will look mottled with different shades of yellow on them.

Tobacco used in any kind such as in cigarettes, cigars, hookahs, or chewed is bound to stain your teeth to a yellowish hue. This is the effect of nicotine as it passes through your teeth. There are several dental side effects of smoking and staining of teeth is just one of them.

These stains caused by smoking are real deeply entrenched in the enamel and not just removed by brushing your teeth regularly. These stains will have to be removed either by bleaching, whitening of teeth by a dentist. Even after these treatments it is not certain whether your teeth will be able to come back to the original white that they were. Once the enamel of the tooth, which is the outermost layer gets discolored it is quite tedious and difficult to get it back to its original shade. Smoking with braces on also helps to build up tartar and plaque which makes dental cleaning difficult and this in turn leads to further development of stains.

Sometimes people believe that if you don’t inhale the smoke you are not at risk of staining your teeth; but, that is a misconception. Your teeth are bound to be stained once you light up the stick. Tobacco that is smokeless tends to produce more harmful toxins and stain to your teeth then the other kinds.

The thing that you must remember is that once you wear braces your teeth does require extra care and more so with you smoking. The best way possible for you to enjoy a nice and healthy smile is to brush your teeth twice a day. If you wear invisialign braces the advantage is that you can remove them and brush your teeth until they sparkle. Floss your teeth daily too to remove any hidden germs, plaque which a toothbrush can’t.

If you don’t smoke, it is a good idea not to start now. Smoking will stain your teeth and gums like nothing else can and will be conducive in tartar build up on your teeth. This will ensure that you have perpetual bad breath. Doesn’t sound really a pleasant circumstance to be in? Then the purpose of getting you braces is not going to be served at all. You won’t be able to bear your smile as they will be spotted with stains on them that will look really ugly.

Although, most stains can be removed by cleanings undertaken at a dentist or hygienist. Though there is no guarantee that the teeth will be as good as new and the way they were prior to smoking.

Wisdom Tooth Extraction

Mon, 18 Aug 2008 21:26:58 GMT

Extraction of wisdom tooth is very common these days. You will find that majority of people have got their wisdom teeth extracted due to complication discussed above. The most common reasons for extraction of wisdom tooth are insufficient space in jaw for their eruption, improper angulation of wisdom teeth. Angulation is an important factor in decision of extraction of wisdom tooth as improper angulation can lead to many problems, like where the wisdom tooth is angulated towards the cheek, it causes repeated cheek bites, which are very painful and in case the wisdom tooth is angulated towards the tongue, it causes painful laceration of the tongue. Due to repeated bruising of tongue by tooth can lead to tongue becoming numb sometimes. Another reason for extraction of wisdom tooth is preventive extraction of wisdom teeth. This is done with a view that if not extracted, can lead to food impaction behind the wisdom teeth. This is because it is very difficult to clean this area as tooth brush or floss does not reach there. The frequent impaction of food at this place can lead to many problems for the patient.

Another reason for extraction of wisdom teeth is in the case of Orthodontic treatment for braces. In such cases sometimes the eruption of wisdom teeth can damage the treatment, so the Orthodontist recommends the extraction of wisdom teeth. Extraction of wisdom teeth is complicated as compared to simple extraction of teeth. Wisdom teeth should be got extracted from its specialist to avoid the complications. Oral Surgeons are the dentists who specialize in extraction of the wisdom teeth. Before extraction, they make the complete diagnosis and take panoramic x-ray to make their decision.

Preventive Extraction of Wisdom Tooth – Different Views

Preventive removal of wisdom teeth is a common practice followed by dentists especially in Western Countries. The Cochrane Collaboration in year 2006 published a systematic review of randomized controlled trials for evaluating the effects of preventative removal of asymptomatic wisdom teeth. The authors found no evidence for supporting and refuting this practice. There was reliable evidence showing that preventative removal did not reduce or prevent late incisor crowding. Based on different studies it has been established that while it is clear that symptomatic impacted wisdom teeth should be surgically removed, it appears that extracting asymptomatic, disease-free wisdom teeth is not advisable due to the risks associates with it like damage of inferior alveolar nerve. Some studies have suggested that extraction of the asymptomatic tooth may be beneficial if caries are present in the adjacent second molar or if periodontal pockets are present distal to the second molar. Even the dentists graduated from different countries or even from different dental schools in one country, may have different clinical views on preventive removal of wisdom teeth.

Advantages And Disadvantages Of Composites

Sun, 06 Jul 2008 01:34:09 GMT

Avantages of Composites are as under

Tooth colored appearance of composites is more cosmetically appealing than dental amalgam.
A composite dental composite filling will often be smaller in size than a comparable silver amalgam filling
Tooth bonding usually creates less post treatment thermal sensitivity.
Dental composite fillings are ready to be used immediately after the dental appointment has been completed.
These fillings cause no galvanic reactions.
Direct composite fillings are placed in one appointment only.
These can be easily repaired.
Bonded resins may enhance tooth strength.
Some materials release fluoride.
Available in variety of shades so that filling can match the shade of tooth.

Disadvantages of Composites

Lacks self sealing ability, unlike amalgam.

Leakage occurs with a high rate of secondary caries because of the breakage of adhesive tooth bond.

Excessive wear under stress.

Low fracture strength.

High technique sensitivity as the tooth must be adequately isolated when a dental composite is placed

Generation and inhalation of dust during finishing procedures present potential hazards for patient and the staff.

Composite filling usually cost more than amalgam.

It takes more time for a dentist to place a bonded restoration These fillings discolor over time.

What Are Veneers

Sun, 06 Jul 2008 01:38:50 GMT

Veneers is outer cover or mask for the tooth or we can say it is custom designed outer shell of the tooth to restore localized or generalized defects and discoloration. Materials for veneers are:

Chairside composite
Processed Composite
Pressed ceramic

When Veneers Are Needed?

There are various indications like:

Heavily Stained And Discolored Teeth – For minor staining of teeth, bleaching or tooth whitening is indicated. But for heavily stained teeth veneers are indicated.

Chipped Or Damaged Teeth If minor chipping is there or a small corner is damaged then one can opt for composite filling but if damage is more and the dentist recommend it ,then one can get the veneers

Minor Crooked Teeth–If there is minor misalignment that can be treated with veneers. In that case long and painful orthodontic treatment can be avoided.

Small Teeth If the teeth are smaller in size than the normal like peg laterals, they can be treated by going for Veneers.

Spacing Between The Teeth – If there is spacing between the teeth, it gives very unaesthetic look. The simplest way to treat this is to give Veneers .