Functions of a tooth

Pacifier

PACIFIER
A pacifier isn't a substitute for nurturing or feeding, of course, but if your baby is still fussy after you've fed, burped, cuddled, rocked, and played with her, you might want to see if a pacifier will satisfy her.

There's another benefit to using a pacifier: Some studies have shown that babies who use pacifiers at bedtime and nap time have a lower risk of  sudden infant death syndrome. These studies don't show that the pacifier itself prevents SIDS, just that there's a strong association between pacifier use and a lower risk of SIDS.

Also, a pacifier habit is easier to break than a thumb-sucking habit.Pacifier use may increase the risk of middle ear infections in babies and young children.

Use of pacifier during the first few years doesn't cause long-term dental problems.

However, Prolonged pacifier use might affect the shape of his mouth by misaligned teeth.

REGENERATIVE ENDODONTICS

REGENERATIVE ENDODONTICS

Regenerative endodontics, is the extension of root canal therapy. 

Conventional root canal therapy cleans and fills the pulp chamber with biologically inert material after destruction of the pulp due to dental caries, congenital deformity or trauma.

 Regenerative endodontics , instead seeks to replace live tissue in the pulp chamber.

Regenerative endodontics uses the concept of tissue engineering to restore the root canals to a healthy state, allowing for continued development of the root and surrounding tissue. 

To replace live tissue, either the existing cells of the body are stimulated to regrow the tissue native to the area or bio active substances inserted in the pulp chamber. 

INDICATION
Tooth with open apex.i.e treatment of necrotic immature permanent teeth resulting in continued root development, increased thickness in the dentinal walls and apical closure.

PROCEDURE

Case Selection:

Tooth with necrotic pulp and an immature apex

Pulp space not needed for post/core, final restoration

No known allergies to antibiotics if intended for use

Compliant patient (parent/guardian)
Informed Consent

Two (or more) appointments

Use of antimicrobial(s)

Possible adverse effects: staining of crown/root, lack of response to treatment, pain/infection

Alternatives: MTA apexification, no treatment, extraction (when deemed non‐salvageable)

First Appointment

Local anesthesia, rubber dam isolation, access

Copious, gentle irrigation with 20ml 1.5% NaOCl using an irrigation system that minimizes the possibility of extrusion of irrigants into the periapical space (e.g., needle with closed end and side‐vents, or EndoVac). The lower concentrations of NaOCl are advised, to minimize cytotoxicity to stem cells in the apical tissues.

Dry canals

Place antibiotic paste or calcium hydroxide. Ca(OH)2 is antimicrobial at concentrations that do not induce stem cell toxicity and is widely available. As an alternative, if the triple antibiotic paste is used: 1) consider sealing pulp chamber with a dentin bonding agent [to minimize risk of staining] and 2) mix 1:1:1 ciprofloxacin:metronidazole:minocycline in a lower concentration (0.01‐0.1 mg/ml) to avoid stem cell toxicity; these lower concentrations appear as a liquid form and are no longer a paste.

Deliver into canal system via Lentulo spiral, MAP system or syringe

If triple antibiotic is used, ensure that it remains below CEJ (minimize crown staining). As an alternative, Ca(OH)2 does not cause staining.

Seal with 3‐4mm Cavit, followed by IRM, glass ionomer cement or another temporary material

Dismiss patient for 3‐4 weeks

Second Appointment

Assess response to initial treatment. If there are signs/symptoms of persistent infection, consider additional treatment with the antimicrobial, or an alternative
antimicrobial. Recall the patient in about 3‐4 weeks as before.

Anesthesia with 3% mepivacaine without vasoconstrictor, rubber dam, isolation

Copious, slow irrigation with 20ml 17% EDTA, followed by normal saline, using a similar closed end needle.

Dry with paper points

Create bleeding into canal system by over‐instrumenting (endo file, endo explorer)

Stop bleeding 3mm from CEJ

Place CollaPlug/Collacote at 3mm below CEJ.

Place 3‐4mm of a MTA and reinforced glass ionomer and place permanent restoration. Glass ionomer may be an alternative to MTA in cases where discoloration of the crown is a potential concern.

Follow‐up

Clinical and Radiographic exam:
o
No pain or soft tissue swelling (often observed between first and second appointments)
o
Resolution of apical radiolucency (often observed 6‐12 months after treatment)
o
Increased width of root walls (this is generally observed before apparent increase in root length and often occurs 12‐24 months after treatment)
o
Increased root length
o
apical closure?

by,
DR.RENJU T GEORGE
INDIA

TOOTH PASTE

TOOTH BRUSH

-When to change your tooth brush?

   Once in every 3 months

- Always use SOFT bristle toothbrush in general.As brush bristles comes in HARD,MEDIUM,SOFT BRISTLE forms.

EXTRA SOFT BRISTLES are also available in the market and can be used under the guidance of a dentist.

- How much time should be taken for brushing?

Brushing should be done for 2 minutes i.e 1 minute for upper teeth and 1 minute for lower teeth.

BY ,
DR.RENJU T GEORGE
INDIA

BRUSHING IN CHILDREN

Brushing of a small child should be done by parents or by  other person in the initial stage.

Later on children are encouraged to do by them self.

* Let them to choose their own toothbrush.

* Brush your teeth along with your child: Because kids want to be like their parents, so they will imitate what you do.If you find a a fun way of brushing ,they will get encouragement  to do brushing .

* Look for Kid friendly toothpastes that are fruity,gummy flavour and a  flouride containing toothpaste rather than adult toothpaste.

ALWAYS FOLLOW A ROUND PATTERN OF BRUSHING FOR A CHILD

BY,
DR.RENJU T GEORGE
INDIA

FLOSSING

Floss aids in inter dental cleaning.Regular use of Floss, stimulates gums to improve blood circulation. Makes you feel fresh and clean.

It should be done regularly along brushing or after meals.

3 METHODS  to floss are   available----

                                            - MANUAL FLOSS

STRING FLOSS

WATER FLOSS

Removes bacteria from deep below the gum line and between teeth, where traditional flossing or brushing cannot reach. Keeps away bad breath.

by,
DR.RENJU T GEORGE,
INDIA.

POWER TOOTHBRUSH

POWER BRUSH / ELECTRICAL TOOTH BRUSH

It is the easiest way of brushing. One can operate the brush by switching it on and no need to master the technique to brush.

Power brushes remove significantly more plaque and improve gum health better than a manual toothbrush.

Re commented for all age groups especially medically compromised patients , children .

But the efficiency of cleaning in the inter dental area is questionable .

Power brushes are available in various types and forms ,but its costly.


BY,
DR.RENJU T GEORGE
INDIA

Brushing methods

BRUSHING TECHNIQUES

There are various mechanical methods of tooth brushing

First and foremost thing is to identify the purpose of brushing habit.It as simple as to wash away the particles that sticks in the oral cavity, mainly the food particles.

• So how long to brush?

Just 2 minutes .

• How much pressure you should give while brushing?

Just to wipe off the food materials,so only as gentle without damaging teeth.

• Which type of brush?

Always use a SOFT bristle toothbrush

• TECHNIQUE

Proper understanding of surfaces of a tooth helps in proper brushing.

• how many surface a tooth has?

front
back
sides
biting areas

So good cleaning remember your brush need to access all these areas.

• Always follow a vertical pattern of brushing in front areas of teeth ,as horizontal method is not advisable.
• Horizontal method may result in abrasion of teeth especially in the gum lines.

• How ever access of brush to inter dental areas (both sides of a tooth)is difficult and it varies from person to person.

• There comes the need to FLOSS, use of  INTERDENTAL TOOTH BRUSH .

• Always many people tends to miss cleaning of last teeth properly and  find it difficult to do.
• 
  
• Remember not to wide open while brushing those areas, instead place the brush inside the mouth and close the mouth and brush.

• PLEASE dont do brushing while engaging in other activities like reading newspaper,magazines etc.

by,
DR.RENJU T GEORGE

• INDIA

A watch for orthodontic treatment