Thursday, 23 July 2015

BAD BREATH/HALITOSIS

BAD BREATH/HALITOSIS

HALITOSIS colloquially called bad breath, feter oris,fege bosta, is  a symptom in which a noticeably unpleasant odor  is present on the exhaled breath. 

CAUSES

- The most common cause is of  the odor is caused by bacteria present below the gum line and on the back of the tongue.
- Of those who feel they have halitosis, significant percentages 5-72% have been reported to have no genuine halitosis when professionally examined. 
- The remaining 10% is accounted for by many different conditions, including disorders in the nasal cavity,sinus,lungs,throat, esophagus,stomach or elsewhere.


Other causes are
  • Deep carious lesions (dental decay) – which cause localized food impaction and stagnation
  • Recent dental extraction sockets – fill with blood clot, and provide an ideal habitat for bacterial proliferation
  • Inter dental food packing – (food getting pushed down between teeth) - this can be caused by missing teeth, tilted, spaced or crowded teeth, or poorly contoured approximal dental fillings. Food debris becomes trapped, undergoes slow bacterial putrefaction and release of malodorous volatiles. Food packing can also cause a localized periodontal reaction, characterized by dental pain that is relieved by cleaning the area of food packing with inter dental brush or floss.
  • Acrylic dentures (plastic false teeth) – inadequate denture hygiene practises such as failing to clean and remove the prosthesis each night, may cause a malodour from the plastic itself or from the mouth as microbiota responds to the altered environment. The plastic is actually porous, and the fitting surface is usually irregular, sculpted to fit the edentulous oral anatomy. These factors predispose to bacterial and yeast retention, which is accompanied by a typical smell.
  • Oral infections
  • Oral ulcerations
  • Fasting
  • Stress/anxiety
  • Menstrual cycle – at mid cycle and during menstruation, increased breathvolatile sulfur compounds were reported in women.
  • Smoking – Smoking is linked with periodontal disease, which is the second most common cause of oral malodor. Smoking also has many other negative effects on the mouth, from increased rates of dental decay to premalignant lesions and even oral cancer
  • Alcohol
  • Volatile foodstuffs – e.g. onion, garlic, cabbage, cauliflower and radish. Volatile foodstuffs may leave malodorous residues in the mouth, which are the subject to bacterial putrefaction and VSC release. However, volatile foodstuffs may also cause halitosis via the blood borne halitosis mechanism.
  • Medication – often medications can cause xerostomia (dry mouth) which results in increased microbial growth in the mouth.

MANAGMENT
The following strategies may be suggested:
  1. CLEANING OF TONGUE SURFACE twice daily is the most effective way to keep bad breath in control; that can be achieved using a tooth brush, tongue cleaner or tongue scraper to wipe off the bacterial biofilim, debris, and mucus. Brushing a small amount of mouth rinse or tongue gel onto the tongue surface will further inhibit bacterial action.
  2. EATING HEALTHY FOODS with rough foods helps clean the very back of the tongue.
  3. CHEWING GUM Since dry-mouth can increase bacterial buildup and cause or worsen bad breath, chewing sugarless gum can help with the production of saliva, and thereby help to reduce bad breath. 
  4. GARGLING right before bedtime with an effective mouthwash .  
  5. MAINTAINING ORAL HYGIENE, including daily tongue cleaning,brushing,flossing and periodic visits to dentist. . 
  6. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by one's dentist).
  7. PROBIOTIC TREATMENTS specifically Streptococcus salivarius K12 has been claimed to suppress malodorous bacteria growth, however well designed randomised control clinical trails are needed to assess this.
by,

DR.RENJU T GEORGE,
SIGNAL DENTAL SPECIALITY CLINIC,
KALAVATHU ROAD ,
PALARIVATTOM,
COCHIN-25,
KERALA,INDIA.



Tuesday, 30 June 2015

LASERS In Dentistry

LASERS IN DENTISTRY 
In 1960 s Maiman developed the first laser prototype based on Albert Einstein's Theory of spontaneous and stimulated emission of radiation.Dental laser is a type of laser designed specifically for use in dentistry.
 Several variants of dental lasers are in use with different wavelengths and these mean they are better suited for different applications.

Dental Laser was first used  by Goldman et al and Stern et al with Ruby laser on enamel and dentin.

Principal of working of a Laser

All lasers work by delivering energy in the form of light. When used for surgical and dental procedures, the laser acts as a cutting instrument or a vaporizer of tissue that it comes in contact with. When used for "curing" a filling, the laser helps to strengthen the bond between the filling and the tooth. When used in teeth-whitening procedures, the laser acts as a heat source and enhances the effect of tooth-bleaching agents.
TWO TYPES
                                1. Lasers for soft tissues
                                2.  Lasers for hard tissues

SOFT TISSUE LASERS
  • diode lasers
  • carbon dioxide lasers
  • Nd-Yag lasers
  • Er-Yag lasers

INDICATIONS
. Removal of caries
. Frenectomy
. Gingivectomy
. Gingivoplasty
. De-epithelisation
. Gingival depigmentation
. Incisional and Excitional biopsy
. Removal of granulation tissue
. Aptous ulcer irradiation
second stage exposure of implants
.Coagulation of free gingival graft donor site.
ADVANTAGE
increases wound healing
DISADVANTAGE
 high power is required, long target exposure 

HARD TISSUE LASERS
  • Er:Yag laser
  • Er;Cr:Yag laser
Erbium lasers are both hard and soft tissue capable.They can be used for a host of dental procedures, and allow for more procedures to be done without local anesthesia. Erbium lasers can be used for hard tissue procedures like bone cutting and create minimal thermal and mechanical trauma to adjacent tissues. These procedures show an excellent healing response. Soft tissue applications with erbium lasers have rapid healing times with minimal postoperative pain.

Conclusion

Lasers are only an adjunctive tool for mechanical therapy.
Compared to the traditional dental drill, lasers:
  • May cause less pain in some instances, so reduces the need for anesthesia.
  • May reduce anxiety in patients uncomfortable with the use of the dental drill.
  • Minimize bleeding and swelling during soft tissue treatments.
  • May preserve more healthy tooth during cavity removal.

by,
DR.RENJU T GEORGE
SIGNAL DENTAL SPECIALITY CLINIC
PALARIVATTOM,COCHIN
INDIA.



Thursday, 26 March 2015

Stem cell Therapy

STEM CELL

Stem cells  are UNDIFFERENTIATED biological cells that can differentiate into specialized cells and can divide (through mitosis) to produce more stem cells. 

TYPES OF STEM CELLS

                                          1. Embryonic Stem Cell

                                          2. Adult Stem Cell


These stem cells can reproduce whole organ (totipotent)or a part of it (pluripotent)depending on the type used.

SOURCES of adult stem cells in humans:
  1. Bone marrow, which requires extraction by harvesting, that is, drilling into bone.
  2. Adipose tissue (lipid cells), which requires extraction by liposuction.
  3. Blood, which requires extraction through apheresis, wherein blood is drawn from the donor (similar to a blood donation), and passed through a machine that extracts the stem cells and returns other portions of the blood to the donor.
            Stem cells can also be taken from umbilical cord blood just after birth
        4. Umbilical cord Tissue
         5. DENTAL PULP
Only blood related diseases can be treated with umbilical cord blood collected stem cells.Ideally samples should be collected below 30 years to preserve a good and healthy stem cell.

Stem cell Therapy-
 Diseases and conditions where stem cell treatment is being investigated include:
Diabetics -type 2
stroke and traumatic brain injury
cleft lip and cleft palate
myocardial infarction
replace missing teeth
Alzheimer disease
Rheumatic arthritis
Osteoarthritis
Spinal cord injuries
Anti-Cancer treatments
Baldness reversal
Repair hearing
Restore vision
Wound healing - eg;diabetic foot
APPLICATION OF STEM CELL IN DENTISTRY
Stem Cell can also be taken from a healthy tooth

- Deciduous tooth - from canine to canine with sufficient pulp

- Tooth that is being extracted for orthodontic purpose.

-Wisdom teeth

COLLECTION
 After the tooth extraction ,the tooth is placed in chlorhexidine mouthwash for 10 seconds and transferred to a specially manufactured container for transport.
It is being taken to organization for further procedures and for the multiplication and storage  of the stem cell.
According to law, the ownership of stem cell is given to parent and the child till 21 years of age after that  the stem cell ownership is transferred to child alone.

GOOD LUCK for a better future.

by,
DR.RENJU T GEORGE,
SIGNAL DENTAL SPECIALTY CLINIC,
OPP. BSNL TELEPHONE EXCHANGE,
KALAVATHU ROAD, PALARIVATTOM,
COCHIN-682025.KERALA, INDIA

Saturday, 22 November 2014

oral health month

I have such a wonderful experience to be a part of camp conducted in association with colgate in nearby school.
The op crossed more than 600 students
.I have noticed majority of students have more prevalence of decay in the molar region with 90 % of mal aligned teeth.the prevalence of enamel hypoplasia secondary to flurosis is also quiet seen in them.
dr.renju

Wednesday, 1 October 2014

INTERNATIONAL DAY FOR OLDER PERSON-1st OCTOBER

KEEP your mouth healthy and strong as you get older:-

-BRUSH at least twice a day
As you age,decay is more likely to develop around old fillings or in the softer exposed root surface of tooth.
- Visit your dentist regularly - As you age, you become more vulnerable to developing chronic diseases like diabetes,heart problems,bone disorders etc.

- In India the prevalence of gum disease is more than tooth decay,which is the most common cause of tooth loss in adults 

Thursday, 18 September 2014

Why is my tooth sensitive ?




TOOTH SENSITIVITY / DENTINAL HYPERSENSITIVITY


DENTINAL SENSITIVITY is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporation, tactile, osmotic, chemical or electrical; and which cannot be ascribed to any other dental disease.

SYMPTOMS

Thermal – hot and cold drinks and foods, cold air, coolant water jet from a dental instrument.

Electrical – electric pulp testers

Mechanical–tactile – dental probe during dental examination, periodontal scaling and root planing,tooth brushing

Osmotic – hypertonic solutions such as sugars

Evaporation – air blast from a dental instrument

Chemical – acids, e.g. dietary, gastric, acid etch during dental treatment

CAUSES

The most common cause - Gingival Recession  ( receding gums )

- Tooth Wear

- Wrong Brushing Habits

- Abrasive tooth paste

LESS COMMON CAUSES - 
- Acid erosion (e.g. related to gastroesophageal reflux disease

- Bulimia or excessive consumption of acidic foods and drinks

- Periodontal root planing

- Dental bleaching 

- Tooth whitening tooth paste

- Decay around the edges of a filling

- Tooth sensitivity after dental visit

- Plaque deposition

- Alcohol containing mouthwash

TREATMENT

= Desensitizing tooth paste

= Correct the brushing technique - avoid horizontal method of brushing

= Use a soft bristle brush and brush for 2 minutes with gentle pressure

= Limit acidic foods or try to drink water having acidic food items to neutralize the acid in your mouth.

= Cover exposed root surface using dentin adhesive sealers with the help of a dentist

= Root canal treatment

= Laser treatment - low output lasers , Nd YAG ,Er YAG CAN BE USED TO TREAT 
SENSITIVITY but It is the most expensive method .


Friday, 12 September 2014

ORAL HYGIENE/ ORAL CARE

HOW TO MAINTAIN GOOD ORAL HYGIENE

1. Oral cleaning should be done in the early childhood days, even before tooth eruption  after the birth of a baby. This can be done by wiping the gums with a clean damp cloth.

As soon as the tooth erupts one has to supervise the child to brush and encourage with toothpaste particularly for kids which has favorable taste and colour that attracts them

2. Always use fluoride containing toothpaste preferably white colour .As the fluoride can control the prevalence of decay in specified quantity. It can also strengthen enamel.

3. Brush twice a day and floss daily. Proper brushing technique should be adopted.

4. Rinse after each meal.  In addition to brushing and flossing, rinsing your mouth with an antibacterial rinse can help prevent decay and gum problems.

5. Chewing sugar-free gum after a meal can also protect by increasing saliva flow, which naturally washes bacteria away and neutralizes acid.

6. In school children, who are engaged in sports and other extracurricular activities usage of mouth guards is advisable. It prevents blows to teeth. Your dentist can make a custom-fitted

Mouth guard. Another option is to buy a mouth guard at a sporting goods store that can be softened using hot water to form fit your mouth.

7. Don’t smoke or use smokeless tobacco. Tobacco stains teeth and significantly increases the risk of gum disease and oral cancer. If you smoke or use chewing tobacco, consider quitting by slowly decrease the intake.

8. A healthy diet is essential to healthy teeth and gums. A well-balanced diet of whole foods -- including grains, nuts, fruits and vegetables, and dairy products -- will provide all the nutrients you need.

Avoid sugary foods. When bacteria in the mouth break down simple sugars, they produce acids that can erode tooth enamel, opening the door to decay.

9. Regular dental check up with an interval of 6 months is recommended in all individuals.


by,

DR. RENJU 
INDIA