PREGNANCY GINGIVITIS

PREGNANCY GINGIVITIS

Swollen, red, tender gums that bleed when you floss or brush is a common complaint during pregnancy. About 50% of pregnant ladies have these symptoms – a condition known as pregnancy gingivitis. Your gums are more likely to become inflamed during pregnancy in part because of hormonal changes that make them more sensitive to the bacteria in plaque.
One may also develop a benign nodule on your gums that bleeds when you brush. This relatively rare nodule is called a pregnancy tumor or pyogenic granuloma – usually harmless and painless.
A pregnancy tumor can grow to up to three-quarters of an inch in size and is more likely to appear in an area where you have gingivitis. Typically, it disappears after you have your baby, but if it doesn't, you'll need to have it removed. If it causes discomfort, interferes with chewing or brushing, or starts to bleed excessively, you can have it removed while you're pregnant.

TREATMENT:
Normally the gingivitis subsides when the oral hygiene is reestablished.
In case of pregnancy tumors, it is left as such if it is not interfering with biting or chewing food. Well if it is interfering with mastication or having constant bleeding then it is surgically excised.

BLEEDING GUMS/ GINGIVITIS

This is on of the common condition which I encounter with, almost every day in my clinical practice.

BLEEDING GUMS

Bleeding gums or Gingivitis is the first sign of inflammation of the gums, this is common following Orthodontic bracket placement, and for others the bleeding is seen following or during brushing the teeth, and in some they have the complaint of profuse bleeding without any provocation.
The common cause for bleeding gums are Dental Plaque
Bleeding Gums is also seen in case of Vitamin K defeciency.

TREATMENT:

Normally bleeding from the subside on Oral Prophylaxis (cleaning of the teeth) followed by using antimicrobial mouth washes containing Povidone Iodine (Empivodin® antimicrobial gargle) or Chlorhexidine (Hexicure® mouthwash).

If the bleeding did not subside following the above mentioned therapy, it is advised to consult a physician.

BAD BREATH/ HAITOSIS/ ORAL MALODOR

DENTAL PLAQUE

Offensive smell coming form the mouth, this has become one of the common conditions seen in the now a days. Most of the people who came to my clinic with this condition were reluctant to say this Halitosis as their chief complaint. As far as what I had seen is that, at least one patient a day visiting my Dental clinic has this complaint.
Halitosis affects the quality of life of the individual. There are several reasons for Halitosis, and out of that more than70% of which comes from local factors mainly due to the release of Hydrogen Sulphide released by the microorganisms harbored in the oral cavity and rest from systemic factors (due to some systemic diseases).

Local Factors Causing Halitosis:

ORAL CANCER

• Calculus deposits 
• Palque deposits
• Bleeding gums
• Aphthous ulcers
• Necrotizing ginsivitis
• Decayed tooth
• Oral Carcinoma
• Periapical abscess

Systemic Factors Causing Halitosis:

BLEEDING GUMS

Diabetes
Gastritis
Stomach or Duodenal ulcers
Kidney disorder
Liver disorder
Lung abscess

TREATMENT:
Oral Hygiene measures to be done, such as scaling

Use of antimicrobial mouthwashes containing Povidone Iodine (Empivodin ® antimicrobial gargle), Chlorhexidine (Hexicure ® mouth wash)

DENTAL CALCULUS

Consulting a physician for curing the systemic condition.

Restoration or extraction of the extraction of the decayed tooth.

MOBILE TEETH

MOBILE TEETH

Tooth mobility is one common complaint seen from the ancient history. About tooth mobility, its referred in the Egyptian era, Roman era and soon.
The major cause of mobility is Periodontitis ( inflamed gums, surrounding bone, periodontal ligament due to trauma or infection)
Tooth mobility is classified into 3 Grades:
Grade 1: mobility of the tooth is less than 1millimeter and the movement is mainly in bucco-lingual direction.
Grade 2: mobility of the tooth is more than 1 millimeter and the movement is bucco-lingual as well as mesio-distal.

X RAY SHOWING MOBILE TEETH

Grade 3: mobility of the tooth is more than 1 millimeter and the movement is bucco-lingual as well as mesio-distal and the tooth intrudes on vertical presure

TREATMENT:
Grade 1: This type of mobility often becomes stable on scaling and root debridement. In some cases curettage is necessary to stabilize the tooth.
Grade 2: scaling, curettage, flap surgery, splinting might be necessary.
Grade 3: Generally this condition is considered hopeless and mostly will have to undergo extraction. In some cases intentional reimplantation of the tooth may stabilize the tooth.

IMPORTANT: If you notice your tooth mobile, what ever grade it might be consult a Dentist preferably
a PERIODONTIST immediately.
 

TOOTH PAIN, DENTAL PAIN

Tooth pain or toothache are of two types, they are clasifid in to two types mainly due to its origin
1. PULPAL PAIN

GROSSLY DECAYED TOOTH

This type of pain will be usually of high intensity, one will be able to point out which tooth is causing the pain, there will be an associated carries (decay), the intensity of pain increases during night or when lying down, the pain is normally pulsating and appears in episodes.
Treatments:
 Earlier the common treatment for such tooth was extraction (removal of the tooth). Presently with the upcoming of Root Canal Therapy (RCT) the pain in such tooth can treated without extracting the tooth. RCT is a time taking process which requires four appointments or more.
  
2.PERIODONTAL PAIN.
This type of pain is normally of low intensity. It is usually a dull and gnawing pain. This is normally caused when the periodontium ( especially the bone surrounding the tooth) is affected. One cannot identify from where the pain is originating. For this type of pain there will be some associated findings are seen like, Calculus (calcified, powdery substance surrounding the neck of the tooth) or any other local deposits around the tooth surface, bleeding from site on brushing or while having food, halitosis (bad breath), mobility of the teeth.
Treatment:
The treatment includes:
1. Scaling (cleaning) the tooth surface
2. Splinting the mobile tooth/ teeth if the tooth/ teeth can be retained
3. Curettage/ Open Flap Surgery
4. Extraction of the tooth/ teeth in case of hopeless prognosis

TOOTH WITH BONE LOSS

ROOT CANAL TREATMENT (RCT)

PARTS OF A TOOTH

ROOT CANAL TREATMENT OR THERAPY (RCT) includes a sequence of treatment for the pulp of a tooth whose end result is the elimination of infection and protection of the decontaminated tooth from future microbial invasion.This is also called as Endodontic therapy.
Every tooth has got PULP and may contain 1-6 pulp canals, the pulp consists of nerve fibers and blood supply to the tooth. When a tooth decay or dental carries becomes deep and enters the pulp, it causes severe tooth ache, which is commonly nocturnal (increases during the night), the pain is commonly pulsating.
If the tooth is left without doing any treatment, this may lead to dental abscess.
Earlier the only treatment method available for such tooth was extraction of the tooth, while with the upcoming of RCT the tooth can be retained without pain or infection.
Steps in RCT:
Step 1: The access cavity is prepared till the pulp chamber.
Step 2: Biomechanical debridrment of the pulp canals done to get rid of the pus and damaged or infected pulp.
Step 3: The pulp canals are cleaned, dried and restored with a inert material named Gutta Percha and the cavity is restored with temporary filling material.
Step 4: The temporary filling material is replaced with High strength permanent filling material.
Step 5: The tooth is trimmed and shaped, impression is made and finally a permanent crown is placed.
All these procedure may take 4 or more appointments.
A properly Root Canal Treated tooth will stay for lifetime without creating any pain.
Crown placement is necessary, since a Root Canal Treated tooth is deprived of the blood supply and becomes fragile, and when the crown is placed the life of the tooth is increased and may stand till the lifetime. 

  

DENTAL CROWNS

A dental crowns is a tooth-shaped "cap" that is placed over a tooth - covering the tooth to improve its appearance. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line with the help of crown equipment When a tooth is fractured, has a large old filling, or is severely damaged by decay, your dentist may recommend the placement of a crown. Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your smile.

DENTAL CROWN (TOOTH COLORED)

Crowns can be made from many materials, which are usually fabricated using indirect methods. Crowns are often used to improve the strength or appearance of teeth. While unarguably beneficial to dental health, the procedure and materials can be relatively expensive.
Crowns are of different types, the most common and widely used types are:
Zirconium (Tooth colored) 
Metal free ceramic crowns (Tooth colored) 

DENTAL CROWN (METALLIC)

Metal fused ceramic crowns (Tooth colored) 
Porcelain  crowns (Tooth colored) 
Metal crowns (Metallic colored)
Acrylic crowns (Tooth colored but very low strength, usually given for temporary purpose or on deciduous tooth) 
Crowns are very much necessary after Root Canal Treatment,  because when the pulp is removed from the tooth or when the pulp gets infected, the becomes very fragile and gets vulnerable for fracture and when the crowns are placed, the tooth gets stronger..