Monday, October 21, 2013

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.

Saturday, October 19, 2013

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.

Wednesday, October 16, 2013

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.
 

Wednesday, October 9, 2013

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