A Brush With Dentistry

Tetanus

2009-12-30T02:37:00.003-08:00

The pic is nt a pretty sight, is it?? It is a painting by Charles Bell depicting a soldier dying of tetanus.

Tentanus is a disease caused by a bacteria called Clostridium tetani. The bacteria enter the body through various puncture wounds.. for eg.. when you cut yourself with a sharp unsterilised instrument, the feared rusty nail.. and in the case of this soldier, probably from a bloody sword..

When an unsterilised instrument is used to cut the umbilical cord of a newborn baby, and if the mother is not immunised, the chances of the baby getting tetanus is high.

The bacteria enter the body and produce a toxin which acts on the body's central nervous system and causes intense muscle spasm. From the time the bacteria enter the body to the the time symptoms are seen may vary from a week to months.

Symptoms include :

1.Inability to open and close the mouth.

2. Stiffness in the neck

3. Stiffness of the facial muscles

4. Muscle spasms lasting several minutes.

Tetanus is a disease that can be prevented. The tetanus toxoid vaccine is administered and a booster dose is administered every ten years.

After an injury, if your immune status is not known, it is advsable to get an injection of tetanus toxoid.

The following is the national immunisation schedule in India. The "T in DPT" indicates tetanus vaccine.

Vaccine	Age
	Birth	6 weeks	10 weeks		14 weeks		9-12 months
Primary vaccination
BCG	X
Oral polio	X	X		X	X
DPT		X		X	X
Hepatitis B*		X		X	X
Measles						X
Booster Doses
DPT + Oral polio	16 to 24 months
DT	5 years
Tetanus toxoid (TT)	At 10 years and again at 16 years
Vitamin A	9, 18, 24, 30 and 36 months
Pregnant women
Tetanus toxoid (PW): 1^st dose 2^nd dose Booster	As early as possible during pregnancy (first contact) 1 month after 1^st dose If previously vaccinated, within 3 years

Tetanus is not a disease to be taken slightly. It is a potentially fatal disease that can be prevented by proper vaccination. So safeguard yourself and your family from this deadly disease.. and keep smiling healthy.. :)

Demystifying Fillings

2008-11-16T07:58:00.005-08:00

Cavities - though avoiding them is the better idea, what do you do once they are formed??

Cavities maybe classified as shallow or deep. They may even destroy part of the crown of the tooth.
The best way to treat cavities is to remove the rotted, decayed enamel and dentin and fill the cavity with a suitable material.

The most commonly used filling materials are - silver amalgam which is silver in colour or tooth coloured filling materials... A rare dentist may actually suggest a gold filling.

Silver amalgam - Its a mixture of mercury and a lot of other metals. Its been a standard for all fillings. Though it is incredibly strong and lasts a very long time.. its silver colour is a drawback. Hence its popularity is dwindling... Still.. it continues to find use in fillings of the back teeth.

Teeth coloured materials.. these are newer better looking options though they are not always as strong as amalgam. The dentist may use a GIC mix or a composite mixture. GIC actually contains fluorides which prevent caries under the filling.. and composites are available in so many different shades that they mimic natural teeth.

With so many options... you can correct mistakes of the past and flaunt a bright new filling and nobody can actually tell the difference between your natural and filled pearlies.. So go on and get those teeth filled.. and keep smiling healthy!!!

Scaling ..

2008-11-08T07:31:00.003-08:00

You may have heard your dentist say, you need a scaling. Iam sure you would know what tartar means..
Scaling is a process that involves scraping of the tartar off your teeth and getting them back to be squeaky clean. Scaling can also remove stains that are on the outer surface of the tooth. Scaling is usually done with an ultrasonic scaler but there are also plain old manual scalers.

An ultrasonic scaler uses the energy of exploding bubbles of water to remove the tartar (cool huh??!!). Its relatively quicker, less painful and less traumatic.
Hand scaling is usually done in patients who have any kind of respiratory trouble or in a patient with active infection. In some patients with old cardiac pacemakers, its better to take the advice of your dentist and your physician as to which method is best for you.

Scaling will not remove the tooth enamel as is wrongly believed. Nor can scaling be used to remove stains inside the tooth surface as occurs in drinking well water.

Before your scaling procedure, brush your teeth to remove all gross particles. Its not very pleasant for the dentist to remove your morning breakfast from your mouth. After brushing, its advisable to rinse your mouth with an antibacterial mouthrinse.

Scaling produces an aerosol - a spray of water and saliva and most importantly the bateria in your mouth. This mouth rinse considerably reduces the bacteria in the aerosol.

During the scaling procedure, if you feel extreme sensitvity, inform your dentist so that he or she can adjust the frequency and water spray level. This does not occur with hand scaling.

After the scaling procedure, if you have pain or sensitivity, ask your dentist for a mild analgesic. It usually resolves in a day.

Scaling done regularly . say once in six months will kee your teeth and gums in good condition. Scaling should be complimented with good brushing and flossing habits. With your teeth shining and your gums a healthy pink, you should not stop smiling .. healthy!!

What is a root canal treatment?

2008-10-13T06:53:00.002-07:00

A tooth has two parts. A crown and a root.
The crown is made up of enamel , dentin and pulp in the inside. The root is made of cementum, dentin and pulp. The pulp is the tissue that supplies blood to the tooth and detects pain. Decay may occur in the enamel, and spread to dentin. From the dentin , it may spread to the pulp. From the pulp in the crown, it may go down to the pulp in the root.

Now, the tooth is held to the jaw bones by means of a tissue called the periodontal ligament. The infection from the tooth , when it reaches the periodontal ligament, starts to destroy the bone and causes inflammation of this tissue. When this happens, you start getting pain when you bite on the tooth. This is when most people see a dentist.
Now, your dentist will give you an option of RCT if enough crown is left that can be restored. If the whole of your crown is gone, and only the root remains, you may have to extract the root.

Now let us see what is done in the root canal treatment.

First, the dentist removes all the decayed tissue in your tooth and then goes on till he or she reaches the pulp. Now, he removes the infected pulp. Next he washes the root canal thoroughly with medicament to remove all infected material and bacteria. Next, the root canal will be filled with a soft rubbery material called Gutta Percha. This is done to prevent bacteria from the mouth entering the canal and reaching the the periodontal ligament.

Now that all the infection is removed, the periodontal ligament heals naturally.

Since a tooth is brittle after root canal treatment , it is necessary to wear an artificial crown over that.

And there, you saved your tooth that was infected so badly.. Hope this bit of knowledge helped you! Keep smiling then .. and keep it healthy!!!!

Crooked Teeth??

2008-10-06T04:59:00.005-07:00

You have crooked teeth and you are past the age where all your friends wore braces????? Dont drop the smile.. there are other ways to get a straight smile !

Lets us look at the options :

Say if you have gaps between your teeth (the gap is called a diastema) , your dentist maybe able to fill the area with a tooth coloured restorative material, thus eliminating the need for braces. Ofcouse, this will work only if the gaps are mild to moderate!

Alternatively, a crown may also be placed to elongate or shorten a tooth. These crowns are usually made of porcelain and cannot be differentiated by most people as being artificial.

These methods will not work if you have gross misalignment.. In those cases, braces are a must to correct them! But there are braces that dont resemble a steel factory in your mouth :P

Lingual Braces - Instead of placing brackets on the front of your teeth, specially made brackets can be placed at the back of your teeth. This literally hides your braces from view! And all the corrections that are done with regular braces can be done with them too!!!

Invisalign - These are clear, removable teeth aligners that are worn successively as your teeth move! They are clear and so essentially are so much better in the cosmetic sense! But your dentist will expect you to wear them for 20 - 22 hours a day!

Ceramic brackets - These are similar to normal braces but instead of the steel brackets, ceramic ones are used. These usually blend with tooth in appearance and are inconspicuous.

Apart from being pleasant to look at, aligned teeth also have the benefit of being self cleansing and easy to brush. Plaque and tartar formation is also reduced. So , go ahead! Its never too late to correct your smile.. Keep smiling - Healthy!!!!!

Oral Ulcers

2008-09-29T11:33:00.004-07:00

Anyone who has had them, knows how extremely painful these tiny ulcers are.. Here is a review of the causes, types, and treatment for them ..

Oral ulcers are also called aphthous ulcers or canker sores.

Causes

Iron deficiency
Vitamin B12 and Folic acid Deficiency
Physical and mental stress
Injury by accidental biting of cheek, lips or tongue
Autoimmune reaction - the body usually produces antibodies to fight against the germs. When antibodies are produced against one's own tissue, ulceration occurs!!!
Hormonal causes - around the time of a woman's period, during puberty and menopause.

Types

Minor aphthous ulcers - usually less than 2-3mm in diameter, extremely painful and usually persist for 7- 14 days .
Major aphthous ulcers - usually more than 10mm in diameter , intensely painful and may last upto 6 weeks
Herpetiform ulcers - Multiple tiny ulcers , sometimes even 100 in number simultaneously and yes, as painful as it sounds! They last in the mouth from one to three years.

Treatment Options

What you can do!

Salt water mouth rinses
Non - prescriptions gels and mouthwashes - that usually contain choline salicylate, benzocaine etc.. You can apply these every three or four hours.

What your dentist can do!

If the pain gets kinda very bad and you are unable to work, your dentist can prescribe

Steroid ointments
Anti- bacterial mouth washes
Anti-viral drugs
Prescription analgesics
Topical anaesthetic preparations

Do not try to use prescription drugs by yourself as they are not to be used by several types of patients and only your dentist will be able to ascertain which is best for you!!!

Bad Breath!!!

2008-09-23T05:48:00.003-07:00

When people keep trying to stay away from you, especially when you talk, you know you have a problem with your breath!! Millions of people suffer from Halitosis (yeah .. thats the scientific word) but seldom seek help. There are also the other million who are convinced they suffer from it but dont.

What causes bad breath?? In the oral cavity , a host of bacteria survive. These bacteria produce sulphur compounds which produce the offensive odour when they become volatile.

Volatility is the property when solids vapourise. As long as the oral cavity is moist , saliva dissolves them and there is no offensive odour. This is the reason for halitosis in the morning .. Saliva secretion is less and the sulphur compounds are increased causing the offensive order. There is no need to worry about this, its normal.

Causes for which you should consult a dentist are,

When food accumulates within a cavity in the teeth.

When you have undergone an extraction and the site is infected. Usually there is severe pain along with a very foul odour.

Presence of tartar and plaque leads to an offensive odour.

When your tongue has a whitish coating. This is a result of food, dead cells and bacteria which combined produce a great substrate for the production of sulphur compounds. Hence the need for regular tongue cleaning.

Causes other than your oral cavity will include,

Throat infections and nasal infections often are associated with bad breath especially when they produce pus.

Contrary to public opinion, the problems in stomach contribute to only 1% of bad breath cases.

So if you suffer from bad breath, it would be wiser to go to your dentist to have a thorough check up.

Treatment options:

Thorough brushing and tongue cleaning
Chewing a sugar-free gum.
Mouth rinses, mouth sprays and lozenges.

If these dont work, your dentist can perform a thorough scaling procedure and suggest prescription mouthrinses that work better than the ones you can get in a pharmacy.

Cheers and do remember, a clean and a healthy mouth is what makes your smile sparkle and shine. Keep smiling.. Keep it Healthy!! :)

White , Off- white or yellow??

2008-09-22T05:06:00.007-07:00

Who doesn't want whiter teeth??
I dont :P

Teeth become stained by a variety of reasons which include food habits, drugs, smoking, and age and certain diseases. We will have a detailed discussion of the reasons of discoloration later. For now, let us look at the various options available to whiten your teeth.

I have divided the options into D-I-Y --- The Do- It - Yourself kind And the Do it the Dentist way kind. :)

Here is what you can do --

You can try out the various whitening toothpastes available. If they work for you , very good!!
You can try your hand with the Paint - on gels and whitening strips. They are more successful than the toothpastes.
You can go to a dentist :)

What the Dentist can do :

Scaling

Scaling is a procedure where the dentist scrapes off the superficial tartar and stains with an ultra sonic or a hand scaler. This procedure is usually sufficient to remove mild to moderate stains that are on the outside of the tooth.

Bleaching

Your dentist will use a chemical dental bleaching solution that is either applied in the clinic or packed into a tooth ( the ones that are root canal filled ).

Additionally heat, light or laser maybe used to increase the efficiency of the procedure.

Bleaching may be done in a single sitting or several depending on the stains you have.
Bleaching offers the best results , second only to veneers.

Veneering

Veneering is where the dentist prepares the external surface of the tooth. Very little tooth material is removed and over this a thin porcelain is cemented with a dental cement. This porcelain will obviously be pearly white and dazzling.

These are the options available for whitening your teeth. You must also be ready to quit smoking and cut down on your coffee and tea to prevent further staining. Iam sure a lot of questions are unanswered. Shoot them off to me at dr.vidhyavenkat@gmail.com and expect a prompt reply.

Cheers!! And Keep Smiling .. Healthy!!

Missing Teeth????

2008-09-20T05:44:00.005-07:00

Have you ever had an extraction? Have any of your teeth never erupted? Normally, i guess you would rather replace a front tooth than a back one.

Though front teeth contribute to the beauty of a smile, the back teeth play a far more vital role in your mouth.

When back teeth on one side are lost, balance is lost while chewing. So more force is exerted on the side with all the teeth. These cannot be taken up and usually teeth of the other side also weaken.
Further, when an imbalance exists, the temporomandibulojoint.. ( dont worry, put your hands just in front of your ears and open and close your jaw,.. u can feel it!!) TMJ in short has unequal forces on it too. This leads to headaches, muscle pain, neck pain and a host of other problems.
The back teeth help to maintain the various other teeth in their positions. The loss of even one causes the other teeth to drift and tilt and generally cause a poor appearance.
Because of the deranged positions of the teeth, often plaque accumulates between the teeth causes gum infection . All these eventually lead to mobility and loss of the adjacent teeth also.
Moreover, we cant chew food properly without the back teeth . The front teeth cut up food. The back one grind.

Now comes the tricky part - How do u replace it????

Option number 1: Dental Implants.

Dental implants are basically titanium and titanium alloy screws that are placed in your jay. Over which a crown is screwed into place. Placing an implant will involve opening your gums and exposing the bone. This is usually a minor surgical procedure which is done with a local anaesthesia. The results are a tooth which is fixed to your jaws. This is the best option available though slightly pricier than the next option which is a fixed partial denture or a crown.

Option number 2: Fixed partial denture

Here, an artificial cap or crown also called a crown and bridge maybe used to replace the missing tooth taking support from the two teethon either side of it. The other two teeth need to be reduced to accomodate a crown. These crowns are connected to one another and then cemented to the tooth with a dental cement. The advantages are - no need to remove it everyday but the disadvantages are that the adjacent good teeth also have to be reduced a bit.

Option number 3 - Removable Partial Denture

Contrary to popular misconception , these can also be used to replace just one or two teeth. When they are made by a good dentist, they can offer excellent chewing efficiency, are not heavy. There is no need to reduce other teeth or undergo any minor operations. They resemble natural teeth closely. The denture maybe worn in the morning and removed at night, much like spectacles and contact lenses.

And when you or your relatives have lost all your teeth??

You can either use a a removable partial denture that replaces all the teeth or you can use an implant supported denture. Here, about four implants are placed in each jaw, over which a regular denture is fixed.

Cheers. Now you have an option of keeping that smile beautiful. Keep smiling .. Healthy!!!

Wat do u do with a toothbrush??!! :P

2008-09-19T04:51:00.005-07:00

Impertinent question? As a part of taking a dental history, I ask patients how they brush. The variety of answers that I've heard proves one thing. Most people dont know how to brush. If u r one of the lucky ones who do know how to ,. well .. here's a "brush - up" for u :P

Brushing involves thoroughly cleansing the outer surfaces of a tooth. This should include removal of any plaque or food debris. Like I said earlier, tooth brushing should be done a minimum of twice a day. Its ideal to use a soft bristled toothbrush. Using a regular or a powered one is left to your choice, as is the brand.

Now for the procedure :

1. We divide the oral cavity into upper jaw and lower jaw.
2.Each are divided into the right half and the left half.
3. Start from the lower left half, come to the lower front teeth and go to the lower right half. 4.Similarly for the upper jaw.
5.The tooth brush is placed such that the bristles lie on the area where the teeth and gums meet. 6.Back and forth motion is given and the area is gently brushed in this manner. All the surfaces of the teeth should be cleaned by this short back and forth motion.

DO REMEMBER - DO NOT POUND YOUR TEETH WITH YOUR TOOTHBRUSH. THE ENAMEL MAY GET WORN OFF.

I've added a video to illustrate the point. You may be in a hurry, but do brush atleast for two minutes.. Remember to clean your tongue and the inner surface of the upper teeth which people tend to forget.

There,... with that smile, you are going to win all the way today . Keep up the good work and keep smiling ... Healthy!!!

When your tooth goes.. Owwwwwwwww!!!!

2008-09-18T06:26:00.006-07:00

Sensitivity of a tooth is the painful response to your favourite ice cream and hot cocoa or even the versatile laddoo !! ( thast definitely not the official definition :P)

Let us first see how a tooth is built..

The portion of the tooth that is visible in the mouth is called the CROWN of the tooth. This crown is made of an outer tough covering called the enamel. Under this is a softer yellowish dentin. This dentin consists of various tubes which connect with the pulp. The pulp is the life of the tooth because of the bloodvessels and nerves in it.

When the enamel layer is lost because of a fractured or a worn out tooth or even when there are cavities where enamel is lost, the dentin with its tubules is exposed. So when a hot or cold or sweet food touches the dentin , it goes straight to the pulp and the pulp responds with a tremendous Owwwwww.

Do we have any treatment for this?? Dont despair..

U can try out various tooth pastes that contain strontium chloride and potassium nitate that will block the tubes in the dentin.. (do check if you are allergic to these toothpastes.)

Ideally though, you should see a dentist who will rule out presence of any cavities and advise you about the best course of treatment.

When the sensitivity gets moderate to severe, a dentist can help u by,

1. Filling the cavities if present.
2. Replacing lost enamel with a tooth coloured restorative material.
3. Sealing the dentinal tubules with a bonding agent.
4. Placing a cap or an artificially made crown so that the offending substances dont come anywhere near the dentin.

With all these options, u dont have to glare at your spouse when they order ice cream anymore.. I know u brush before your date .. Just dont forget to brush thoroughly afterwards too :)
Cheers and keep that smile... Healthy!!!

Bleeding gums - The Story behind Plaque and Tartar

2008-09-17T01:27:00.004-07:00

Though most people claim that the sight of blood scares them , blood is what they see, first thing in the morning. Bleeding from gums is a very very common disease.

What causes it??
The most common cause is inflammation of the gums .. called Gingivitis.

Let us see what inflammation is - When bacteria attack your gums, the defence cells in the body fight against the bacteria. Additionally , the gums become red and swollen. Because of the increased number of fragile capillaries, the gums become easily injured by a toothbrush bristles and bleed immediately.

So how do these bacteria get to the gums?? Here is where it becomes essential to learn about plaque and tartar.

After a meal, food often accumulates inbetween and on the tooth surfaces. Thorough rinsing usually clears it up. But huge numbers of bacteria attach to this and form a very soft whitish deposit on the teeth. This attaches to the tooth very tenaciously and does not get removed by rinsing. This layer is called a PLAQUE - a layer that is teaming with millions of bacteria.

TARTAR is formed when this difficult to remove plaque get calcified with minerals. i.e Instead of being soft, the deposits become hard over time and become even more difficult to remove.

To appreciate their importance, imagine a delicate tissue like your gums onto which harmful bacteria are dripping in millions from the attached plaque and tartar contributing to inflammation and bleeding.

So how do u prevent this?

Plaque -

1.Can be removed by correct brushing.
2.Plaque formation can be prevented by anti-plaque mouth washes.
3. Plaque betwen two teeth can be removed using dental floss and interproximal brushes.

Tartar -
1. After it is formed, can be removed only in a dentist's clinic.

Ideally , if you have bleeding from youy gums, brush with a soft bristled tooh brush in the correct manner. You should more importantly, contact your dentist for a professional scaling.

Cheers! and Keep Smiling .. Healthy!!

Sweet Tooth!!!!

2008-09-16T06:42:00.004-07:00

Chocolates cause cavities.. Do we throw them out??!!!! Oh No!! Thats never going to happen. Instead, let us look at ways to minimise cavities, while eating our favourite foods at the same time.
Cavities occur, when there is a sugary substance(substrate) on which bacteria can act and produce acid that attacks enamel on the tooth. The best substrate is simple carbohydrates like sucrose. The occurence of cavities also depend on .
Frequency of intake: More often foods or beverages with simple sugars are consumed, more oppurtunities for acid production and cavities.
Consistency and Time they stay on the teeth: The longer food remains in the mouth, the more time they offer for the bacteria to do their trick. Liquids ( fruit juices) are quickly cleared from the mouth, whereas solids (laddoos :P) adhere to tooth surfaces . However, liquids such as soft drinks which are sipped for a long period can contribute to tooth decay. Sticky foods (like soft candies) are exposed to tooth surfaces longer than non-sticky foods (hard candy). Sweetened chewing gum -- u chew and chew and chew and the bacteria have the greatest fun in their life producing all the acid they can.
Time of intake: Eating sweets along with meals is not as harmful as eating them in-between meals This is because of the increased saliva production during mealtime that cleanses the teeth better.
So.. your options for eating that huge bar of chocolate are:
1. Eat it along with your breakfast or dinner.
2. Brush your teeth well - immediately after.
3. Chewing a sugar-free xylitol gum after a chocolate which increases saliva. (not the gum in itslef.. the action of chewing does that)
4. Eating protective food like cheese or complex carbohydrates like fresh fruits.
5. Eat that chocolate once in a while.
Smiling now, are'nt you?!! And now, u can rest assured that that smile is going to stay healthy. Cheers!

Why should you brush twice a day???

2008-09-15T06:15:00.002-07:00

IF any of you have visited a dentist, you would have been advised to brush twice or thrice a day by most of them.
We aren't being overzealous on this, you know!!!

To understand why u should brush twice daily, you have to understand how cavities occur

Saliva plays a major role in clearing away most of the food debris on the teeth after a meal. This works fine for morning and noons. But after dinner, we go to sleep and saliva secretion is reduced when we sleep. Some of u may have realised this already by waking up with a parched throat and a dry mouth. So when , the major source of cleansing is gone, the debris accumulate on the tooth surface. This provides ready food for bacteria to breakdown and produce acids which dissolve the tooth structure producing cavities.

Hence brushing at night is crucial to cleanse the oral cavity.
Aren't you wondering then why should u brush in the morning???!!!!

Well.. Most toothpastes have materials in them like fluoride, which PREVENT the formation of cavities. Brushing also freshens your breath. Some even prevent the accumulation of tartar and thus protect you gums.

No more laziness then.. Take up your brush and make your teeth sparkle. ( Twice a day ;))

Cheers! Keep smiling..., healthy!!!

Your Friendly Neighbourhood Dentist!!!!

2008-09-14T22:12:00.002-07:00

Greetings

A Brush with Dentistry is a website that is going to brush you up on your knowledge about your teeth, gums and your oral health in "bite-size" articles.
Additionally, u can post your dental queries which may include your oral problems, questions about treatment options, questions about various diseases to dr.vidhyavenkat@gmail.com and expect a studied, knowledgeable reply from me in two working days. Further clarifications can be continued over email or IM.

Comments and Suggestions are welcome. You can also suggest what the next topic should be :)

Cheers. And Keep Smiling.. healthily!! :)