An interesting patient with hyperdontia. Three supernumerary premolars in the lower jaw. Luckily the arch is straight and the treatment plan is easy – just removing the extra premolars.
Gingivitis is a periodontal disease which is quite common in the recent times. This dental disease does cause a lot of pain but it is characterized by inflammation of gingiva present in the mouth which is more commonly called as “gums”.
It is commonly observed that patients are just bothered about getting treated by the doctor as soon as possible and get well soon. So in order to get rid of the gingivitis, the dentist has to follow a protocol so that the further occurrence of the gingivitis disease does not happen again in future. When a patient comes for treatment, a doctor looks for the history of the patient and current status of the patient so that the correct disease can be diagnosed and treated.
Gingivitis treatment protocol
Gingivitis has a particular treatment protocol which keeps changing with advancement in the technology of dentistry. After diagnosing the patient disease, care must be taken that the patient is not given any medicine without checking the case history of the patient. This will make sure that the treatment given by the dentist is worth useful to the patient in the near future. The main aim of the treatment of gingivitis is the detection and safe removal of the plaque without harming the gingival and other oral tissues. In these kind of diseases, oral hygiene plays a very important role in the treatment of gingivitis. So the dentist as well as the patient should take oral hygiene as a plus point in the treatment. The treatment first considers the controlling of microbial organism in the mouth responsible for causing gingivitis. Considering this, there are many methods used for prevention that can also be used for treatment of gingivitis. Some of the methods include root planning, scaling, mouthwashes which contain hydrogen peroxide or chlorhexidine, flossing. Using the correct interdental brushes at recommended frequent levels will help you to get rid of the microbial organisms which have caused gingivitis. In the 21st century, mouthwashes are on a rise and anyone can easily access a mouthwash after eating or drinking something. This will help to keep a clean mouth and fight odor. In the recent times, new treatment ways have come up. So Non-Steroidal Anti-Inflammatory Drugs have now been introduced in the field of dentistry to treat diseases like gingivitis. But due to their side effects in the major parts of our body, dentists recommend to use mouthwashes as they much safer than the NSAID’s on the body and are effective too. Diclofenac Epolamine is a diclofenac salt which has shown a remarkable benefit to the patient’s condition. This salt when used with a mouthwash is more effective than when used individually. Brush your teeth properly so that you don’t unnecessarily harm your gums. Clean your tongue regularly.
As we all know prevention is better than cure, so follow the basic tips given by your dentist and practice them regularly to keep yourself and your mouth healthy forever. Oral health is a precious gift and if you understand its importance on time.
The white spots on the teeth are mainly a cosmetic issue but should be taken under serious consideration because it may be an early sign of initial tooth decay. The white spots are usually a result of enamel demineralization. This is how the caries begins – the acids from the bacteria that reside in the mouth and the acids from the food cause this loss of minerals. If the ph stays lower than 5.5 there is no balance between the demineralization and remineralization and loss of minerals is at place. This process can be seen on the tooth as opaque areas. These opaque areas have a white color and people complain of “white spots on their teeth”.
Having such hypocalcified spots does not mean that the patient’s hygiene is bad, sometimes can be caused by other factors like wearing braces for a long time. In these cases the hygiene is hard to be improved due to this plaque retention factor. The mineral loss can be caused by consuming too much acidic foods (citric fruits, drinking juices with low ph). People do not realize how acidic some foods may be. Let’s take for example Coca Cola. While drinking it you feel the sweet taste but that does not mean that it does not contain acidic components. As a matter of fact such juices and drinks are the most dangerous for the enamel, you feel they are sweet but they contain a huge amount of acids and sugar at the same time. Keep in mind that the cariogenic bacteria in the mouth use simple sugars for living and their final metabolic product are acids. In this way acids are delivered by the juice itself and from the bacterial terminal products of metabolism. These demineralized areas can be restored if the ph is raised over 6.5 ph.
The white spots can also be a result of hereditary conditions such as enamel and dentine hypoplasia. The mineralization of the tooth tissue is lower than usual but that is not a consequence of acidic foods or poor hygiene but other factors we will discuss later on.
Sometimes babies have teeth that are present in their mouth at the time of their birth. They are called natal teeth and their presence is very uncommon. According to National Institute of Health studies they appear in one of 2000-3000 babies. Usually this is the set of the lower central incisors. The babies born with teeth have to be monitored because this condition could cause some problems.
What to do with the natal teeth?
The doctors should decide what to do with the natal teeth. They can be extracted before the mother has started nursing. The natal tooth can hurt the mother’s breasts and also cause choking if the tooth is loose and at some point it falls in the baby’s throat. Don’t worry if your child has lost his natal tooth because he will still have his decidous and adult teeth and won’t affect their development and eruption. If the babies are born with a loose tooth it is better to be extracted.
Another decision the dentist can take is to keep the natal tooth. If it doesn’t have pointy and sharp edges and doesn’t bother the breastfeeding the tooth can be kept. Keep in mind that it is a retention factor and should be cleaned often. That can happen by rinsing or rubbing the gums with cloth soaked in hydrogen hydroxide. If the tooth is sharp it can be polished with a bur and other polishing brushes and disks. The baby can hurt the mother’s breast and even himself when sucking his own teeth.
It is very important for the clinician to be aware of the teeth eruption dates. Not only for the primary but also for the permanent teeth. In this way the diagnosis of the supernumerary tooth will be easier to place. The eruption dates can vary and depend on hereditary factors but there are certain periods in which the tooth eruption is considered as premature or delayed eruption. The baby teeth chart will help you orientate about the normal eruption dates. The presence of these conditions should alert the dentist to a potential problem.
Assessment of the oral soft tissues and dental check-up must be executed. After the assessment the dentist should write down all the information received during the intra-oral examination. The following factors should be included in the dental charting
Sometimes the patients complain about a weird change in the color of their gums. They come to us complaining about their bad outlook and want to solve this problem as soon as possible. This situation may happen very often in the regular dental practice since most of the patients are concerned only about the esthetic point of view. On the other hand the clinicians have a different way of evaluating these conditions and are mostly concerned about the function and anatomical health of the surrounding tissues. As a matter of fact both points of view meet in the right clinical decision when it comes to gum diseases.
The best way to evaluate the importance of the clinical case is by obtaining the medical history information- what the complaints are, the history of the complaint, past dental issues, social and family dental and medical history. The patients have noticed a significant change in the gingiva margin which is close to the tooth crown. They say “Doctor, my gums turned black and look awful. Is there an explanation for this color change and what can I do to restore their previous color?” When we observe a healthy gingiva its normal color is pink. Actually this pink color comes from the small arteries and capillaries in the gums.