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Month: May 2015

Beware, your gums may be shrinking

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YES IT’S true! Gums do shrink, whilst not literally as in becoming minute, yet due to various reasons, they shrivel, desclosing the roots of teeth that are meant to be covered. This, in turn, leads to a needless heap of problems like root decay, teeth sensitivity and so on thereby worsening the scenario. Check out why it pays to take appropriate care of gums in good synchrony with the teeth.

What is recession and why it happens?

Recession is a shift in the position of the gums thus exposing parts of the root surfaces of teeth.

The incidence of recession ranges from eight per cent in children to more than 90 per cent in children to more than 90 per cent after the age of 50 years. The following key factors have been implicated in contributing to recession of gums.

Faulty tooth brushing :

Ironically recession tends to be more in persons with healthy gums and good oral hygiene. This is because of wrong burshing methods and undue pressure.

Tooth malposition : Susceptibility to cringing of gums is influenced by the position of teeth in the mouth. The bone support for tilted, rotated or displaced teeth is scrawny and fragile. Hence even moderate tooth brushing or pressure from chewing wears away unsupported gums causing them to recede.

Inflammation in gums : Poor oral hygiene leads to food and other debris collecting between the teeth and gums. This causes the gums to be inflamed (gingivitis) particularly around the margins. Inflammation makes way for recession and further more enhances trapping of ebris. It’s a vicious cycle

What happens is receding gums are neglected?

Several aspects of recession in gums make it clinically significant Exposed root surfaces are highly susceptible to decay.Once the gums shrivel, the outermost component of roots, the cementum, wears away leaving the underlying dentine extremely sensitive, particularly to touch. As mentioned before, recession creates space in which food and bacteria accumulate, which is both irritating and unhealthy. Well, the best possible way to know if you’ve shrunk your gums is to ask your dentist. She will update you with the current status of health of your gums and guide you in the treatment aspects and in addition offer suitable advice on optimum gum care.

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.

Root canal treatment – Get the facts right

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Among a whole host of dentel remedies, if there’s one that are most injudicious and ill advised about,-it has to be the infamous Root canal Treatment (RCT). In fact, time and again, it is discussed synonymously with pain. How very incorrect! your RCT, as it is commonly called, may well turn out to be 100 per cent paineless; chances are you might even enjoy the whole procedure!

When do you need an RCT?

A root canal treatment is generally indicated when

1.There has been trauma to tooth as in an injury, fall or accident where tooth is fractured or discoloured.2.There is a large decay in the tooth extending to the roots causing recuring pain or swelling or both.

3.There is an opening in gums, which drains pus through a sinus tract that leads to an abscess sur-rounding the roots. Cavitties extend very close to the nerve causing exterme pain.

What extactly is done?

The procedure begins with an intra-oral x-ray, which shows the extend of decay or the the rounded black spot at the end of the roots indicating a decrease in density of bone to infection.

After local anesthesoa to the concerned tooth, access is gained to the nerve area by a dental drill and a hole is made which leads to pulp chamber. Cleaning the tooth out to remove bacteria, degen erated nerve and debris is then done using RC files. These files are a series of increasing diameter used with a twisting motion as well as up and down in tooth to scrape and scrub sides of canals.

The tooth is peridically flushed with saline or water. Once the tooth has been thoroughly cleaned, the interior is sealed by placing a root canal filling material either the same day or sub-sequently. The most commonRC filling material, a rubber compound called ‘gutta oercha’ comes in preformed cones that are sized to match the files used to clean the canals. The cones are placed into the root canal(coated with a sealer))

exactly to the tip of tooth, lengh is confirmed with an x-ray. The crown of tooth is then filled with amalgam(silver) filling which seals tooth from above.

Common myths about RCT:1. The pain is unbearable: In most cases RCT almost becomes a non-event, it being no more uncomfortable than an average filling as the nerve tissue in the tooth has degenerated and cannot transmit pain.

2. It’s a long procedure: Contrary to popular belief that it takes several appointments lasting two to three weeks, your RCT may be over in as many as 3-4 sittings.

3. Once RCT is done its over: This procedure is followed by placement of a custom made crown (cap) available in different materials like ceramic, metal or combination to give addittional reinforcement to weakened tooth.

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230

As candid as that

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DID you know that there are scores of micro – organisms, on the skin and in our mouth at any given point of time? That this micro – organisms, which include bacteria and fungi, are relatively common inhabitants of the oral cavity and gastrointestinal tract even in clinically unaffected persons?

Well, yes healthy or otherwise, we have hordes of these all over our body. However, the mere presence of these microorganisms is not sufficient to produce any sort of disease; they are harmless by themselves. But when certain

Situations arise, the microorganisms, especially the fungi, flare up to know about one such infection, candidiasis, its features and care.

What is candidiasis? What factors predispose to it?

Candidiasis is a fungal infection caused by a yeast-like fungus, Candida albicans, which is a normal inhabitant of the mouth. People whose immune responses have been suppressed (those with HIV infection, leukemia, malignancy), or those undergoing key hormonal changes (diabetes, pregnancy), or those on prolonged use of antibiotics (predominantly corticosteroids), or some of those wearing ill-fitting dentures are Susceptible to this malady.

This fungus causes whitish plaques on the palate, gums, tongue and the inner aspect of the cheeks. When these lesions are rubbed, the superficial white membrane disappears leaving behind a red area.

In some cases, the white lesions are firm and cannot be wiped away and in some other cases there is a diffuse swelling and redness of the entire mouth in denture wearers along with infection involving the corners of the (denture sore mouth). It can develop suddenly or can be of a long-term nature; there is no apparent age limit and women are affected more frequently than men

Diagnosis and care:

You could be totally unaware of it as the condition is relatively painless save for an occasional burning sensation. If you are not in touch with your dentist regularly, its good to get yourself checked, particularly If you happen to have any of the stimulating factors like uncomfortable dentures or been though long –drawn-out antibiotics.

Contact your physician if it turns out that you have not been following closely, which could be a possible predisposing factor. Don’t go for over – the counter anti-fungal ointment/ cream on your own; once the diagnosis is confirmed (with a biopsy), your dentist will present you with the appropriate advice and medications.

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.

Could these queries be yours too ?

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HERE are a few doubts most commonly expressed. Check out if they are yours too.

1.Can I get my teeth straightened with braces, now that Im in my 40s ?

By all means! Once it is ascertained that your bone support is good (with a few radiographs), your teeth may well be brought in line. And with the option of ceramic brackets now available, you are saved the embarrassment of a metallic smile. Although the treatment could take a little longer; and the orthodontist will put you on a retainer (a thin metallic wire attached to the back surfaces of the front teeth to prevent relapse), its worth the time and effort. Better late than never!

2.Why do my gums bleed though I brush my teeth twice a day?

Bleeding gums are not healthy gums. Poor oral hygiene (especially in areas where the toothbrush doesn’t reach) leads to the accumulation of tartar on teeth, which moves deep into the gums causing them to loosen and bleed on touch/brushing. If neglected further, the infection moves on to the bones altering support to the teeth, making them loose over a period of time. Approach a dentist for a professional cleaning to remove tartar; he will also put you on a mouthwash and brief you other oral hygiene aids and their appropriate use. If the infection has already progressed to a certain extent, you may be advised to go for gum surgeries and bone grafts to restore back the healthy status.

3.Are there any quick remedies for bad breath?

Breath mint, lozenges, drops, spray, chewing gum etc provide instant relief but only for a short while. Bad breath could be due to odouriferous foods, bacteria, smoking or gum problems. Regular use of a mouthwash along with ultrasonic cleaning at dentist will definitely make a difference.

4.Are wisdom teeth meant to be extracted?

Not always. Wisdom teeth (the third molars) are the back teeth on either side of each jaw and normally appear between 17 and 25 years of age. More often since there is scarcity of space for them to emerge in the right position, they get stuck in the bone in all possible angulations. Such a situation frequently causes pain radiating to the ear or lower jaw, infection in the tissues surrounding the tooth and recurrent tooth decay due to inaccessibility to maintain hygiene. Only then is it justified to get them removed. If the wisdom teeth have erupted normally without any hassles, you don’t need to bother about them.

5.Decay in my child’s milk teeth doesn’t necessarily have to be treated, as they are going to fall anyway, right?

Wrong! Unchecked decay in any set of teeth, ilk or permanent could lead to pain, swelling and infection. Toothache at a tender age drastically changed your child’s attitude towards dental health and the impression could remain for a lifetime. On the other hand, if you get milk teeth removed prematurely instead of getting them filled, it creates psychological problems especially if front teeth are lost. There could be severe space and alignment problems when there is a huge time gap between the exfoliating milk teeth and the erupting permanent teeth as the former plays a crucial role in the development of the latter. Your child needs a dentist just like you do!

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.

Tooth decay in children: Unchecked and rampant

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IF your kids are plump as children, chances are they won’t outgrow that fat, as they get older unless you help them eat right and exercise sufficiently. According to a new study from Wright State University, children with a high body-mass index (BMI) during their earliest years are 20 per cent more likely to remain obese in adulthood than children with lower BMIs. Looks like chubby cheeks do not indicate the pink of health any more!

Much before the monitoring of your child’s food and fitness routines come his dental care; which begin as early as when he is six months old! Check what you can do to preserve dental health in your dear one so that he doesn’t cry even before he learns to smile!

Nursing caries

When the child has been put to bed with a bottle of milk or sugar containing beverage, the liquid pools around the upper teeth (lower teeth are relatively unaffected as the tongue acts as a barrier). As the salivary flow is decreased during sleep, clearance of the liquid from the mouth is slow and the carbohydrate-containing medium provides an excellent environment for bacteria to grow. Te lactose content of human milk as well as that of bovine milk can be cariogenic (potential to cause decay), if allowed to stagnate of the teeth.

What can be done

1.Child’s first dental check-up should be between 6-12 months of age along with counseling for parents.

2.Infant should be held while feeding; if the baby falls asleep while nursing, it should be burped and then put to bed. Never allow the child to sleep with a bottle in the mouth

3.Parent should start brushing the child’s teeth as soon as the child can start drinking from a cup (approximately 12 moths of age).

Rampant caries Decay of sudden onset, widespread and rapidly burrowing usually involving the lower teeth has been termed rampant caries. There are generally 10 or more new lesions per year occurring in teeth that have been relatively immune to decay so far and affect children of all ages. There is considerable evidence that emotional disturbances could be the cause besides poor oral hygiene and requent consumption of sticky carbohydrates. Stressful situations, repressed emotions and fears, undue academic pressure, dissatisfaction with achievement etc, have been shown to be associated with decreased salivary flow and decreased decay resistance leading to rampant caries.

What can be done

1. A visit to the dentist once in six months will keep situations under control.

2. Diet counseling to eliminate wrong foods and timings helps a great deal.

3. Psychological counseling is of utmost importance. Parents should find out if the child is under stress and take measures to relieve him of it.

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.

The way to a men’s heart is through his mouth!

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Right, the age-old saying has been slightly modified! ‘Cause we’re not talking about winning over or person through his stomach with delicious tongue-tingling foodstuff as the proverb rightfully suggests. Far from it! This discussion centers on the fact that infection can enter the blood stream from the mouth and end right in your heart! Unbelievable but if you neglect the maintenance of good dental health, its not exactly heart warming! And before we go on to infective endocarditis, catch this bit on what sugar can do to your heart. Think twice before adding extra sugar to your coffee or morning cereal. According to a new report from the American Heart Association, adding sugar to your diet could give you clogged arteries! Sugar makes you fat and increase your risk of developing diabetes apart from lowering levels of the good cholesterol (HDL) in your body.So, keep your sugar intake in check as it puts you at great risk of heart disease and at a greater risk of decayed teeth!

What is infective endocarditis?

Infective endocarditis to due to microbial infection of a heart valve (either your own or a replaced one), the lining of a heart chamber or blood vessel.The causative organism enters the blood stream form various access sites such as the mouth (from gum abscesses, periodontal infections etc. And enter blood stream on chewing, teeth brushing or at the time of dental treatment), the skin (from skin infections, abscesses or intravenous sites) or the bowel (from large bowel tumours or urinary tract or bowel infections) or through post-operative wound infection following cardiac surgery. Once blood-borne the bacteria reach the heart valve or blood vessel and cause valve destruction, produce florid vegetations, which result in obstruction, conduction disorders and cardiac failure. Besides cardiac problems, endocarditis clinically presents persistent fever, bleeding beneath the skin, retina and under the finger or toe-nails, painful tender swellings at the fingertips and kidney disorders.

Red alert at the dental office:

The diagnosis and treatment of endocarditis is the cardiologist’s arena. However, there are two things you need to bear in mind when you see your dentist:

1. Do not forget to give your dentist your complete medical history, which should include every single minor or major procedure you’ve undergone, cardiac or otherwise. As people with valvular or congenital heart disease are susceptible to endocarditis, sufficient antibiotic prophylaxis is given before any dental procedure.

2. Whether or not you have a medical problem it is immensely important that you devote time to dental care and maintain hygiene. Do not make your mouth an access site for endocarditis, as the situation then is literally heart breaking!

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.


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The Environmental Protection Agency (EPA) has found that roughly 44% of men and 39% of women will develop a potentially life-threatening cancer in their lifetime. Gosh! Isn’t that scary? Well, its time to ponder and act! Despite voluminous statistics, few firm conclusions can be drawn as to the direct cause for cancer. However, with research, a number of risk factors have been identified; the important ones are discussed below. So, wake up and take charge!


Cigarette smoking is by far the most important risk factor for lung cancer, cancers of the mouth and more. And many thanks to them, passive exposure to secondhand smoke (especially from spouses) puts us at an increased risk for cardiovascular diseases. To avoid secondhand smoke, ban smoking in your house, car and office.


Chewing areca nut with lime with or without tobacco is prevalent largely in Asian countries like India and leads to precancerous esions and conditions before transforming to cancer of the mouth. Avoid the stuf


Whisky and brandy are termed spirits; beer and wine do not come under this category. But studies show that even a drink or two of the spirits or beer can increase a woman’s risk of breast cancer; 2-5 drinks a day ups the risk 1.5 times that of teetotalers. Consider avoiding alcohol or if you find that difficult, try and reduce the intake.


Actinic radiation in sunlight causes keratotic lesions in the lips of farmers who work long hours in the fields; but most of the times the melanin pigmentation on the lips protects the malignant conversion


Thousands of chemicals, including suspected carcinogens, escape from industrial smokestacks. Benzene is belched out in car exhaust. Factors that favour ozone buildup and lead to smog alerts probably cause these chemicals to build up too. Avoid exercising outdoors near high traffic areas and on polluted days; stay indoors during smog alerts.


Exercising for at least 30 minutes daily, five days a week may reduce your risk of several cancers, notably colon and breast cancer and also prevent heart disease, diabetes and bone loss.


Swedish researchers have discovered high levels of the carcinogen acrylamide in French fries and potato chips; go easy on them. Avoid charred meat; limit red meat consumption to reduce your risk of colon cancer. Cut down on fatty fish like carp, catfish, bass, king mackerel etc. Choose a well balanced diet rich in fibre and low in fat with lots of fresh fruits and vegetables.The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.


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In 1497 when Vasco da Gama sailed round the Cape of Good Hope, 100 out of his 160 men died of a strange disease. Nearly 300 years later it was discovered that prolonged consumption of a diet devoid of fresh fruit and vegetables was what caused it! Scurvy, which results from vitamin C deficiency, has been known since the time of the Ebers papyrus in Egypt (1500 BC). British sailors in the 19th century were referred to as ‘limeys’ because of their consumption of citrus fruits to prevent scurvy while on long voyages. Vitamin C is essential for healthy gums, is required for healing of wounds besides being necessary for a number of metabolic processes in the body. All the more reason to have your fruit, and eat it too!

Dietary sources:

Man, unlike several animals, is unable to produce vitamin C in the body. So, that makes it very important that we derive our daily requirement from our diet. Vitamin C is found aplenty in oranges and other citrus fruits, blackcurrants, guavas, green peppers, broccoli, raw cauliflower, cabbage, Brussels sprouts and potatoes. The recommended dietary intake ranges from 35 mg. in infants to 60-75 mg. in adults.

What happens in scurvy?Scurvy, where there is a deficiency of ascorbic acid or vitamin C, could be either adult or infantile. Ascorbic acid is responsible for formation of ‘collagen’ in connective tissues, the absence of which leads to swollen and spongy gums particularly in between teeth. The colour is a violaceous red with a shiny surface. The gums bleed easily; the teeth become loose and may even fall out. In infants the swollen gums almost cover the teeth.Fresh wounds fail to heal. There is bleeding under the skin in the lower thighs, feet and ankles; spontaneous bleeding may occur into the joints, under the nails or through the nose.

You may be unaware of this deficiency. But if you’re suffering from any of the above-mentioned symptoms, consult your physician immediately and get a complete blood picture done. Once you are through with him, consult your dentist; he will check with the physician and take the best possible course of action. In the meantime, call yourself a ‘limey’ and binge on the oranges!

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.

Get Your teeth in line

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IF you’ve watched the English flick THere’s Something About Mary, you might recall the incident where there is a bevy of handsome men trying to woo the lady in several ways, one of them being the display of dazzling white teeth! Well, you don’t have to be Cameron Diaz to have a million dllar smile or be impressed by one. Men and women, the world over, like to present themselves smart in this increasingly looks’conscious age. You wouldn’t want to have crooked teeth also, would you?

What are braces?

Braces or clips are superficial, lay terms (often misused) to indicate comprehensive orthodontic care for adults and children. The ideal bite (occlusion) is where the upper front teeth extend slightly outward and overlap the lower front teeth both horizontally and vertically and the molars meet. When this doesn’t happen, the person is said to have ‘malocclusion’ or altered bite. There are several divisions in malocclusion; Class 1 (teeth are turned or crooked), Class 2 (upper teeth are too far forward and lower teeth are too back ) and Class 3 (upper teeth are too back and lower teeth are too forward). Apart from these there is the cross bite where one or more lower teeth overlap upper teeth; the deep bite where upper teeth overlap the lower far too much and the lower teeth hit the palate and the open bite where the front teeth remain apart even when the back teeth meet. The reasons for malocclusion are many, some of them being bad habits like thumb sucking, tongue thrusting, mouth breathing etc or may be the result of a fall or accident or may be due to heredity.

Facts you should know :

1.Orthodontic care is not just ofr teenagers; childre (where early recognition and treatment of malocclusion by interceptive orthodontics can correct irregularities) and adults (people well into their late 30s and 40s having good bone support) can well avail of it.

2.Seek a second opinion if you’re not too happy with getting 2-4 healthy teeth extracted to gain

space (if required).

3.Know the contraption well. Fixed orthodontics consists of brackets, which are small, square metapieces (ceramic or tooth coloured brackets also in vogue) bonded to the front surfaces of the teeth that hold the stainless steel arch wire which in turn is attached to metal bands around the first molars and elastics which apply pressure between the jaws. Removable appliances consist of an acrylic plate to which a stainless steel wire is attache. There is slight pain and discomfort but can be managed.

4. There are two techniques in fixed therapy; the Begg’s technique and the straight wire technique. Each case is different and selection of technique for that particular case and the cost is left to the discretion of the orthodontist.

5. Ask questions and get your facts right. Clear your doubts well before you start. So, go on, get your teeth in line, better your smile and boost your confidence.

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC, 26673439, 9845085230.


Wise up to your wisdom tooth!

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EVEN IF You were among the lucky few who missed the curse of acne as a teenager, you can still experience breakouts well into your 40s and beyond. Paradoxically it is the same story with wisdom teeth.

The back teeth on either side of each jaw, these normally appear between 17 and 25 years of age but could cause you trouble at just about any age. The general belief is that individuals have gained knowledge, prudence and discreation around the age these teeth erupt (unlike the rest which erupt at various stages of growth) Which is why they are called wisdom teeth; however there is no scientific basis for it.

What are wisdom teeth?

Molars are the teeth we use for chewing and grinding found farthest in the mouth. We have three molars on either side of each jaw; the last molar is called the wisdom tooth. More often, since all other teeth have erupted by the time these emerge, there is scarcity of space for them to appear in the right position.

This results in their ‘impaction’, which is a term coined for teeth which have failed to emerge fully into their expected position in the mouth. Also, these wisdom teeth erupting in a wrong angulation could render them impacted either horizontal, vertical or sideways withing the bone or just in the soft tissues.

Why should wisdom teeth be extracted?

1. Pericoronitis : This is the infection located in the tissues surrounding a wisdom tooth that has not fully emerged through the gums. The partial eruption creates a space between the overlying tissues and erupting wisdom tooth where bacteria, food and debris tend to collect causing an active infection. There is tooth pain, swelling and tenderness in relation to the offending wisdom tooth, a foul odour emanating from the mouth and a bad taste on the tongue.

2. Recurrent tooth decay: The remoteness makes it hard to clean with a toothbrush theryby resulting in cavities. But the sad part is that access for the dentist to do a filling is poor and chances of recurrent tooth decay even after a dental filling are high. Frequently, because of poor oral hygiene the neighouring tooth is also affected.

3. Gum disease : Health or disease related to gums is never an isolated event, it almost definitely affects neighbouring teeth. The space above the wisdom tooth, if partially erupted, and the difficulty of constant cleanliness leads to gingivitis and pockets where debris and bacteria accumulate causing further dental problems.

4. Cysts and tummours : An x-ray is the best way to confirm an impaction which you should get done at the dental office. Incidentally it also indicates the presence of systs or tumours in relation to the impacted wisdom tooth.

5. Tooth crowding : The wisdom tooth whether erupting in a wrong direction or impacted exerts pressure on the other teeth especially lower front teeth causing them to be crowded and shifted (malaligned).

Having discussed this, the procedural steps and post teeth extraction care will be dealt with next week.

The author is dental surgeon and can be contacted at ALL SMILES DENTAL CLIN- IC, 6673439, 9845085230.

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