The smile is the first thing we notice about a person, and more than anything else, it reveals the teeth first. We all yearn for that set of perfectly aligned teeth that are pearly white in color. However, this is not a reality in all people.

Due to various reasons, the teeth are not always bright and white. In some cases, the high fluoride content in the water can lead to fluorosis, which causes irregular patches on the teeth. Chewing tobacco and smoking are another reason for teeth discoloration, ranging from yellow to brown to black. The most inevitable of all reasons is ageing, where they naturally change to a darker shade of yellow. However, dental technology has also improved to come up with various solutions, so that the dream for that set of pearly whites can be made a reality.

Bleaching is by far the most commonly used method for teeth whitening. The tooth has an outer layer called enamel, a next layer called dentin, and a final inner layer called the pulp. The enamel contains organic particles that give the tooth its color, and the bleach material attacks these organic particles and thereby removes the stains.

It is always advisable to use tooth bleaching under the supervision of a dentist. A thorough examination and diagnosis is required before deciding on one of the two modes of bleaching.
1. In-office bleaching: This involves use of whitening gels that are not available over the counter. The gel is applied on the discolored portions of the teeth to leave a whiter tooth behind after the stipulated time.
2. Home bleaching: In cases where more regular application is desired, the patient is given a kit which has customized trays and the whitening gel. The patient is educated on a schedule including how and when to apply the gel and instructions for this application.

In addition, for minor discolorations, there are other options as below:
1. Whitening strips: These strips are similar to adhesive bandage and contain the bleaching agent. They are applied onto the tooth and left for usually about 30 minutes to take effect.
2. Brush-on whitening: These gels are applied directly on the tooth and left for a while or overnight if required.
3. Whitening chewing gum: For the chewing gum lovers, this could be an option. These chewing gums are similar to any chewing gum but include bleaching agents.

Side effects: Sensitivity and gum irritation are the two common side effects of bleaching. This could be either from the chemical or the trays that are used. The need to repeat the treatment again is another shortcoming. Repeated visits to the dentist may be needed once or twice a year to maintain the pearly white smile!

Bleaching for Extra White Teeth

Mouthwash has become an essential ingredient of one's oral hygiene kit. Though not a substitute for flossing or brushing, it offers additional oral protection. Due to a host of ingredients, such as alcohol,
Chlorhexidine, cetylpyridinium chloride, menthol, methyl salicylate, fluoride, antibacterial enzymes, hydrogen peroxide, essential oils, zinc chloride and other herbs and "natural" ingredients mouthwash has a number of benefits.

Alcohol is the basic ingredient in all of them. While fluoride protects against decay, chlorhexidine protects against gum diseases. Hydrogen peroxide produces a mild bleaching effect. Herbs and essential oils produce a freshening effect.

Benefits of using a mouthwash

1. Reduces formation of tartar and plaque.
2. Protects from oral problems like gingivitis and periodontal disease, especially if it contains cetylpyridinium or essential oils. Chlorhexidine is also effective in protecting plaque formation and gingivitis.
3. Kills bacteria in the mouth and prevents cavities or decay, especially if it contains fluoride.
4. Mouthwash, to some extent, covers up bad breath due to oral hygiene or oral disease and produces a fresher breath.
5. Certain mouthwashes containing cetylpyridinium chloride and zinc chloride produce a better breath freshening effect.
6. Helps manage dry mouth, especially if containing biotene.

Types of Mouthwash

1. Cosmetic
2. Therapeutic

The cosmetic one is usually for freshening up the breath and is not regulated by the FDA. The therapeutic ones contain active ingredients aimed at addressing one of the issues like plaque formation, bad breath, dry mouth, or decay. They kill bacteria, reduce plaque, fight gingivitis, and control decay. They are not a substitute for brushing or flossing but supplement these two very well. These are approved by FDA and are proven in terms of safety and efficacy. Rinses with zinc chloride are effective against bad breath, those with fluoride are useful in people who are cavity-prone, and chlorhexidine helps prevent gum disease.

Choosing a mouthwash: This depends on the oral health condition, and it is always advisable that the dentist prescribes the right rinse for you.

When and how to use mouthwash: When you are done with your brushing and flossing, rinse your mouth with a capful of the mouthwash liquid. Swish it around your mouth for about 30 seconds and spit it out. Avoid brushing, drinking water, or rinsing your mouth after using a mouthwash for about 15 to 20 minutes. This will give sufficient time for the active ingredients in the mouthwash (especially if it is a therapeutic one) to act in the mouth. Brushing after mouthwash removes all the effect of the rinse.

Mouthwash: All You Need to Know About it

Hyperdontia is a peculiar and quite rare dental problem which involves the growth of excess number of teeth. It can appear during birth and last till the primary teeth fall out to be replaced by the permanent set of teeth, or appear with the rise of the permanent teeth. If a person shows a tendency to grow more than 20 temporary teeth or more than 32 permanent teeth, he or she suffers from hyperdontia. 

Where do the additional teeth occur?
The additional teeth or supernumerary teeth can appear anywhere inside the mouth or dental arch, but the most common ones are called wisdom teeth and they grow as anterior molars after a certain age. Extra teeth in new born infants are called natal teeth. Occurrence of more than 4-6 supernumerary teeth is rare, although there have been known cases of more than 30 supernumerary teeth. 

Why does hyperdontia occur?
1. Hyperdontia often occurs in association with a few select disorders like cleidocranial dysplasia, Ehler - Danlos syndrome, Gardner syndrome, and cleft lip and palate. 
2. Although the exact cause of hyperdontia has not yet been discovered, some studies have shown that it might be a result of over activity of dental lamina during the phase of tooth development in infancy. 
3. It could also possibly be due to genetic or environmental factors. 

What problems does it pose and how can hyperdontia be corrected?
1. The existence of extra teeth often causes problems in speaking.
2. It may also cause deformation in the mouth region, and impediments in a lot of other functional activities like eating. 
3. In rare cases, the extra tooth/teeth may be agents of tumors or cysts. 
4. Therefore, treatment must be swiftly undertaken so as to remove the extra teeth and prevent rise of further teeth in the same spot. 
5. Sometimes, hyperdontia also leads to overcrowding and misshapen rows of teeth; this can also be corrected with extensive procedures.

All About Hyperdontia

Myofascial pain syndrome refers to a chronic condition that affects a person s musculoskeletal system. With this disorder, pressure on the sensitive points (known as trigger points) in the muscle induces pain in various parts of the body.

Myofascial pain syndrome mostly affects people in the age group 40-60 years.

What causes myofascial pain?

Typically, myofascial pain syndrome occurs because of repetitive muscle contraction or overuse, or due to an injury. Sensitive areas of the tight muscle fibres can develop following an injury/trauma, and ultimately lead to pain and strain throughout the muscle.

Symptoms to watch out for-

Common signs and symptoms of myofascial pain syndrome include-

  Severe pain in localized muscle areas
  Pain that worsens when you stretch or strain the affected muscle
  Muscle pain that persists for longer than usual, or worsens with time
  Painful, tender knots in the muscles that lead to severe pain when pressed
  Weakness and stiffness in the muscles
  Inflexibility or a reduced range of motion

Although muscle pain is temporary in most cases, and usually subside on its own, you should visit a doctor immediately if the pain becomes intense and severe. Otherwise, the symptoms of myofascial pain syndrome can aggravate and impede your daily routine.

What is the treatment for myofascial pain syndrome?

Treatment for myofascial pain syndrome include a range of pain management options such as the following-

  Medications
Your doctor will likely prescribe medications that include anticonvulsants, analgesics, and over-the-counter Non-steroidal Anti-inflammatory Drugs (NSAIDs). These work as painkillers and help relieve pain and reduce muscle spasms.

  Dry-needling
Dry-needling is a quicker way of getting rid of myofascial pain symptoms. The doctor inactivates the trigger points by directly inserting a needle into it. He/she will then slowly move the needle around and poke it inside and out. The initial process can be a little painful, but it certainly helps manage the pain in your muscles. Alternatively, acupuncture needles can be used for the same procedure since they are small and are less painful.

  Local injections
Local injections, also known as trigger point injections, are similar to dry-needling. The only difference is that local injections involve injecting a solution (saline/steroid/or a local anaesthetic) into the trigger points. The method yield similar results as does dry-needling.

  Therapy
Different types of therapies can be used to ease the pain associated with this chronic pain disorder.

Ultrasound therapy where sound waves are transmitted into the muscle tissues through a sound-conducting gel applied on the skin. The sound waves heat up and relax the muscles, thereby improving blood circulation and removing the scar tissues. Ultrasound therapy is also effective in reducing muscle stiffness and increasing one s mobility.
Massage therapy also is very effective in treating myofascial pain syndrome. The therapist usually uses his/her fingers or some sort of equipment to induce pressure on the various trigger points. When performed, this procedure may first aggravate the muscle pain and then release muscle tension.
Apart from these, the doctor may prescribe regular exercising or physiotherapy treatment for patients suffering from chronic muscle pain.

Myofascial pain syndrome can be managed well using the techniques mentioned above. In addition, it is very important that you stick to some sort of physical activity. Talk to your doctor and incorporate these pain management techniques to live a pain-free healthy life.

Myofascial Pain - Causes, Symptoms & Treatment Of It!

2 Biggest dental mistakes that Indians make!

Your dental health chiefly depends on the way you care for your teeth and gums. Most Indians consider maintaining oral health a very simple thing, and end up committing quite a few dental blunders as a result. As a result, a whopping 95% of the population in India suffers from gum disease! (Source: National Oral Health Programme)

Read on to find which of these dental mistakes you are making and how to avoid them.

1. Not flossing your teeth
Flossing plays a significant role in getting rid of sticky bacteria or plaque from your teeth. The acid generated by dental plaque is the chief cause behind oral cavities, gum irritation and various other gum diseases. Flossing is essential for cleaning the space between your teeth and in turn eliminating most of the bacteria present in your mouth. This is the very reason it should not be ignored.However in India, well over 70% of the population does not floss.

2. Not regularly visiting the dentist
Most Indians have the habit of not visiting the dentist at regular intervals due to laziness, a forgetful nature or fear. Quite a few hold the common belief that if they aren’t experiencing a toothache, they don’t need to visit the dentist at all. Only 2% of Indians visit the dentist.  This often puts you in greater risks of developing a gum disease, which may require painful and costly treatment in the future. So, make it a priority to visit the dentist at least once every year to ensure better dental health.

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2 Biggest Dental Mistakes that Indians Make!

The last molar teeth in the mouth are called as wisdom teeth. While in some people they erupt completely into the mouth and function with no problem whatsoever, in others, they remain embedded in the bone, erupt incompletely, erupt at an angle, or are covered by bone or a flap of tissue. They are absent in many.
Of late, dentists recommend removal of wisdom teeth, more a preventative than remedial measure. Some of the reasons for wisdom tooth removal are listed below-
Impaction: Often, wisdom teeth do not have enough space to erupt in their normal position. This can only be evaluated properly on an x-ray. If the x-ray shows that the tooth is unlikely to erupt because of being blocked by a root or bone, this needs to be removed.
Pericoronitis: The tooth partially erupts into the mouth but is covered by a flap of gum. This attracts food and bacteria to accumulate, leading to decay and infection, a condition called as pericoronitis. Very common in the lower wisdom teeth, it leads to severe tooth pain, painful swallowing and swelling of the lymph nodes. This is the most common cause for wisdom teeth to be removed. An x-ray will reveal the tooth to be infected and sometimes periapical abscess may also be present.
Cysts: Impacted teeth can develop fluid-filled cysts which can cause severe and even permanent damage to the jaw bone, adjacent teeth and nerves. Dentigerous cysts are the most common type.
Alignment: Misaligned wisdom teeth exert a constant mild pressure on the adjacent teeth which can hamper the alignment and reverse the effects produced by braces. The bite may be altered also, thereby necessitating removal.
Adjacent Tooth Damage: If the malposed wisdom tooth is causing pocket formation or decay in the adjacent teeth, it is time to get them removed.
Recurrent Sinus Infections: With their proximity to sinuses, there could be constant pain and pressure and infection of the sinuses. This is another indication for their removal.
However, not all wisdom teeth need to be removed. If they have erupted fully, are healthy, produce a good bite, and can be cleaned easily, they do not require removal.
During the teenage years and through 20s, check with your dentist on the health of the wisdom teeth. X-rays can be taken to monitor them and for early identification of problems. If they need to be removed, it is easier to take them out when you're young. The bone surrounding the impacted tooth is less dense, and therefore easier. The ability of the body in general and the jaw bones in particular to heal is also better at a younger age. 


Wisdom Teeth - When To Get Them Removed

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