Dr Khurana's Multi - Speciality Dental Clinic

Dental problems can be very painful and take the smile off your face completely. Those who have experienced sensitivity would vouch for it. It just will not allow you to enjoy the hot coffee or a favourite sweet or a cold smoothie.  The pain that shoots down the tooth after any of these would leave the person shuddering.

The tooth has 3 layers, from the outside in these are the enamel, the dentin and the pulp. The outermost enamel is mineralized and the hardest structure in the body. The next layer, dentin, has fine tubules and when the enamel is worn off exposing the dentin, sensitivity sets in. The enamel is thinner in some portions of the tooth like the neck and the roots, therefore sensitivity onset is quicker in these areas.

Some of the common reasons for sensitivity are listed below:

1. Tooth decay:  As caries progresses from enamel to dentin, sensitivity sets in, especially to hot and cold foods.
2. Wear and tear:  Excessive brushing of teeth can lead to wearing of teeth, especially near the neck areas, leading to loss of enamel and resulting in sensitivity.
3. Dental damage:  Chipped or broken tooth can lead to sensitivity.
4. Gingival disease: This leads to loss of gum cover over the tooth, leading to exposure of dentin and therefore sensitivity.
5. Bruxism: Clenching of teeth, common in people with high levels of stress, can lead to enamel wearing and subsequent sensitivity.
6. Dental treatment: Some dental procedures like scaling, crowns, root planing, and some fillings can cause transient sensitivity.
7. Highly acidic food items: Citrus fruits, tomatoes, tea, etc. can lead to tooth sensitivity.
8. Bleaching agents:  Most tooth whitening agents result in sensitive teeth.
9. Excessive use of mouthwash: The mouth rinses contain high amount of alcohol which can also lead to tooth sensitivity.

Management: As with all health conditions, the first step in management is to identify the problem.  Whether it is dental decay or recent dental treatment, food habits or tooth whitening agents, the cause needs to be identified and then treatment begun accordingly.

1. For lost enamel, be it decay or damage, the tooth again needs to be restored to its original form to cover the dentinal tubules and reduce sensitivity.
2. For habits, be it food related or bruxism, in addition to treating the tooth, the habit per se needs to be addressed to prevent recurrence.
3. For associated dental products like whitening agents or mouth rinses, talk to a dentist to switch to a less harmful product.
4. De-sensitizing pastes are also available that can be used on a regular basis to reduce the problem.

Tooth sensitivity is annoying, but there are ways to manage it effectively, please get in touch with your dentist, today!

Gone are the days when braces were only for children and teenagers. Today, adults don’t need to shy away from wearing braces just because it will look unattractive. It is time to not put them off. Here are the reasons to tell you why you should flaunt the braces:

1. Your smile is more important: A beautiful smile can change your life. It creates a positive impact in your life. People around you get influenced by your positive and attractive smile. But, if you cover your mouth just to hide your teeth while smiling, it will hamper your life. Therefore, straighten you teeth and get back your confidence. A dental implant is of no use unless you straighten all the teeth using a brace.

2. Wearing a brace can keep you away from other dental issues: Misaligned teeth can cause various dental disorders or issues. If the teeth are not aligned properly, food particles can get accumulated on the surface of the teeth, forming dental plaque. This in turn can give birth to a number of dental diseases or disorders.

3. Braces prevent you from other diseases: Improper alignment of teeth will not allow you to chew your food properly. This in turn may cause several gastrointestinal problems.

New Age Braces-

Today, braces have evolved. They no longer look very ugly or unattractive. You will not suffer from the embarrassment of having metal braces. Nowadays, ceramic braces are available in the markets. These are translucent in nature. Besides, a new age teeth cover called Invisalign is available. These are made up of clear plastic. An individual wears them over the teeth. So, you will not have to look unattractive with the metal wire.

Advantages of Ceramic Braces-

1. They are less painful and cause no irritation to the gums. They are friendlier to the gums than the old metal ones.

2. Ceramic braces are translucent in nature. They have white or tooth-coloured brackets which look better than metal wires.

3. They are durable and stronger. They can break only if they are abused or misused.

Saphire Braces-

Nowadays, you get clear braces in the markets. These are known as Saphire Braces. They are expensive than the metal ones. But, they are stronger and the greatest advantage of wearing a sapphire brace is that you don’t develop stains on them easily.

Cost of Braces-

The cost of adult braces depends upon the nature of brace you are choosing. Metal wires are cheaper. Ceramic and clear braces are costlier. Metal braces are available from INR 30,000 to 40,000 in the markets. Other braces look better but are costlier.

When to take braces?

In order to know whether or not you require a brace, you must consult a dentist first. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Diabetes is a chronic, systemic disease and affects all parts of the body. While its effect on the nerves, eyes, kidneys, and skin is more common, their oral effects are less known. However, diabetes will vouch how they lost tooth and have dry mouth after their sugars went out of control.

1. Oral Symptoms in Diabetics: There is a strong correlation between oral health and poorly controlled blood sugars. Some of the common oral indications of diabetes are as follows.
2. Dry Mouth: There is less amount of saliva, which brings with it a whole lot of symptoms including soreness of the mucosa, ulcers, increased chances of infection, gum inflammation and tooth decay.
3. Thrush: The saliva has higher sugar levels and attracts fungus (Candida in particular) which thrives in this dry, sugary environment. This produces a burning sensation in the mouth.
4. Periodontal Disease: The gums get severely infected with gingival recession, where the gum line recedes exposing more of the tooth (tooth length seems to have increased). There is “pocket” formation, or space between the tooth and the gum which hosts a variety of bacteria. The periodontal ligament loses its strength to hold the tooth in place, and thereby teeth become mobile. If not worked upon in time, there could be multiple teeth lost.

As much as it sounds alarming, it is not. There are easy, simple ways to manage these. In fact, good overall management of diabetes will ensure the oral symptoms are also maintained under control. Following are some things to do which will help in managing diabetes in general and the oral symptoms in particular:

As soon as diabetes is diagnosed, visit a dentist to take stock of the oral health condition. Any identified problem should be treated to avoid progression.

1. Keep a close watch to ensure blood sugar remains as close to normal as possible.

2. Switch to a toothbrush with soft or extra-soft bristles. This will help reduce the pressure on the gums and thereby prevent gum bleeding

3. After every meal, remember to brush the teeth.

4. Flossing at least once a day will help remove food deposits between the teeth. Alternately, use interdental brushes.

5. Rinse at least twice daily using an antiseptic mouthwash.

6. Denture-wearers should always clean them daily and never go to sleep with the denture in the mouth.

7. Smoking with diabetics is a strict no-no, work on quitting at the earliest.

8. Visit a dentist every 3 months to ensure oral issues are identified at the earliest and treatment done with minimal intervention.

9. Any dental procedure should be done only when sugar levels are under control.

These will ensure not just oral health but also overall control of diabetes.

Tooth loss occurs due to various reasons decay and infection, fracture, accidents, gum disease, to name a few. Tooth loss has a negative impact on various aspects facial appearance, chewing efficiency, and overall nutrition. The attempts to restore the lost tooth have led to various advancements from removable dentures to cast partial dentures to fixed dentures to implants.

Listed below are features (covering advantages and disadvantages) of both dentures (fixed and removable) and implants. While dentures can be complete or partial, implants are more often partial, of course can be used to replace multiple teeth. A detailed discussion with your dentist along with oral and radiographic examination will help in making a decision.

Removable Dentures:

Advantages:

1. Replaces tooth but more for cosmetic reasons than function.

2. Poor chewing efficiency.

3. Useful when multiple teeth are to be replaced, especially when no adjacent teeth are available for support.

4. If good bone support is not available, retention is an issue.

5. Not very healthy for the underlying jaw bone and adjacent gums.

6. Requires daily and routine maintenance.

Fixed Denture(s):

Also called as bridges, as the artificial replaced tooth is a bridge between two natural teeth.

1. Requires removal of sound tooth structure as abutment (support). This is the major disadvantage with fixed dentures, which promoted further work from the dentists, ending up with discovery of implants.

2. Promotes tooth decay in the adjacent teeth.

3. Good support, so retention is not an issue.

4. Not as harmful to the underlying jaw bone as removable denture.

5. Requires maintenance but not like the removable denture.

6. Expensive compared to removable dentures.

7. Replacing a bridge also means the adjacent healthy teeth are affected.

Implants:

1. Very good replacement alternative, replaces not just the crown structure but also the root structure.

2. An excellent option when the jaw bones and gums are extremely in good condition.

3. Almost natural restoration of both chewing efficiency and facial appearance, the person can eat almost anything.

4. Not as harmful on the gums like dentures.

5. Does not cause bone loss like dentures.

6. Can be used to replace single or multiple teeth, where multiple implants are placed and a bridge is placed over them.

7. The titanium screws that are used fuse with the jaw bone over a period of time.

8. The titanium is also biocompatible, thereby reducing chances of allergy.

9. Implants are expensive, and many insurance companies may not cover them.

10. If properly fabricated and maintained well, then it can last for decades.

The decision to go for a denture or for an implant should be decided based on a detailed evaluation of overall health and if required radiographic examination. Both dentures and implants have advantages and disadvantages, and the dentist will help make the right choice. If you wish to discuss about any specific dental problem, you can consult a specilized dentist and ask a free question.

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-

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

Pregnancy may bring a glow to your face, but can affect your dental health quite adversely. Thus it is important to pay attention to your dental care routine and visit your dentist regularly for checkups. Most of the changes in your dental health are due to hormonal surges that occur during pregnancy.

1. Pregnancy and plaque buildup: Pregnancy can aggravate gum diseases like gingivitis. This is caused by the buildup of plaque on the teeth and is characterized by red, swollen and bleeding gums. Pregnancy gingivitis affects of majority of pregnant women. If left untreated, it can lead to a more serious condition known as periodontitis. The swelling of gums can also trigger the development of pregnancy tumours and non-cancerous growths. These tumours will usually subside on their own after delivery. However, if they interfere with eating or your dental care routine, your dentist may advise you to get it removed. A link has also been suggested between gingivitis and the delivery of premature babies by triggering the production of prostaglandins that induce an early delivery.
2. What to keep in mind while visiting the dentist: Regular dental checkups are as important as your gynecological checkups. Be open with your dentist and let him know the status of your pregnancy. Dental visits are recommended in the first, second and third trimester of pregnancy. At your visit, the dentist will assess the condition of your teeth and suggest an oral care routine. Getting your teeth regularly cleaned can prevent the buildup of plaque and lower your chances of suffering from gingivitis. Regular fillings and non emergency procedures can be performed during pregnancy. However, the best time to undergo any dental procedure if you are pregnant is between the 4th and 6th month. Avoid X-rays unless in cases of emergencies when pregnant. If you need to take any form of medication or need to put under anesthesia, consult your gynecologist about the procedure. Wherever possible, try and postpone dental treatment till after delivery.
3. Brushing while pregnant: Along with brushing your teeth regularly, it is also important to use the right toothpaste when pregnant. Choose fluoride toothpastes and mouthwashes for your daily routine. Rinsing your mouth with mouthwash can also help curb morning sickness and erase its distaste from your mouth. Flossing can also help keep your teeth healthy. Along with this, include plenty of vitamin C and B12 in your diet to prevent dental problems.