Dr. Premendra Goyal

Tobacco has many ill effects on the health of an individual. Dental health is equally affected with use of tobacco. From dark stains to poor gum health to increased incidence of decay to the more severe effects like oral cancer, tobacco has a very detrimental effect on your dental health. Read on know more about how harmful tobacco can be on the dental system. 

1. Brown teeth and tongue: One of the tell-tale signs of a smoker are the brown teeth and stained tongue and lips. A dentist need not even be told that the person smokes, it just shows!! What is interesting is that these stains on the teeth do not easily go away with a scaling (Cleaning of teeth), they just continue to form as long as tobacco is being put into the system. 
2. Gum disease: The oral health of a smoker is definitely not at its best. With the stains on the teeth, the gums are more prone for irritation and infection. This leads to grayish, unhealthy gums. The periodontal fibers are also affected, leading to bad breath, pocket formation and even tooth mobility in severe cases. The mouth is generally drier in comparison and so bacterial growth is more favored, further accelerating the process of gum disease and teeth decay. 
3. Dental caries: The increased amount of bacteria and dryness in the mouth leads to greater incidence of dental decay. Chances of cervical decay (decay around the gum line) and root decay are higher in smokers. 
4. Bad breath: Use of tobacco in itself cause bad breath which is exacerbated by dry mouth caused by useof tobacco. 
5. Impaired taste: The tongue has a constant coating too, leaving the taste buds unable to completely taste food substances. Ask any smoker a couple of questions and you would realize how they never get to enjoy and taste the food as it should be. 
6. Poor healing: Whether it is a gum disease, a tooth removal or a root canal therapy, smokers who go for dental treatment need a longer time to respond compared to nonsmokers. If smoking is continued at the same pace, then the chances of developing a dry socket with an extraction or a failed root canal therapy are quite high. There are more failures reported in success of implant in smokers as compared to non smokers. 
7. Cancer: The most dangerous and the most severe of all, cancer of the cheek, gums, lips, tongue, roof of the mouth can all happen in smokers, twice more likely in comparison with non-smokers. 

Now, if all these are not good enough to kick the habit, remember this list is only for the mouth and the teeth. The whole body goes through a lot more harmful effects, and that should be a good reason to quit tobacco use in any form. If you need professional help, do not be embarrassed to seek.

Pregnancy is a transformation phase in itself -it brings with it changes to almost all body systems. The oral tissues and the teeth are also affected significantly. Extra precaution is required to maintain regular oral health and avoid severe decay and/or gum disease. If not avoided, the dental infections can cause severe systemic infections and require strong antibiotics, x-rays, minor surgeries, and root canal therapy which may not be safe during pregnancy.

Higher levels of estrogen during pregnancy in the blood lead to a lot of visible changes in the oral cavity -higher incidence of tooth decay, gingival and periodontal inflammation, and even minor benign tumours in some cases. The notorious morning sickness plays havoc with the person's oral hygiene habits, thereby further complicating the situation.

Prior to pregnancy: A pre-pregnancy dental check-up to look for gum health and decay would go a long way in a healthy pregnancy, from the dental point of view at least. A thorough scaling and screening for cavities done before pregnancy can help avoid dental visits during the term, other than for routine checkup.

Pregnancy: If that pre-pregnancy visit could not happen, then visiting your dentist should be one of the first things to do as soon as you have confirmed your pregnancy. At this stage, no dental treatment can be done. Any elective procedures (cosmetic, etc.) will have to be done only after delivery. If the dentist identifies no cause for worry, that is great news. However, if there are any causes for concern, like a decay, the non-invasive treatment should be done at the earliest. When you are pregnant, note the following from a dental point of view:

1. Noninvasive treatments like minor fillings can be done
2. Regular scaling and polishing is not a problem
3. Let the dentist know about all the medications you are taking
4. Visit the dentist every 3 to 4 months for a regular check-up
5. Follow good oral hygiene practices including, brushing, rinsing, and flossing
6. Switch to a bland toothpaste in case of severe morning sickness
7. Watch your diet - the teeth forming in the fetus require nutrition through you, so ensure adequate intake of minerals like calcium and potassium
8. Avoid sweets and sticky/chewy foods that can lead to plaque formation

Though dental procedures can be done during the 4th to 6th month, they are best avoided, which can be done with better planning and some minimal care.

After delivery: After the delivery of the baby, please visit your dentist to ensure you have again ensured there is no emergent dental condition requiring attention. Resume your regular dental care after delivery.
With a little planning and extra care, dental health can be managed nicely during pregnancy with minimal to no pain. If you wish to discuss about any specific problem, you can consult a Dentist.

Omega-3 fatty acids are 'good' fats that reduce cholesterol levels and 'bad' saturated fats from your body. They belong to a family of unsaturated fatty acids and are necessary for the normal functioning of the body. The body cannot synthesize omega-3 fatty acids; hence, you can get it from sources such as salmon which provides omega-3 fatty acids known as ALA (alpha-linolenic acid) and vegetable oils such as soybean oil, rapeseed oil and flaxseed oil that are rich in omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).

How can they help in gum problems?

A study, published in the Journal of the American Dietetic Association, was based on a survey called the National Health and Nutrition Examination Survey, researched and studied the effects of consumption of DHA on dental health. After studying data from over 9000 participants, researchers found that the people, who consumed the highest amount DHA amongst all, were 20% less prone to developing periodontitis.

Periodontitis is an inflammatory gum disease caused by bacteria that accumulate around the gums. It causes the gums to recede, leading to the development of gaps between the gums and teeth and loss of bones that provide support to the teeth. Periodontitis may even cause tooth loss.

The research showed that even consuming a small amount of omega-3 fatty acids offered protection against gum diseases. Omega-3 fatty acids have anti-inflammatory properties, which help relieve inflammation of gums that occurs in periodontitis. Researchers from Kentucky University found that omega-3 fatty acids have anti-bacterial properties, which prevent and cure gum diseases. Gum diseases have been related to other conditions such as heart disease, pneumonia and diabetes, hence keeping gum diseases at bay keeps other fatal diseases away as well. If you wish to discuss about any specific problem, you can consult a Dentist.

Hi friend, I am  Dr Goyal. I am a dentist from Mumbai India. Tday I will talk about cavities and dental caries as we call it. This is the condition which is affecting almost everyone in some or the other form. Most commonly seen in children and teens even adults post 50 years of age are not insulated from this sort of problems , because the moment the gums start to go down we start getting cavities on the root surfaces of our teeth.

How do these cavities form?

We have a lot of normal bacteria in our mouth which use up the food staff which we eat and form a thin film called plaque on our teeth. This plaque thermos the acid which in turn removes the calcium from the enamel of our tooth making the tooth soft and susceptible to removal by any means. The best way to keep our mouth free of cavities is to clean our mouth after eating anything, that has been always told by everyone. But there is more, this give and take of calcium from enamel is always going on. The moment we eat something the acid levels of our saliva goes up which removes the calcium from our tooth but at the same time the same saliva is going on replenishing this calcium and phosphate iron in our teeth. If this balance is broken the moment the removal of calcium is more, then the resupply of calcium we end up getting cavities.

The best way to avoid this is to limit the number of meals e have per day. It is recommended to have not more than four meals a day . after every meal we need to clean our mouth properly possibly brush our teeth but at the same time it is very important to note that we should not brush our teeth immediately after eating because that is when the saliva is more acidic leaving our enamel more susceptible to damage by brushing itself. Brushing itself may cause lot of damage so wait for a few minutes before you brush your teeth. If it is not possible to brush atleast rinse your mouth forcefully there are lot of fluoridated toothpaste available in India also which have a formulation called as anti k which lets our saliva carry more calcium and phosphate which will repair the damage which has been done by the acids on the enamel . all in all get into a healthy habbit of brushing after every meal , eat healthy food , avoid very sticky food avoid too many colas avoid too many chocolates and you can get rid of habbit of cavity formation and be healthy.

Thank you very much for more information you can contact us via lybrate .

Hi friends, this is Dr Goyal from Mumbai, I am a dentist. I am here to talk about the most complicated topic which is the least discussed topic in dentistry is bad breath.

Studies have shown that more than 50% of people suffer from bad breath at some or the other time in their life. Bad breath as we in our language call Halitosis, can be because of a barrage of reasons there can be a lot of reasons for bad breath something like bacteria which are there in our mouth, they are there in the mouth always. When we feed them with a lot of food stuff which we don’t clean from our mouth they eat up that food causing a lot of bad breath, the second can be dry mouth which may happen because of dehydration certain medicines or some other reasons which are not letting you saliva form. Gum disease can form a lot of bad breath. There is certain food stuff which can cause bad breath, something like garlic onions they can give you bad breath, some unhealthy lifestyle habits like smoking, tobacco chewing can cause a lot of trouble. Then there are systemic diseases which can lead to bad breath, the systemic diseases may be something like diabetes, sinusitis or gastro oesophagal reflux which can lead to bad breath.

Now that we know what causes bad breath let us try and understand how we can control this bad breath. First and foremost comes to the healthy habit of keeping our mouth clean after eating anything after consuming anything we need to clean our mouth, brushing after every meal may not be possible it is recommended but not possible many times, at least rinse your mouth forcefully to remove all your food stuff. In case you notice your gums bleeding or any other problem developing in your mouth please visit your dentist who can rectify the problem at the earliest. Get rid of bad habits like smoking tobacco chewing which will cause many other complicated problems other than bad breath. If your dentist finds that your bad breath is not controlled even after you have a healthy mouth he may suggest you a medical opinion where in your systemic problems can be diagnosed and treated by your physicians. Keep the saliva flowing always keep consuming small sips of water throughout the day to stop your mouth from drying, you can consume healthy foods like carrots, cucumbers of and on throughout the day which will help you produce more and more saliva, which will keep your mouth clean and let you avoid bad breath.

I hope this video helps you in taking care of bad breath.

Thank you very much for more information you can contact us via lybrate.

Thank you.

Cavities, or tooth decay, is the destruction of your tooth enamel, the hard, outer layer of your teeth. It can be a problem for children, teens and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and over time the enamel can break down. This is when cavities can form. 

A cavity is a little hole in your tooth. Cavities are more common among children, but changes that occur with ageing make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. 

It’s common for people over age 50 to have tooth-root decay. Decay around the edges, or a margin, of fillings is also common for older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay. 

You can help prevent tooth decay by following these tips: 

1. Brush twice a day with a fluoride toothpaste.
2. Clean between your teeth daily with floss or inter dental cleaner.
3. Eat nutritious and balanced meals and limit snacking.
4. Check with your dentist about the use of supplemental fluoride, which strengthens your teeth, and about use of dental sealants (a plastic protective coating) applied to the chewing surfaces of the back teeth (where decay often starts) to protect them from decay. 

Consult a dentist regularly for professional cleanings and oral examination.

If you are advised to wear braces, it could be due to crooked / improperly positioned teeth which are not cosmetically pleasing or are not very efficiently chewing the food. Today, there is a big variety of braces available to correct the problems. Although all braces serve a similar purpose, but not all braces are suitable for everyone. Here, I am trying to explain some of the types of braces available, which will help you in a better understanding of braces. 

1. Metal braces: These braces are placed in the outer side of the teeth . A wire is then placed in the brackets which helps in realigning your teeth. This wire needs to be replaced from time to time with other wires usually the wires are replaced in 4 to 6 weeks. This type of braces are the most are the most affordable of the lot and thereby the most common choice. 
2. Ceramic braces: These types of braces are very similar to the metal braces in terms of functionality. The advantage of ceramic braces is that they resemble the colour of the teeth and are less noticeable. These braces are costlier than their metal counterpart and take a longer time to mount. One common complaint about these braces is that they become yellowish over time. It is therefore very important to clean your teeth properly on a daily basis. 
3. Lingual braces: Lingual braces mounted at the back of the teeth. As a result, these braces are hardly visible. They are typically recommended to those whose teeth are not very crooked and the amount of teeth straightening required is very less. These braces are ideal for those patients who require an orthodontic device for a long time. They require very good oral hygiene and are also expensive when compared to other braces. 
4. Damon braces / Self-ligating braces: Damon braces can be mounted on any patient who is fit to get for regular braces. These braces do not require any extra attachment for holding the wire in place. The wire can straight away pass through the brackets making the treatment time shorter by a good six months or so. The healing process tends to be faster with these braces and is one of the easier ones to mount onto the teeth. 

They are costing almost close to the cost of the lingual braces. These details are to give you a broad overview of the types of fixed braces available. Your orthodontist will be able to discuss the pros and cons of each after analysing the changes needed and desired. If you wish to discuss about any specific problem, you can consult a dentist.

You often get into this mess of losing part or whole of the tooth, and this is actually a nasty situation in several ways. You may get severe pain there, or the sharp edge of the broken tooth may cut the cheek and other areas of the skin in the mouth while chewing or biting. Besides, if left untreated the broken part may accumulate dirt and food particles can later turn into serious infections in the gum too. It looks bad too when a front tooth is broken, and often leaves your inner lips with cuts and abrasions when the sharp edge of the broken tooth rips off skin inside the mouth as you chew. 

The first aid part 

There are several ways to manage a broken tooth, and the initial steps of first aid after the incident are as follows: 

1. To control the acute pain after a tooth breaks, you may take a painkiller like paracetamol (if you have no known allergy to the same). This will soothe the pain, and make it much easier and bearable. 
2. You may try sticking some sugarless chewing gum on the tooth to prevent the edges from cutting inside the mouth. In case a gum is not available, you may try putting some simple wax in there. 
3. Try to have food which will require less of chewing, or go on a liquid diet. This will help prevent any further damage to the tooth and surrounding tissues. 

Filling and Bonding- The initial treatment 

On going to the dentist, based on the severity, you will be suggested various remedies. A tooth filling or bonding is generally the remedy. If a small portion of the tooth is broken, then the tooth can be simply filed. In case it is one of the rear teeth, the tooth will be chipped and filed to smoothen the cut edge so that it never again pokes the skin around. If the break is not small, then bonding is a good option. The dentist fills the rest of the tooth space with a resin or porcelain material to make it look whole and natural again, and this solves the problem both physically and cosmetically. 

Crowning the tooth 

If the tooth is damaged till the nerve, root canal treatment may be needed, and thereafter a cap or crown is placed over the broken tooth. This restores both natural looks and the strength to chew. 

What happens in case the entire front tooth of my child pops out of the mouth?

Do not panic in such a situation. Time is of utmost importance in such conditions. Pick the tooth from the crown portion (the portion which is visible in the mouth) and wash it under the gentle flow of tap water. After that, preserve the tooth in saline or milk. If a clean container is not available and the child is conscious, the tooth can be preserved under the tongue. Once this emergency measure is taken, rush to the dentist as soon as possible. The same tooth can be replaced (replanted) in its original position. The success of this procedure will be much more predictable if the tooth is replaced in its original place within the first few minutes. If you wish to discuss about any specific problem, you can consult a dentist.

Brushing and flossing are the best ways to help prevent cavities, but it’s not always easy to clean every nook and corner of your teeth – especially those back teeth you use to chew (premolars & molars). Premolars & Molars are rough, uneven and a favorite place for leftover food and cavity-causing bacteria to hide. There is another safety net to help keep those teeth clean. It’s called a sealant.

Sealant is a thin, protective coating (made from plastic or other dental materials) that adheres to the chewing surface of your back teeth. They’re no substitute for brushing and flossing, but they can keep cavities from forming and may even stop early stages of decay from becoming a full-blown cavity. In fact, sealants have been shown to reduce the risk of decay by nearly 80% in molars. This is especially important when it comes to your child's dental health. 

Who can get Sealants? 

Children and adults can benefit from sealants, but the earlier you get them, the better. Your first molars appear around age 6, and second molars break through around age 12. Sealing these teeth as soon as they come through can keep them cavity-free from the start. 

How are dental sealants applied? 

It’s a quick and painless process. Your dentist will clean and dry your tooth before placing an acidic gel on your teeth. This gel roughs up your tooth surface so a strong bond will form between your tooth and the sealant. After a few seconds, your dentist will rinse off the gel and dry your tooth once again before applying the sealant onto the grooves of your tooth. Your dentist will then use a special blue light to harden the sealant. 

How do Sealants Work? 

When the cavity-causing bacteria that live in everyone’s mouth meet leftover food particles, they produce acids that can create holes in teeth. These holes are cavities. After sealant has been applied it keeps those bits of food out and stops bacteria and acid from settling on your teeth. It is never too late to protect yourself. Ask us today about Sealants, to keep your teeth healthy and decay free. If you wish to discuss about any specific problem, you can consult a dentist.

Is the taste of ice cream or a sip of hot coffee sometimes a painful experience for you? Does brushing or flossing make you wince occasionally? If so, you may have sensitive teeth.

Possible causes include:

• Tooth decay (cavities)

• Fractured teeth

• Worn fillings

• Gum disease

• Worn tooth enamel

• Exposed tooth root

In healthy teeth, a layer of enamel protects the crowns of your teeth—the part above the gum line. Under the gum line a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin. 

 

Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.

Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity. Your dentist may suggest one of a variety of treatments:

• Desensitizing toothpaste. This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced.

• Fluoride gel. An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.

• A crown, inlay or bonding. These may be used to correct a flaw or decay that results in sensitivity.

• Surgical gum graft. If gum tissue has been lost from the root, this will protect the root and reduce sensitivity.

• Root canal. If sensitivity is severe and persistent and cannot be treated by other means, your dentist may recommend this treatment to eliminate the problem.

Proper oral hygiene is the key to preventing sensitive-tooth pain. Ask your dentist if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity.

Know how Root Canal treatment helps to save a tooth

Hi friends I am doctor Premendra Goyal. Lot of questions are asked to us about whether to save a tooth or to extract it. I will talk to you about root canal treatment today which is a treatment by which we can save your tooth and it can serve for a lifetime with good maintenance. A tooth basically is a lot of hard tissue with some tissue in the center, you can it the heart of your tooth which in our language is called as pulp and layman end up calling it something as nerve. Once that nerve or pulp portion of your tooth is exposed to the oral cavity in some way may be a fracture of your tooth, may be decay, cavities- as we call them, once the heart of your tooth, the pulp of your tooth, the nerve of your tooth is exposed to the oral cavity your tooth is in danger. Tissue goes bad, infection travels, it goes deeper and it enters your bone area.

Now to save that tooth or not that is the first question that comes to the mind. By saving that tooth we are saving the natural thing that nature has given us. We have been trying to replace or replicate what nature has given us, but 100% replication of what nature has given us is not possible till date. So the best option is always to save a natural thing, and that can be easily done by root canal treatment. In root canal treatment I will try to explain in as simple language as simple the procedure is for the patient. I will reiterate- for the patient, for the clinician or for your dentist it definitely is a process which involves a lot of intricacies but for a patient it is a very simple procedure, wherein local anesthesia is given and the area is numbed and you don’t feel any pain when you undergo the treatment.

A small hole is drilled on the top of the tooth, if it is a grinder, if it is the front tooth the hole is drilled on the back side of your tooth and the nerve area is accessed. And through small instruments the inside and the root area of your tooth is cleaned, up it is shaped, it is disinfected with lot of medicaments and then it is finally filled up with artificial material and then your tooth is restored to normalcy with a cap sometimes or a post which is a support inside the root and building up with the tooth canal material or a material of your choice.

I will give you a broad overview about how a root canal treatment goes about in the pictorial representation. (Displaying pictures) Suppose this was the decayed tooth, a small opening is made on the top of the tooth, we enter the tooth with small instruments, and with the advent of newer technologies it is possible today to complete your root canal in one single sitting, a half an hour to 45 minute appointment and you can end up with a painless tooth. First the root canal is cleaned, it is disinfected with certain medicaments, a artificial filling is placed in the root and then the tooth is restored on the top. So the question of whether to save a tooth or whether to extract it ends up with a proper restored tooth which works for a very long time serving you, thank you.

For more information you can contact us via Lybrate.

Most of us suffer from some or the other dental problem in our lifetime. Majority of these problems are attributed to tooth decay. Tooth decay or cavities occur when bacteria living in the mouth produce a strong acid that slowly deteriorates the health of the teeth. If left untreated such decays will lead to infection, causing extreme pain and eventually tooth loss. To prevent this, dental fillings are done. Fillings are also used to repair broken or cracked teeth. Here is everything you need to know about fillings. 

What is a Dental Filling?
A dental filling is one of the most commonly used methods that can restore the normal functioning and shape of the tooth, which may have been damaged due to tooth decay. These fillings close off the spaces where bacteria can set in and cause further decay. This protects the surrounding tissues too as food and bacteria accumulated in cavities can harm gums too. 

Procedure of Dental Filling: 
Before a filling session, the dentist will carry out proper assessment of your teeth. Dental X-rays may be used to ascertain the extent of the damage. This can be followed by a procedure with which the dentist will clean out the affected area of the tooth. After the decay has been cleaned out, the cavity will be filled with desired filling material. 

Types of Dental Fillings: 
There are various kinds of dental fillings. Let us find out a little bit about each kind. 

1. Gold Filling: These are made in a laboratory before they are cemented in place. These fillings are known to last over two decades thanks to the fact that they are tolerated exceptionally well by the gum tissue. This is also an expensive option, which will require multiple visits to the dental clinic. 
2. Amalgam Filling: These are also known as silver fillings and are usually an alloy containing tin, silver, and other metals, which bond well with the teeth. Many Dentists today are advising against the use of these fillings as it has been proved that mercury content in these fillings can harm the body.
3. Composite Resin Filling: These kinds of fillings are matched to the colour of your teeth for a natural appearance. These are the most commonly uses fillings today as they fulfill most of the criteria we would desire from a dental filling. 
4. Porcelain Filling: These are known as inlays or onlays. These fillings are used in restorations where a large part of the tooth structure has been lost. If you wish to discuss about any specific problem, you can consult a dentist and ask a free question.

What is a root canal?

Root canal is a layman's term to describe a dental procedure that is performed to preserve a tooth that is at risk of being lost due to deep decay, infection, or other forms of trauma. Endodontic therapy or root canal treatment are the dental terms to describe this procedure. Root canal treatment is the removal of the infection-prone contents within the tooth and its roots. Subsequently, the resulting space is filled with an inert material to prevent infection. This treatment thoroughly disinfects the tooth's inner space. Root canal treatment enables a tooth to remain intact to function and serve its purpose in the mouth despite losing its vitality. Vitality is the tooth's ability to sense pain, pressure, or temperature. Prior to the implementation of root canal treatment, if a tooth had a large cavity or was abscessed, the only option was extraction of the bad tooth. All in all with Root Canal Treatment, we get to preserve a natural tooth and restore good dental health.