Dr. Srushti Shaha

If we think about what attracts us to a person in general, the first thing that we can think of is a great, warm smile. A good set of well-aligned white teeth is an important aspect of this great smile. However, white teeth remain an elusive thing for most of us. Some of the common reasons for discolored teeth are as below.

1. Ageing
2. Hypo mineralized tooth structure
3. Fluourosis
4. Food habits
5. Tobacco smoking/chewing (learn more for Smoking  Effect on Teeth)
6. Side effects of medication (tetracyclines, for instance)

The degree of discoloration varies widely and also is hereditary. Whatever the reasons, there is the option of tooth whitening, which is effective with optimal oral health and good oral hygiene habits. Tooth whitening is not for everybody though, the following are the definite contraindications.

1. Teeth with fillings: The bleaching agents work best on natural tooth structure. Whether it is a crown or a veneer or a bridge, the bleaching agent will not work on these tooth-colored fillings and composite resins. On the contrary, using bleaching agent on a tooth filling can produce uneven whitening. The teeth without fillings will appear lighter than those with fillings. If the person has discoloration due to fluorosis or any other reason, then it is ideal to complete any pending restorative work before initiating tooth whitening procedure. This should be allowed to settle in for about 2 weeks. After that, whitening should be undertaken which will ensure the best results and match with the composite filling/veneer/crowns. In people with multiple restorations, whitening can result in uneven coloration of the teeth and so veneers or crowns would be better suited than whitening.
2. Sensitive teeth: Sensitivity is an indication that the dentin is exposed or is covered by a very thin layer of enamel. Whitening agents will not work very well in these cases.
3. Poor oral health (gingivitis, worn enamel, cavities, and root decay): The whitening agent can irritate the gums or penetrate the existing decay or worn enamel leading to sensitivity. The tooth whitening agent works on the enamel, and as the tooth surfaces do not have enamel, they do not produce a whitening effect.
4. Age: Hydrogen peroxide which is the most common bleaching agent is not safe for use in children below 16 years of age. The pulp chambers are quite high and the tooth is still forming, so bleaching agents are not to be used.

While choosing to go for tooth whitening, one thing to bear in mind is that it is not a permanent solution to discolored teeth and might require repetition of the treatment. Having a detailed discussion will help set realistic expectations and achieve optimal results.
 

Remember the sensation similar to that of a warm liquid flooding your tongue when you smell a deliciously baked chocolate cake? Or a freshly baked brown bread early in the morning? That is your saliva. The salivary glands present in the inner linings of the lips, cheeks and the mouth produce saliva. Saliva protects one from tooth decay, keeps the mouth moist and helps in the digestive process. Any disease that affects the saliva gland comes under the domain of ‘salivary gland disorders’.

Causes

There are three salivary glands in humans known as the Submandibular, Parotid and the Sublingual gland. The most common disorder that affects salivary glands is that of ‘blocked salivary glands’. Sialothiasis is a disorder wherein, calcium stones are formed in the salivary glands, which obstruct these glands. Obstruction of the salivary glands leads to an infection called sialadenitis, caused by strep or staph bacteria.

Sjogren’s syndrome is another condition which affects the salivary glands. In this condition, the antibodies in the body target the cells that produce saliva. This occurs mostly in women who suffer from autoimmune disorders. Viral infections are also common; flu virus and mumps are a few examples.

Symptoms

The symptoms of salivary gland disorders are problem specific; for Sialolithiasis, you will feel a painful lump below the tongue, which tends to aggravate when you eat. In case of Sialadenitis, there will be an odorous pus-filled discharge along with a lump beneath the chin. For viral infections, the symptoms will include muscle pain, swelling and fever. Symptoms of Sjogren’s syndrome are dry eyes and mouth, joint pain, fatigue and tooth decay.

Treatment

Like the symptoms, the treatments for salivary gland disorders are also problem specific. For salivary gland tumors, surgery is required. If it is a malignant tumor, then radiation therapy will be prescribed which may cause dry mouth syndrome (Xerostomia). For bacterial and viral infections, anti-bacterial and anti-viral medications are required for treatment, respectively. It is also important that you take good care of your oral health for an even more effective treatment. Brushing and flossing your teeth on a regular basis will help keep salivary gland disorders at bay. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.