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Dental Prophylaxis Tips

Dengue prophylaxis by Homoeopathy

Dr. Arpit Chopra 90% (509 ratings)
MD - Homeopathy, BHMS
Homeopath, Indore
Dengue prophylaxis by Homoeopathy
For dengue prophylaxis take homoeopathic eupatorium perf 1 m two doses in single day as prevention is better than cure.
24 people found this helpful

PEP (Post-Exposure Prophylaxis) in HIV

Dr. Ashutosh Upadhyay 94% (477 ratings)
MBBS, PGDHIVM (HIV Medicine)
General Physician, Delhi
PEP (Post-Exposure Prophylaxis) in HIV

PEP (Post-Exposure Prophylaxis) in HIV.

First of all we should know what PEP is?

PEP stands for Post-Exposure Prophylaxis. It means things to be done if anyone gets exposed to HIV. PEP consists of a combination of ARV (Anti-Retroviral) drugs which is given for a complete duration of 28 Days.

If any person (male/female/transgender) comes in contact with a person who might be having risk of HIV infection, then in such case the former have chance of getting HIV infection too. Such person falls in the category of clients who should start PEP depending upon the risk of transmission and mode of exposure.

What Are the Modes of Exposure?

  1. Sexual contact with a Commercial Sex Worker OR with an unknown person whose HIV status is not known. Examples.-
  1. In case of unprotected sex or
  2. Condom bursts while having protected sex
  1. Needle prick injury OR injury from sharp object (blades) from unknown source. Examples.-

  1. People taking drugs by sharing same needle/syringe or
  2. People working in laboratory and getting needle prick from infected blood or
  3. Accidental needle prick from an unknown source or
  4. Cut by used Blades in barber shop.

What to “DO” in such circumstances?

Previously there were no options available for persons who by any means gets exposed to HIV.

But due to recent advances, now we have a set of medicines available which are very much beneficial in such conditions.

So any person getting into such circumstances knowingly or unknowingly SHOULD visit a HIV Specialist for management as soon as possible (it should be within 72 Hours), because the PEP is beneficial only if started early (maximum within 72 Hours).

By doing this we can PREVENT patients from getting HIV infection.

Always Remember Prevention Is Better Than Cure.

6 people found this helpful

How Post Exposure Prophylaxis (PEP) Can Help With HIV?

Dr. Vikram Jeet Singh 89% (26 ratings)
MD - Physician, PG Diploma Diabetes, MBBS Bachelor of Medicine and Bachelor of Surgery
General Physician, Delhi
How Post Exposure Prophylaxis (PEP) Can Help With HIV?

When you are potentially exposed to HIV, and if there is a way to prevent from getting infected, you will seek to perform it. One such procedure is Post Exposure Prophylaxis (PEP) which must be initiated within 72 hours of possible exposure to HIV.

What is PEP meant for?
The Human immune deficiency virus causes HIV infection that affects the immune system and is considered to be one of the deadly forms of infections. This virus spreads through bodily fluids such as blood, semen, vaginal fluids and breast milk. There are chances of encountering the infection under the circumstances such as having sexual intercourse or sharing needles with an infected person by accident. In such a case, PEP (Post Exposure Prophylaxis) can come to your aid in preventing the infection.

The medical term PEP refers to the intake of ARV or antiretroviral medicines after being exposed to the human immunodeficiency virus. To be more specific, PEP is a short-term antiretroviral treatment that works towards reducing the symptoms and likelihood of the HIV infection after being exposed to it.

Who should opt for PEP treatment?
PEP can be ideal for everyone who comes in contact with the HIV and is an HIV negative. Whether one is exposed to HIV through a needle stick injury during his/her work as a health care professional, or whether it’s unprotected sex that has exposed one to HIV, or the sharing of used needles or through sexual assault, opting for the PEP can be the next best step as it is particularly meant for emergency situations.

When and how long PEP can be taken?

As per the research, PEP should be taken within 3 days or 72 hours from the possible time of being exposed to HIV. If taken after 72 hours, the PEP most likely cannot help in preventing the HIV infection, hence the sooner, the better in this case. The course of PEP involves 3 ARV or more per day for almost 28 days. Along with taking the ARV medications, one must visit his/her health care professional at certain intervals for HIV testing and other related tests.

Are there any side-effects of taking PEP?
When opting for PEP treatment, some people may experience a few side effects due to it, which varies from person to person, such as vomiting, nausea, headaches, diarrhea, fatigue, etc. However, none of the side effects are life-threatening and can be easily treated. Often, it is due to the reaction of the PEP medications with other drugs that one is taking at the same time that the side-effects start showing. Moreover, as PEP can potentially prevent HIV infection, this benefit certainly outweighs the inconvenience caused as side effects.

PEP is considered to be one of the most effective and promising treatments available for preventing HIV infection if taken correctly and within the certain time duration. In case one thinks he or she has been exposed to HIV somehow, talking to a health care professional regarding PEP becomes crucial.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2976 people found this helpful

Pre-Exposure Prophylaxis - How It Can Help You?

Dr. R.Pavan Kumar 88% (39 ratings)
MBBS, PGDHS,PGDHIVM
General Physician, Nalgonda
Pre-Exposure Prophylaxis - How It Can Help You?

Pre-exposure prophylaxis is a treatment method for people who do not have the HIV infection but who might be facing a considerable risk of contacting the disease. It is done by taking one pill daily. The pill comprises of two medicines i.e. tenofovir and emtricitabine. These two are combined with other drugs in order to treat HIV. When a person is exposed to HIV, be it through sexual intercourse or shared needles, these drugs help in stopping the infection from reaching an advanced stage.

Dosage and use
When the drug is consumed on a regular basis, pre-exposure prophylaxis has been observed to decrease the risk of HIV infection in individuals with increased risk by up to 92%. Pre-exposure prophylaxis is not as effective when not taken on a consistent basis.

Advantages

  1. It can actually help patients: While many still consider it to be a farce, pre-exposure prophylaxis has been proven to reduce the risk of HIV infection transmitted from unprotected sex. Recording a success rate of over 90% in that field, Pre-exposure prophylaxis has been proven to show a success rate of 70% in people who inject drugs in their body. These results could be a reflection of individuals on being consistent in this treatment method. For people who are forced to limited possibilities to protect themselves from the HIV virus, pre-exposure prophylaxis permits them to control their risk of contacting HIV.
  2. Affordable: The PrEP drug costs are lesser than HIV treatment when analyzed at both per-dose and duration of use levels. Furthermore, PrEP is prescribed on a consistent basis, only when an individual is facing a heightened risk of HIV. But if an individual contracts HIV, they will be required to be a part of the Antiretroviral Treatment (ART) process for the rest of their lives in order to stay in good physical shape. A PrEP program is projected to cost less than 5% of an average HIV program’s entire budget.

In case you have a concern or query you can always consult an expert & get answers to your questions!

 

3370 people found this helpful

What Is Post Exposure Prophylaxis?

Dr. Vinod Raina 89% (5853 ratings)
MD - General Medicine
Sexologist, Delhi

Post exposure prophylaxis(PEP) is a systemic treatment in which we can save life of a patient and help him to prevent from being HIV positive. Any possible exposure which will lead to HIV infection including sexual intercourse with sex worker and during that condom get burst or having intimate massage at massage parlor, the person is exposed to direct contact that can lead to the possible exposure to HIV.

2 people found this helpful

What Is Post-exposure Prophylaxis?

Dr. Vinod Raina 89% (5853 ratings)
MD - General Medicine
Sexologist, Delhi
What Is Post-exposure Prophylaxis?

What is post-exposure prophylaxis?

With PEP, an HIV-negative person who may have been exposed to HIV takes anti-HIV drugs prescribed by a doctor to prevent infection. These are the same drugs that people living with HIV take. PEP involves taking two or three of these drugs for a period of one month. To effectively reduce a person’s risk of becoming HIV-positive, PEP must be taken within 72 hours of possible exposure to HIV but ideally as early as possible.  

In the world of PEP, exposure to HIV is often divided into two categories: occupational exposure and non-occupational exposure. “Occupational” exposure refers to exposure to HIV at work, in a healthcare setting. For example, a healthcare provider could be exposed to HIV through a needlestick injury at work. “Non-occupational” exposure refers to exposure to HIV through sex or drug use, for example, when a person shares a needle or has sex without a condom.

What is the rationale for PEP?

In the first one to three days following exposure to HIV, there is a ‘window of opportunity’ when taking PEP might prevent an HIV infection from occurring.1 During this ‘window of opportunity,’ the virus is busy infecting cells at the site of exposure (such as in the anus, penis or vagina). Once the virus is inside a cell, it starts replicating to produce more HIV (also known as virions). After a few days, these new HIV virions start to spread throughout the body; once this happens, infection is permanent. The theory is that if PEP is given to a person early enough, it can stop the virus from replicating at the initial site of exposure, preventing virions from spreading throughout the body – stopping the infection from becoming permanent. The cells that initially became infected would eventually die out and the virus would not be able to replicate.   

What is the evidence on PEP?

There is some evidence that suggests that providing PEP after a potential exposure to HIV can help reduce a person’s risk of HIV infection. However, we also know that PEP is not 100% effective, meaning that it will not prevent all HIV infections.

Learn more about the evidence on PEP

What does someone need to know to access PEP?

People at risk need to know that PEP exists. If people are unaware of PEP, they won’t know that PEP is an option in the event of a high-risk behaviour that could result in being exposed to HIV. Very little research has been done to determine how many people are aware of PEP; however, based on the research that has been done, it seems that only a small proportion of gay and heterosexual men and women, even in cities with well-established PEP programs, are aware of PEP.9,10,11,12

People at risk need to know that time is of the essence. The later someone starts PEP, the less likely it is to prevent HIV infection. The best time to start PEP is immediately after exposure. However, PEP has some ability to prevent HIV infection up to 72 hours after infection.

People at risk need to know where to go. PEP must be prescribed by a doctor. Since time is of the essence, people need to be able to access services that are always open, such as emergency rooms. As a service provider, it may be important for you to know if there is a physician or healthcare facility in your area willing to prescribe PEP. If there isn’t, perhaps your organization can inform local clinicians of PEP and push for access to PEP for your clients.

Anyone accessing PEP will be tested for HIV. PEP is used to prevent HIV, not to treat it. People who go to a healthcare facility for PEP will be tested for HIV. They will still be prescribed PEP while the test results are pending; however, if the result is positive, PEP may either be discontinued or the anti-HIV drugs may be changed to HAART (highly active antiretroviral therapy) to treat the person’s HIV infection.

PEP can be costly and it may have to be paid for out of pocket. The cost of a full course of PEP is approximately $1100 to $1500. PEP may be covered by some private insurance plans and some public health insurance plans, depending on the province and the nature of the exposure. However, many at-risk individuals may not have access to any drug coverage and may not be able to afford it. There may be a need for advocacy in your area or province to fight for universal access to PEP.  

People on PEP may experience side effects. Depending on the anti-HIV drugs prescribed, people may experience side effects from PEP, such as fatigue, nausea or diarrhea. This can cause people to stop taking their PEP drugs as prescribed, which can decrease the ability of the medications to prevent HIV infection and increase the likelihood of being infected with a drug-resistant strain of HIV.

People on PEP have to be monitored by a doctor. Testing for toxicity will be required to make sure the drugs are not causing harm to the body. The type of tests may differ depending on the anti-HIV drugs that are prescribed but would likely include liver and kidney tests.

PEP can fail to prevent HIV infection if someone doesn’t take the anti-HIV drugs as prescribed. Taking the anti-HIV drugs exactly as prescribed (also known as adherence) is central to the success of PEP. If someone doesn’t take their PEP as prescribed, then HIV infection could occur. There are two issues with adherence:

Some people might start PEP but stop using it early (before the four weeks are over). In research studies 24% to 78% of people who started PEP stopped taking it early.13
Some people may not take their PEP exactly as prescribed. For example, some people may occasionally forget doses, or take only every second dose.  
Drug resistance can develop if a person doesn’t take the anti-HIV drugs as prescribed. If a person becomes HIV-positive due to non-adherence, they may develop drug resistance. When someone does not take PEP as prescribed, the amount of anti-HIV drugs in the blood can be too low to suppress the HIV, which can allow the virus to evolve and develop resistance. It is important to understand that infection with a drug-resistant strain of HIV limits a person’s future treatment options. If a person with a drug-resistant strain of HIV subsequently infects someone else with HIV, drug resistance spreads within the community.

Community agencies can provide adherence support for people on PEP by providing ongoing consultation and encouragement to help people take PEP exactly as prescribed and to complete their treatment.

PEP may fail to prevent HIV infection due to drug resistance. If a person is exposed to a drug-resistant strain of HIV and the person is prescribed the drug they are resistant to, as part of their PEP regime, then PEP may fail to prevent HIV infection. Unfortunately, there is no way to know within the first one to three days if someone has been exposed to drug-resistant HIV.
 

Why Dental Cleaning and Polishing???

Dr. Isha Malhotra 93% (6103 ratings)
BDS
Dentist, Gurgaon
Why Dental Cleaning and Polishing???

What are dental cleanings (scale and polish) and why have them?

Dental cleanings involve removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time. Your teeth are continually bathed in saliva which contains calcium and other substances which help strengthen and protect the teeth. While this is a good thing, it also means that we tend to get a build-up of calcium deposits on the teeth. This chalky substance will eventually build up over time, like limescale in a pipe or kettle. Usually, it is tooth coloured and can easily be mistaken as part of the teeth, but it also can vary from brown to black in colour.

If the scale or calculus (tartar, as dentists like to call it) is allowed to accumulate on the teeth it will, unfortunately, provide the right conditions for bacteria to thrive next to the gums. The purpose of the cleaning and polishing is basically to leave the surfaces of the teeth clean and smooth so that bacteria are unable to stick to them and you have a better chance of keeping the teeth clean during your regular home care.Also it leaves your teeth feeling lovely and smooth and clean, which is nice when you run your tongue around them. Actually, come to think of it, there's nothing worse than someone you fancy running their tongue around your teeth and finding a piece of spinach or something! Still, if they're hungry

The professional cleaning of teeth is sometimes referred to as prophylaxis (orprophy for short). It's a Greek word which means 'to prevent beforehand' - in this case, it helps prevent gum disease.

How are dental cleanings done?

The dental hygienist or dentist uses specialized instruments to gently remove these deposits without harming the teeth. The instruments which may be used during your cleaning, and what they feel like, are described below.

Ultrasonic instrument

Commonly used first is an ultrasonic instrument which uses tickling vibrations to knock larger pieces of tartar loose. It also sprays a cooling mist of water while it works to wash away debris and keep the area at a proper temperature. The device typically emits a humming or high pitched whistling sound. This may seem louder than it actually is because the sound may get amplified inside your head, just like when you put an electric toothbrush into your mouth.

The ultrasonic instrument tips are curved and rounded and are always kept in motion around the teeth. They are by no means sharp since their purpose is to knock tartar loose and not to cut into the teeth. It is best to inform the operator if the sensations are too strong or ticklish so that they can adjust the setting appropriately on the device or modify the pressure applied.

With larger deposits that have hardened on, it can take some time to remove these, just like trying to remove baked-on grime on a stove that has been left over a long time. So your cleaning may take longer than future cleanings. Imagine not cleaning a house for six months versus cleaning it every week. The six-month job is going to take longer than doing smaller weekly jobs.


Fine hand tools

Once the larger pieces of tartar are gone, the dental worker will switch to finer hand tools (called scalers and curettes in dental-speak) to remove smaller deposits and smoothen the tooth surfaces. These tools are curved and shaped to match the curves of the teeth. They allow smaller tartar deposits to be removed bycarefully scraping them off with a gentle to moderate amount of pressure. Just like taking a scrubbing brush to a soiled pot, the dental worker has to get the areas clean and smooth.

Polishing

Once all the surfaces are smooth, the dental worker may polish your teeth. Polishing is done using a slow speed handpiece with a soft rubber cup that spins on the end. Prophylaxis (short for prophy) paste - a special gritty toothpaste-like material - is scooped up like ice cream into the cup and spun around on the teeth to make them shiny smooth.

Fluoride


Your dentist may also apply fluoride. This is the final, and my favorite part of the dental cleaning! Fluoride comes in many different flavours such as chocolate, mint, strawberry, cherry, watermelon, pina colada and can be mixed and matched just like ice cream at a parlour for a great taste sensation! Make no mistake though, this in-office fluoride treatment is meant for topical use only on the surfaces of the teeth and swallowing excessive amounts can give a person a tummy ache as it is not meant to be ingested.

Fluoride foam or gel is then placed into small, flexible foam trays and placed over the teeth for 30 seconds. Afterwards, the patient is directed to spit as much out as possible into a saliva ejector. The fluoride helps to strengthen the teeth since the acids from bacteria in dental tartar and plaque will have weakened the surfaces. It is best not to eat, drink or rinse for 30 minutes after the fluoride has been applied.

Is it going to be painful?

Most people find that cleanings are painless, and find the sensations described above - tickling vibrations, the cooling mist of water, and the feeling of pressure during 'scraping' - do not cause discomfort. A lot of people even report that they enjoy cleanings and the lovely smooth feel of their teeth afterwards! There may be odd zingy sensations, but many people don't mind as they only last a nanosecond.

Be sure to let your dentist/hygienist know if you find things are getting too uncomfortable for your liking. They can recommend various options to make the cleaning more enjoyable.

Painful cleaning experiences can be caused by a number of things: a rough dentist or hygienist, exposed dentine (not dangerous, but can make cleanings unpleasant), or sore gum tissues.

In case you may have had painful cleaning experiences in the past, switching to a gentle hygienist/dentist and perhaps a spot of nitrous oxide can often make all the difference. You could also choose to be numbed. If you find the scaling a bit uncomfortable because the gum tissues (rather than the teeth themselves) are sensitive, topical numbing gels can be used.

 

1 person found this helpful

After Complications Of Dental Cleaning

Dr. Isha Malhotra 93% (6103 ratings)
BDS
Dentist, Gurgaon
After Complications Of Dental Cleaning

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities (dental caries), gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

Brushing

Careful and frequent brushing with a toothbrush helps to prevent build-up of plaque bacteria on the teeth.[1] Electric toothbrushes were developed, and initially recommended for people with strength or dexterity problems in their hands, but they have come into widespread general use. The effectiveness of electric toothbrushes at reducing plaque formation and gingivitis is superior for reducing plaque and gingivitis to that of conventional manual toothbrushes

Flossing

In addition to brushing, cleaning between teeth may help to prevent build-up of plaque bacteria on the teeth. This may be done with dental floss or interdental brushes.

80% of cavities occur in the grooves, or pits and fissures, of the chewing surfaces of the teeth,[3] however, there is no evidence currently showing that normal at-home flossing reduces the risk of cavities in these areas.

Special appliances or tools may be used to supplement toothbrushing and interdental cleaning. These include special toothpicks, oral irrigators, and other devices. A 2015 Cochrane review found insufficient evidence to determine whether the interdental brushing decreases the levels of plaque when compared to flossing.[5]

Scrubbing

Teeth can be cleaned by scrubbing with a twig instead of a toothbrush. Plant sap in the twig takes the place of toothpaste. In many parts of the world teeth cleaning twigs are used. In the Muslim world the miswak or siwak is made from twigs or roots that are said to have an antiseptic effect when used for cleaning teeth.

Professional teeth cleaning

Dental hygienist polishing a person's teeth

Teeth cleaning (also known as prophylaxis, literally a preventive treatment of a disease) is a procedure for the removal of tartar(mineralized plaque) that may develop even with careful brushing and flossing, especially in areas that are difficult to reach in routine toothbrushing. It is often done by a dental hygienist. Professional cleaning includes tooth scaling and tooth polishing and debridement if too much tartar has accumulated. This involves the use of various instruments or devices to loosen and remove deposits from the teeth.

As to the frequency of cleaning, research on this matter is inconclusive. That is, it has neither been shown that more frequent cleaning leads to better outcomes nor that it does not. A review of the research literature on the question concluded "[t]he research evidence is not of sufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals". Thus, any general recommendation for a frequency of routine cleaning (e.g. every six months, every year) has no empirical basis. Moreover, as economists have pointed out, private dentists (or other dental professionals) have an economic incentive to recommend frequent cleaning, because it increases their revenues.

Most dental hygienists recommend having the teeth professionally cleaned every six months. More frequent cleaning and examination may be necessary during treatment of dental and other oral disorders. Routine examination of the teeth is recommended at least every year. This may include yearly, select dental X-rays. See also dental plaque identification procedure and removal.

Good oral hygiene helps to prevent cavities, tartar build-up, and gum disease.

Complications

Overly vigorous or incorrectly performed brushing or flossing may cause injury to the gingiva (gums). Improper or over-vigorous brushing may cause sore gums, damage to tooth enamel, gingivitis, and bleeding gums. Dentists and dental hygienists can instruct and demonstrate proper brushing or flossing techniques.

2 people found this helpful

Dental Care

Dr. Vishal Malik 85% (19 ratings)
BDS
Dentist, Panchkula
Dental Care
Do not use your teeth for doing something other than chewing food. Using them for cracking nuts, removing bottle tops or ripping open packaging can result in chipped or broken teeth.

Dental care!

Dr. Bikramjeet Singh 90% (73 ratings)
BDS
Dentist, Amritsar
Dental care!

Toothpicks can be an alternative to use for flossing if dental floss is not available. Remember not to be too harsh while using it.

2 people found this helpful
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