Dentistry and Pregnancy - Part II

Regular dental work during pregnancy

Dental work such as cavity fillings and crowns should be treated to reduce the chance of infection. If dental work is done during pregnancy, the second trimester is ideal. Once you reach the third trimester, it may be very difficult to lie on your back for an extended period of time.

The safest course of action is to postpone all unnecessary dental work until after the birth. However, sometimes emergency dental work such as a root canal or tooth extraction is necessary.

Elective treatments, such as teeth whitening and other cosmetic procedures, should be postponed until after the birth. It is best to avoid exposing the developing baby to any risks, even if they are minimal.

Medications used in dental work during pregnancy

Currently, there are conflicting studies about possible adverse effects on the developing baby from medications used during dental work. Lidocaine is the most commonly used drug for dental work. Lidocaine (Category B) does cross the placenta after administration.

If dental work is needed, the amount of anesthesia administered should be as little as possible, but still enough to make you comfortable. If you are experiencing pain, request additional numbing. When you are comfortable, the amount of stress on you and the baby is reduced. Also, the more comfortable you are, the easier it is for the anesthesia to work.

Dental work often requires antibiotics to prevent or treat infections. Antibiotics such as penicillin, amoxicillin, and clindamycin, which are labeled category B for safety in pregnancy, may be prescribed after your procedure.

X-rays used in dental work during pregnancy

Routine x-rays, usually taken during annual exams, can usually be postponed until after the birth. X-rays are necessary to perform many dental procedures, especially emergencies. According to the American College of Radiology, no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus.


Fetal organ development occurs during the first trimester; it is best to avoid all potential risks at this time if possible. If non-emergency dental work is needed during the third trimester, it is usually postponed until after the birth. This is to avoid the risk of premature labor and prolonged time lying on your back.

Dentistry and Pregnancy - Part I

Pregnancy is a very exciting and busy time. There are so many changes going on in your body and your mouth is no exception. Good oral hygiene is extremely important during pregnancy because the increase of hormone levels during pregnancy can cause dental problems to be intensified.

One of the most common dental problems associated with pregnancy is a condition known as pregnancy gingivitis, which usually occurs during the first trimester. Symptoms of pregnancy gingivitis are usually bleeding, swollen, red and tender gums.

Good oral health during pregnancy could also be important to your fetus. Some researchers have suggested that the serious stage of gum disease, periodontitis, could cause premature birth and low birth weight.

The tips listed here can help you maintain good oral health throughout your pregnancy.

• Visit your dentist for regular check ups and cleanings. This is the best way to make sure that you are maintaining good oral hygiene.
• Brush your teeth properly at least twice a day to remove plaque.
• Floss your teeth daily. Flossing will remove food debris from in between the teeth that a toothbrush can't reach.
• Use an antimicrobial mouth rinse. Antimicrobial mouth rinses can help prevent gingivitis.
• Brush or scrape your tongue daily to help remove bacteria.
• Eat nutritious meals and healthy snacks.

Now that you know what to do to protect your oral health, sit back, relax and enjoy this beautiful time in your life.

Children likelier to see dentist if parents have regular visits

A new study shows that 77 percent of children and 64 percent of parents had seen a dentist in the previous year. About 86 percent of children whose parents had a dental visit during the preceding year had a dental exam, compared to about 63 percent of the children whose parents had not seen a dentist.

The data is from a recent National Health Interview Study of 6,107 children age 2 to 17 and their parents. The findings show that programs that promote children's oral health also should target their parents, said the study's author, Inyang Isong, M.D., a pediatrician and research fellow at the Massachusetts General Hospital Center for Child and Adolescent Health Policy.

About 76 percent of parents in the study were employed and had health insurance. However, financial barriers still kept some of those families from seeing a dentist. Some parents delayed dental care due to cost, and 27 percent of their children also had care deferred.

Tooth decay is one of the most common chronic diseases in the United States, especially among minority children and those from lower-income families, thus "strategies to promote oral health should focus on the whole family," said Dr. Isong.

What's more, many people are unaware of the important role dental care plays in children's overall health, according to the ADA in a National Children's Dental Health Month news release.

The ADA recommends that parents take action early to ensure the health of their children's teeth because attitudes and habits established at an early age are critical in maintaining good oral health throughout life.

Red wine helps in oral health!!!

Studies in Italy have shown that chemicals in red wine called proanthocyanidins, phytonutrients found in foods like grapes, apples and chocolate that have antioxidant properties, seem to prevent the bacteria Streptococcus mutans, which causes tooth decay, from sticking to saliva and teeth.

Italian researchers removed the alcohol from a high-quality Italian red wine, then added the nonalcoholic red wine to cultures of S. mutans in saliva, saliva-coated extracted teeth and saliva-coated calcium ceramic beads. They found that the addition of the wine prevented the bacteria clinging to the saliva and the teeth.

The Italian researchers say they would like to study the effects of grape juice on S. mutans in the future.

Research conducted at Cornell University in New York and in Canada found that polyphenols, or chemicals in grape seeds and red wine that help neutralize the damaging effect of damaging free radical atoms in the body, seem to help limit inflammation caused by gingivitis, or bacterial infections of the gums. Limiting inflammation may also protect against periodontal disease, a more serious form of gingivitis that can lead to tooth decay or tooth loss.

"Our findings demonstrate that red wine polyphenols have potent antioxidant properties," concluded the study authors from the Université Laval in Quebec, Canada.

Research isn't as clear about benefits of white wines, and some researchers say the high acid content of white wine might erode tooth enamel

Dental Tourism : Part 1

Dental Tourism is a budding concept for a planned vacation along with total Dental solution and care. Health problems and treatment are very costly in most of the European and American countries compared to this part of the world. We provide excellent package to meet your treatment expenditure and at the same time guide you to spend the vacation. You can enjoy your holidays and receive services related to Dentistry such as Dental Implants at a very affordable price.

A dentist can charge US$300 to US$400 for a Dental Filling in USA & Europe. It costs only US$20 to US$40 in India. A Root Canal is US$800 to US$1300 in the West but only US$200 to US$250 in India. Dentures can cost US$1000 overseas but only US$300 in India.

Dental implants, the most sought after dental treatment modality, can cost US$3000 to US$ 5000 abroad, but only US$1100 in India, along with Ceramic prosthesis. The difference in charge of a Dentist from US to India is worth a thought.

That is why India has recently become a Major Tourist Hub of Dental Care Solutions.

You can have your tooth fixed and make your holidays memorable at the same time or simply, enjoy the different hues of Mystic India and get the Dental treatment done without getting a hole in your pocket.

Treatment for oral side effects of cancer

A mouth cancer expert has welcomed two new treatments for patients suffering with cancer. MuGard is a mouth rinse for prevention and management of the lesions and symptoms of oral mucositis.
Head and neck cancer patients often suffer severe mucosal ulcerations and soreness as side-effects of these treatments and will benefit from using it.The other product is Xerotin, a ready-to-use moisturising mouth spray for the relief of the dry mouth (Xerostomia), a common side-effect of radiation damage to the salivary glands.
Oral complications are common in patients receiving radiation and or chemotherapy treatment especially in the head and neck area.
The Mouth Cancer Foundation's Dr Vinod Joshi welcomed the new mouth rinse and spray. He said: ‘These new options could provide much-needed respite for patients. They will be grateful if MuGard is effective in delaying the onset of oral mucositis and reducing its severity. He added: ‘Following radiotherapy and or chemotherapy, many patients also suffer from a dry mouth. Xerotin's ability to lubricate and moisturise the mouth will offer a new option for patients. Xerotin has a neutral pH and will not be damaging to teeth.'

Getting Wiser About Wisdom Teeth

Rites of passage for American teenagers include obtaining a driver's license, high school graduation, voting for the first time, and for many, prophylactic (preventive) extraction of their (third molar) extraction.

Generally, dentists believe that the removal of third molars before the age of 22 prevents later disease and difficulty. Some dentists who specialize in public health opine that because only about one of eight third molars ever cause significant health problems, it does not make sense to remove them all. Information continues to evolve and will effect the future of dental treatment recommendations and patients' comfort with their own decisions

The web site of the American Association of Oral and Maxillofacial Surgeons, www.aaoms.org, carries a report titled "White Paper on Third Molar Data." This thorough paper enumerates the reasons for prophylactic extraction of third molars. The authors refer to recent studies demonstrating that periodontal disease around third molars is a cause for more serious ailments including coronary artery disease, stroke, kidney disease, diabetes, and obstetric complications. Additionally, the AAOMS asserts that retained wisdom teeth of pregnant women are likely to cause low birth weight of their offspring.

The links between periodontal disease and systemic illness and low birth weight are driving dental insurance companies to cover more frequent dental care for some individuals. Medical associations and medical insurance companies advise physicians to refer their patients for dental treatment. Linking periodontal disease to third molars would have the effect of increasing demand for third molar extraction.

Implant or Root Canal ????

There are some who argue that implants are more successful than endodontically treated teeth. This is despite the evidence that shows that implants and endodontically treated teeth have similar, almost identical success rates.

Richard Mounce DDS, an endodontist, points out that the only controversy between endodontics and implants is "primarily economic and more artificially manufactured than exists in reality...There are clear indications for endodontic therapy and clear indications for implant therapy. Rarely are these treatment options so evenly weighted that when considered side by side (as to their advantages and disadvantages) that there should be a 'competition' or 'controversy', most especially when the patient's interest is put first".

According to Gregori M. Kurtzman DDS, "as a general rule, it is better to save a tooth...if you can". Restorability is the key factor in determining when a tooth needs to be removed. Ability to get a good margin, not violate biological width, cracks, strength of furcation, crown:root ratio etc. are all important factors in determining the restorability of the tooth. An endodontically treated tooth with a poor restoration, will generally not have long term success.

However in the same article, Dr. Kurtzman goes on to questions the success rates of endodontic surgery, and even the value of endodontic retreatment. Dr. Kurtzman points out that the financial investment into retreatment, like all treatment options which does not have 100% success rate, may be better made in a more predictable treatment of an implant.
That argument shows lack of understanding and appreciation for modern microscopic endodontic therapy.

Drink Green Tea For Healthy Teeth And Gums

With origins dating back over 4,000 years, green tea has long been a popular beverage in Asian culture, and is increasingly gaining popularity in the United States. And while ancient Chinese and Japanese medicine believed green tea consumption could cure disease and heal wounds, recent scientific studies are beginning to establish the potential health benefits of drinking green tea, especially in weight loss, heart health, and cancer prevention.

A study recently published in the Journal of Periodontology, uncovered yet another benefit of green tea consumption. Researchers found that routine intake of green tea may also help promote healthy teeth and gums. The study analyzed the periodontal health of 940 men, and found that those who regularly drank green tea had superior periodontal health than subjects that consumed less green tea.

"It has been long speculated that green tea possesses a host of health benefits," said study author Dr. Yoshihiro Shimazaki of Kyushu University in Fukuoka, Japan. "And since many of us enjoy green tea on a regular basis, my colleagues and I were eager to investigate the impact of green tea consumption on periodontal health, especially considering the escalating emphasis on the connection between periodontal health and overall health."

Male participants aged 49 through 59 were examined on three indicators of periodontal disease: periodontal pocket depth (PD), clinical attachment loss (CAL) of gum tissue, and bleeding on probing (BOP) of the gum tissue. Researchers observed that for every one cup of green tea consumed per day, there was a decrease in all three indicators, therefore signifying a lower instance of periodontal disease in those subjects who regularly drank green tea.

Green tea's ability to help reduce symptoms of periodontal disease may be due to the presence of the antioxidant catechin. Previous research has demonstrated antioxidants' ability to reduce inflammation in the body, and the indicators of periodontal disease measured in this study, PD, CAL and BOP, suggest the existence of an inflammatory response to periodontal bacteria in the mouth. By interfering with the body's inflammatory response to periodontal bacteria, green tea may actually help promote periodontal health, and ward off further disease. Periodontal disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth, and has been associated with the progression of other diseases such as cardiovascular disease and diabetes.

"Periodontists believe that maintaining healthy gums is absolutely critical to maintaining a healthy body," says Dr. David Cochran, DDS, PhD, President of the AAP and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio. "That is why it is so important to find simple ways to boost periodontal health, such as regularly drinking green tea – something already known to possess certain health-related benefits."

UV Light-enhanced Tooth Bleaching Dangerous To Eyes And Skin

The light treatment gives absolutely no benefit over bleaching without UV, and damages skin and eyes up to four times as much as sunbathing, reports a study in Photochemical & Photobiological Sciences.

The treatment is at least as damaging to skin and eyes as sunbathing in Hyde Park for a midsummer’s afternoon – one lamp actually gave four times that level of radiation exposure.

And as with sunbathing, fair-skinned or light-sensitive people are at even greater risk, said lead author Ellen Bruzell of the Nordic Institute of Dental Materials.

Bruzell also found that bleaching damaged teeth. She saw more exposed grooves on the enamel surface of bleached teeth than on unbleached teeth. These grooves make the teeth more vulnerable to mechanical stress.

Tooth bleaching is one of the most popular cosmetic dental treatments available. It uses a bleaching agent – usually hydrogen peroxide – to remove stains such as those from red wine, tea and coffee, and smoking.

UV light is claimed to further activate the oxidation process, improving bleaching efficiency. The authors of this Photochemical & Photobiological Sciences article say there is very little substantive evidence to support this claim, and their new study finds no benefit to using UV light.

New Tooth Cavity Protection: Nanoparticles Make Surface Too Slippery For Bacteria To Adhere

Clarkson University Center for Advanced Materials Processing Professor Igor Sokolov and graduate student Ravi M. Gaikwad have discovered a new method of protecting teeth from cavities by ultrafine polishing with silica nanoparticles.

The researchers adopted polishing technology used in the semiconductor industry (chemical mechanical planarization) to polish the surface of human teeth down to nanoscale roughness. Roughness left on the tooth after the polishing is just a few nanometers, which is one-billionth of a meter or about 100,000 times smaller than a grain of sand.

Sokolov and Gaikwad showed that teeth polished in this way become too “slippery” for the "bad" bacteria that is responsible for the destruction of dental enamel. As a result the bacteria can be removed fairly easily before they cause damage to the enamel.

Although silica particles have been used before for tooth polishing, polishing with nanosized particles has not been reported. The researchers hypothesized that such polishing may protect tooth surfaces against the damage caused by cariogenic bacteria, because the bacteria can be removed easily from such polished surfaces.

Eye and Teeth Development Linked to Same Protein

Scientists from the University of Leeds have found a link between eye and teeth formation in the protein CNNM4.
The findings will be reported in American Journal of Human Genetics.

In the Gaza Strip, scientists studied residents who suffer from a genetic condition that causes blindness early in life, as well as significant tooth decay. The condition has been named Jalili syndrome after one of the research team members, Ismail Jalili. A protein known as CNNM4 can be found in the cells responsible for laying down tooth enamel and retinal layers. It may also carry calcium and magnesium to other cells. A mutation in CNNM4 is responsible for Jalili syndrome, which can be transferred genetically to children.

Now that scientists know that the protein is responsible for tooth and eye development, they hope to research gene therapy to battle the condition. Finding this link may also lead to progress in understanding inherited blindness.

ViziLite Plus......for Qral Qancer screening

Using ViziLite Plus along with a standard oral cancer examination improves our ability to identify suspicious areas at their earliest stages. ViziLite Plus is similar to proven early detection procedures for other cancers such as mammography, Pap smear and PSA. ViziLite Plus is a simple and painless examination that gives the best chance to find oral abnormalities at the earliest stage. Early detection of pre-cancerous tissue can minimize or eliminate the potentially disfiguring effects of oral cancer and possibly save your life.

The ViziLite Plus Screening Process:

After a conventional oral cancer examination:

1. The patient rinses with ViziLite Solution for 30 – 60 seconds.

2. The oral cavity is illuminated withthe ViziLite light wand.

3. The dentist looks for and documents any abnormalities.

Healthy tissue absorbs ViziLite illumination. Abnormal tissue reflects it and appears white.

Appearance of abnormal tissue with and without ViziLite illumination.

4. If an abnormality is found a toludene blue solution (Tblue630) is swabbed onto it and photographs are taken for inclusion in the patient record and follow-up.

Appearance of abnormal tissue without and with Tblue630 staining

Simroid

We've finally created the robot version of Hell: force one to sit, eternally, in a dentist chair and have it's mouth operated on. Could we make it worse? Why not give the bot sensitive teeth, eh? Unfortunately for the Simroid, Kokoro went the whole nine yards when the company designed it to act as a responsive training aid for dentists — teeth and all.

Simroid is designed to simulate a human patient. It can follow spoken orders and react to what's happening. Sensitive teeth allow the robot to know where the trainee is poking around and if said trainee blunders. Simroid responds in appropriate discomfort, visibly grimacing, moving its arms, and telling the doc-hopeful that it hurts. It also has silicon skin that's soft to the touch and air-powered muscles enable its realistic gestures. The designers found that a Simroid garners a better response from dentist than an inert dummy.

Kokoro, a division of Sanrio (known for making Hello Kitty products), showed the Simroid at the 2007 International Robot Exhibition in Tokyo,

To watch video : http://www.youtube.com/watch?v=Vaf-QxhQh6g

DIASTEMA CLOSURE : A CASE

Pre-operative frontal view.
Pre-operative smile.
Pre-operative Left lateral view.
Pre-operative right lateral view
Etching of tooth with adjacent area protected
Characterisation of enamel layer with white tint
Finishing with aluminium oxide discs.
finishing the restorations.
Egg shaped carbide bur used in the lingual concavities
Silicon carbide brush.
Frontal view of anterior teeth
Right lateral view.
Left lateral view.

DIASTEMA CLOSURE 3

Final shaping and polishing is achieved with burs, sandpaper disks, rubber wheels, points, cups, and polishing pastes. Mesial distal dimension is measured on the restored tooth and compared to the distal mesial dimension of the adjacent tooth and space. Adjustments are made to the restored tooth with burs or sandpaper disks. Restoration of the adjacent tooth is achieved using the same technique. Close approximation of composite to composite on the adjacent tooth is achieved by holding the matrix against the adjacent composite with an instrument and light curing.

DIASTEMA CLOSURE 2

The back of the mouth is a dark area because it receives no light. Composite must block out darkness or a restoration appears dark. Placement of opaque material to the lingual covered with translucent material to the facial achieves a natural looking restoration that is not influenced by this darkness. Blending composite color to tooth color is further achieved by proper composite selection, placement and preparation design.
Restoring small diastemas or restoration of teeth that have a large buccal lingual dimension do not require placement of lingual opaque composite.Bonding to enamel provides strength to hold composite onto tooth structure and minimize microleakage. Removal of caries often creates areas of mechanical locking that aids retention. Strength of enamel bonding is increased by beveling across enamel rods. A longer bevel or chamfer preparation creates more surface area for strength and provides a long gradual show through of tooth color for better color transition. A translucent outer layer of composite provides a chameleon effect picking up and showing through surrounding color.
Gingival control eliminates a black triangle in the papillae area. Placement of composite subgingival is achieved by placement of a matrix that reflects gum tissue to allow bonding and composite placement.
Tooth structure is prepared, a plastic matrix placed, etching and bonding completed on one tooth. A lingual wall of composite placed trying to achieve ideal interproximal contours and light cured. Dimensions are made exact or too large. Cured composite is difficult to add to when the oxygen inhibited layer is lost but it is easily removed.
Wrapping a matrix is avoided because it produces a straight contour and eliminates the oxygen inhibited layer. A contoured matrix or hand shaping produces convex interproximal areas. A layer of translucent composite is placed across the facial aspect, shaped with hand instruments and light cured.

DIASTEMA CLOSURE

A diastema is a space between front teeth. Diastemas are closed by orthodontics or restoration. A highly successful technique is addition of composite. A space which is too large and closed with composite results in teeth that are esthetically too wide and orthodontics is recommended. Space closure requires placement of composite two adjacent teeth.
Placement of composite onto one tooth can be done it proper tooth dimensions allow it.Anesthetic is not required unless dentin or root structure is involved. Diamond burs prepare tooth structure creating a rough surface for improved bond strength and to produce bevels that show through tooth color at restoration cavosurface areas. Cross section of enamel rods improves enamel bond strength.

Some newer ways to find tooth decay

Digital Imaging Fiber-Optic Trans-Illumination (DIFOTI)

DIFOTI technology uses computers to collect images of your teeth while a light is shined behind them. Softened (demineralized) tooth areas can appear darker than healthy areas, so dentists can use the images to help them find early problems. The technique is similar to X-ray but does not use radiation.

Collecting images with DIFOTI takes more time than with X-rays because the camera has to be placed accurately on each tooth to collect the image. The technology is relatively simple to use, but the images must still be interpreted by a dentist, which leaves room for differences of opinion.

Digital Imaging: DIAGNOdent

DIAGNOdent uses a laser to collect information. A handheld laser probe is shined on each tooth. The laser beam is absorbed by each tooth and then leaves the tooth again as fluorescent light. Solid tooth structure gives off very little fluorescent light, but damaged parts of a tooth and bacteria give off more. Information from each tooth is transmitted to a control unit, which looks something like a digital clock radio.

Studies have found that this technique helps diagnose early decay in the underlayer of the tooth (the dentin) whbefore a cavity develops in the outer, visible layer (enamel). DIAGNOdent can also be used to follow a suspicious tooth or teeth over time and see if the values change. Its manufacturer claims the device is 90% accurate.

Quantitative Light-Induced Fluorescence (QLF)

Of these three technologies, QLF is the newest. It uses a light source, camera, fluorescent dye and computer software. The camera acquires images of each tooth, and the software analyzes the images and provides information about possible mineral loss.

The technology can detect early decay in primary (baby) and permanent teeth, as well as early decay that is close to fillings, crowns or orthodontic hardware.

QLF is useful for finding caries in people at high risk of decay and for confirming that teeth are healthy in people at low risk. However, it can miss early decay in high-risk people and can identify low-risk people as having decay when they really don't.

Lasers in Dentistry II (Treatments)

The application of lasers in dentistry opens the door for dentists to perform a wide variety of dental procedures they otherwise may not be capable of performing. Dentists using lasers in dentistry have become adept at incorporating the state-of-the-art precision technology into a number of common and not-so-common procedures:

• Benign Tumors: Dental lasers may be used for the painless and suture-free removal of benign tumors from the gums, palate, sides of cheeks, and lips.
• Cavity Detector: Low intensity soft tissue dental lasers may be used for the early detection of cavities by providing a reading of the by-products produced by decay.
• Viewing Tooth and Gum Tissues: Optical Coherence Tomography is a safer way to see inside tooth and gums in real time.
• Cold Sores: Low intensity dental lasers reduce pain associated with cold sores and minimize healing time.
• Crown Lengthening: Dental lasers can reshape gum tissue and bone to expose healthier tooth structure. Called crown lengthening, such reshaping provides a stronger foundation for a restoration.
• Dental Fillings: Hard tissue dental lasers may eliminate the need for a local anesthetic injection and the traditional turbine drill. Lasers used in dental filling procedures are capable of killing bacteria located in a cavity and this may lead to better long term tooth restorations.
• Muscle Attachment (Frenula): A laser frenectomy is an ideal treatment option for children who are tongue tied (restricted or tight frenulum) and babies unable to breast feed adequately due to limited tongue movement. A laser frenectomy may also help to eliminate speech impediments.
• Nerve Regeneration: Photobiomodulation can be used to regenerate damaged nerves, blood vessels, and scars.
• Sleep Apnea: In cases where sleep apnea is a result of a tissue overgrowth in areas of the throat (which sometimes occurs with age), a laser assisted uvuloplasty or laser assisted uvula palatoplasty (LAUP) procedure can be performed to reshape the throat and relieve the correlating breathing problems associated with sleep apnea.
• Soft Tissue Folds (Epulis): Dental lasers may be used for the painless and suture-free removal of soft tissue folds often caused by ill-fitting dentures.
• Teeth Whitening: Low intensity soft tissue dental lasers may be used to speed up the bleaching process associated with teeth whitening.
• Temporomandibular Joint Treatment: Dental lasers may be used to quickly reduce pain and inflammation of the temporomandibular jaw joint.
• Gummy Smile: Dental lasers can reshape gum tissue to expose healthy tooth structure and improve the appearance of a gummy smile.
• Tooth Sensitivity: Dental lasers may be used to seal tubules (located on the root of the tooth) that are responsible for hot and cold tooth sensitivity.