Saturday, January 28, 2012

Digital Dentist

Advantages of Digital Dental Radiography

            Well, our office has been using the digital radiography since September of 2009 and I thought this topic might be good one for a blog post.
For sure, not having to develop film saves a lot of time every day and my patients almost universally approve of my upgrade to digital radiography. They like being able to easily view images of their teeth and are happy when they hear that the images are achieved with much lower radiation settings. This is the most obvious advantage of digital radiography; Patients receive a much lower dose of radiation(90% less) than they would from the use of traditional X ray films. I find I can produce usable images with a Tenth of the radiation that I used to produce film images.

Another feature of digital radiography is their ability to easily produce enlarged images of the teeth. In the last year I have found that found that showing enlarged images of their teeth to patients makes it much easier for them to understand my treatment recommendations and the digital enhancement features of my software program (Vatech) I use can help with the visualization of problems.

I also appreciate of the ease of emailing these images to specialists. I am able to get almost "instant second opinions" for my patients. Almost every day I send a radiograph to either my endodontist, prosthodontist or oral surgeon, in order to get their input for one of my patients. This is a great service since not only do my patients not have to pay an additional fee for the consultation, but prior to this I would have mailed their film to the specialist and I would have waited several days for the feedback.

Although I must confess that I sometimes miss the "richness" old fashioned film produced images, there is no going back for me. The advantages of digitally produced dental images far out way any disadvantages and I am fully committed to this new digital age!

Saturday, January 14, 2012

Some Common Queries

Continuing with the common problems that patients have.. 
Today i have decided to come out with Root Canal Problems...

         This is the most common question that i am asked from everyone.. including Non Patients also.. and when i say it doesnt.. Patients become all the more suspicious..:)
 Root Canal Doesnt Hurt... Period..

                  With proper anesthesia root canals can be a pain free procedure. Most teeth respond to regular local anesthesia injections. For Maxillary (upper teeth) dentists usually employ a combination of buccal infiltration and a palatal injection. For Mandibular teeth(lower teeth)a mandibular or mental block is used.

               Some teeth do seem to be hypersensitive at the time that root canal is started and patients still can report some sensitivity when a dentist attempts to access the pulp chamber. When this happens I sometimes use an additional intrapulpal injection in order to achieve complete anesthesia. Usually this injection does the trick for my patient and their endodontic procedure can be completed without further discomfort.

Can Successfully treated Root canal tooth experience occasional Pain/ Tenderness?

            Sometimes root canal treated teeth, that we consider a success, do have some "low grade inlammation ". The teeth are not infected but are not entirely without tenderness.

          Another possible explanation of continued symptoms it that some teeth have a small undetected crack and heavy chewing may cause some small movement of the the crack.

         If symptoms are disturbing sometimes a retreatment of the root canal can cause the tooth to become less symptomatic. After all, most of our check radiographs are two dimensional and do not show the root canal system as it acutally is. Small discrepencies in the 3-D fill also may be responsible for symptoms.

          Also for these types sometimes we do have an additional sitting or two.. But normally Root Canals are generally done in single Sittings.

Do ask me If any query on Dental problems is there... Would like to help it out.. 

Thursday, January 12, 2012

Gum Disease and Human Health

             This post is a result of a sad news I heard on twitter in the morning that a middle aged man had a sudden heart attack and he couldn't survive that. 
             Now we all know of the common reasons of why we have BP, Heart problems, Diabetes and we all so much take care of the reasons and feel happy of taking low fat Ice creams, Diet coke, Exercising, Yoga, Meditation and what not. But there's some other major reason which i thought we should all know bout.
             So i decided to shed some light on the relation of Dental problems and in particular Gum Problems with our very common diseases that we so so commonly see now a days.
There's a whole new subject on this now, calling it Periodontal Medicine which deals with the inter relationship of Dental problems with the other chronic disease of the body.
Gum Problems and Diabetes
                                         Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes.
                                          Tooth and gum problems can happen to anyone. A sticky film full of germs, called plaque, builds up on your teeth. High blood glucose helps germs, also called bacteria, grow. Then you can get red, sore, and swollen gums that bleed when you brush your teeth. People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose can make tooth and gum problems worse. You can even lose your teeth
                                          Gum Problems have been listed as a Side effect of Diabetes long ago and they are interrelated in both ways. Uncontrolled Diabetes leads to higher rate of gum problems and more gum diseases leads to Uncontrolled Diabetes.

Gum Problems and Heart Disease
                                  Gum disease and heart disease appear to be related, thanks to several extensive studies in the early 2000s which suggested that people with periodontal disease were twice as likely to also have coronary artery disease, along with other heart-related health conditions.
                    People with severe gum disease often experience bleeding gums, and nicks and cuts in the gums can provide a way for bacteria to enter the bloodstream. If the bacteria is not attacked by the immune system in time, it can reach the heart and may cause an infection such as endocarditis or damage other organs.
                     In addition, some oral bacteria appear to secrete sticky proteins which can allow them to adhere to the walls of the arteries, rather than being swept away by the flow of blood. As the bacteria accumulate, they contribute to the narrowing of the arteries called Atherosclerosis also called "hardening of the arteries," develops when deposits of fats and other substances in your blood begin to stick to the sides of your arteries. These deposits, called plaques, can build up and narrow your arteries, clogging them like a plugged-up drain. If these plaques ever block the blood flow completely, you could have a heart attack or stroke, depending on the location of the blockage.
                     So now it comes down to How do u prevent it...  Well Prevention is as simple as maintaining a good oral health.. 
                      To maintain the best oral health, you should:

  • Establish and maintain a healthy mouth. This means brushing and flossing daily and visiting your dentist regularly.
  • Make sure your dentist knows you have a heart problem.
  •         Carefully follow your physician's and dentist's instructions, and use prescription medications, such as antibiotics, as directed.

Other Problems which are affected by Dental Problems and have been conclusively established
Pregnancy -  The birth weight of the baby gets affected and the mother can go for a Pre term labor because of the Gum Disease
Osteoporosis - Because Gum Disease can cause loosening of teeth and also resorption of bone around the teeth it also can result in increase in osteoporosis specially for females.
Respiratory Disease - Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage.

Monday, January 9, 2012

Some Common Queries

I have decided to post some of the common queries which are regularly asked by the patients and also they get confusing answers while they keep asking the general population...

So lets get started.

What does it mean when someone says "I never have any cavities"? 

                    As a practicing dentist I sometimes encounter new patients, who have loved their previous dentist and are especially proud of how their teeth 'never need work'. 

                   I often hear this remark with a sense of dread; Although it can mean they have great teeth, it sometimes can be a tip off that their prior dentist was not detecting some dental problems. In such a situation, It can be awkward telling them the bad news, and I am always concerned that my potential new patient will not believe me If it turns out that they do have a number of dental problems.

                   After all they trusted and loved their old dentist and I am the 'new dentist in the area'. Often patients do not want to believe bad news and seek a second and third opinion ( often from their friends and family) before having a unwanted dental procedure.

Should Wisdom tooth ever get a Root Canal Done.?

                  The answer is sometimes. If a wisdom tooth has a deep cavity and has a pulpal exposure it can be a good candidate for endodontic therapy if it has erupted in a cleanable position and is in good function. Like other posterior teeth, after having a root canal wisdom teeth should be crowned. In my practice I recommend full metal crowns for wisdom teeth(and second molars), since the chewing pressure they can experience can make porcelain breakage more likely when porcelain fused to metal is used.

                If the wisdom tooth is not fully erupted or difficult for the patient to clean, then root canal is not the best option for dealing with a compromised pulp. Instead extraction is the best option. In this event, often the opposing wisdom tooth is extracted as well, since without an opposing tooth present, it may extrude over time.

Hope these are helpful for you... any more queries or any comments on these are surely welcomed...
Every day i shall be trying to post some query or other.. so Follow this blog regularly and follow the good dental habits too... 

Friday, January 6, 2012

Happy New Year! Some Dental Resolutions for the New Year!

Happy New Year to everyone! May it be happy, healthy and prosperous!

Just wanted to give some dental resolutions that could be implemented with a little effort to ensure a great smile for the New Year:

  1. Brush 2 minutes twice a day...yes, I said 2 minutes (not 1 minute or 30 seconds or once a day). It really does take that long to clean the majority of surfaces your mouth decently.
  2. Floss...yes, I know you tend to do it before dental appointments. However, 40% of your teeth are not being cleaned if you don't do it and a substantial percentage of cavities start in those areas
  3. Clean your tongue. I would say 95% of patients don't do this. A couple of quick swipes on the tongue is usually enough.
  4. Reduce your intake of candies/sweets: it will reduce the incidence of cavities, improve your blood sugar and weight.
  5. Drink more water. In moderation, this a great thing, especially after staining drinks like coffee, tea and wine. Want to reduce all that coffee/tea stain between hygiene appointments? Take a sip or two of water after you finish your drink.
  6. Regular maintenance appointments. Seeing your Dentist for a checkup and scaling is truly the dental version of the oil change. Prevention is always the best option.
  7. Get things fixed while they are small (don't procrastinate). Dentistry seemingly operates on an exponential cost scale as things get more involved and complex. Getting a restoration that costs a couple of hundred rupees  is much better for you and your pocket than letting it turn into a multi-thousand rupees root canal/core/crown or implant