Sensitivity after a Crown placement

              There are two types of sensitivity that can commonly experienced after a crown is cemented. One is sensitivity to biting pressure and the other is sensitivity to cold (and or hot) liquids. If a patient is  experiencing either of these after a permanent crown is placed, then probably the best thing to do is to let their dentist know.

                  Sensitivity after a permanent crown is placed is not that uncommon. If a patient reports sensitivity, I check their bite, since a high bite can be irritating to the ligaments holding a tooth and can even cause pulpal sensitivity. A patient should be able to close there mouth comfortably without feeling any pain. If when they close their mouth (without chewing any food) they experience pain from a new crown, the bite should be adjusted.

              If a patient can comfortably close their mouths, but does experience pain on heavy chewing, I usually ask them to wait and see if the pain gets better with time. A crown cementation can sometimes irritate the pulp and with time this irritation can diminish. This can take months to go away and if a patient is willing, its usually best to wait. If I see them at their next recall, the tooth is still sensitive to chewing or when drinking cold liquids, I take a radiograph and if no pathology is evident, I usually try to get the patient to wait longer, since the only real other options are to perform a root canal on the tooth or to cut off the crown and place a temporary crown with a sedative filling. Which of these I would choose, if I feel the need to treat the tooth, is dependent on whether I believe the pulp has a reversible or irreversible pulpitis.

              Deciding whether a pulpitis is reversible is not always easy, but the prior history of the tooth has a lot to do with the decision. If a tooth was assymptomatic prior to me working on it initially, I am more likely to choose to remove a crown and place a temporary. If a tooth had a pre-existing crack in it or was symptomatic prior to me preparing it for a crown, I am more likely to recommend the patient visiting an endodontist and have a root canal done through the crown.

               I feel that the pulp is still vital and not infected, there is usually no harm in watchful waiting, since with enough time sensitive crowned teeth can calm down. I explain this to my patient and if the symptoms are bearable we often wait for the symptoms to slowly go away. If the symptoms are worsening instead, we can always choose the root canal option.

Ask me no questions, and I'll tell you no lies.

               The title of the post is a saying by Oliver Goldsmith which personifies the subject i am writing upon.. 

           It seems like some of the patients that we see, read this quote before coming to the doctors.. Well as hard nuts as we are, we do ask questions and a lot of them at that.. 

            The details of the patient or as we call it the Case History of the patient which involves a set of questions to be put forward to the patient - starting from Name, Age, Address, occupation to the Complain and the the details about it and also about the other parts of the body and sometimes about the parents and children too.. 

          I dont understand why do some patients have to lie about these things and that also to a doctor.. the noble profession as we call it.. We are here to alleviate your misery not to gain some vital info about your house or family.. 

           Each and everyone of these questions is necessary to us for forming a diagnosis to your disease and to  treat you well. And if you tell lies about any of this you are hampering your own health and treatment and God forbid if some complication occurs, you shall never be able to forgive yourself.. 

         Even a phone number or your correct and full address is necessary sometimes.. We arent here to spam your phones with msgs or to flirt (female patients look astonished when we ask their age) so better we get all your details correctly and well informed then to play with your own lives..

            

          Here I would give you 3 examples of patients giving me wrong / incomplete information in the last 1 month and putting their lives or their children lives in danger..

1. A Female scheduled to undergo a surgery didnt tell us about her pregnancy until it gained a complication 1 week after the surgery was done.. She put herself under the stress of surgery, put herself under the Xrays and the complication later and then decided to abort the child..

2. A 8 yr old child who was scared to visit a dentist and had very little medical history suffered a Brain Stroke on the dental Chair and had to be immediately shifted to the hospital and underwent a Brain surgery..

3. A 28 yr old Patient fills up a form and details of all his brother and gets his treatment done just for faking a bill and getting reimbursed for it.. 

              So i request you to kindly give all your details as they are in your full knowledge to the doctors and we shall treat you to the best of our capability.. Remember we are all under Hippocrates oath and your information remains with us only..

Lastly, I pray to God that you dont have to come to us at all.. 

Keep Smiling.. 

What are the best ways to maintain a healthy mouth?

This article attempts to explain some of the habits that people can develop that will help insure the ongoing health of their mouths. I will list my top ten list. Most of the these are no brainers, but still i see people not following them but here goes.
1.Take responsibility for your mouth!
2.Brush and floss your teeth on a daily basis
3.Schedule regular checkups and cleanings at the dentist
4.  Ask the hygienist or dentist to check your brushing and flossing technique
5.Do not chew on bones and ice cubes 
6.Wearing a night guard is usually recommended for patients.
7. Refrain from excessive drinking of carbonated sodas
8.Diet plays a large role in keeping our teeth healthy.
9.Do not wait until you have pain to visit your dentist
10.Find a good dentist (meee) and try to stick with them

Clearly there are many additional habits that play a role, including ., not smoking, and controlling acid reflux, I invite readers to add to this list with their own suggestions in the comment section.

People With Stress are more Likely to get Dental Disease

People who are live high-stress lifestyles can benefit from re-evaluating their situations in order to prevent many health complications, include dental care problems.

One dental-related issue linked to too much stress is developing mouth sores. Bacteria and viruses that develop in the mouth can lead to fatigue, allergies and immune system complications, according to WebMd.com

Dealing with too much stress can also lead to teeth grinding, which can cause joint degeneration in the jaw and the breakdown of enamel. If the problem persists, it is recommended to see a dentist and have them mold a custom mouth guard.

Being overly busy can also cause people to put proper dental care at the bottom of their busy schedules, the website reports. This could include postponing or canceling dental appointments, and if a person isn't taking preventative measures at home, they could develop more severe dental problems, such as gum disease.

For example, more than 8 percent of all adults in the U.S. aged 20 to 64 years have been diagnosed with gum disease.

GUM DISEASE

Gum (Periodontal) Disease
Periodontal disease (infection of the gum tissue and bones surrounding teeth) is an increasing health risk which will not go away by itself, but requires professional treatment.

What Is It?

Gum (periodontal) disease is an infection that is a major cause of tooth loss in adults. Because gum disease is usually painless and develops slowly, a person may not be aware that the infection exists.
Gum disease is caused by plaque, a sticky film of bacteria (germs) that constantly forms on the teeth. These bacteria create toxins that can eventually damage the gums and the bone surrounding the teeth.

Bleeding Gums Are Not Normal!
In the early stage of gum disease, called gingivitis, the gums become red, swell, and bleed easily. The disease is still reversible at this stage, and can usually be eliminated by careful daily brushing and flossing. In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. If the disease is left untreated, it can eventually lead to loss of teeth.What are the signs of gum disease?
Any of the following conditions may indicate the presence of gum disease, and a dentist or dental specialist called a periodontist should be consulted.

If the gums:
· bleed when brushing teeth
· are red, swollen or tender
have pulled away from the teeth
Or if one of the following conditions is present:
bad breath that doesn't go away
pus between teeth and gums
loose teeth
a change in the way the teeth fit together when biting
a change in the fit of partial dentures
Remember that pain usually is not present in the early stages of gum disease.

Other Risk Factors for Gum Disease
Although bacterial plaque is the primary cause of gum disease, other risk factors can affect the health of gums and increase the chances of contracting the disease. Some of those factors include smoking, stress, certain medications, diabetes, poor nutrition, clenching or grinding teeth, hormonal fluctuations, and a genetic pre-disposition. Regular check-ups with a dentist and/or consultation with a periodontal specialist are especially important if any of these risk factors are present.

How to Prevent Gum Disease:
Gum disease can be prevented by taking good care of teeth and by having regular dental checkups that include a periodontal examination. A little time invested in prevention of this disease can improve dental and general health and can help minimize dental expenses.

Here are some suggestions to help keep teeth, gums and supporting bone structures healthy:
1. Brush teeth thoroughly twice a day. This removes the film of plaque (germs) from the teeth. Be sure to use a soft-bristled toothbrush that is in good condition and anti-plaque toothpaste. Rinsing will not remove the sticky bacterial plaque.
2. Clean between teeth every day. Cleaning between teeth with floss or interdental cleaners removes bacteria and food particles from between the teeth where a toothbrush can't reach. Early gum disease can often be reversed by daily brushing and flossing.
3. Eat a balanced diet. Choose a variety of foods from the basic food groups, such as breads, cereals and other grain products; fruits; vegetables; meat, poultry and fish; and dairy products, such as milk, cheese and yogurt. Limit between-meal snacks and candy. Avoid excessive use of sweetened soda pop.
4. Visit the dentist regularly. It is important to have regular dental checkups, which include a thorough periodontal exam. Professional cleaning is essential to prevent periodontal diseases. Once you have been treated for periodontal disease, these maintenance visits are especially important.
5. Avoid use of tobacco. Tobacco use can inflame gum tissue and aggravate existing periodontal disease.

Treating Gum Disease
Periodontal Scaling:
Once gum disease has begun to destroy the gum and bone around teeth, an ordinary cleaning will not be enough to stop the progress of the infection. A procedure called periodontal scaling, which is more extensive and time-consuming than routine cleaning, becomes necessary. It removes plaque and tartar that are causing the infection below the gum line. Root planing smoothes the root surfaces, which allows the gum tissue to heal and to reattach to the tooth.

Other Surgery: When deep pockets of infection persist after periodontal scaling, corrective surgery or other treatment may be needed. Surgical treatment is designed to correct defects by reshaping or by regenerating new, healthy bone and gums.

After treatment, it is critical that patients practice good oral hygiene and that they seek regular professional maintenance care in the dental or periodontal office.

Health Note: Gum disease has been linked to heart disease, low birth weight in babies and other health problems, so it is a condition that should be taken seriously.