Holi tips for healthy teeth

Teeth are often the silent sufferers during Holi, for variety of reasons -  

1. Children and youngsters are prone to falling with their face down while running with friends. Other than your face, your tooth often get the brunt of this fall. 

2. Binge eating is prevalent during Holi and this has implications for middle aged and elderly people, who have or prone to cavities. “Good brushing followed by flossing is often recommended

3. Most critical thing is safeguarding your teeth against chemical-laced colors. “Stained teeth can not only affect your looks but may also shatter your confidence. While best way is to avoid getting into a situation like this by being careful, if you do get it, we recommend bleaching, scaling and polishing,

Honesty is the Best Policy

        I have found my ability and the need to relate honestly is both a virtue and a curse. People who know you well may tend to trust you more if you are known for your honesty, since what they see and hear is what they get.

         People who meet you for the first time, not so much. Often people meeting someone new tend to "judge a book by it's cover, even when the cover doesn't project what's really inside. Personally I prefer to be truthful in my interactions with others. I may sometimes not tell others my every thought ( a sin of omission) but I really try to be truthful in my communications. This has for the most part worked out well but not in every instance.

             My patients who know me well, tend to know that I give them my best and most honest advice. I don't always paint an overly optimistic picture, but they can rely on me to be truthful and they know if I recommend a procedure, I truly believe it is their best option.

                  Sometimes this trait doesn't sit well with new patients who sometimes are hoping for a particular treatment plan that can be accomplished fast and good, in the most economical manner. This can at times happen, but some patients have unrealistic expectations and I will not mislead them into starting treatment with me without a discussion of what is their best option. I may include a second and even third option, but if what they want is something I can't in good conscience offer, I won't do it. These patient's either adjust their expectations or go somewhere else.

                 Sometimes  they tell me how a previous dentist was able to accomplish some dental magic, but to my mind the way that that dentist handled their treatment is not how I want to approach their treatment. Personally I enjoy sleeping soundly at night and dislike treatments that seem to be temporary in nature and may lead to worse problems. After all teeth don't grow on trees and implants are expensive replacements.

Growing Need for Cosmetic Dentistry

                 With the constant growing phenomenon that includes social media, TV, magazines, evolution of technology, more patients think about their image. It results in an extreme desire to have great selfies and an overarching desire to look younger.

For Example when a picture is posted on any social Media, no one wants to look bad. If someone scrolls through their pictures and feels that they have some extra kilos to lose; the individual will feel more pressured and motivated to lose weight to show the world that they look better than before.

This is happening all around us and is being reinforced by the cultural and societal norms of the twenty-first century. Celebrities in magazines and on TV have the desired look of tall and slim, with beautiful features, including their teeth.

          Its said that 47% of the people notice the smile first in a photograph or while talking to a person.

When a photographer takes a photo and asks the subject to smile, people don’t want to be embarrassed or ashamed of their teeth. Nowadays, the average person is more likely to invest in teeth whiteners, as well as cosmetic dentistry for the constant search of perfection.

When someone trips and cracks a tooth, their first instinct is to go running to the dentist in order to fix the broken tooth. In addition, coffee addicts are buying teeth whiteners to remove the unwanted stains on their teeth.

Everyone wants to feel and look beautiful within the definition set by the world around them. Brushing and flossing is not satisfying anymore because individuals do not believe that it does a sufficient job cleaning their teeth. Patients want bright, white, and flawless teeth, and are willing to pay extra to get them.

          Each year, the cosmetic dental industry has an increase in patients and revenue, making it a great option for individuals who have an interest in joining the dental field.

The schooling that is necessary to become a cosmetic dentist may be long and difficult, but the success afterwards makes it worth the while. Cosmetic dentists help patients feel more confident about them, which is something each dentist should pride themselves on.

Why does my crown keep falling out?

Maybe it's not that into you.....? :)
              Being rejected by your crown hurts, especially when it was recently made and cost some serious money. Why does it happen? Usually either it has to do with the shape of the prepared tooth holding it or because the crown is ill fitting.

                For a crown to be retentive (resist the forces that may tend to remove it) the preparation has to be smooth and only SLIGHTLY tapered. It also has to be long enough to provide enough surface area to grab the cement. If the prepared tooth is too irregular, too short or too tapered, it may not have the proper shape to hold onto its crown.

                 Also, another possibility is that the crown can be cemented with a poor fit. In this case the crown does not hug the tooth well enough for the crown to stay put and since the crown is completely dependent on cement to stay. An analogy would be found in furniture making where most good furniture is made with dovetails, that increase the ability of the furniture to hold the wood together. Without dovetails, the pieces tend to work themselves loose more quickly. 
                 
                The same can be true with crowns, since their success is dependent on having a properly shaped tooth holding them and an intimate contact with it. The space between the crown and the tooth should be minimal (20-40 microns) in order for the cement achieve maximum holding power.

                   Most dentists faced with a permanent crown that comes out will first try to re-cement it. In my practice, I upgrade to a different permanent cement with more holding power. Unfortunately these cements do not always offer a long term solution and I am faced with the option of making the crown over.  When I do so I pay special attention to correcting any shortcomings in my tooth preparation and making sure that I take a perfect impression.

                  I should add a few  additional reasons that crowns can come loose. If the bite is high or just unfavorable, crowns can be more likely to come loose. Crowns do better when most of the occlusion is experienced along a  mostly vertical force vector and without much  of a horizontal component. Anterior teeth with deep over bites can experience a lot of horizontal forces on them and can sometimes be challenging to crown. Also some patients do have habits that are just not that friendly to crowns such as eating stale tootsie rolls or very hard and sticky candies. When chewed often these sweets tend to loosen even well fitting crowns


Dr. Pankaj Malhotra is a Periodontist & Implantologist in DELHI NCR region of INDIA, who maintains a practice in Noida. For more information about his Dental Practice please visit his website at www.dentalclinicnoida.in 

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.

Teeth Whitening Case

Hello,

       Well just putting out a recent case showing how easy it is to get those stains removed which stop from making us smile...

        This patient came to us quite very Unhappy about the stains that he had got from a continuous 10 yrs of smoking, paan and gutka chewing... 

        Finally after my insistence he decided to kick off this Bad habit and for this firstly for motivation he thought of getting his teeth in order.. We did a normal cleaning and polishing of his teeth and then we proceeded to get on with Bleaching to remove those stains of his teeth..

Pre - Operative Photograph

And after giving him 45 mins of a single sitting have a look of what his teeth have turned into...

Post - Operative Photograph

To Read more about what TEETH WHITENING is all about Click Here