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.

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