Gum disease - Should it be taken lightly?

The Teeth-ing Troubles

Periodontal Treatment for gum disease and its relevance in Dentistry and Medical practice-
Gum disease more often progress slowly and cause underlying bone damage. In most cases, it is not very painful and bleeding gums is the only sign. It may be vital to know that our dentition is healthy and strong only as long as our bone structure and neuromuscular control is. The joint and muscular coordination that help us chew efficiently , may also be affected majorly with loss of teeth(dentition) due to bone loss caused by periodontal(gum) infection.People with valve defects and rheumatic heart disease have a greater risk towards infective endocarditis. In Diabetics, bone loss is progressive that make gums sore and have a greater tendency towards gingival and periodontal abscess.
A visit to the Dentist is recommended for the best interest of the individuals susceptible to a greater damage than obvious.

Periodontal Treatment:

What is periodontal disease? 

Periodontitis is the outcome from infection that is resulting from a complex interplay between bacterial infection and host response, often modified by behavioral factors. 

Epidemiology of periodontal diseases:

Documentation reveals 5-15% of any population suffers from severe generalised periodontitis, even though moderate disease affects majority of adults. The adult population suffers from chronic periodontitis with mild attachment loss.

Chronic Periodontitis:

Chronic periodontitis is an infectious disease resulting in inflammation within the supporting tissues of the teeth, with progressive attachment and bone loss.

Risk Factors and determinants associated with chronic periodontitis: 

· Plaque,poor oral hygiene

· Tobacco

· Genetic predisposition

· Psychosocial stress

· Diabetes

· Systemic disease

Diagnosis: is based on the following- 

· Bleeding on probing,probing depth and clinical attachment loss

· Testing teeth for mobility

· Radiographic examination(vertical bitewings and periapical view)


Treatment includes:

· Scaling and root planning

· Pharmacological therapy

· Surgical therapy and occlusal adjustment



For more information :

Contact: Dr.Sreenita Chowdhury

email:Smileoracles@gmail.com

Dental Trauma In Children

The Teeth-ing Troubles

Dental Trauma:     

Prognosis is good in cases of dental trauma with immediate treatment.
KEY TO SUCCESS: SEEING THE PATIENT AS SOON AS POSSIBLE
Points to remember-
1.Avulsed permanent teeth should be replanted immediately.
2.Avulsed primary/milk tooth should never be replanted as there are possibilities of ankylosis.
3.Crown or root fractures have different modalities of treatment depending on the position of the fracture.

Principles of Treatment:

1.Emergency Treatment-
Elimination of pain;
Protection of pulp;
Reduction and immobilization of teeth;
Suturing of soft tissue laceration
Antibiotics,Tetanus,Analgesics,Chlorhexidine mouthwash

2.Intermediate treatment
Pulp therapy
Orthodontic treatment considerations
Semipermanent restorations
Review-1month/3months/6months /2years

3.Permanent treatment
Usually deferred until 16years

PREVENTION OF TRAUMA ESPECIALLY DURING SPORTS:

For Further Information
Contact: smileoracles@gmail.com
Dr.Sreenita Chowdhury, New Delhi, India

The Child and Oral Health Problems

The Teeth-ing Troubles

The Child and Oral Health Problems

The anxious child:


Techniques for behaviour management come with experience of treating children over a period of time.


There are various behaviour modification techniques that we follow at Smileoracles’ Multispeciality Dental Centre to make the child friendly to the Dental office and the staff. Its quite natural with the fear of the unknown and being unable to understand the sequence of events during the procedure, the child remains apprehensive.


The techniques we follow to comfort the child:

1.Sedation:Oral and intravenous drugs like midazolam and chloralhydrate can be used.
2.Hypnosis
3.General Anaesthesia
4.Lasers in Dentistry


The Child with toothache:
It is quite natural for a child with toothache to be irritable, uncooperative and not be able to eat comfortably. For children less than 4/5years of age inability to express the discomfort in the oral cavity often aggravates the problem and further makes treatment extensive and complicated.

It is advisable to get periodic dental check up very soon the first tooth erupts.

At Smileoracles’ Multispeciality Dental Centre we take special care to make your child painfree with our specialized team of doctors.

Assisted guidance in other problems associated with Oral cavity:
1.Abnormalities in tooth exfoliation and eruption.
2.Abnormalities of tooth number.
3.Abnormalities of tooth structure
4.Abnormalities of tooth form.
5.Abnormalities of tooth colour.

Extraction Versus restoration of primary teeth:


Despite a welcome reduction in the prevalence of dental decay,the dilemma of whether to restore or extract a primary tooth is still familiar. In making a decision at Smileoracles’ number of factors are considered.
1.Age
2.Medical History: Pulp therapy in medically compromised like heart disease is inappropriate. These are possible sources of recurrent bacteremia. In haemophiliacs, extraction should be avoided IF POSSIBLE.
3.Motivation and cooperation of parents: The parents must understand the benefits of maintaining the child’s primary dentition.Unfortunately, a small proportion of the population still regard a dentist that fills primary teeth with suspicion- after all ,everyone knows that the baby teeth will not stay forever!!
4.Caries rate
5.Pain
6.Extent of the lesion
7.Position of the tooth
8.Presence/absence of permanent successor.
9.Malocclusion

Severe Early Childhood Caries

Cause: Frequent intake of sugary and sticky food stuff.

Nursing Caries/Bottle caries: Frequent consumption of sugar-containing drink especially from a feeding bottle. It is also attributed to prolonged on demand breast feeding, especially at night, from the lactose in breast milk.

Rampant Caries: Rapidly progressing caries affecting many teeth in the primary and permanent dentition.

Deep Dental decay involving the pulp/nerve tissue:
Vital and Non-vital Pulp Therapy-


1.Pulpotomy- For infected tissue limited in the coronal portion
2.Pulpectomy-For infected tissue down below the root canals with possibilities of abscess.


Lasers in Paediatric Dentistry:
Biolase- The most promising pain-free dental management with Hard tissue lasers for children.

For further information:
Email: smileoracles@gmail.com
Dr.Sreenita Chowdhury

Importance of Milk tooth and Concerns in Paediatric Dentistry

The Teeth-ing Troubles

Pediatric Dentistry:

Diagnosis:
Dental caries a rapidly progressing condition in children. The accurate diagnosis of the disease is of prime importance prior to development of treatment plan.
Radiographic diagnosis and a proper history( especially diet and food habits) is essential before treatment is commenced.

Treatment Plan for children:

Why is it important to treat a child’s dentition before he/she reaches adulthood?

A good dental status in the young age often assures a healthy dental condition even during adulthood. The positive attitude towards dental health more often establishes a healthy diet and prevention of oral health problems.


The treatment plan in children will take account of the following considerations:
1.Behaviour Management
2.Prevention of dental decay
3.Restorative treatment
4.Developing Occlusion
Restorative treatment without prevention is of limited value. Hence,we emphasise on a modified diet. Most often a combination of prevention,restoration and extraction is indicated for most children with caries/dental decay in primary/milk teeth.

Other considerations:

Pain or evidence of abscess/infection.
1.Temporization of open cavities
2.Use of medicated fillings
3.reduction of bacterial count(Streptococcus mutans)
4.preliminary coronal seal enhances the chances of pulpal recovery.

Delivery of care:                               

1.Counselling of the parents
2.LA/Sedation/GA- Risks vs Benefits of each
3.Planning of operative care at a pace appropriate to the child’s ability to cope.
4.Consideration of medically compromised children(like heart diseases, small stature,systemic diseases)

For further information
Contact: Dr.Sreenita Chowdhury
Dentist, New Delhi, India
smileoracles@gmail.com

Zimmer One Piece Implant

The Teeth-ing Troubles

Patient's Cosmetic Concerns In Dentistry

The Teeth-ing Troubles-Cosmetic needs and patient satisfaction

Ref: American Dental Association Newsletter

http://www.quintpub.com/journals/ejed/abstract.php?article_id=14383#.U4zpqPZOWcw

Achieving patient satisfaction, step-by-step

 It’s not uncommon for cases that start out with low esthetics to be accompanied by high patient expectations. Researchers publishing in the summer 2014 issue of The International Journal of Esthetic Dentistry described how to manage such circumstances using the case of a 27-year-old woman with amelogenesis imperfecta.
Caused by protein mutations involved in enamel formation, the genetic developmental disorder causes light and dark discolorations and atypical crown shapes. The subject’s chief complaint was dark and white opaque staining. However, she was also bothered by teeth that overlapped and an asymmetrical gingival margin. Researchers hoped to sacrifice as little healthy enamel as possible, while still meeting high expectations for an improved appearance.
The initial clinical examination did not reveal the true depth of the staining, so in agreement with the patient, a step-by-step treatment plan was adopted.
The first treatment step consisted of a home bleaching process. The patient noticed a positive change and was motivated to seek further improvement.
Step two was a microabrasion technique. Only the most superficial enamel layer was etched and removed with an abrasive paste and a rubber cup. Again, in the follow-up visit, the patient noticed improvement and wanted to continue treatment. This time the goal was to correct the position and shape of her front teeth.
All conditions were ideal for step three, a plan to restore the maxillary incisors and canines with ceramic veneers. At the outset, corrections were performed digitally, and foreseen changes were transferred into a wax-up. The dentist used the resulting mock-up to serve as a communication tool and discuss the prospective outcome with the patient.
Both were satisfied with the result during a try-in session, when veneers were inserted with glycerin gel in order to improve color assessment. All involved with the treatment plan were “very satisfied with the final treatment outcome,” authors reported.
“The patient was heavily involved in the process of decision-making and, therefore, her esthetic expectations could be integrated into the final treatment,” authors commented about the success. “For the predictability of the treatment, a meticulous prediagnostics and a stepwise treatment protocol is crucial; otherwise the outcome may be compromised.”

American Dental Association Family Nutrition: Message to the children and parents

The Teeth-ing Troubles

Antiplatelet drugs, anticoagulants and elective dental surgery

What Are the Risks of Having a Stent?

Why do you need to be cautious before a dental extraction??




There is an increased risk of bleeding when patients taking anticoagulant or antiplatelet drugs require surgery.This risk must be balanced against the risk of harm if treatment is stopped. For many minor procedures aspirin or warfarin can be continued. Patients having non-cardiac surgery may be able to continue aspirin, but clopidogrel should be stopped unless there is a high risk of thrombosis. Patients taking warfarin may require bridging anticoagulation around the time of major surgery.This involves replacing the warfarin with unfractionated or low molecular weight heparin. Consultation with a cardiologist is particularly recommended if a patient with a coronary stent requires surgery.

Figure A shows the coronary arteries located on the surface of the heart.

Figure B shows a stent-widened artery with normal blood flow. The inset image shows a cross-section of the stent-widened artery.

In figure C, tissue grows through and around the stent over time. This causes a partial blockage of the artery and abnormal blood flow. The inset image shows a cross-section of the tissue growth around the stent.



Risks Related to Percutaneous Coronary Intervention

Percutaneous coronary intervention (PCI), the procedure used to place stents, is a common medical procedure that is sometimes referred to as coronary angioplasty. PCI carries a small risk of serious complications, such as:

Bleeding from the site where the catheter was inserted into the skin
Damage to the blood vessel from the catheter
Arrhythmias (irregular heartbeats)
Damage to the kidneys caused by the dye used during the procedure
An allergic reaction to the dye used during the procedure
Infection

Another problem that can occur after PCI is too much tissue growth within the treated portion of the artery. This can cause the artery to become narrow or blocked again. When this happens, it's called restenosis (RE-sten-no-sis).

Using drug-eluting stents can help prevent this problem. These stents are coated with medicine to stop excess tissue growth.

Treating the tissue around the stent with radiation also can delay tissue growth. For this procedure, the doctor threads a wire through a catheter to the stent. The wire releases radiation and stops cells around the stent from growing and blocking the artery.


During any dental procedure which might involve bleeding, a consultaton with the cardiologist is mandatory and bridging treatment with Low molecular weight Heparin and close monitoring is mandatory.

For more information
Kindly contact
Dr.Sreenita Chowdhury
sreenita28@gmail.com

Glidewell Clinical Tutorial--Bite Splint Delivery

The Teeth-ing Troubles

Dentures Adjust & Reline - Roseville Dentist

The Teeth-ing Troubles

Smoking and Periodontal Disease[downey dentist]

The Teeth-ing Troubles

How are teeth cleaned at the dentist

The Teeth-ing Troubles

THE DENTIST'S VIEWPOINT: Why Are Fluoride Treatments Important In Children?

THE DENTIST'S VIEWPOINT: Why Are Fluoride Treatments Important In Children?

I hope the information was valuable to you.
Any enquiry in New Delhi,India
Please contact
Dr.Sreenita Chowdhury
sreenita28@gmail.com
drsreenita@tutdental.com

Cellulitis and Dental Infection

Cellulitis due to Tooth Infection??

Cellulitis is a common skin infection caused by bacteria.

Causes

Staphylococcus and streptococcus bacteria are the most common causes of cellulitis.

Normal skin has many types of bacteria living on it. When there is a break in the skin, these bacteria can cause a skin infection. Skin in the infected area will become red, hot, irritated, and painful.

Risk factors for cellulitis include:

1.Dental infection

2.Periodontal abscess

3.Cracks or peeling skin between the toes
4.History of peripheral vascular disease
5.Injury or trauma with a break in the skin (skin wounds)
6.Insect bites and stings, animal bites, or human bites
7.Ulcers from certain diseases, including diabetes and vascular disease
8.Use of corticosteroid medications or medications that suppress the immune system
9.Wound from a recent surgery

                                               How does Dental abscess lead to Cellulitis?? 

The infection from the root and the surrounding support system of the tooth finds its way through the least path of resistance to the tissue spaces.

Symptoms of cellulitis include:

Fever
Pain or tenderness in the affected area
Skin redness or inflammation that gets bigger as the infection spreads
Skin sore or rash that starts suddenly, and grows quickly in the first 24 hours
Tight, glossy, "stretched" appearance of the skin
Warm skin in the the area of redness

Signs of infection:

Chills or shaking
Fatigue
General ill feeling
Muscle aches and pains
Warm skin
Sweating

Treatment

Most of the time, treatment involves antibiotics taken by mouth and close follow-up by your doctor. You may be given painkillers.

You should raise the infected area higher than your heart to reduce swelling. Rest until your symptoms improve.

You may need to stay in a hospital if:

You are very sick (for example, you have a very high temperature, blood pressure problems, or nausea and vomiting that does not go away)
You have been on antibiotics and the infection is getting worse
Your immune system is not working well (due to cancer, HIV)
You have an infection around your eyes
You require antibiotics through a vein (IV)

Hope this information has been useful.
Thanking you
Dr.Sreenita

Dental Emergencies

 Dental Emergencies

                                  

Accidents happen, and knowing what to do when one occurs can mean the difference between saving and losing a tooth. Here are some common dental emergencies and how to deal with them. For all dental emergencies, it’s important to visit your dentist as soon as possible. Most dentists reserve time in their daily schedules for emergency patients so be sure to call your dentist and provide as much detail as you can about your condition. If the accident occurs when your dental office is not open, visit your local emergency room.



Question: What do I do if I knock out my tooth?
Answer: For a knocked-out permanent or adult tooth, keep it moist at all times. If you can, try placing the tooth back in the socket without touching the root. If that’s not possible, place it in between your cheek and gums, in milk. Then, get to your dentist’s office right away.

Q: What if I crack my tooth?
A: For a cracked tooth, immediately rinse the mouth with warm water to clean the area. Put cold compresses on the face to keep any swelling down. See your dentist as soon as possible.

Q: If I bite my tongue or lip, how do I treat it?
A: If you bite your tongue or lip, clean the area gently with water and apply a cold compress. See your dentist or go to the emergency room as soon as possible.

Q: How do I treat a toothache?
A: For toothaches, rinse your mouth with warm water to clean it out. Gently use dental floss to remove any food caught between your teeth. Do not put aspirin on your aching tooth or gums; it may burn the gum tissue. If the pain persists, contact your dentist.

Q: What if I think my jaw is broken?
A: If you think your jaw is broken apply cold compresses to control the swelling. Go to your dentist or a hospital emergency department immediately.

Q: How do I remove an object that’s stuck in my mouth or teeth?
A: For objects stuck in the mouth, try to gently remove with floss but do not try to remove it with a sharp or pointed instrument. See your dentist or go to the emergency room as soon as possible.

Q: How can I avoid a dental emergency?
A: There are a number of simple precautions you can take to avoid accident and injury to the teeth:
Wear a mouthguard when participating in sports or recreational activities.
Avoid chewing ice, popcorn kernels and hard candy, all of which can crack a tooth.
Use scissors, NEVER your teeth, to cut things.

Reference material: American Dental Association

If you like my post and find the information productive, follow my blog 

drsreenita@tutdental.com

Dr.Sreenita Chowdhury

Unerupted /Impacted teeth

Impacted Tooth

An impacted tooth is a tooth that fails to fully pass through the gums.


Alternative Names
Tooth - unemerged; Unemerged tooth; Dental impaction; Unerupted tooth

Causes

Teeth start to pass through the gums (emerge) during infancy, and again when the primary (baby) teeth are replaced by the permanent teeth.

If a tooth fails to emerge, or emerges only partially, it is considered to be impacted. The most common teeth to become impacted are the wisdom teeth (the third set of molars). They are the last teeth to emerge, usually between the ages of 17 and 21.

An impacted tooth remains stuck in gum tissue or bone for various reasons. It may be that the area is just overcrowded and there's no room for the teeth to emerge. For example, the jaw may be too small to fit the wisdom teeth. Teeth may also become twisted, tilted, or displaced as they try to emerge, resulting in impacted teeth.

Impacted wisdom teeth are very common. They are often painless and cause no apparent trouble. However, some professionals believe an impacted tooth pushes on the next tooth, which pushes the next tooth, eventually causing a misalignment of the bite. A partially emerged tooth can trap food, plaque, and other debris in the soft tissue around it, leading to inflammation and tenderness of the gums and unpleasant mouth odor. This is called pericoronitis.


Symptoms
1.Bad breath
2.Difficulty opening the mouth (occasionally)
3.Pain or tenderness of the gums (gingiva) or jaw bone
4.Prolonged headache or jaw ache
5.Redness and swelling of the gums around the impacted tooth

6.Swollen lymph nodes of the neck (occasionally)
7.Unpleasant taste when biting down on or near the area
8.Visible gap where a tooth did not emerge




Exams and Tests
Your dentist will look for swollen tissue over the area where a tooth has not emerged, or has only partially emerged. The impacted tooth may be pressing on nearby teeth. The gums around the area may show signs of infection such as redness, drainage, and tenderness. As gums swell over impacted wisdom teeth and then drain and tighten, it may feel like the tooth came in and then went back down again.

Dental X rays confirm the presence of one or more teeth that have not emerged.


Treatment

No treatment may be needed if the impacted tooth is not causing any problems.

Over-the-counter pain relievers may help if the impacted tooth causes discomfort. Warm salt water (one-half teaspoon of salt in one cup of water) or over-the-counter mouthwashes may be soothing to the gums.

Removal of the tooth (extraction) is the usual treatment for an impacted tooth. This is usually done in the dentist's office, but difficult cases may require an oral surgeon. Antibiotics may be prescribed before the extraction if the tooth is infected.


Outlook (Prognosis)

Impacted teeth may cause no problems for some people and may never require treatment. Treatment is usually successful when it does cause symptoms.

It is often preferable to have wisdom teeth removed before age 30 due to the flexibility of bone, which will allow an easier removal and better healing. As a person ages, the bone becomes more rigid and complications can develop.



Possible Complication

Complications of an impacted tooth include:
Abscess of the tooth or gums
Chronic discomfort in the mouth
Infection
Malocclusion of the teeth
Plaque trapped between teeth and gums

When to Contact a Medical Professional

Call your dentist if there is an unemerged tooth (or partially emerged tooth) and pain in the gums or other symptoms have developed.

MORE INFORMATION ON THIS TOPIC

Review Date: 4/5/2012
Reviewed By: Paul Fotek, DMD, Florida Institute for Periodontics & Dental lmplants, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

Pus In The Mouth : Dental Abscess

Tooth Abscess:
A tooth abscess is a collection of infected material (pus) due to a bacterial infection in the center of a tooth.

Overview 

Alternate Names
Causes
Symptoms
Exams and Tests
Treatment
Outlook(Prognosis)
Possible Complications
When to Contact a Medical Professional
Prevention 

What Is a Tooth Abscess?

A tooth abscess is a collection of infected material (pus) due to a bacterial infection in the centre of a tooth.

REFERENCE FROM A.D.A.M.

Alternative Names

1.Periapical abscess;
2. Dental abscess; Tooth infection; Abscess - tooth

https://www.youtube.com/watch?v=M1ie1cpKlLw

Top
Causes

A tooth abscess is a complication of tooth decay. It may also result from trauma to the tooth, such as when a tooth is broken or chipped. Openings in the tooth enamel allow bacteria to infect the centre of the tooth (the pulp). Infection may spread out from the root of the tooth and to the bones supporting the tooth.
Infection results in a collection of pus (dead tissue, live and dead bacteria, white blood cells) and swelling of the tissues within the tooth. This causes a painful toothache. If the pulp of the tooth dies, the toothache may stop, unless an abscess develops. This is especially true if the infection remains active and continues to spread and destroy tissue.

Symptoms

The main symptom is a severe toothache. The pain is continuous and may be described as gnawing, sharp, shooting, or throbbing.

Other symptoms may include:

Bitter taste in the mouth
Breath odour
General discomfort, uneasiness, or ill feeling
Fever
Pain when chewing
Sensitivity of the teeth to hot or cold
Swelling of the gum over the infected tooth, that may look like a pimple
Swollen Glands of the neck
Swollen area of the upper or lower jaw -- a very serious symptom

Exams and Tests

The dentist will closely look at your teeth, mouth, and gums. You may have pain when the dentist taps the tooth. Biting or closing the mouth tightly also increases the pain. The gums may be swollen and red and may drain thick material.

Dental x-rays and other tests can help your dentist determine which tooth or teeth is causing the problem.

Treatment

1.The goals of treatment are to cure the infection, save the tooth, and prevent complications.

2.Antibiotics may be given to fight the infection. Warm salt-water rinses may be soothing. Over-the-counter pain relievers may relieve the toothache and fever.

3.Do NOT place aspirin directly over the tooth or gums, because this increases irritation of the tissues and can result in Mouth ulcers.

4.A root canal may be recommended in an attempt to save the tooth.

5.If there is a severe infection, the tooth may be removed or surgery may be needed to drain the abscess. Some people may need to be admitted to the hospital.

Outlook (Prognosis)

1.Untreated abscesses may get worse and can lead to life-threatening complications.
2.Prompt treatment usually cures the infection. The tooth can usually be saved in many cases.

https://www.youtube.com/watch?v=M1ie1cpKlLw
Possible Complications

Loss of the tooth
Blood infection (sepsis)
Spread of infection to soft tissue (facial cellulitis, Ludwig's angina)
Spread of infection to the jaw bone (osteomyelitis of the jaw)
Spread of infection to other areas of the body resulting in brain abscess, endocarditis,pneumonia, or other complications

When to Contact a Medical Professional

Call your dentist if you have a persistent, throbbing toothache.

Prevention

Prompt treatment of dental caries reduces the risk of tooth abscess. Traumatised teeth should be examined promptly by the dentist.

Root Canal Treatment:

Overview:-
Alternative names
Description
Risks
References

What is Root Canal Treatment:

A root canal is a dental procedure to remove dead or dying nerve tissue and bacteria from inside a tooth.

REFERENCE FROM A.D.A.M.

Alternative Names:
Endodontic Therapy

Description:
A dentist will use a needle to place numbing medicine(anesthetic) around the bad tooth.You may feel a slight prick when the needle is being inserted.
Next, your dentist uses a tiny drill to remove the top part of your tooth and expose the pulp. Pulp is made up of nerves, blood vessels, and connective tissue. It is found inside the tooth and runs to the jaw bone. Pulp supplies blood to a tooth and allows you to feel sensations such as temperature.


The infected pulp is removed with special tools called files. The canals (tiny pathways inside the tooth) are cleaned. Medicines may be placed into the area to make sure all the germs are gone and prevent further infection.
The cleaned tooth area is sealed with a soft, temporary material. Once the tooth is filled, a permanent crown may be placed on top.
You may be given antibiotics to treat and prevent infection.

Risks
Abscess
Loss of tooth
Nerve Damage
Tooth Fracture

References

Pogrel MA. Damage to the inferior alveolar nerve as the result of root canal therapy. J Am Dent Assoc. 2007;138(1):65-69.

Sore Throat or Tooth Infection or A Bigger Problem?

Lymphadenitis: Is Tooth A Cause?

A brief article on how pain in your tonsillar area or in your lymph nodes could be due to infection in the mouth.

Swollen Lymph Glands – Is tooth a cause?

A lymph node or lymph gland is a pea-sized organ of the immune system. They are an important part of the immune system and are widely distributed throughout the body, interconnected by lymphatic vessels. They act as the reservoir of immune cells and are tightly packed with white blood cells like T lymphocytes, B lymphocytes and macrophages. Lymph nodes also act like filters. They trap the foreign particles or cells, effectively removing them out of circulation.

What is the significance of these lymph glands?

Lymph glands along with the white blood cells help to fight infections caused by bacteria, viruses, fungi, etc. and trap allergens and foreign particles. As a response to these infections or disease process they may become enlarged due to inflammation. Swollen lymph gland is known medically as lymphadenopathy. The lymph glands may be enlarged due to infections, glandular fever, immune system disorders or even cancer. So a swollen or a painful lymph gland may indicate some underlying pathology. If required your doctor can find out the cause of enlarged lymph node with blood tests, X-ray or a biopsy.

What are the common causes of swollen lymph glands?

This swelling is usually a result of local infection. Local infection is contained in a particular area of the body, for e.g. head and neck. Typical examples are –

·         Skin or wound infections, such as Cellulitis or Erysipelas

·         Dental Abscess or pus

·         Common cold

·         Throat infections

·         Ear infections

Swelling may also occur due to virus or bacteria entering the blood and affecting the whole body. Sometimes bacterial infection may cause blood poisoning and develop into a life threatening condition. Some of the examples of these systemic causes are –

·         Rubella

·         Measles

·         Glandular fever

·         Staph infection

Rarely lymph glands may be swollen due to cancerous growth. You can differentiate the selling due to cancer when the lymph gland;

·         Slowly gets bigger

·         Is in an unusual location

·         Is painless

·         Is firm or hard in consistency

Some of the unusual causes of swollen lymph glands may be lupus, rheumatoid arthritis, cat scratch fever, toxoplasmosis, syphilis, tuberculosis, etc.

Can an infected tooth cause swollen lymph node/gland?

Yes. The bacteria or micro-organisms affecting the wisdom tooth and harbouring in the mouth is primarily due to strains of Streptococcus and Staphylococcus. In case of the partially erupted wisdom tooth that hides under the gum tissue, forming a pocket in the mouth - food accumulation is often observed. These are favourable conditions for micro-organisms to grow and usually result in acute infections around these teeth and collection of pus. Considering the fact that this is an inaccessible zone and the dependent position of the tooth often harbours infection, lymphadenitis is a common problem. This when ignored, infection spreads backward into the area of your tonsils and throat causing inflammation and pain in your lymph nodes.

Infection in the lymph nodes could also be due to the other teeth. The various lymph nodes closest to the offending tooth are affected depending on their location. Infection in the mouth could also be due to tuberculosis or syphilis. The diagram below illustrates the harmful position of a partially erupted wisdom tooth.

Symptoms and Diagnosis

Infected lymph nodes enlarge and are usually tender and painful.  Sometimes the skin over the infected lymph node looks red and feels warm to touch. Occasionally pockets of pus develop.

Enlarged lymph nodes that do not cause pain, tenderness or redness may indicate a serious disorder such as Tuberculosis, Lymphoma or Hodgkin's disease.

Usually lymphadenitis can be diagnosed on the basis of symptoms and its cause is an obvious nearby infection. When the cause cannot be identified easily, a biopsy or a tissue sample under a microscope and a culture may be needed to confirm diagnosis.

The video shows the lymph nodes in the head and neck region which are often affected due to infection in the oral cavity and surrounding areas.

When you should see a doctor?

See your doctor if:

·         you also have a sore throat or find it difficult to swallow or breathe

·         you also have unexplained weight loss or a persistent fever

·         your glands feel hard or don’t move when you press them

·         your glands have been swollen for more than two weeks or are getting bigger

·         your glands are swollen for no apparent reason and you don't feel unwell

Treatment and Prognosis

1. Treatment depends on the organism causing the infection.

2. For a bacterial infection, antibiotics are usually given orally or intravenously.

3. Warm compresses may relieve the pain in inflamed lymph nodes.

4. Usually once the lymph node infection has been treated, the nodes shrink and pain subsides.

5. Sometimes the nodes remain firm but no longer feel tender.

6. Abscesses must be drained surgically.

                7. For a tooth related infection, the tooth should be removed or treated .

The video shows the lymph nodes in the head and neck region which are often affected due to infection in the oral cavity and surrounding areas.

If you like the write up kindly follow my blog and post queries at www.tutdental.com
Thank you
Dr.Sreenita Chowdhury
drsreenita@tutdental.com

Trauma To The Tooth

Fractured, Loosened or Knocked-Out Tooth? 

Fractured tooth:

The Upper front teeth are prone to injury and fracture.If after injury, a tooth is not sensitive to air, most likely the superficial surface of the tooth has been harmed.

The hard protective layer of your tooth is called Enamel. This layer on injury does not cause pain.

Even if the enamel has sustained a small chip,immediate treatment is not required.

Fractures of the intermediate layer of your tooth(dentin) are usually painful or very sensitive when exposed to air or food. PEOPLE WITH SUCH FRACTURES SEEK DENTAL HELP QUICKLY.

The innermost part of the tooth is called the pulp. This is the life of your tooth. It has nerve and blood supply to the tooth. If injured it is very painful and you may be able to see a red spot or some blood will appear in the fracture.

In such cases, root canal treatment may be required to remove the remaining pulp before it dies and causes more pain/infection.

Loosened Tooth:

If an injury loosens a tooth in the socket or if the surrounding gum tissue bleeds a great deal, a person should see a Dentist immediately.

Milk tooth/Deciduous Teeth: If its a milk tooth, damaged and mobile, it may be removed to prevent harm to the permanent tooth.

Permanent tooth if loosened due to injury, the professional may do a procedure called splinting in the clinic. However, it is advised to hold the tooth in place for five mins with digital pressure until you reach the dentist.

Such teeth may require a root canal treatment eventually.

They may also change colour over the period of years and get brownish to black in appearance.

Discolouration Of The Tooth Subjected To Trauma

Knocked out or dislodged teeth:

Knocked out baby teeth should not be re-implanted for fear it will damage the permanent tooth bud.

A knocked out permanent tooth requires immediate treatment.

The tooth should be rinsed off and placed back in the socket in the right direction. If that is not possible,the tooth should be placed  in a glass of cold milk In either case, the tooth and the patient should be taken immediately to the dentist within 20 mins to 30 mins.

If a tooth is re-implanted within 30 minutes, the likelihood that it will stay healthy is good.

The longer the tooth is out of the socket, the worse the chance for long term success.

The dentist usually splints the tooth to the surrounding teeth for 7-10 days.

Re-implanted teeth eventually need root canal treatment.

In case the bone around the teeth has got fractured, the tooth may have to be splinted for 6 to 10 weeks.

In case of intrusion into the socket, its most likely going to come back to its position. However, consultation with a Dentist and x rays are mandatory.

If you like my post, please follow my blog www.tutdental.com
Good luck
Dr.Sreenita Chowdhury
drsreenita@tutdental.com