(Continuation of the previous issue)
Following the signs & symptoms of dental caries we are here to discuss about control of caries.
Dr N Nachammai, B.D.S.,
Meenakshi Dental Clinic
# 40, Apparsamy Koil Street
Mylapore, Opp: Sanskirit College
CHENNAI - 600 004. India
Tel: +91 44 4231 2555
Mobile: +91 98407 30209
- CONTROL OF ALL ACTIVE LESIONS:
-visit to dental office
-preventive & restorative approach to the problem
2.REDUCTION IN INTAKE OF FREELY FERMENTABLE CARBOHYDRATES:
between meal eating & frequency of eating are directly related to incidence of dental caries.
Fermentable carbohydrate +Oral bacteria in plaque =Acid
Acid +Susceptible tooth =Dental caries.
Examples of freely fermentable carbohydrates are soft drinks, soda pop, hard candy, marshmallows,pastries,brownies,jams,jellies etc.
Substitutes for those containing sugar are unsweetened fruit juices,sugarfree chewing gums , walnuts, almonds etc.
3.REDUCTION IN NUMBER OF ORAL MICROBES:
Increase in frequency of tooth brushing.
Eg:brushing teeth with in 10 min after each meal.
4. ENCOURAGEMENT OF GOOD ORAL HYGIENE
5. USE OF FLUORIDES:
exposure of teeth to greater concentration of fluorides present in professionally applied solutions & gels,dentifrices&rinses results in preeruptive incorporation of fluoride into the enamel.
-communal water fluoridation
-school water fluoridation
-dietary fluoride supplement- pediatric fluoride supplements –fluoride vitamin preparation.
The following cascade will explain the different possible mechanism of action of fluorides:
Ingestion of fluorides-incorporation of fluorides into dentin & enamel-teeth more resistant to decay.
Ingestion of fluorides –secretion into saliva-accumulation in dental plaque-enhancement of remineralization of the underlying enamel-decreased caries suscepiblity.
The second topic under common dental problems is mouth ulcers.
Mouth ulcers/Apthous ulcers/Stress ulcers are open sores ie. Break in the continuity of the mucous membrane with associated inflammation.
Causative factors include
1. altered immunity-auto immunity
2.altered microbial flora- antibiotic ingestion
3.emotional tension- exam fear, job interviews,etc
4.minor truma- sharp dentures,fractured fillings & teeth
5.food allergy
6.menstruation.&
7.vitamin deficiency- folate& B12 deficincy.
Signs &Symptoms:
These are painful ulcers with reddish base covered with a yellowish false membrane.
Treatment
1. Always towards management of symptoms as the first step.
2.Adhesive bland ointments
3.Topical steroids.
4. Vitamin supplements.
The third topic under common dental problems is staining of teeth.
Staining of teeth can be classified under two major categories viz:
Extrinsic stains
Intrinsic stains
Extrinsic stains are stains caused by stimulants like tobacco,coffee, tea, betel nut, Artificial food colours as present in fruit juices ,jellies,lolypops etc.
Tobacco: SMOKERS - nicotin stains.-inner surface of upper teeth predominantly.
Tea coffee intake- excessive intake –light brown stains-front teeth
Betelnut chewers -dark brown stains of all teeth surfaces.
Extrinsic stains are deposited only superficially hence they are best handled by
BLEACHING OF TEETH- carried out by two different ways: OFFICE BLEACH & HOME BLEACH. The first one entirely carried out &controlled by the Dentist whereas the second one worked out by the patient himself as per the Dentists’advice.
Intrinsicstains are stains that are incorporated into the different layers of the tooth by certain stimulants like fluorides, tetracycline etc. As far as fluorides are concerned apart from the cariostatic potential that they offer, they also cause ugly stains if taken/ingested in excess.For eg: people living in highly fluoridated areas may present with stains varying from chalky white spots called the MOTTLED ENAMEL to varied colour bands on the enamel ranging from rust orange to cocoa
brown.This condition is called FLUOROSIS(dental). Such condition render high resistance to caries attack compromising the esthetic strategy of the patient.This dental condition is best handled by fabricating porcelain laminates/veneers for the visible teeth surfaces to enhance the esthetic profile.
The fourth topic under common dental problems is viral infections.
Viral infections that have oral manifestations are considered under this heading.The most common viral infections are
1. Herpes Simplex- childhood disease,characterized by fever,malaise,gingivostomatitis-inflammation of gums& lymphnode enlargement.Vesicles develop in the oral cavity & soon rupture followed by painful ulcers.Healing takes place in 10-14 days.Treatment includes symptomatic relief by local application of topical anaesthetics& adherent bland ointments,anti-pyretics&vitamin supplements.
2. Herpes Varicella-chickhen pox – childhood exanthematous disease associated with fever malaise, nausea, vomiting,skin & mucous membrane eruptions.
3. Measles-characterised by fever, malaise photophobia
4. Herpes Zoster
5. Mumps-Highly contagious ,acute painful enlargement of parotid& other salivary glands.
6. Rubella- German measles
7. Herpangina
8. Hand Foot Mouth Disease.
