Friday, August 26, 2011

PAIN: THE UNIVERSAL DISORDER

It comes all of a sudden, as a weird sensation or a dull ache or can be a sharp pierce. It is nothing but the pain. In its early stages, it warns us that something is going wrong and we should take medicine or see a doctor. As it is worst, it makes our lives miserable.

Earlier humans considered pain as an evil or a demon or magic. The Greeks and Romans were the ones to advance the theory of sensation, the idea that the brain and nervous system play a role in the perception of pain. Later, Leonardo da Vinci and his contemporaries believed that brain is the central organ for perception or sensation. They also stated that the spinal cord transmits sensations to the brain.

Now you must be wondering what exactly happens in our body that causes pain?

Well, there are microscopic structures called pain receptors throughout our body. When a painful event happens, the damaged area releases chemicals, which in turn excite the nerve fibers. They transmit the pain signals to the spinal cord where the pain intensity is filtered and modified and then sent to the sensory cortex of brain through a bundle of nerve fibers which makes the person perceive the pain.

How is the pain treated?

The body’s own pain killers have proven to be the most effective pain relievers. The brain may signal the spinal cord to release the pain killers.

One way of relieving pain from outside the body is by inhibiting the hormones like prostaglandins which stimulate the nerve at the site of injury and cause inflammation and fever. Certain drugs like NSAIDs act against these hormones by blocking the enzymes required for the release of these hormones.

How does the pain killer act in the body?

The mechanism of pain killers (analgesics) is inhibition of prostaglandin synthesis. This reduces pain and inflammation.

What is drug tolerance?

When a person needs higher doses of the drug as the person’s reaction to the drug reduces though the dose at the effect site is the same is known as drug tolerance. This means larger doses of the drug is required to achieve the same effect. This occurs due to continuous intake of the drug.
When a specific molecule is present in higher levels in the brain through regular use of a drug, the brain adjusts accordingly. It changes the level of the chemicals which it produces to compensate the increased levels of the drug taken.

The best way to prevent tolerance is to reduce the use of drugs.

Tuesday, August 23, 2011

TEETH SPACING


Space between the teeth is a problem encountered by many and the cause of it varies from one person to the other.

There are many causes that lead to spacing between teeth:

In children, space between their milk teeth is that they save space for the permanent teeth and guide them into position, so parents do not need to panic as it is a natural process.

Space between the upper front teeth is due to the low frenal attachment, the frenum attaches the upper lip to the upper portion of the gum. If the frenum is attached at low level in the gum line, it causes a gap known as a diastema. Gaps can occur between any two teeth.

We may counter an unusual space between the teeth, if you come across such a gap then suspect for a gum disease. It is the plaque that plays a major role in causing this gum disease. The inner layers of the gums are pulled away from the teeth leading small gaps between the teeth.

A mismatch between the jaw size and teeth size can also cause spacing. When the size of the jaw is big and the teeth are too small, it leads to spacing.

Frequent use of tooth picks can also damage the gums causing space between teeth.

Some drugs that may stimulate the growth of granulation tissue in the gums may cause tooth movement leading to space.

Treatments for closing the space between teeth:
A diastema can be closed by undergoing orthodontic treatment or by placing thin pieces of porcelain bonded to the outside of the teeth or ceramic crowns.

Spacing caused due to gum disease can be closed by treating the gum disease itself. Proper maintenance of oral hygiene, including vitamin C rich foods in your diet helps in healing the gums.

Avoid frequent use of toothpicks especially the wooden tooth picks that are very harsh to the gums.


Wednesday, August 3, 2011

DENTAL CARIES

Dental caries commonly known as tooth decay or cavity is a disease caused by the bacteria where they change the carbohydrate like sugar in the food left on the tooth surface into acid that demineralises the hard tooth structure (enamel and dentin). It is still one of the most common diseases in the world today.

Dental caries will not occur if the oral cavity is free of bacteria. These bacteria are organized into a material known as dental plaque which forms thin yellowish film on the tooth surface. These plaque bacteria covert the sugars and carbohydrates into acids that dissolve the minerals on the tooth surface leading to tooth cavity.

Dental caries is not painful until it reaches the nerve or root of the tooth. The earliest sign of caries is chalky white spots on the tooth surface indicating demineralization of the enamel. As the lesion continues to progress it turns to brown and will eventually form a cavity. Before the cavity forms, the process is reversible but once the cavity is formed, the lost tooth structure cannot be regenerated.

Once the decay passes through enamel and enters dentin, the dentinal tubules have passages to the nerve of the tooth, when it reaches the nerve it causes tooth pain. In highly progressed cases, the infection may spread to the soft tissues surrounding the tooth.

How to reduce the risk of dental caries:

Studies revealed that it is not what one eats but how often carbohydrate is ingested is the significant dietary factor causing dental caries. It is advisable to avoid frequent snacking.

Teeth should be cleaned thoroughly at least twice a day using a fluoride tooth paste. Brushing helps remove the plaque on the tooth surface and flossing helps remove the plaque in between the teeth.

Visit your dentist regularly for routine cleaning and examination.


Treatment for dental caries:

At the early stages, fluoride treatment may help restore your tooth enamel by using fluoridated tooth paste and mouth rinses.

Once the damage becomes permanent, when the decay progresses beyond enamel the decayed part of the tooth is drilled away and is filled with restorative materials.

When the decay reaches the inner part of the tooth (pulp), it reaches the nerve and cause pain. It is treated by doing a root canal. In this procedure, the tooth pulp is removed and replaced with a filling material.

Some teeth are severely damaged that they need to be extracted. In such cases, the extracted tooth leaves a gap that causes the adjacent tooth to shift to the gap. To avoid this, the missing tooth should be replaced with a bridge or an implant.