MOUTH ULCERS: CAUSES AND PREVENTION

Mouth Ulcers or Aphthous ulcers are painful sores which each and every person might have experienced at some stage in their life. These ulcers are absolutely harmless and most of the time they subside without any treatment.

Usually these ulcers occur inside of the lips and cheeks, tongue and gums. They normally subside within 2 weeks. It is always advisable to see a doctor if the ulcers persist for more than 3 weeks, increasing in size and is getting more painful. It could be a cause of underlying disease.

Causes of mouth ulcers

There are many contributing factors such as

•  Bacterial infection 
•  Stress
•  Iron or folic acid deficiency
•  Vitamin B12 deficiency
•  Any local trauma such as accidental cheek or lip biting or a sharp tooth or vigorous tooth brushing
•  Allergic factors like food or drug allergy
•  Hereditary

How to get rid of mouth ulcers

Most of the time, the ulcers subside without any treatment. Some simple home remedies will help most of the time.

•  Try gargling with a mixture of warm water and salt.
• Avoid eating hard and spicy foods which can aggravate pain.

But if they are really disturbing your daily routine then you should definitely seek a dentist’s help. Your dentist might prescribe you a topical protective gel to apply on the ulcer or a topical mouthwash. If still the ulcers do not subside, your dentist might prescribe a topical medication containing steroid to reduce the inflammation.

How to prevent mouth ulcers

• Visit your dentist regularly
• Try to maintain low stress levels
•  Avoid any foods or drugs that seem to trigger mouth ulcers         
• Eat a healthy diet

GUM RECESSION: CAUSE, TREATMENT & PREVENTION

What is Gum Recession?

Gum recession is a process where in the margins of the gum tissue surrounding the tooth wears off exposing more of the tooth structure or the tooth’s root. Gum recession is the indication of gum disease which if not treated leaves the teeth more susceptible to cavities and infection.                            

The first sign of gum recession is teeth are highly sensitive to heat and cold at the gum line.

What Causes Gum Recession?
There are many contributing factors causing gum recession:

• Teeth that are malpositioned in the jaw bone are at high risk of gum recession. When the teeth do not come together evenly, it causes more stress on the gums and bone, which leads to gum recession.
• Bacterial infection that destroys gum and the surrounding bone that hold the tooth in position leads to gum recession if not treated.
• Aggressive tooth brushing using hard tooth brush and wrong brushing techniques leads to gum recession. In such cases the front teeth are most likely to have this problem.
• Clenching and grinding the teeth during night can also lead to gum recession affecting the front teeth mainly.
• Inadequate dental care such as poor oral hygiene, improper brushing technique and usage of tobacco leads to gum recession.
• Hereditary is also one of the contributing factors for gum recession.

Treatment for Gum Recession

• Mild gum recession can be treated by your dentist by deep cleaning the affected area. This treatment involves removal of the plaque and tartar on the teeth and root surfaces below the gum line and the exposed root area is smoothened.
• Severe gum recession involving bone loss can be treated with gum surgery to repair the damage.
• There are three ways to treat gum recession surgically. One is using the adjacent tissue surrounding the affected tooth as a graft to cover the exposed area. Second is using tissue from the roof of the mouth to repair the recession. Third is using AlloDerm grafting material to repair recession without any donor tissue.

How to prevent Gum Recession?

• Practicing good oral hygiene by regular and correct way of brushing teeth.
• Visit your dentist regularly every 6 to 8 months for examination and professional cleaning.
• Treat your teeth grinding habit. your dentist may advice you to wear night guards to prevent grinding teeth during sleep.
• Correct your malocclusion by taking proper treatment.
• Avoid usage of tobacco.

ORAL HYGIENE

As an old saying goes “Prevention is better than cure”, it is always wise to maintain your oral hygiene to prevent any kind of damage to the teeth. 

Now the question is how to maintain a proper oral hygiene to protect the teeth from damage? Well let us see how it is.
How would a well maintained teeth look like?

• Your teeth will be free of plaque and debris
• Your gums do not bleed when you brush, indicates they are infection free.
• You are free from bad breath.              

These are the major signs indicating you are maintaining a proper oral hygiene. But how to achieve is the major concern. Here are few instructions:

• Brush your teeth twice a day with fluoridated toothpaste and make a habit of washing your mouth thoroughly after consuming any kind of food.

• Brush your teeth in up-down and circular motion, never brush sideways as this will eventually abrade your teeth, leading to hyper sensitivity.

• Floss your teeth at least once in a day.

• Watch what you eat, avoid excess consumption of sticky and sugary foods. Especially children should avoid taking such foods to prevent tooth decays.

• Eat foods rich in calcium and minerals to build healthier and stronger teeth.

• Visit your dentist every six months to get a thorough dental check up as it is always wise to detect dental problems at the earliest stage and get appropriate treatment done.

• Children should be taken to a dentist as a rule of thumb “first visit at the first birthday".

• Parents should start brushing their child's teeth when their first tooth appears. Use a soft brush and a non-fluoridated tooth paste. Children of age five and above can use fluoridated tooth paste as permanent teeth starts erupting at this age.

Now that we have the basic knowledge of maintaining oral hygiene, let us look at the consequences of bad oral hygiene.

• Accumulation of plaque leads to bacterial growth resulting in dental caries.

• Poor oral hygiene leads to gum infection resulting in red, swollen and bleeding gums and bone loss.
• Bleeding gums give bacteria direct access into the blood stream. Certain bacteria stick to the blood cells (platelets) leading to blood clots which increases the risk of heart stroke or attack.

• As oral cavity is a gate way to the rest of the body, the bacteria in plaque can travel from mouth to lungs causing lung infections or aggravating already existing infection. 

             
Maintain a good oral hygiene to lead an overall healthy life

               

DENTAL IMPLANTS

For many years the options we had to replace a missing tooth were dentures and bridges. But today with the help of research and advanced technology we have an improved treatment option, the dental implants.           

 

What are Dental Implants?

• Dental implant is an artificial tooth root which resembles the root of a tooth secured into the jawbone through a surgical procedure to replace a missing tooth or teeth. 
• They are generally titanium screws which are bio compatible with the bone.
• Dental implants are used to support the crowns and bridges, dentures. 

Who can get Dental Implants?                   

• Any healthy person who has a missing tooth or teeth is a ideal person for a dental implant.
• There must be enough strong bone to support and hold the implant in position.
• Best candidates for implant will have healthy gums and periodontal tissues.
• However there are certain medical conditions which affect the success rate of dental implants such as diabetes, cancer, gum disease, smoking.  It is very important to let your dentist know about your detailed medical history.

• Prior to the surgery a detailed assessment of the overall bone and gum health is evaluated. A full mouth x-ray is taken to evaluate the shape and dimensions of the bone so as to properly orient the implant.

How is a dental Implant placed? 

• Local anesthesia is given prior to the procedure. An incision is made over the gums at the site where the implant is to be placed. Then the gum flaps are elevated. Dental implants are secured into the bone by drilling into the bone using precision drills with regulated speed. Care is taken to avoid any damage to the vital structures.
•  The amount of time required for the healing is ideally 4-6 months during which the bone is formed around the implant and the implant fuses with the surrounding bone.
•  Bone grafting may be required prior to placing the implant if there is insufficient bone.
•  Once the dental implant bonds with the jawbone, a small connector post called abutment is attached to the implant to hold the new tooth. To fabricate a new tooth, impression of your teeth are made and sent to the dental lab where your new tooth is fabricated and this new tooth or crown is then attached to the abutment.  It is the similar procedure if multiple teeth need to be replaced.

Success of Dental Implant

• Success of dental implant is mainly related to the operative skills, health of bone at the site and patient’s oral hygiene
•  Maintenance is one of the crucial factors for the success of implant. It is important to maintain a proper and healthy oral hygiene by proper brushing and flossing. Visit your dentist regularly to monitor your implant and bone health.

Image courtesy drvincentdolce.com

POST DENTAL EXTRACTION CARE

Tooth extraction is always the last line of treatment given to a patient under the condition when the tooth cannot be saved by any other alternative treatments.

Now let’s see the conditions under which a tooth is extracted:

• Tooth that is grossly decayed and cannot be saved with any other treatment.
• Advanced gum disease associated with bone loss resulting in severe mobility of the tooth.
• Fracture of the tooth which is vertical along the axis of the tooth, splitting the tooth to two halves.
• Mal positioned tooth which has disturbed the arch form.
• Impacted third molars (wisdom tooth) causing any sort of problems.
• For orthodontic treatments to create required space.

Care to be taken before extraction:

• Thorough medical and dental history of the patient will be taken by the dentist.
• Make sure you give a proper medical history as there are certain medical conditions which contraindicate extraction until the condition is under control.
• Antibiotics prescribed must be used as directed by the dentist, do not forget to mention any drug allergies if there are any.
• Do mention if pregnant.
• Do not go for the procedure on empty stomach.

Care to be taken after extraction:

• Bleeding is the most common complication after extraction, hence bite on the gauge or the  cotton pressure pack that the dentist have placed in the socket for at least half an hour.
• To avoid further bleeding avoid rinsing the mouth for the day, do not spit if there is bleeding.
• Avoid drinking liquids with a straw, touching the extraction area with tongue which can disturb the clot.
• Eat soft, non spicy, cold diet for 24 hours after the procedure.
• To minimize the swelling you can place ice packs to the side of face over the extraction area 10min on and off.
• Do not smoke or consume alcohol at least for 48 hours after the surgery.
• Take the medications as per the instructions.
• Keep the area clean by mild rinsing with warm salt water after 24 hours of the procedure at least twice a day.
• If stitches placed, get it removed after a week.
• Contact you doctor if any unusual symptoms occur.