Categories
Ailmemts & Remedies

Bruxism

Alternate terms: Bite stress; Clenching; Tooth grinding.

Definition:
Bruxism (from the Greek  (brugmós), “gnashing of teeth“) is characterized by the grinding of the teeth and is typically accompanied by the clenching of the jaw. Bruxism can be defined as the grinding of teeth for non-functional purposes. Some authors refer to nocturnal grinding as bruxism while the term bruxomania is given for grinding during the day time. It is an oral parafunctional activity that occurs in most humans at some time in their lives. In most people, bruxism is mild enough not to be a health problem.  While bruxism may be a diurnal or nocturnal activity, it is bruxism during sleep that causes the majority of health issues and can even occur during short naps. Bruxism is one of the most common sleep disorders.

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Bruxism led to the loss of nearly 50% of this patient’s visible tooth structure.

Bruxism is a chronic habit of clenching or grinding the teeth. Its significance lies in the potential damage the habit can cause to all three elements of the body’s “stomatognathic system” (i.e. the teeth, jaw muscles, and jaw joints).

If you find yourself waking up with sore jaw muscles or a headache, you may be suffering from bruxism — the grinding and clenching of teeth. Bruxism can cause teeth to become painful or loose, and sometimes parts of the teeth are literally ground away. Eventually, bruxism can destroy the surrounding bone and gum tissue. It can also lead to problems involving the jaw joint, such as temporomandibular joint syndrome.
Signs:
BruxismFor many people, bruxism is an unconscious habit. They may not even realize they’re doing it until someone comments that they make a horrible grinding sound while sleeping. For others, a routine dental checkup is when they discover their teeth are worn or their tooth enamel is fractured.

Other potential signs of bruxism include aching in the face, head and neck. Your dentist can make an accurate diagnosis and determine if the source of facial pain is a result from bruxism.

Most bruxers are not aware of their bruxism, and only 5% go on to develop symptoms, such as jaw pain and headaches, which will require treatment.[6] In many cases, a sleeping partner or parent will notice the bruxism before the person experiencing the problem becomes aware of it.

Bruxism can result in abnormal wear patterns of the occlusal surface, abfractions and fractures in the teeth. This type of damage is categorised as a sign of occlusal trauma.

Over time, dental damage will usually occur. Bruxism is the leading cause of occlusal trauma and a significant cause of tooth loss and gum recession.
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The effects of bruxism on an anterior tooth, revealing the dentin and pulp which are normally hidden by enamel
In a typical case, the canines and incisors of the opposing arches are moved against each other laterally, i.e., with a side-to-side action, by the medial pterygoid muscles that lie medial to the temporomandibular joints bilaterally. This movement abrades tooth structure and can lead to the wearing down of the incisal edges of the teeth. People with bruxism may also grind their posterior teeth, which will wear down the cusps of the occlusal surface. Bruxism can be loud enough to wake a sleeping partner. Some individuals will clench the jaw without significant lateral movements. Teeth hollowed by previous decay (caries), or dental drilling, may collapse, as the cyclic pressure exerted by bruxism is extremely taxing on the tooth structure.

Symptoms :
Patients may present with a variety of symptoms, including:

1.Anxiety, stress, and tension
2.Depression
3.Earache
4.Eating disorders
5.Headache
6.Insomnia
7.Sore or painful jaw

Sequelae

Eventually, bruxism shortens and blunts the teeth being ground and may lead to myofascial muscle pain, temporomandibular joint dysfunction and headaches. In severe, chronic cases, it can lead to arthritis of the temporomandibular joints. The jaw clenching that often accompanies bruxism can be an unconscious neuromuscular daytime activity, which should be treated as well, usually through physical therapy (recognition and stress response reduction).

Causes:
Multiple articles have incorrectly cited bruxism as a reflex chewing activity; bruxism is more accurately classified as a habit. Reflex activities happen reliably in response to a stimulus, without involvement of subconscious brain activity, and bruxism does not. All habitual activities are triggered by one kind of stimulus or another, and that does not make the habit a reflex. Chewing is a complex neuromuscular activity that is controlled by subconscious processes, with higher control by the brain. During sleep, the subconscious processes become active, while the higher control is inactive, resulting in bruxism. Some bruxism activity is rhythmic (like chewing), and some is sustained (clenching). Researchers classify bruxism as “a habitual behavior, and a sleep disorder.”

The etiology of problematic bruxism is unknown, though several conditions are known to be linked to bruxism. It is theorized that certain medical conditions can trigger bruxism, including digestive ailments and anxiety.
Other Causes of Tooth Wear
Bruxing isn’t the only cause of tooth wear. Here are a couple other common sources:

?Teeth that don’t mesh properly can wear at an accelerated rate, even under normal function. If you have this problem (known as “malocclusion” in dental terms), ask your dentist if orthodontic treatment might be an option.

You may click to learn more: Diagnoses › Malocclusion

?Factitious habits: Repeatedly chewing on hard or abrasive objects, biting your nails, grinding sunflower seed husks and other habits like these can accelerate the formation of wear facets (flattened planes) and chips on your teeth. An occlusal guard won’t help with this, but you may need the chipped or worn teeth repaired with bonding, fillings, or crowns. And you should try to quit the habit to avoid re-occurrence.

You may click to learn more: Diagnoses › Factitious habits
Diagnoses:
Bruxism can sometimes be difficult to diagnose by visual evidence alone, as it is not the only cause of tooth wear. Over-vigorous brushing, abrasives in toothpaste, acidic soft drinks and abrasive foods can also be contributing factors, although each causes characteristic wear patterns that a trained professional can identify. Additionally, the presenting symptoms may be difficult for a physician to attribute to bruxism.

The effects of bruxism may be quite advanced before sufferers are aware they brux. Abraded teeth are usually brought to the patient’s attention during a routine dental examination. If enough enamel has been abraded, the softer dentin will be exposed, and abrasion will accelerate. This opens the possibility of dental decay and tooth fracture, and in some people, gum recession. Early intervention by a dentist is advisable.

The most reliable way to diagnose bruxism is through EMG (electromyographic) measurements. These measurements pick up electrical signals from the chewing muscles (masseter and temporalis). This is the method used in sleep labs. There are three forms of EMG measurement available to consumers for use outside sleep labs. The first is bedside EMG units similar to those used by sleep labs. These units can be purchased for about $2000 and pick up their signals from facial muscles through wires connecting the bedside unit to electrodes that are adhesively attached to the user’s face. TENS electrodes or ECG electrodes may be used.

The second type of EMG measurement available to consumers is a self-contained EMG measurement headband sold under the trade name SleepGuard, available on loan from some dentists or at a rental rate of $50 per month from the manufacturer. The EMG measurement headband does not require adhesive electrodes or wires attached to the face. While it does not record the exact time, duration, and strength of each clenching incident as the most expensive bedside EMG monitors do, it does record the total number of clenching incidents and the total clenching time each night. These two numbers easily distinguish clenching from rhythmic grinding and allow dentists to quantify severity levels accurately.

Bedside EMG units and the self-contained EMG measurement headband can both be used either in silent mode as a diagnosis measurement or in biofeedback mode as a treatment.

A third method of diagnosis using EMG is available in disposable form under the trade name BiteStrip. The BiteStrip is a self-contained EMG module that adhesively mounts to the side of the face over the masseter muscle. The BiteStrip can only do one night of measurement and does not display the clench count or total clenching time, but rather provides a single-digit display related to bruxism severity. The BiteStrip provides significantly less information than an EMG bedside unit or EMG headband and costs about $60 per day to use.

Associated factors:
The following factors are associated with bruxism:

*Malocclusion, in which the upper and lower teeth occlude in a disharmonic way, e.g., through premature contact of back teeth
*Relatively high levels of consumption of caffeinated drinks and foods, such as coffee, colas, and chocolate
*High levels of blood alcohol
*Smoking
*High levels of anxiety, stress, work-related stress, irregular work shifts, stressful profession and ineffective coping strategies
*Drug use, such as SSRIs and stimulants, including methylenedioxymethamphetamine (ecstasy), methylenedioxyamphetamine (MDA), methylphenidate and other amphetamines, *including those taken for medical reasons .
*Hypersensitivity of the dopamine receptors in the brain
*GHB and similar GABA-inducing analogues such as Phenibut, when taken with high frequency
*Disorders such as Huntington’s and Parkinson’s diseases.
*Obsessive Compulsive Disorder

Treatment:

Many cases of bruxism are associated with emotional and psychological disturbances. Thus appropriate psychological counseling by a psychiatrist may be initiated. Hypnosis, relaxing exercise and massage can help in relieving muscle tension. Occlusal adjustments have to carried out to eliminate prematurities. Night guards or other occlusal splints that cover the occlusal surfaces of teeth help in eliminating occlusal interference, prevent occlusal wear and break the neuromuscular adaptation.

Self-care steps:

*Relax your facial and jaw muscles throughout the day. The goal is to make facial relaxation a habit.
*Massage the muscles of the neck, shoulders, and face.
*Learn physical therapy stretching exercises to help the restore a normal balance to the action of the muscles and joint on each side of the head.
*Apply ice or wet heat to sore jaw muscles
*Avoid eating hard foods like nuts, candies, steak.
*Drink plenty of water every day.
*Try to reduce your daily stress and learn relaxation techniques.
*Get plenty of sleep.

There is no single accepted cure for bruxism.  However, treatments are available.

Bruxism may be reduced or even eliminated when the associated factors, e.g., sleep disorders, are treated successfully.

Mouthguards and splints
Ongoing management of bruxism is based on minimizing the abrasion of tooth surfaces by the wearing of an acrylic dental guard, or splint, designed to the shape of an individual’s upper or lower teeth from a bite mold. Mouthguards are obtained through visits to a dentist for measuring, fitting, and ongoing supervision. There are four possible goals of this treatment: constraint of the bruxing pattern such that serious damage to the temporomandibular joints is prevented, stabilization of the occlusion by minimizing the gradual changes to the positions of the teeth that typically occur with bruxism, prevention of tooth damage, and the enabling of a bruxism practitioner to judge—in broad terms—the extent and patterns of bruxism through examination of the physical indentations on the surface of the splint. A dental guard is typically worn on a long-term basis during every night’s sleep. Although mouthguards are a first response to bruxism, they do not in fact help cure it. These mouthguards can cost anywhere from $200 to $650. Professional treatment is medically recommended to ensure proper fit, make ongoing adjustments as needed.

Another type of device sometimes given to a bruxer is a repositioning splint. A repositioning splint may look similar to a traditional night guard, but is designed to change the occlusion, or bite, of the patient. Randomly controlled trials with these type devices generally show no benefit[17][18] over more conservative therapies.

Nociceptive trigeminal inhibitor
The NTI-tss device is another option that can be considered. Nociceptors are nerves that sense and respond to pressure. The trigeminal nerve supplies the face and mouth. The NTI appliance fits on top of the teeth and alters the angle at which the jaw opens, by covering only the front teeth and preventing the rear molars from coming into contact, thus limiting the contraction of the temporalis muscle. When the grinding starts in the night the pressure which is applied to the two front teeth can, it is claimed, send quite a strong alarm signal to the brain. The NTI device must be fitted by a dentist.

The efficacy of such devices is debated. Some writers propose that irreversible complications can result from the long-term use of mouthguards and repositioning splints.

Biofeedback
Various biofeedback devices are currently available, and effectiveness varies significantly depending on whether the biofeedback is used only during waking hours, or during sleep as well. Many authorities remain unconvinced of the efficacy of daytime-only biofeedback.[21] The efficacy of biofeedback delivered during sleep can depend strongly on daytime training, which is used to establish a Pavlovian response to the biofeedback signal that persists during sleep.

The first wearable nighttime bruxism biofeedback device (introduced in 2001), was originally sold under the trademark GrindAlert by BruxCare, and is now sold under the trademark SleepGuard by Holistic Technologies, which owns the patents on the technology. The SleepGuard biofeedback headband is a battery-powered device that sounds a tone against the forehead when it senses EMG (electromyographic) muscle activity in the temporalis muscles. The tone starts out very quiet and then gets louder, allowing people to stop clenching without waking up. This device records and displays nightly data on the number of bruxism events that last for at least two seconds and the total accumulated duration of those events. The volume of the alarm and the bite force required to trigger the device are adjustable. After proper Pavlovian training during waking hours, more than 50% of users achieve significantly reduced bruxism.[22] The biofeedback sound on the headband is designed to come on slowly, allowing users to subconsciously respond in their sleep without waking up. The manufacturer offers a free three-week trial so that only people who find the device works well for them have to pay for it and claims that less than 15% of trial units are returned.

A mild electric shock bio-feedback device for treating Bruxism, GrindCare,[23] has been approved by the European regulatory authorities and was introduced to the market in 2Q2008 – and was approved by FDA Authorities in the US in early 2010. The device works by using simple electrodes mounted on the skin close to the cheek bones prior to sleeping; it detects the initial muscular contractions and immediately provides mild electrical shock pulses to the facial muscles. The electric shocks serve to interrupt bruxism activity. The device is worn on the head and reportedly reduces grinding, usually without interfering with the sleep of the patient as described by Jadidi, Castrillon & Svensson.   Thereby facial tension, joint defects and teeth disruption are reportedly reduced.

A taste-based biofeedback method was developed by Moti Nissani, Ph.D. and is called “The Taste-Based Approach to the Prevention of Teeth Clenching and Grinding”.     The therapy involves suspending sealed packets containing a bad-tasting substance (e.g. hot sauce, vinegar, denatonium benzoate, etc.) between the rear molars using an orthodontic-style appliance. Any attempt to bring the teeth together will rupture the packets and alert the user to the habit. This approach finds favor with some people who prefer to relate to biofeedback as “aversive therapy”. The Taste-Based Approach claims to suffer less from desensitization over time than sound-based biofeedback approaches may have, but may interrupt sleep more. (There is effectively no limit to the aversive taste of certain substances. We[who?] can therefore be sure that some harmless substance exists that will alert anyone to the habit.)

One bruxism biofeedback device which was briefly on the market but is no longer available was sold under the trademark Oralsensor. This device consisted of a pneumatic pouch embedded in a soft polymer plate that fits over upper or lower teeth. When the teeth came together with a force that exceeded a set threshold, an alarm is sounded in an earpiece worn by the user; the device is no longer sold.

In 2005, a new type of occlusive device was patented that produces a movement incompatible with teeth clenching. When nighttime bruxism occurs, people breathe through the nose. The device forces people to breathe through the mouth; by forcing the opening of the mouth, the device is claimed to stop clenching. The occlusive device has an electromyogram system that monitors the electric activity of the jaw muscle via wireless electrodes. These electrodes transfer jaw-muscle activity by radio frequency to an external monitoring system. Once the signal has been interpreted by the monitoring system, if a person clenches, the monitoring unit sends a radio frequency signal to a transceiver integrated in a mechanical actuator. The mechanical actuator has two occlusive flaps that block the nostrils, forcing breathing to occur through the mouth. Once the patient stops clenching, the flaps open, allowing breathing through the nose again. The occlusive device does not wake up people since it blocks nostrils slowly, and it never closes them completely to avoid sleep disruption.

Botox
Botulinum toxin (Botox) can be successful in lessening effects of bruxism, though serious side-effects are possible. Less than one microgram ingested or inhaled is sufficient to kill an adult human. In extremely dilute form (Botox), this toxin is used as an injectable medication that weakens (partially paralyzes) muscles and has been used extensively in cosmetic procedures to relax the muscles of the face and decrease the appearance of wrinkles. In April, 2008, a study was published in the Journal of Neuroscience  that showed that facially injected Botox can and does propagate into the brains of some test animals, and the U.S. Food and Drug Administration (FDA) announced that it was beginning a safety review of Botox and other similar drugs.

Botox was not originally developed for cosmetic use. It was, and continues to be, used to treat diseases of muscle spasticity such as blepharospasm (eyelid spasm), strabismus (crossed eyes) and torticollis (wry neck). Bruxism can also be regarded as a disorder of repetitive, unconscious contraction of the masseter muscle (the large muscle that moves the jaw). In the treatment of bruxism, Botox works to weaken the muscle enough to reduce the effects of grinding and clenching, but not so much as to prevent proper use of the muscle. The strength of Botox is that the medication goes into the muscle and is not supposed to get absorbed into the body (though the new research shows it does). The procedure involves about five or six simple, relatively painless injections into the masseter muscle. It takes a few minutes per side, and the patient starts feeling the effects the next day. Occasionally, some bruising can occur, but this is quite rare. Injections must be repeated more than once per year, and the risk factor of spread of the botulinum toxin is compounded by this repetition.

The symptoms that can be helped by this procedure include:

*Grinding and clenching
*Morning jaw soreness
*TMJ pain
*Muscle tension throughout the day
*Migraines triggered by clenching
*Neck pain and stiffness triggered by clenching

The optimal dose of Botox must be determined for each person as some people have stronger muscles that need more Botox. This is done over a few touch-up visits with the physician injector. This treatment is expensive, but sometimes Botox treatment of bruxism can be billed to medical insurance. The effects last for about three months. The muscles do atrophy, however, so after a few rounds of treatment, it is usually possible either to decrease the dose or increase the interval between treatments.

Other authorities caution that Botox should only be used for temporary relief for severe cases and should be followed by diagnosis and treatment to prevent future bruxism or jaw clenching, suggesting that prolonged use of Botox can lead to permanent damage to the jaw muscle.

Dietary supplements
There is anecdotal evidence that suggests taking certain combinations of dietary supplements may alleviate bruxism; pantothenic acid[citation needed], magnesium,   and calcium   are mentioned on dietary supplement websites. Calcium is known to be a treatment for gastric problems, and gastric problems such as acid reflux are known to increase bruxism .

Repairing damage
Damaged teeth can be repaired by replacing the worn natural crown of the tooth with prosthetic crowns. Materials used to make crowns vary; some are less prone to breaking than others and can last longer. Porcelain fused to metal crowns may be used in the anterior (front) of the mouth; in the posterior, full gold crowns are preferred. All-porcelain crowns are now becoming more and more common and work well for both anterior and posterior restorations. To protect the new crowns and dental implants, an occlusal guard should be fabricated to wear during sleep.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Bruxism
http://www.toothiq.com/dental-diagnoses/dental-diagnosis-bruxism-overview.html
http://www.whereincity.com/medical/topic/dental-health/diseases/bruxism-33.htm
http://www.colgate.com/app/Colgate/US/OC/Information/OralHealthBasics/CommonConcerns/BruxismToothGrinding/BruxismSignsAndSymptoms.cvsp

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Ailmemts & Remedies

Xerostomia Or Dry Mouth

Definition:
Xerostomia (pronounced as zeer-o-STO-me-uh)  is the medical term for the subjective complaint of dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties, cottonmouth, drooth, doughmouth or des (like a desert). Xerostomia is also common in smokers.

Lack of saliva is a common problem that may seem little more than a nuisance, but a dry mouth can affect both your enjoyment of food and the health of your teeth. The medical term for dry mouth is xerostomia (zeer-o-STO-me-uh).
.CLICK & SEE THE PICTURES
Dry mouth can cause problems because saliva helps prevent tooth decay by limiting bacterial growth and washing away food and plaque. Saliva enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

Xerostomia can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva’s remineralizing the enamel is no longer present, and can make the mucosa and periodontal tissue of the mouth more vulnerable to infection. Notably, a symptom of heavy methamphetamine use usually called “meth mouth” is largely caused by xerostomia which is worsened by the fact that methamphetamine at recreational doses can cause tight clenching of the jaw, bruxism (compulsive grinding of the teeth), or a repetitive ‘chewing’ movement like the user is chewing without food in the mouth.
Symptoms:
If you’re not producing enough saliva, you may notice the following signs and symptoms:

*Dryness in your mouth
*Saliva that seems thick, stringy
*Sores or split skin at the corners of your mouth
*Cracked lips
*Bad breath
*Difficulty speaking, swallowing
*Sore throat
*An altered sense of taste
*A fungal infection in your mouth
*Increased plaque, tooth decay and gum disease

In women, dry mouth may result in lipstick adhering to the teeth.

Causes:
Dry mouth has numerous causes, including:

*Medications. Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, decongestants, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson’s disease medications.

*Aging. Getting older isn’t a risk factor for dry mouth on its own; however, older people are more likely to be taking medications that may cause dry mouth. Also, older people are more likely to have other health conditions that may cause dry mouth.

*Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.

*Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.

*Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren’s syndrome, diabetes, Parkinson’s disease, HIV/AIDS, anxiety disorders and depression. Stroke and Alzheimer’s disease may cause a perception of dry mouth, even though the salivary glands are functioning normally. Snoring and breathing with your mouth open also can contribute to the problem.

*Tobacco use. Smoking or chewing tobacco can increase dry mouth symptoms.

It may be a sign of an underlying disease, such as Sjögren’s syndrome, poorly controlled diabetes, or Lambert-Eaton syndrome, but this is not always the case.

Other causes of insufficient saliva include anxiety,  or the consumption of alcoholic beverages, physical trauma to the salivary glands or their ducts or nerves, dehydration caused by lack of sufficient fluids, excessive breathing through the mouth, previous radiation therapy, and also a natural result of aging, other conditions or factors not mentioned also can have the ability to cause dry mouth. The vast majority of elderly individuals will suffer xerostomia to some degree, although the most common cause is the use of medications. Output from the major salivary glands does not undergo clinically significant decrements in healthy older people and clinicians should not attribute complaints of a dry mouth and findings of salivary hypofunction in an older person to his or her age. The results of one study suggested that, in general, objective and subjective measurements of major salivary gland flow rates are independent of age, gender, and race. Furthermore, signs and symptoms of dry mouth in the elderly regardless of race or gender should not be considered a normal sequela of aging. Playing or exercising a long time outside on a hot day can cause the salivary glands to become dry as the bodily fluids are concentrated elsewhere. Xerostomia is a common side-effect of various drugs such as cannabis, amphetamines, antihistamines, and some antidepressants.

Diagnosis:
To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you’ll need blood tests and imaging scans of your salivary glands to identify the cause.

He or she will do the following:-
Evaluate the patient’s complaint of dry mouth by asking pertinent history questions: When did he first notice the symptom? Was he exercising at the time? Is he currently taking any medications? Is his sensation of dry mouth intermittent or continuous? Is it related to or relieved by a particular activity? Ask about related symptoms, such as burning or itching eyes, or changes sense of smell in or taste.

Next, inspect the patient’s mouth, including the mucous membranes, for any abnormalities. Observe his eyes for conjunctival irritation, matted lids, and corneal epithelial thickening. Perform simple tests of smell and taste to detect impairment of these senses. Check for enlarged parotid and submaxillary glands.  Palpate for tender or enlarged areas along the neck, too.

Treatment:
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping non-carbonated sugarless fluids frequently, chewing xylitol-containing gum,[3] and using a carboxymethyl cellulose saliva substitute as a mouthwash may help. Aquoral or Pilocarpine may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth. Drinking water when there is another cause of the xerostomia besides dehydration may bring little to no relief and can even make the dry mouth more uncomfortable. The use of an enzymatic product such as Biotene toothpaste, Biotene mouthwash, and Biotene dry mouth moisturizing liquid has been proven to reduce the rate of recurrence of dental plaque resulting from dry mouth. Of note is that Biotene does not significantly reduce the count of streptococcus mutans.

If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn’t cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.

Lifestyle and home remedies:
When the cause of the problem either can’t be determined or can’t be resolved, the following tips may help improve your dry mouth symptoms and keep your teeth healthy:

*Chew sugar-free gum or suck on sugar-free hard candies.
*Limit your caffeine intake. Caffeine can make your mouth drier.
*Avoid sugary or acidic foods and candies because they increase the risk of tooth decay.
*Brush with a fluoride toothpaste. (Ask your dentist if you might benefit from prescription fluoride toothpaste.)
*Use a fluoride rinse or brush-on fluoride gel before bedtime.
*Don’t use a mouthwash that contains alcohol because these can be drying.
*Stop all tobacco use if you smoke or chew tobacco.
*Sip water regularly.
*Try over-the-counter saliva substitutes. Look for ones containing carboxymethylcellulose or hydroxyethyl cellulose, such as Biotene Oralbalance.
*Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse.
*Breathe through your nose, not your mouth.
*Add moisture to the air at night with a room humidifier.

Alternative medicine:-
Studies of acupuncture have shown that acupuncture may be helpful for people with dry mouth stemming from various causes. This procedure involves the use of fine needles, lightly placed into various areas of the body, depending on your area of concern. While this treatment looks promising, researchers are still studying exactly how this therapy works for xerostomia. You may click to see:->Acupuncture relieves symptoms of xerostomia


You may click & See also
: Xerosis

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.com/health/dry-mouth/HA00034
http://www.wrongdiagnosis.com/x/xerostomia/tests.htm
http://en.wikipedia.org/wiki/Xerostomia

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News on Health & Science

Secrets Your Dentist Doesn’t Want You To Know

Here are the secrets your dentist may not want you to know — but you need to know to get the best care possible:

………………..
Secret #1: Your dentist may not be as educated as you think.

Dentistry has changed a lot since your dentist graduated from dental school. There have been major advances in most materials used in fillings, bonding and root canals. If your dentist is not actively engaged in continuing education, it is unlikely that he or she is keeping up with these developments.

Secret#2. Your dentist may not have the latest technology. ret #2:

Digital x-ray: Dentists who do not have digital x-ray equipment are practicing in the dark ages. Digital x-rays use less radiation than film. They are easier to read and the ability to manipulate contrast makes diagnosis more accurate.

Ultrasonic Cleaning: Ultrasonic instruments vibrate plaque and calculus off your teeth, even in areas below your gums. It is much more comfortable than old-fashioned hand scraping.

CEREC: The CEREC system lets your dentist provide a ceramic crown or veneer in only one visit. CEREC means fewer injections, less drilling and no annoying temporaries.

Diagnodent: This is a laser that the dentist shines on the tooth and it tells whether there is a cavity and how deep it is. With the use of this technology, the dentist can detect cavities, and find them at an earlier stage, than traditional poking around the tooth.

Secret #3: Your dentist may be using mercury.

Mercury is toxic. Norway and Sweden have banned the use of mercury fillings.. But mercury fillings are less expensive and easier for the dentist to use. If your dentist does not use composite fillings, don’t go to that dentist any more. In the US, the FDA is way behind the ball and not actively warning patients about this like they have been mandated by the courts to do.

Secret #4: The lab may be more important than your dentist.

Dental labs create dentures, crowns, bridges, orthodontic appliances, and other dental restorations like implant crowns. There is a huge difference in the quality of these labs. You should be particularly wary if your dentist is using a lab in China or Mexico. Some of the top labs in the U.S. are Aurum Ceramics, MicroDental Laboratories, da Vinci Dental Studio, and Williams Dental Lab.

Secret #5: There’s more to good dentistry than filling cavities.

A competent dentist screens for more than tooth decay. He or she should be concerned about sleep apnea, jaw-related pain known as TMJ or temporomandibular joint disorder, periodontal disease, oral cancer, diabetes and hypertension.

Secret #6: You are probably using the wrong specialist for dental implants.

Since dental implants involve the removal of a tooth and replacing it with an artificial tooth, many patients assume that an oral surgeon is best qualified to do it. This can be a flawed assumption. Periodontists, who specialize in gum disease, may be a better option. Periodontists have special training in gum tissue and underlying bone in the mouth, which are significant issues in dental implants.

Secret #7: Bad dental advice about dentures can be fatal!

Dentures are no joke. Your dentist should examine your dentures for evidence of wear. Wearing down the teeth on your dentures can result in distorted facial characteristics, collapse of the bite and closure of the airway.

Secret #8: Your dentist may not know enough about sleep apnea.

The most common form of sleep apnea is caused by a blockage of the airway during sleep. It is a pretty scary condition. The patient can stop breathing hundreds of times during the night. A common treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP), which involves blowing pressurized room air through the airway at high enough pressure to keep the airway open.

As an alternative, your dentist, working with your physician, can custom make a device that guides the lower jaw forward, called a mandibular advancement device or MAD. MAD devices are more comfortable to wear and the compliance rates are much higher than using CPAP.

Secret #9: Not all cosmetic dentists have the skills to really improve your smile.

Any dentist can call herself a “cosmetic dentist.” Your dentist should be able to show you ten or more before and after photographs or videos, and be willing to give you the names of patients who have consented to be used as references.

Secret #10: How to avoid the root canal your dentist says you need.

Ask about the “ferrule effect.” Technically, this means that a root canal is unlikely to be successful if there is not enough tooth structure above the gum line to protect the tooth from coming loose or fracturing after it has been prepared for a crown. If your tooth fails the “ferrule effect” test, you might be better off with an extraction and an implant.

Source: Daily Finance August 27, 2009

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Taking Care of Your Teeth

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You teeth for a Lifetime
Many people could keep healthy teeth throught their lives. Although some diseases and conditions can make dental disease and tooth loss more likely, most of us have a good deal of control over whether we keep our teeth into old age.

The most important thing you can do to maintain good oral health is to brush and floss your teeth regularly.

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The Most mouth woes are caused by plaque, that sticky layer of microorganisms, food particles and other organic matter that forms on your teeth. Bacteria in plaque produce acids that cause cavities. Plaque also leads to periodontal (gum) disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth.

The best defense is to remove plaque daily before it has a chance to build up and cause problems. Brushing removes plaque from the large surfaces of the teeth and, if done correctly, from just under the gums. Flossing removes plaque between teeth.

Brushing
we learn  to brush our teeth when we were children and have kept the same technique throughout our lives. Unfortunately, many of us learned the wrong way. Even if we learned the correct method, it’s easy to become sloppy over the years. Brushing correctly isn’t instinctive. Getting the bristles to remove plaque without damaging your gums is a little trickier than you might think.
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There are different ways to brush teeth, and your dentist or dental hygienist can show you the method that he or she feels would be best for you. The modified Bass technique is among the most popular for adults and is very effective in removing plaque above and just below the gum line. Children, however, may find it difficult to move the toothbrush this way. A dentist or dental hygienist can explain to your child the best way to brush. Parents should supervise their children’s oral hygiene until age 9 or 10.

Some general  points are mentioned below about brushing:-
Brush at least twice a day — Many oral health professionals recommend brushing just before going to bed. When you sleep, saliva decreases, leaving the teeth more vulnerable to bacterial acids. Teeth should also be brushed in the morning, either before or after breakfast, depending on your schedule. After breakfast is ideal so food particles are removed. But if you eat in your car, at work or skip breakfast entirely, make sure you brush in the morning to get rid of the plaque that built up overnight.

Brush no more than three times a day
— Brushing after lunch will give you a good mid-day cleaning. Remember, though, that brushing too often can cause gums to recede over time.

Brush lightly
—Brushing too hard can cause gums to recede. Plaque attaches to teeth like jam sticks to a wooden spoon. It can’t be totally removed by rinsing, but just a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can’t remove it, so brushing harder won’t help. Try holding your toothbrush the same way you hold a pen. This encourages a lighter stroke.

Brush for at least two minutes — Set a timer if you have to, but don’t skimp on brushing time. Longer is fine, but two minutes is the minimum time needed to adequately clean all your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.

Have a standard routine for brushing — Try to brush your teeth in the same order every day. Some oral health professionals feel that this helps patients remember to brush all areas of their mouths. If you do this routinely, it eventually will become second nature. For example, brush the outer sides of your teeth from left to right across the top then move to the inside and brush rights to left. Repeat the pattern for your lower teeth. Always use a toothbrush with “soft” or “extra soft” bristles — The harder the brush, the greater the risk of harming gum tissue.

Change your toothbrush regularly — As & when the bristles begin to splay, the toothbrush loses its ability to clean properly. Throw away your old toothbrush after three months or when the bristles flare, whichever comes first. If you find your bristles flaring much sooner than three months, you may be brushing too hard.

Try easing up.
Choose a brush that has a seal of approval — Oral health-care professionals say, “It’s not the brush, it’s the brusher,” meaning that the exact type of brush you use isn’t nearly as important as your brushing technique and diligence. Any approved brush will be a good tool, but you have to know how to use it.

Electric is fine, but not always necessary  — Electric or power-assisted toothbrushes are a fine alternative to manual brushes. They are especially useful for people who are less than diligent about proper brushing technique or for people with physical limitations that make brushing difficult. As with manual brushes, choose soft bristles, brush for at least two minutes and don’t press too hard or you’ll damage your gums.
Choose the right toothpaste for you — It can be overwhelming to face the huge number of toothpaste choices in the average supermarket. Remember, the best toothpaste for you may not be the best toothpaste for someone else.
Toothpastes don’t merely clean teeth anymore. Different types have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or desensitizing teeth.

Most toothpastes on the market today contain fluoride, which has been proven to prevent, stop or even reverse the decay process. Tartar-control toothpastes are useful for people who tend to build up tartar quickly, while someone who gets tooth stains may want a whitening toothpaste. Whitening toothpastes will remove only surface stains, such as those caused by smoking, tea or coffee. To whiten teeth that are stained at a deeper level, talk with your dentist.

Your needs will likely change as you get older, so don’t be surprised if your hygienist recommends a type of toothpaste you haven’t used before. Look for the ADA seal of approval, which assures that the toothpaste has met the standards set by the American Dental Association. Once these conditions are met, choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint — these work alike, so let personal preference guide your decision.

Some people find that some toothpaste ingredients irritate their teeth, cheeks or lips. If your teeth have become more sensitive or your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.

How To Brush

Modified Bass brushing technique:

Hold the head of the toothbrush horizontally against your teeth with the bristles part way on the gums
Tilt the brush head to about a 45-degree angle, so the bristles are pointing under the gum line.

Move the toothbrush in very short horizontal strokes so the tips of the bristles stay in one place, but the head of the brush waggles back and forth
. Or use tiny circular motions. This allows the bristles to slide gently under the gum. Do this for about 20 strokes. This assures that adequate time will be spent cleaning away as much plaque as possible. Note: this is a very gentle motion. In healthy gums, this should cause no pain. Brushing too vigorously or with large strokes can damage gum tissue.

Roll or flick the brush so that the bristles move out from under the gum toward the biting edge of the tooth. This helps move the plaque out from under the gum line.

Repeat for every tooth, so that all tooth surfaces and gum lines are cleaned.
For the insides of your front teeth, where the horizontal brush position is cumbersome, hold the brush vertically instead. Again, use gentle back and forth brushing action and finish with a roll or flick of the brush toward the biting edge.

To clean the biting or chewing surfaces of the teeth, hold the brush so the bristles are straight down on the flat surface of the molars.
Gently move the brush back and forth or in tiny circles to clean the entire surface. Move to a new tooth or area until all teeth are cleaned.
Rinse with water to clear the mouth of food residue and removed plaque.
You can clear even more bacteria out of your mouth by brushing your tongue. With your toothbrush, brush firmly but gently from back to front. Do not go so far back in your mouth that you gag. Rinse again.
Flossing
Many people never learned to floss as children. But flossing is critical to healthy gums and it’s never too late to start. A common rule of thumb says that any difficult new habit becomes second nature after only three weeks. If you have difficulty figuring out what to do, ask your dentist or dental hygienist to give you a personal lesson.

Here are a few general pointers about flossing:...CLICK & SEE
Floss once a day — Although there is no research to recommend an optimum number of times to floss, most dentists recommend a thorough flossing at least once a day. If you tend to get food trapped between teeth, flossing more often can help remove it.

Take your time —
Flossing requires a certain amount of dexterity and thought. Don’t rush.
Choose your own time — Although most people find that just before bed is an ideal time, many oral health professionals recommend flossing any time that is most convenient to ensure that you will continue to floss regularly. Choose a time during the day when you can floss without haste.

Don’t skimp on the floss
—se as much as you need to clean both sides of every tooth with a fresh section of floss. In fact, you may need to floss one tooth several times (using fresh sections of floss) to remove all the food debris. Although there has been no research, some professionals think reusing sections of floss may redistribute bacteria pulled off one tooth onto another tooth.

Choose the type that works best for you — There are many different types of floss: waxed and unwaxed, flavored and unflavored, ribbon and thread. Try different varieties before settling on one. People with teeth that are closely spaced will find that waxed floss slides more easily into the tight space. There are tougher shred-resistant varieties that work well for people with rough edges that tend to catch and rip floss.
How To Floss
How you hold the floss is a matter of personal preference. The most common method is to wind the floss around the middle fingers then pull it taut and guide it with your index fingers. You also can wind it around your index fingers and guide it with your thumb and middle fingers or simply hold the ends of the floss or use a floss-guiding tool. (If you have a fixed bridge, a bridge threader can help guide floss under the bridge for better cleaning.) How you hold the thread is not as important as what you do with it. If you can’t settle in on a good method, ask your dentist or hygienist for suggestions.

Hold the floss so that a short segment is ready to work with.
Guide the floss gently between two teeth. If the fit is tight, use a back-and-forth motion to work the floss through the narrow spot. Do not snap the floss in or you could cut your gums.

Hold the floss around the front and back of one tooth, making it into a “C” shape. This will wrap the floss around the side edge of that tooth.

Gently move the floss toward the base of the tooth and up into the space between the tooth and gum.
Move the floss up and down with light to firm pressure to skim off plaque in that area. Do not press so hard that you injure the gum.
Repeat for all sides of the tooth, including the outermost side of the last tooth. Advance the floss to a clean segment for each tooth edge.
Other Ways To Clean Between The Teeth
Many people have larger spaces between their teeth and need additional tools, called interdental cleaners, to remove food particles and bacterial plaque adequately. You may have larger spaces that need extra care if you have had gum surgery or if you have teeth that are missing or out of alignment.

Small interdental brushes are tiny bristle or filament brushes that can fit between teeth and come in a variety of sizes and handle designs. These brushes clean better than floss when the gum tissue does not completely fill the space between your teeth. These little brushes also can help people with orthodontic bands on their teeth to remove bacterial plaque from around the wires and brackets.

Another tool for cleaning between teeth is wooden interdental cleaners. These long, triangular strips of wood can be softened and used to clean between teeth.

You can find these interdental cleaners at most drugstores and grocery stores. Your dentist or dental hygienist can show you how to use these cleaners to remove plaque between your teeth.

Other Cleaning Tools
To supplement your at-home brushing and flossing, your dentist or hygienist may suggest one or more of the following:

Oral irrigators These electrical devices pump water out in a slim steady or pulsating stream. Although they do not seem to remove plaque that is attached to the tooth well, they are very effective at flushing out food and bacteria byproducts in periodontal pockets or that get caught in orthodontic appliances. They are particularly useful for delivering medication to hard-to-reach areas. For example, prescription antibacterial rinses can be sprayed into gum pockets with an oral irrigator. Irrigators should be used in addition to brushing and flossing, not as an alternative.

Interdental tip — These soft, flexible rubber nibs are used to clean between the teeth and just below the gum line. Plaque and food debris can be removed by gently running the tip along the gum line.

Mouthwashes and rinses — As with toothpaste, your choice of mouthwashes or rinses will be guided by your personal mouth care needs. Over-the-counter rinses are available to freshen the breath, add fluoride or kill plaque bacteria that cause gingivitis. Some mouthwashes are designed to help loosen plaque before you brush. Ask your dentist or hygienist to recommend the type of rinse that would be best for you. If you need to avoid alcohol, read ingredient labels carefully. Many over-the-counter mouthwashes contain significant amounts of alcohol. In some cases, the dentist might prescribe a stronger fluoride or antibacterial rinse.

Source:Colgate World of Care

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Crowded Teeth

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What is Crowded or Crooked teeth?
Crowded or crooked teeth that overlap, protrude, or recess in a haphazard fashion can often be perceived as a personal disfigurement. If you feel embarassed to smile, then you should consider having your teeth straightened out.
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Apart from looking aesthetically unpleasing, crowded teeth also affect the general dental condition of your mouth. They tend to attract food deposits, which get trapped in the narrow spaces, and are difficult to keep clean with routine oral hygiene. This leads to higher incidence of tooth decay and gum disease.

What causes orthodontic problems ?

Most orthodontic problems like crowding,spacing,protrusion,extra or missing teeth and jaw growth problemshave a genetic origin.

Why is treatment important ?
Crooked,crowded and irregular teeth are hard to clean and maintain,these problems can contribute to tooth decay,gum problems and tooth loss.A bad bite can also cause an abnormal wear of tooth surfaces,difficulty in chewing,speaking and abnorml stress on supporting bone and tissueand possible joint problems,children and adultswhose malocclusion are left untreated may go through life feeling self conciousness,hiding their smiles with tight lips or keeping a protective hand.

The objective of any corrective therapy is to create an illusion of well-aligned teeth in relation to lip position when you smile. Such an illusion can sometimes be achieved by means of cosmetic contouring, the technical term used to reshape teeth. In more involved cases, it may be necessary to use bonding to build-out a portion of a tooth to create the impression of alignment. As the cases get more complex, we may need to veneer or crown the teeth to achieve the necessary objective.
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A child with severely crowded teeth. Such a case will need orthodontic treatment to achieve an acceptable result.
It may be necessary on occasion to extract certain teeth in conjunction with orthodontics, particularly in cases where crowding is extreme.

What about the problems of teenagers ?
When you think of orthodontics you tend to think of teenagers.And the fact is that orthodontic treatment in most cases begins between 9 and 14 years of age.It is important to know for the parents that some orthodontic problems are easier to correct in the early stages.

Does orthodontic treatment have any harmful effects ?

There is some discomfort or pain in the teeth after fixing the braces,which usually subsides within a week,the myth that the orthodontic treatment weakens the tooth is not correct.

Does extraction of teeth necessary for orthodontic treatment  ?
It depends on the severity of the problem,severly crowded,irregular teeth which are out of alignment cannot be aligned without the extraction of teethand no residual space is left after the treatment.

Till some years ago, orthodontic treatment was the only solution to crowded teeth. But now we have an alternative in cosmetic dentistry. We may add that orthodontics is still widely used in the younger population, while cosmetic procedures are more useful in professionals who may not have the time necessary to carry out the orthodontic procedures. Cosmetic dentistry is also useful in the older generation, who may not have an ideal gum or bone condition necessary to withstand the orthodontic forces.
Laminating with ceramic veneers can provide a pleasing result. This patient is a female adult who did not have the time to go in for orthodontic treatment. The protruding tooth was reduced to first bring it into alignment with the other teeth, and then both the front teeth were veneered.
The other two side teeth were cosmetically contoured to change their alignment, thus giving a fairly acceptable result.

Crowded teeth may require a combination of treatments in order to achieve an aesthetically and functionally satisfactory result. Individual problems require individual solutions, and the final decision about the right treatment procedure for you will be made by your dentist.


Resources:

http://www.lakshdeep.com/crowded.htm
http://www.whereincity.com/medical/topic/dental-health/articles/670.htm

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