Categories
Ailmemts & Remedies

Tooth Abscess (Dental Abscess)

What is a Tooth Or Dental abscess?

A Tooth abscess or Dental abscess occurs when the nerve of a tooth has become infected. This is usually due to dental decay, but may also be caused by injury to the tooth. Pus is formed, which can only escape through the root of the tooth. This causes pressure under the tooth, which makes it painful if touched. The pain is intense and throbbing may affect the side of the face.

You may click to see pictures of different tooth abscess

An abscess usually develops as a complication of dental caries, which gradually destroys the layer of enamel on the outside of the tooth and the inner dentin, allowing bacteria to invade the soft central core, or pulp, of the tooth. Eventually, a dental abscess may form. the pulp may also become infected if a tooth is damaged by a blow to the mouth.

An abscess may also form as a result of certain forms of gum disease. Periodontitis is usually caused by a buildup of dental plaque in a pocket that forms between a tooth and gum.

Usually the abscess originates from a bacterial infection that has accumulated in the soft pulp of the tooth. This is usually but not always associated with what is commonly described as a dull throbbing excruciating ache.

A tooth abscess typically originates from dead pulp tissue, usually caused by untreated tooth decay, cracked teeth or extensive periodontal disease. A failed root canal treatment may also create a similar abscess.

There are two types of dental abscess. A periapical abscess starts in the dental pulp and is most common. A periodontal abscess begins in the supporting bone and tissue structures of the teeth.

A dental abscess can be extremely painful and may cause the affected tooth to loosen in its socket.

What are the symptoms?
Common symptoms of an acute tooth abscess is a toothache or a persistent, throbbing pain at the site of the infection.Putting pressure or warmth on the tooth can induce extreme pain.

In some cases, a tooth abscess may perforate bone and start draining into the surrounding tissues creating local facial swelling. The lymph glands in the neck in some cases will become swollen and tender in response to the infection.
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The main symptoms of a dental abscess develop gradually and may include:-

· Dull aching around either or both of the cheekbones.
· Severe pain on touching the affected tooth and on biting or chewing.
· Loosening of the affected tooth.
· Red, tender swelling of the gum over the root of the tooth.
· Release of pus into the mouth.

If the abscess is not treated, the infection may make a channel from the tooth to the surface of the gum, and a painful swelling, known as a gumboil, may form. If the gumboil bursts, foul-tasting pus is released and the pain decreases. In some cases, the channel may persist, leading to a chronic abscess that discharges pus periodically. If the infection spreads to surrounding tissues, your face may become swollen and painful, and you may also develop a fever. If you suspect that you have a dental abscess, you should consult your dentist as soon as possible.

What should you do if you get a dental abscess?

You should seek advice from a dentist urgently to get the abscess drained. It may be possible to drain the pus through the tooth itself so the tooth can be saved (root canal treatment). If not, the tooth will need to be extracted to prevent the abscess recurring.

Sometimes, a dental abscess may burst. This allows the pus to drain and can ease the pain. The process can be encouraged by using a hot salt-water mouthwash (a teaspoon of salt to a cup of water).

Do not apply any heat directly to the face – a hot-water bottle, for example – as this will make the swelling worse. However, something cold on the face may ease the swelling, while painkillers occasionally help reduce the pain. In severe cases, antibiotics may be necessary.

Treatment:
Your dentist will ask you about your symptoms and examine your teeth and gums. He or she may take an x-ray of your mouth to confirm the diagnosis.

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One treatment for an abscessed tooth is to extract it, thereby removing the source of infection. However, in select cases a root filling or root canal therapy may be able to save the tooth by cleaning the source of infection in the pulp chamber and root canal system (for more information see Root canal therapy). Another possible treatment of an abscessed tooth is an invasive surgery through the cheek.The doctor will then remove the tooth, ridding the source of infection. Finally, the doctor will insert a tube through the cheek routing it the site of the tooth so any other pus may drain out through the tube in to either a Jackson-Pratt bulb or directly onto a surgical sponge.

If the abscess has been caused by decay, your dentist may try to save tooth. under local anesthesia, a hole is drilled through the top of the tooth to release the pus and relieve the pain. if there is a gumboil, a small cut may be made in the boil to drain the pus. The cavity is then cleaned with an antiseptic solution. a small tube may be left in place for a few days to allow any remaining pus to drain, and you will probably be given a course of antibiotics. Once the infection has cleared up, you will probably need root canal treatment. If it is not possible to save the tooth, it will be extracted.

To treat an abscess caused by gum disease, your dentist may use a probe to scrape out the plaque from the pocket between the affected tooth and gum. afterward, the pocket is washed out with an antiseptic solution. In severe cases, the tooth may be extracted.

What is the prognosis?
Most treatment is successful, but a small area of infection may persist and further treatment may be required.

Untreated Consequences:
An untreated severe tooth abscess may become large enough to perforate bone and extend into the soft tissue. From there it follows the path of least resistance. Largely dependent on the location of the infected tooth; the thickness of bone, muscle and fascia attachments, the infection then spreads either internally or externally.

External drainage may begin as a boil which bursts allowing pus drainage from the abscess, intraorally (usually through the gum) or extra orally. Chronic drainage will allow an epithelial lining to form in this communication to form a pus draining canal (fistula). Sometimes this type of drainage will immediately relieve some of the painful symptoms associated with the pressure.

Internal drainage is of more concern as growing infection makes space within the tissues surrounding the infection. Severe complications requiring immediate hospitalisation include Ludwig’s angina, which is a combination of growing infection and cellulitis which closes the airway space causing suffocation in extreme cases. Also infection can spread down the tissue spaces to the mediastinum which has significant consequences on the vital organs such as the heart. Another complication, usually from upper teeth, is a risk of septicaemia (infection of the blood), from connecting into blood vessels. Brain abscess, while extremely rare, is also a possibility.

Depending on the severity of the infection, the sufferer may feel only mildly ill, or may in extreme cases require hospital care.

How can a dental abscess be avoided?

Keeping your teeth healthy is the best way to prevent dental abscess.
Try to avoid cavities by reducing your intake of sugary foods and drinks – have them as an occasional treat, at mealtimes only. Brush your teeth twice daily using a toothpaste containing fluoride. To get the most benefit from the fluoride, do not rinse the toothpaste away after brushing.

Visit your dentist regularly, at agreed intervals. This way, problems can be diagnosed early and your treatment will be more straightforward.Remember that even if the abscess drains by itself, you should seek advice from your dentist for further assessment.

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.charak.com/DiseasePage.asp?thx=1&id=68
http://en.wikipedia.org/wiki/Tooth_abscess
http://www.netdoctor.co.uk/diseases/facts/dentalabscess.htm
http://www.dentalgentlecare.com/decay_process.htm

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Categories
Ailmemts & Remedies

Dental Caries

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“Baby bottle caries”,Dental caries is an infectious disease which damages the structures of teeth. Tooth decay or cavities are consequences of caries. If left untreated, the disease can lead to pain, tooth loss, infection, and, in severe cases, death of the tooth.

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.Destruction of a tooth by cervical decay from dental caries

There is a long history of dental caries, with evidence showing the disease was present in the Bronze, Iron, and Medieval ages but also prior to the neolithic period. The largest increases in the prevalence of caries have been associated with diet changes. Today, it remains one of the most common diseases throughout the world.

There are numerous ways to classify dental caries. Although the presentation may differ, the risk factors and development among distinct types of caries remain largely similar. Initially, it may appear as a small chalky area but eventually develop into a large, brown cavitation. Though sometimes caries may be seen directly, radiographs are frequently needed to inspect less visible areas of teeth and to judge the extent of destruction.

Tooth decay is caused by certain types of acid-producing bacteria which cause damage in the presence of fermentable carbohydrates such as sucrose, fructose, and glucose. The resulting acidic levels in the mouth affect teeth because a tooth’s special mineral content causes it to be sensitive to low pH. Specifically, a tooth (which is primarily mineral in content) is in a constant state of back-and-forth demineralization and remineralization between the tooth and surrounding saliva. When the pH at the surface of the tooth drops below 5.5, demineralization proceeds faster than remineralization (i.e. there is a net loss of mineral structure on the tooth’s surface). This results in the ensuing decay. Depending on the extent of tooth destruction, various treatments can be used to restore teeth to proper form, function, and aesthetics, but there is no known method to regenerate large amounts of tooth structure. Instead, dental health organizations advocate preventive and prophylactic measures, such as regular oral hygiene and dietary modifications, to avoid dental caries.

Epidemiology:
An estimated 90% of schoolchildren worldwide and most adults have experienced caries, with the disease being most prevalent in Asian and Latin American countries and least prevalent in African countries. In the United States, dental caries is the most common chronic childhood disease, being at least five times more common than asthma. It is the primary pathological cause of tooth loss in children. Between 29% and 59% of adults over the age of fifty experience caries.

The number of cases has decreased in some developed countries, and this decline is usually attributed to increasingly better oral hygiene practices and preventive measures such as fluoride treatment. Nonetheless, countries that have experienced an overall decrease in cases of tooth decay continue to have a disparity in the distribution of the disease. Among children in the United States and Europe, 60-80% of cases of dental caries occur in 20% of the population. A similarly skewed distribution of the disease is found throughout the world with some children having none or very few caries and others having a high number. Some countries, such as Australia, Nepal, and Sweden, have a low incidence of cases of dental caries among children, whereas cases are more numerous in Costa Rica and Slovakia.

Clasification:
Caries can be classified by location, etiology, rate of progression, and affected hard tissues. When used to characterize a particular case of tooth decay, these descriptions more accurately represent the condition to others and may also indicate the severity of tooth destruction.

Location:
Generally, there are two types of caries when separated by location: caries found on smooth surfaces and caries found in pits and fissures. The location, development, and progression of smooth-surface caries differ from those of pit and fissure caries.

Pit and fissure caries:
Pits and fissures are anatomic landmarks on a tooth where tooth enamel infolds creating such an appearance. Fissures are formed during the development of grooves, and have not fully fused (unlike grooves), thus possessing a unique linear-like small depression in enamel’s surface structure, which would be a great place for dental caries to develop and flourish.

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The pits and fissures of teeth provide a location for caries formation

Fissures are mostly located on the occlusal (chewing) surfaces of posterior teeth and palatal surfaces of maxillary anterior teeth. Pits are small, pinpoint depressions that are found at the ends or cross-sections of grooves. In particular, buccal pits are found on the facial surface of molars. For all types of pits and fissures, the deep infolding of enamel makes oral hygiene along these surfaces difficult, allowing dental caries to be common in these areas.
The occlusal surfaces of teeth represent 12.5% of all tooth surfaces but are the location of over 50% of all dental caries.

Among children, pit and fissure caries represent 90% of all dental caries. Pit and fissure caries can sometimes be difficult to detect. As the decay progresses, caries in enamel nearest the surface of the tooth spreads gradually deeper. Once the caries reaches the dentin at the dentino-enamel junction, the decay quickly spreads laterally. Within the dentin, the decay follows a triangle pattern that points to the tooth’s pulp. This pattern of decay is typically described as two triangles (one triangle in enamel, and another in dentin) with their bases conjoined to each other at the dentino-enamel junction (DEJ). This base-to-base pattern is typical of pit and fissure caries, unlike smooth-surface caries (where base and apex of the two triangles join).

Smooth-surface caries
There are three types of smooth-surface caries. Proximal caries, also called interproximal caries, form on the smooth surfaces between adjacent teeth. Root caries form on the root surfaces of teeth. The third type of smooth-surface caries occur on any other smooth tooth surface.

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In this radiograph, the dark spots in the adjacent teeth show proximal caries

Proximal caries are the most difficult type to detect. Frequently, this type of caries cannot be detected visually or manually with a dental explorer. Proximal caries form cervically (toward the roots of a tooth) just under the contact between two teeth. As a result, radiographs are needed for early discovery of proximal caries.

Root caries, which are sometimes described as a category of smooth-surfaces caries, are the third most common type of caries and usually occur when the root surfaces have been exposed due to gingival recession. When the gingiva is healthy, root caries is unlikely to develop because the root surfaces are not as accessible to bacterial plaque. The root surface is more vulnerable to the demineralization process than enamel because cementum begins to demineralize at 6.7 pH, which is higher than enamel’s critical pH. Regardless, it is easier to arrest the progression of root caries than enamel caries because roots have a greater reuptake of fluoride than enamel. Root caries are most likely to be found on facial surfaces, then interproximal surfaces, then lingual surfaces. Mandibular molars are the most common location to find root caries, followed by mandibular premolars, maxillary anteriors, maxillary posteriors, and mandibular anteriors.

Lesions on other smooth surfaces of teeth are also possible. Since these occur in all smooth surface areas of enamel except for interproximal areas, these types of caries are easily detected and are associated with high levels of plaque and diets promoting caries formation.

Other general descriptions:
Besides the two previously mentioned categories, carious lesions can be described further by their location on a particular surface of a tooth. Caries on a tooth’s surface that are nearest the cheeks or lips are called “facial caries”, and caries on surfaces facing the tongue are known as “lingual caries”. Facial caries can be subdivided into buccal (when found on the surfaces of posterior teeth nearest the cheeks) and labial (when found on the surfaces of anterior teeth nearest the lips).

Lingual caries can also be described as palatal when found on the lingual surfaces of maxillary teeth because they are located beside the hard palate.Caries near a tooth’s cervix—the location where the crown of a tooth and its roots meet—are referred to as cervical caries.

Occlusal caries are found on the chewing surfaces of posterior teeth. Incisal caries are caries found on the chewing surfaces of anterior teeth. Caries can also be described as “mesial” or “distal.” Mesial signifies a location on a tooth closer to the median line of the face, which is located on a vertical axis between the eyes, down the nose, and between the contact of the central incisors. Locations on a tooth further away from the median line are described as distal.

Etiology:
In some instances, caries are described in other ways that might indicate the cause. “Baby bottle caries”, “early childhood caries”, or “baby bottle tooth decay” is a pattern of decay found in young children with their deciduous (baby) teeth. The teeth most likely affected are the maxillary anterior teeth, but all teeth can be affected. The name for this type of caries comes from the fact that the decay usually is a result of allowing children to fall asleep with sweetened liquids in their bottles or feeding children sweetened liquids multiple times during the day.

.CLICK TO SEE
………….Rampant caries as seen here may be due to methamphetamine use.

Another pattern of decay is “rampant caries”, which signifies advanced or severe decay on multiple surfaces of many teeth. Rampant caries may be seen in individuals with xerostomia, poor oral hygiene, methamphetamine use (due to drug-induced dry mouth, and/or large sugar intake. If rampant caries is a result from previous radiation to the head and neck, it may be described as radiation-induced caries. Problems can also be caused by the self destruction of roots and whole Tooth Resorption when new teeth erupt or later from unknown causes.

Rate of progression:
Temporal descriptions can be applied to caries to indicate the progression rate and previous history. “Acute” signifies a quickly developing condition, whereas “chronic” describes a condition which has taken an extended time to develop. Recurrent caries, also described as secondary, is caries that appears at a location with a previous history of caries. This is frequently found on the margins of fillings and other dental restorations. On the other hand, incipient caries describes decay at a location that has not experienced previous decay. Arrested caries describes a lesion on a tooth which was previously demineralized but was remineralized before causing a cavitation.

Affected hard tissue:
Depending on which hard tissues are affected, it is possible to describe caries as involving enamel, dentin, or cementum.

Early in its development, caries may affect only enamel. Once the extent of decay reaches the deeper layer of dentin, “dentinal caries” is used. Since cementum is the hard tissue that covers the roots of teeth, it is not often affected by decay unless the roots of teeth are exposed to the mouth. Although the term “cementum caries” may be used to describe the decay on roots of teeth, very rarely does caries affect the cementum alone. Roots have a very thin layer of cementum over a large layer of dentin, and thus most caries affecting cementum also affects dentin.

Signs and symptoms:
Until caries progresses, a person may not be aware of it. The earliest sign of a new carious lesion, referred as incipient decay, is the appearance of a chalky white spot on the surface of the tooth, indicating an area of demineralization of enamel. As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation, a “cavity”.

The process before this point is reversible, but once a cavitation forms, the lost tooth structure cannot be regenerated. A lesion which appears brown and shiny suggests dental caries was once present but the demineralization process has stopped, leaving a stain. A brown spot which is dull in appearance is probably a sign of active caries.

As the enamel and dentin are destroyed further, the cavitation becomes more noticeable. The affected areas of the tooth change color and become soft to the touch. Once the decay passes through enamel, the dentinal tubules, which have passages to the nerve of the tooth, become exposed and cause the tooth to hurt. The pain can be worsened by heat, cold, or sweet foods and drinks. Dental caries can also cause bad breath and foul tastes. In highly progressed cases, infection can spread from the tooth to the surrounding soft tissues which may become life-threatening, as in the case with Ludwig’s angina.

Diagnosis:
Primary diagnosis involves inspection of all visible tooth surfaces using a good light source, dental mirror and explorer.

CLICK & SEE.

Dental radiographs, produced when X-rays are passed through the jaw and picked up on film or digital sensor, may show dental caries before it is otherwise visible, particularly in the case of caries on interproximal (between the teeth) surfaces.

Large dental caries are often apparent to the naked eye, but smaller lesions can be difficult to identify. Unextensive dental caries was formerly found by searching for soft areas of tooth structure with a dental explorer. Visual and tactile inspection along with radiographs are still employed frequently among dentists, particularly for pit and fissure caries.

Some dental researchers have cautioned against the use of dental explorers to find caries. In cases where a small area of tooth has begun demineralizing but has not yet cavitated, the pressure from the dental explorer could cause a cavitation.

Since the carious process is reversible before a cavitation is present, it may be possible to arrest the caries with fluoride to remineralize the tooth surface. When a cavitation is present, a restoration will be needed to replace the lost tooth structure. A common technique used for the diagnosis of early (uncavitated) caries is the use of air blown across the suspect surface, which removes moisture, changing the optical properties of the unmineralized enamel. This produces a white ‘halo’ effect detectable to the naked eye. Fiberoptic transillumination, lasers and disclosing dyes have been recommended for use as an adjunct when diagnosing smaller carious lesions in pits and fissures of teeth.

Causes:
There are four main criteria required for caries formation: a tooth surface (enamel or dentin); cariogenic (or potentially caries-causing) bacteria; fermentable carbohydrates (such as sucrose); and time. The caries process does not have an inevitable outcome, and different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene habits, and the buffering capacity of their saliva. Dental caries can occur on any surface of a tooth that is exposed to the oral cavity, but not the structures which are retained within the bone.

Teeth:
There are certain diseases and disorders affecting teeth which may leave an individual at a greater risk for caries.

Amelogenesis imperfecta, which occurs between 1 in 718 and 1 in 14,000 individuals, is a disease in which the enamel does not form fully or in insufficient amounts and can fall off a tooth.Dentinogenesis imperfecta is a similar disease. In both cases, teeth may be left more vulnerable to decay because the enamel is not as able to protect the tooth as it would in health.

In most people, disorders or diseases affecting teeth are not the primary cause of dental caries. Ninety-six percent of tooth enamel is composed of minerals. These minerals, especially hydroxyapatite, will become soluble when exposed to acidic environments. Enamel begins to demineralize at a pH of 5.5. Dentin and cementum are more susceptible to caries than enamel because they have lower mineral content. Thus, when root surfaces of teeth are exposed from gingival recession or periodontal disease, caries can develop more readily. Even in a healthy oral environment, the tooth is susceptible to dental caries.

The anatomy of teeth may affect the likelihood of caries formation. In cases where the deep grooves of teeth are more numerous and exaggerated, pit and fissure caries are more likely to develop. Also, caries are more likely to develop when food is trapped between teeth.

Bacteria:
The mouth contains a wide variety of bacteria, but only a few specific species of bacteria are believed to cause dental caries: Streptococcus mutans and Lactobacilli among them. Particularly for root caries, the most closely associated bacteria frequently identified are Lactobacillus acidophilus, Actinomyces viscosus, Nocardia spp., and Streptococcus Bacteria collect around the teeth and gums in a sticky, creamy-coloured mass called plaque, which serves as a biofilm. Some sites collect plaque more commonly than others. mutans.

.A gram stain image of Streptococcus mutans.

The grooves on the biting surfaces of molar and premolar teeth provide microscopic retention, as does the point of contact between teeth. Plaque may also collect along the gingiva. In addition, the edges of fillings or crowns can provide protection for bacteria, as can intraoral appliances such as orthodontic braces or removable partial dentures.

Fermentable carbohydrates:
Bacteria in a person’s mouth convert sugars (glucose and fructose, and most commonly sucrose – or table sugar) into acids such as lactic acid through a glycolytic process called fermentation. If left in contact with the tooth, these acids may cause demineralization, which is the dissolution of its mineral content. The process is dynamic, however, as remineralization can also occur if the acid is neutralized; suitable minerals are available in the mouth from saliva and also from preventative aids such as fluoride toothpaste, dental varnish or mouthwash. Caries advance may be arrested at this stage. If sufficient acid is produced over a period of time to the favor of demineralization, caries will progress and may then result in so much mineral content being lost that the soft organic material left behind would disintegrate, forming a cavity or hole.

Time:
The frequency of which teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries development. After meals or snacks containing sugars, the bacteria in the mouth metabolize them resulting in acids as by-products which decreases pH. As time progresses, the pH returns to normal due to the buffering capacity of saliva and the dissolved mineral content from tooth surfaces. During every exposure to the acidic environment, portions of the inorganic mineral content at the surface of teeth dissolves and can remain dissolved for 2 hours. Since teeth are vulnerable during these periods of acidic environments, the development of dental caries relies greatly on the frequency of these occurrences.

For example, when sugars are eaten continuously throughout the day, the tooth is more vulnerable to caries for a longer period of time, and caries are more likely to develop than if teeth are exposed less frequently to these environments and proper oral hygiene is maintained. This is because the pH never returns to normal levels, thus the tooth surfaces cannot remineralize, or regain lost mineral content.

The carious process can begin within days of a tooth erupting into the mouth if the diet is sufficiently rich in suitable carbohydrates, but may begin at any other time thereafter. The speed of the process is dependent on the interplay of the various factors described above but is believed to be slower since the introduction of fluoride. Compared to coronal smooth surface caries, proximal caries progress quicker and take an average of 4 years to pass through enamel in permanent teeth. Because the cementum enveloping the root surface is not nearly as durable as the enamel encasing the crown, root caries tends to progress much more rapidly than decay on other surfaces. The progression and loss of mineralization on the root surface is 2.5 times faster than caries in enamel. In very severe cases where oral hygiene is very poor and where the diet is very rich in fermentable carbohydrates, caries may cause cavitation within months of tooth eruption. This can occur, for example, when children continuously drink sugary drinks from baby bottles. On the other hand, it may take years before the process results in a cavity being formed, if at all.

Other risk factors:
In addition to the four main requirements for caries formation, reduced saliva is also associated with increased caries rate since the buffering capability of saliva is not present to counterbalance the acidic environment created by certain foods. As a result, medical conditions that reduce the amount of saliva produced by salivary glands, particularly the parotid gland, are likely to cause widespread tooth decay. Some examples include Sjögren’s syndrome, diabetes mellitus, diabetes insipidus, and sarcoidosis. Medications, such as antihistamines and antidepressants, can also impair salivary flow. Moreover, 63% of the most commonly prescribed medications in the United States list dry mouth as a known side effect. Radiation therapy to the head and neck may also damage the cells in salivary glands, increasing the likelihood for caries formation.

The use of tobacco may also increase the risk for caries formation. Smokeless tobacco frequently contains high sugar content in some brands, possibly increasing the susceptibility to caries. Tobacco use is a significant risk factor for periodontal disease, which can allow the gingiva to recede. As the gingiva loses attachment to the teeth, the root surface becomes more visible in the mouth. If this occurs, root caries is a concern since the cementum covering the roots of teeth is more easily demineralized by acids in comparison to enamel. Currently, there is not enough evidence to support a causal relationship between smoking and coronal caries, but there is suggestive evidence of a causal relationship between smoking and root-surface caries

Treatment:
Destroyed tooth structure does not fully regenerate, although remineralization of very small carious lesions may occur if dental hygiene is kept at optimal level. For the small lesions, topical fluoride is sometimes used to encourage remineralization. For larger lesions, the progression of dental caries can be stopped by treatment. The goal of treatment is to preserve tooth structures and prevent further destruction of the tooth.

Generally, early treatment is less painful and less expensive than treatment of extensive decay. Anesthetics   local, nitrous oxide (“laughing gas”), or other prescription medications — may be required in some cases to relieve pain during or following treatment or to relieve anxiety during treatment. A dental handpiece (“drill”) is used to remove large portions of decayed material from a tooth. A spoon is a dental instrument used to remove decay carefully and is sometimes employed when the decay in dentin reaches near the pulp.Once the decay is removed, the missing tooth structure requires a dental restoration of some sort to return the tooth to functionality and aesthetic condition.

Restorative materials include dental amalgam, composite resin, porcelain, and gold. Composite resin and porcelain can be made to match the color of a patient’s natural teeth and are thus used more frequently when aesthetics are a concern. Composite restorations are not as strong as dental amalgam and gold; some dentists consider the latter as the only advisable restoration for posterior areas where chewing forces are great. When the decay is too extensive, there may not be enough tooth structure remaining to allow a restorative material to be placed within the tooth. Thus, a crown may be needed. This restoration appears similar to a cap and is fitted over the remainder of the natural crown of the tooth. Crowns are often made of gold, porcelain, or porcelain fused to metal.

In certain cases, root canal therapy may be necessary for the restoration of a tooth. Root canal therapy, also called “endodontic therapy”, is recommended if the pulp in a tooth dies from infection by decay-causing bacteria or from trauma.

During a root canal, the pulp of the tooth, including the nerve and vascular tissues, is removed along with decayed portions of the tooth. The canals are instrumented with endodontic files to clean and shape them, and they are then usually filled with a rubber-like material called gutta percha. The tooth is filled and a crown can be placed. Upon completion of a root canal, the tooth is now non-vital, as it is devoid of any living tissue.

An extraction can also serve as treatment for dental caries. The removal of the decayed tooth is performed if the tooth is too far destroyed from the decay process to effectively restore the tooth. Extractions are sometimes considered if the tooth lacks an opposing tooth or will probably cause further problems in the future, as may be the case for wisdom teeth.

Extractions may also be preferred by patients unable or unwilling to undergo the expense or difficulties in restoring the tooth.

Prevention:
Oral hygiene
Personal hygiene care consists of proper brushing and flossing daily. The purpose of oral hygiene is to minimize any etiologic agents of disease in the mouth. The primary focus of brushing and flossing is to remove and prevent the formation of plaque. Plaque consists mostly of bacteria.As the amount of bacterial plaque increases, the tooth is more vulnerable to dental caries. A toothbrush can be used to remove plaque on most surfaces of the teeth except for areas between teeth.
Toothbrush are commonly used to clean teeth

When used correctly, dental floss removes plaque from areas which could otherwise develop proximal caries. Other adjunct hygiene aids include interdental brushes, water picks, and mouthwashes.

Professional hygiene care consists of regular dental examinations and cleanings. Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible dental caries development in high risk areas of the mouth.

CARIES PREVENTION IN CHILDREN- THE INDIAN CHALLENGE.

Ayurvedic Treatment & Prevention Of Tooth Decay

Homeopathic Treatment & Prevention of Tooth Decay…………..(1)………….(2).…….(3)

Dietary modification:
For dental health, the frequency of sugar intake is more important than the amount of sugar consumed. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids which can demineralize enamel, dentin, and cementum. The more frequently teeth are exposed to this environment, the more likely dental caries are to occur. Therefore, minimizing snacking is recommended, since snacking creates a continual supply of nutrition for acid-creating bacteria in the mouth.

Also, chewy and sticky foods (such as dried fruit or candy) tend to adhere to teeth longer, and consequently are best eaten as part of a meal. Brushing the teeth after meals is recommended. For children, the American Dental Association and the European Academy of Paediatric Dentistry recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep. Mothers are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the mother’s mouth.

It has been found that milk and certain kinds of cheese like cheddar can help counter tooth decay if eaten soon after the consumption of foods potentially harmful to teeth. Also, chewing gum containing xylitol (wood sugar) is widely used to protect teeth in some countries, being especially popular in the Finnish candy industry. Xylitol’s effect on reducing plaque is probably due to bacteria’s inability to utilize it like other sugars. Chewing and stimulation of flavour receptors on the tongue are also known to increase the production and release of saliva, which contains natural buffers to prevent the lowering of pH in the mouth to the point where enamel may become demineralised.

Other preventive measures:
The use of dental sealants is a good means of prevention. Sealants are thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves and thus prevents the formation of pit and fissure caries, the most common form of dental caries. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants, but their dental history and likelihood of caries formation are usually taken into consideration.

Fluoride therapy is often recommended to protect against dental caries. It has been demonstrated that water fluoridation and fluoride supplements decrease the incidence of dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel. The incorporated fluoride makes enamel more resistant to demineralization and, thus, resistant to decay. Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions as part of routine visits.

Furthermore, recent research shows that low intensity laser radiation of argon ion lasers may prevent the susceptibility for enamel caries and white spot lesions. Also, as bacteria are a major factor contributing to poor oral health, there is currently research to find a vaccine for dental caries. As of 2004, such a vaccine has been successfully tested on non-human animals, and is in clinical trials for humans of May 2006.

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

Source:http://en.wikipedia.org/wiki/Dental_caries

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Ailmemts & Remedies

Pyorrhoea

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Pyorrhoea, or periodontal disease, to give it a proper medical term, is disease of the gums. It is one of the most widely prevalent diseases. It affects the membrane surrounding the roots of the teeth and lead to loosening of the teeth, us formation, and shrinkage of the gum. This disease is the primary cause for tooth loss among adults….click & see

Symptoms:

The gums become tender, and on pressing, pus oozes out along the margin of the teeth. Us from the cavities continually find its way into the stomach. When the disease is far advanced, the gums become swollen, and the stomach being sosed with increasing quantities of pus, does not function properly. A sepsis may appear in various forms, digestion gets disturbed, liver trouble sets in, and the whole system is adversely affected.

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Root cause:
Pyorrhoea is triggered by bacterial activity .A thin layer of harmful bacteria is continuously building up on our teeth. If it is not removed by tooth cleansing, especially after meals, it forms an organized mass on the tooth surface in a short time. This is referred to as bacterial plaque. When accumulated, bacteria in plaque produce many toxins, which irritate the gums, causing them to become inflamed, tender and prone to bleeding easily. The bacterial activity is however, facilitated by the lowered vitality of the system. Other factors contributing to the development of pyorrhea include chemical irritants in the mouth, incorrect brushing, stagnation of food particles, and improper use of tooth picks.

Untreated gingivitis will develop into true periodontal disease. The term pyorrhoea is often used for advanced periodontal disease. There are three easily defined stages of periodontitis:

A) Early periodontitis:- In this stage plaque has been allowed to build up around the gums, and under the edges of the gums. This causes swelling of the edges of the gums and the gum pulls away from the tooth, allowing more harmful bacteria into this “pocket”.

B) Moderate Periodontitis :-At this stage the gum is detaching from the tooth further down the root, and the pockets are difficult to clean with normal methods. The detached gum spreads down beyond the top of the bone which is starting to get eaten away by the bacteria and toxins.This can still be treated non surgically.

C) Advanced Periodontitis :-The gums receed down the tooth –so called long in the tooth appearance. The pockets deepen and fill with pus . The teeth will become loose. You are quite likely to have severe bad breath and blood in your mouth when you eat most firm foods. This stage may need to be treated surgically.

Can antibiotics cure gum disease?

An antibiotic can help if you have a very painful swelling where pus has formed between the teeth, but generally we do not use antibiotics in the treatment of gum disease. We may however recommend localised antibiotic treatments for particular areas of your mouth. For example periochips, elyzol, gengigel, dentomycin. These are not a cure but can help us control an acute phase of gum disease.

Can I prevent gum disease?
In almost all cases the answer is yes. Good oral hygiene, use of dental floss or interdental brushes will prevent plaque building up. Regular dental examinations are also vital to ensure any gum disease is found at an early stage. To check if gum disease is present you will often find we gently probe your gums with a special blunt probe to see if their is any bleeding.

Other Healing Option :
The information of preventing and curing pyorrhea.

1. Improvement of your pseudo-diabetic constitution :-

To prevent pyorrhea you should cure diabetes or improve your pseudo-diabetic constitution by taking exercise.
In other words you can not cure your pyorrhea without improving your pseudo-diabetic constitution.
In Japan almost all dentists do not or can not explain this.

a. Exercise
Exercise is the best way for improving your pseudo-diabetic constitution. Only 30 minutes walk a day will improve your physical constituion.

b. Weight Control
we recommend you to control your weight. To this end Body Fat Calculator is useful.

c. Garlic & Royal jelly
Taking garlic is effective in improving your pseudo-diabetic constitution and pyorrhea.
Also taking royal jelly is effective in improving your pseudo-diabetic constitution and pyorrhea.

2. Brushing your teeth for over 20 minutes a day. :-
Long time brushing of gums will improve the blood circulation of gums. It will improve your pyorrhea.
Brushing of gums with an interdental brush also improve the blood circulation of gums. It improve your pyorrhea.
Brushing of gums with dental floss also improve the blood circulation of gums. It will improve your pyorrhea.

Herbs that helps: 1. Guava Leaves 2 Lemon & Lime 3.Spinach juice 4.Wheat

Ayurvedic: 1.Applications Dant Manjan Lal 2.Lavang Tel 3.Iremedadi Taila

Diet :The patient should take only boiled vegetable, fruit juice and fruit at first. Oranges and carrot should be used at

first. After the juice fast patient can take three normal meals per day but he or she has to take properly cooked food. White bread, white sugar, all tinned food, must be given up. Condiments, sauces, alcohol, coffee, and strong tea as well as meat and other flesh foods should be avoided.

Lifestyle: During the juice fast the bowels should be cleaned daily with a warm water enema. Daily dry friction and hipbath as well as breathing and other exercises, should form a part of the morning routine. A hot Epsom salts bath taken twice weekly will also be beneficial.

Homeopathic Treatment for Gum Disease that will prevent Pyorrhoea

Home Remedies for Pyorrhoea:
Pyorrhoea treatment using Guava
Chewing unripe guava is an excellent tonic for the teeth and gums. It stops the bleeding from the gums due to its styptic effect and richness in vitamin C. Chewing the tender leaves of the guava tree also helps in curing bleeding from the gums and keeps the teeth healthy. A decoction of root-bark can also be beneficially used as a mouthwash fur swollen gums

Pyorrhoea treatment using Lemon and Lime:
The regular use of lemon and lime is useful in pyorrhoea due to their high vitamin C content. They strengthen the gums and teeth, and are very effective in preventing and curing acute inflammations of the gum margins

Pyorrhoea treatment using Orange:
The use of orange has also been found beneficial in the treatment of pyorrhoea. This fruit should be eaten regularly and its skin rubbed over the teeth and gums. This will improve the condition

Pyorrhoea treatment using Pomegranate Rind:

Powder of the dry rind of pomegranate, mixed with pepper and common salt, can be applied as a very good dentifrice. Its regular application strengthens the gums, stops bleeding, and prevents pyorrhoea

Pyorrhoea treatment using Spinach Juice:
The juice of raw spinach is another valuable remedy for the prevention and treatment of pyorrhoea because of its beneficial effect on the teeth and gums. This effect is greatly enhanced if spinach juice is taken in combination with carrot juice. Both spinach juice and carrot juice should be taken in quantities of 125 ml each daily. A permanent aid for this affliction has been found in the use of natural raw foods, and in drinking an ample quantity of carrot and spinach juice

Pyorrhoea treatment using Lettuce:
Lettuce has proved useful in preventing pyorrhoea The leaves of this vegetable should be chewed everyday immediately after meals for this purpose

Pyorrhoea treatment using Wheat:
Wheat is especially valuable in the prevention and treatment of pyorrhoea. Wheat chapatis are usually taken with other foods, and hence, the other food also gets chewed properly. This not only provides the needed exercise for the teeth and gum but also aids in digestion

Pyorrhoea diet
Fruit juice and fruit diet
The patient should begin the treatment with a short juice fast for three to five days. Oranges and carrot should be used for juices. After the juice fast, the patient should spend the next three to five days on an exclusive fresh fruit diet, taking three meals a day of juicy fruits

Balanced diet
Thereafter he may gradually embark upon a balanced diet, with emphasis on fresh fruits, green salads, whole-meal bread, properly cooked vegetables, cheese, nuts, and milk

White bread,refined food, condiments, meat etc should be avoided

White bread, white sugar, and all refined and tinned foods must he completely given up. Condiments, sauces, alcohol, coffee, and strong tea, as well as meat and other fresh foods should also be avoided

Other Pyorrhoea treatment
Warm-water enema and a hip bath
During the juice fast, the bowels should be cleansed daily with a warm-water enema. Daily dry friction and a hip bath should be taken

Breathing exercises and hot Epsom salts bath
Breathing and other exercises, should form a part of the morning routine. A hot Epsom salts bath taken twice weekly will also be beneficial.

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.

Help taken from:allayurveda.com,www.home-remedies-for-you.com and

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Ailmemts & Remedies

Gum Bleeding

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Bleeding gums is among the common conditions affecting the oral cavity. The Chinese might have noticed bleeding gums as early as 2500 BC. They termed the associated diseases as “Ya-Kon” which means diseases of soft tissue surrounding the teeth. This problem still continues to affect us even with so many modern facilities available in the field of oral care. Gum disease begins with plaque, a sticky film of food particles, germs and saliva. If not removed, plaque will settle at the gum line. The germs will produce toxins that makes the gums red, tender and likely to bleed when brushing your teeth. There are chronic conditions and even some medications that can cause plaque to accumulate more quickly. The purpose of daily brushing rinsing and flossing is to clean away this plaque. When this plaque is not removed it can harden into tartar which builds up along the gum line and traps germs below. The mildest form of gum disease is called gingivitis and is the most common.

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The primary cause of gingivitis is the bacteria that coat your teeth, and if oral hygiene is poor, it forms a sticky white substance called plaque. The bacteria here proliferates faster and produces toxins that irritates your gums, keeping them swollen and red. When they are left untreated, they will destroy the tissues connecting the gums to the tooth, and eventually the tooth to the bones, causing a deep pocket and eventually attacks the bony structure. It has now progressed into what we call periodontitis, which is an irreversible form of gum disease.

ROOT CAUSES:
The following medical conditions are some of the possible causes of Bleeding gums as a symptom.

Poor dental hygiene

Gingivitis

Gum disease

Periodontitis

Trench mouth

Poorly fitting dentures

Leukemia

Diabetes

Pregnancy

Dry mouth (type of Dental conditions)

Vitamin deficiency

Certain medications

SYMPTOMS:

Bad Breath

Bleeding is usually noticed during brushing, or flosing with water or in the saliva, while spitting.

Eating of any coarse food items may induce bleeding

HOME REMEDY: With a pinch of salt soaked in a glass of lukewarm water, you now create a homemade saline solution. Use this to rinse in the morning and in the evening. This will help increase circulation in your gums and reduce the swelling.

No matter how well and how often you brush your teeth, you can’t reach the areas between your teeth and below the gums. Make the habit of flossing. Floss comes in very handy. Keep one in your bag or at your office. After meal, floss it!

LIFE STYLE :To brush your teeth to gain maximum benefits.
Push the loaded brush as far as you can into the area where the tooth meets the gum (sulcus).

Use a vibrating motion (very small wiggling motion) so that the bristles that are forced into the sulcus remain there as you vibrate. It’s an agitating type of motion. Do not use wide circular motions. Repeat this action as you move along the gum line for three to five seconds at each spot on both the cheek and tongue side.

Repeat this procedure until you have completed both upper and lower gum lines, inside and out. Whenever necessary spit out any build up of toothpaste and saliva until you finish. When done just rinse your mouth with filtered water.

Do this once a day gradually increasing to twice a day. When you are able to do it twice a day, do so for two weeks. After two weeks, your gums should have become very tough and should have a pink-white color.

WATER IRRIGATION:

Another important tool that you should have is a water pik system. Do not underestimate the power of water. Water can do a lot of damage (as you have seen with floods and huge tidal waves) and it can also be your friend.

An oral irrigator can drastically inhibit the formation of plaque and tartar. As time goes by, plaque, if not removed, turns into tartar. An oral irrigator pulls away approximately 50% of the negative bacteria with each use, leaving good bacteria that are needed to fight microbes.

A toothbrush is not designed to clean anything more than 1-3 mm, which is a normal healthy gum condition. Therefore an oral irrigator is necessary to reach those areas that cannot be maintained with the toothbrush and floss alone.

In the conclution it can be said if you perform the proper treatments to your teeth and do it right, and use the tools available to you, you shouldn’t have to suffer from gum disease or bleeding gums. You’ll have healthy white teeth with rosy-red and pink gums that will last you a life time and keep the rest of your body healthy to boot.

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.

Source:Allayurveda.com

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Tips for healthy teeth and gums

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Maintain a healthy smile with a few simple oral hygiene habits.

Don’t take your smile for granted. Maintain a healthy mouth by routinely practicing good oral hygiene habits and reporting problems.
Routine care
Clean your teeth daily and see your dentist one to two times a year to prevent gum disease and other oral problems.

To clean your teeth properly, brush them at least twice a day — plus preferably after each meal and snack — and floss daily. Also follow these other tips:

* Use a soft-bristled brush — it’s gentler on the gums.
* Place your brush at an angle against your teeth, and use short back-and-forth motions to clean your teeth. Also clean the inside and chewing surfaces of the teeth and your tongue.
* Replace your brush every three months.
* When you floss, gently ease the floss between your teeth. Then pull the ends of the floss against the front and back surface of a tooth so that the floss forms a “C” as it wraps around the tooth. Gently pull the floss from the gumline to the top of the tooth to scrape off plaque. Remember to floss the backs of your teeth and to expose fresh floss between your fingers as you progress through your teeth.

It is advised to gently massage the gum with one finger after you finish brushing and then floss with clean water.

Report problems

In addition to regular care and dental appointments, call your dentist if you develop any of the following signs and symptoms of gum disease:

* Red, tender, swollen gums
* Gums that bleed when you brush them, even if they’re not sore
* Gums that are pulling away from your teeth; you may notice that your teeth seem longer
* Pus around your teeth and gums when you press on the gums
* A continual bad taste in your mouth
* Loose teeth
* Changes in the way your top and bottom teeth touch, or changes in the feel of your dentures

The benefits of a healthy mouth
Good oral hygiene doesn’t have to be difficult. Get in the habit of taking a few simple steps each day and seeing your dentist regularly. You’ll be setting yourself up for a brighter smile and for better overall health, too.

Source:MayoClinic.com

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