General Measures For Good Oral Hygiene
-
Select the right quality of tooth brush which should be short, soft and have uniformly trimmed bristles
-
Brush teeth at least twice a day for 2-3 minutes particularly at night before going to sleep.
- Use right technique of teeth brushing
- Never use force while brushing
- Avoid too much sugar and aerated drinks
- Avoid eating in between meals, if can not be avoided rinse your mouth or preferably brush your teeth
- Ensure regular dental checkup at 6 monthly interval
Tooth brushing is extremely important for cleaning teeth, for massage of the surrounding gums and maintaining oral hygiene. Regular brushing keeps the tooth surface free of plaque, which is soft material that gets deposited on the tooth surface and is the cause of dental caries and periodontal problems
Categories: Dental Conditions Tags:
Inflammatory Gingival Enlargements
The gingival enlargement can be acute which is very painful or they can be chronic which may be painless.
Salient features
|
Treatment
Pharmacological
-
Tab Ciprofloxacin 500 mg 2 times a day for 3-5 days
-
Tab Nimesulide 100 mg 2 times a day for 3-5 days
-
Rinsing with 0.2% Chlorhexidine twice daily
Refer to a periodontist for surgical management and drainage of pus
Patient education
-
Proper brushing twice daily with super soft tooth brush
References
-
Ramford and Ash. Periodontology and Periodontics. In: Modern theory and practice. 1st Indian edition AITBS Publishers 1996, pp 145.
-
Shafer, Hine, Levy. In: A textbook of oral pathology. 4th edition, Saunders, pp 782.
Categories: Dental Conditions Tags:
Juvenile Periodontitis
Common in the age group of 13-25 years characterized by rapid destruction of periodontal tissues.
Salient features
|
Treatment
Pharmacological
Cap Tetracycline 250 mg 4 times a day for 14 days
Surgical
Extraction of badly involved teeth. Refer the patient to periodontist for further periodontical management at the earliest
Patient education
-
Proper brushing twice daily with super soft tooth brush.
References
-
Ramford and Ash. Peridontology and Periodontics. In: Modern theory and practice. 1st Indian edition AITBS Publishers 1996, pp 166.
-
Carranza. In: Clinical Periodontology, 5th edition, Saunders, pp 299.
Categories: Dental Conditions Tags:
Adult Type Peridontitis
Most common dental disease includes diseases of the gum.
Salient features
|
Treatment
Nonpharmacological
Advise brushing twice daily once after breakfast and once after dinner with super soft tooth brush for atleast 3 minutes and refer to a dentist for oral prophylaxis by thorough scaling and root planing.
Pharmacological
Local Therapy
-
Rinsing with 0.2% chlorhexidine twice daily
-
Gel Metronidazole to be massaged on the gums twice daily
-
Gel Chlorohexidine to be massaged on the gums twice daily
Systemic therapy
In adults Cap Tetracycline 250 mg 4 times a day for 5-7 days. In children very deep pockets: Combination of drugs i.e.,
-
Cap Ciprofloxacin 500 mg twice daily for 5-7 days
-
Tab Tinidazole 600 mg twice daily for 5-7 days
Recheck the depth of periodontol pockets, if it persist, refer to a periodontist for further management.
References
-
Ramford and Ash. Peridontology and periodontitis. In: Modern therapy and practice. 1st Indian Edition, AITBS Publishers 1996, pp 163.
-
Mitchell D A, Mitcchell L. In: Oxford handbook of clinical dentistry, 2nd edition reprint.1996, pp 212.
Categories: Dental Conditions Tags:
Dental Caries
This is a microbial disease of hard tissues of teeth characterized by demineralization of inorganic and destruction of organic part of the tooth.
Salient features
|
Treatment
Examine for stage of caries and treat accordingly.
Nonpharmacological
In non-cavitated lesion and low risk patient with good oral hygiene practices, no treatment is given. In cavitated lesion, restoration is done
Pharmacological
Where caries is likely to progress (in high risk patient) pit and fissure sealout
-
Topical 2% Sodium fluoride
-
0.2% Chlorhexidine mouth wash twice a day
Assessment of response to therapy
- For caries active patient – follow up visit every 3 months and to check the progression of white spot on the teeth.
- For normal patients – follow up every 6 months to 1 year to check the development of the white spot/cavitation
Patient education/prevention
For caries active/high risk patient preferably
- Diet control and avoidance of sugar containing food
- Frequent ingestion of food containing sucrose should be substituted by sugar free foods
- Oral hygiene: a) brushing of teeth twice a day b) flossing c) thorough rinsing after every meal
- Fluoride application using Topical 2% Sodium fluoride (by dentist) 4 applications at weekly intervals at the age of 3, 7, 11 and 13 years.
0.05% sodium fluoride daily rinse, (should not be swallowed)
0.2% sodium fluoride supervised weekly rinse in school (age of children >7 years) only if these children have been identified as caries active patients
References
- Sturdevant CM. Roberson TM, Heymann HO, Sturdevant JR. In: The Art and Science of Operative Dentistry, 3rd edition, Mosby 1995, pp 100-120.
- Mitchell DA, Mitchel L. In: Oxford Handbook of Clinical Dentistry, 2nd edition, reprint 1996, pp 28.
Categories: Dental Conditions Tags:
Lateral Peridontal Abscess
Salient features
|
Treatment
Pharmacological
-
Cap Amoxycillin 250-500 mg 3 times a day for 5 days
-
Tab Metronidazole 400 mg 3 times a day for 5 days
For surgical treatment refer to a dentist for debridement of pocket and drainage of pus and irrigation with chlorhexidine. Spread of infection to be closely observed to prevent complications like Ludwig’s Angina.
Patient education
-
Maintenance of oral hygiene
-
No hot fomentation over the skin
-
Control of diabetes mellitus if present
References
- Ramford and Ash. Peridontology and Peridontics. In: Modern Therapy and Practice, 1st Indian edition AITBS Publishers 1996, pp 126
- Mitchell D A, Mitchell L. In: Oxford Handbook of Clinical Dentistry. 2nd edition, reprint 1996, pp 266.
Categories: Dental Conditions Tags:
Dental Abscess
Patient presents with pain and swelling. The most common types of dental abscesses are periapical abscess and lateral periodontal abscess.
Periapical Abscess
Salient features
|
Immediate treatment
To give antibiotics as given below and refer to a dentist
Pharmacological
Cap Amoxycillin 250 -500 mg 3 times a day for 5 days
Or
Tab Ciprofloxacin 250-500 mg two times a day for 5 days
Surgical
Drainage of pus to relieve occlusion by entering the pulp chamber. If fluctuant swelling of soft tissue is present drain by incision. Extraction or root canal treatment should be done when acute symptoms subside. Spread of infection should be closely observed to prevent complications like Ludwig’s angina.
Patient education
-
Maintenance of oral hygiene
-
Control of diabetes mellitus, if present
-
No hot fomentation over the skin
References
-
Kruger G O. In: Textbook of oral and maxillofacial surgery, 6th edition, C.V. Mosby 1984, pp 196.
-
Grossman I I, Seymore O, Carlos D R. In: Endodontic Practice 2nd Indian Reprint 1991, pp 20
Categories: Dental Conditions Tags:
Tooth Ache
|
The causes of toothache directly associated with tooth are caries, periodontal socket, abrasion, attrition, erosion and peridontitis. The indirect causes of toothache are maxillary sinusitis (recent bout of common cold), trigeminal neuralgia where pain is sudden, sharp, severe or short duration, like electric shock. Trigger zone may or may not be present. Treatment Pharmacological
Surgical Removal of irritant (like high filling, high spot on crown or bridge). Excavation of caries and sedative dressing with clove oil. Anaesthetize the tooth and extirpate the pulp (if pulp is exposed). Assess the response by getting immediate radiographs, radiograph after 6 weeks to assess bone loss and root resorption, and clinical assessment of mobility of tooth after 6 weeks Patient education
References
|
Categories: Dental Conditions Tags:
Tooth Avulsion
One of the commonest sequelae of facial trauma is tooth avulsion or exfoliation.
Salient features
|
Treatment (Immediately refer to a dentist)
-
Best result are observed if tooth is reimplanted within 5-10 minutes
-
Fixation of implanted tooth with periodontal wiring, arch bar wiring or composite resin; fixation period 6 to 8 weeks; root canal treatment done after replantation only (to avoid desiccation of periodontal ligament).
Interim storage
-
Best method is to place back the tooth in the socket immediately
-
Other storage mediums are saliva, milk (placed in ice since this minimizes the adverse effects on the periodontal ligament) and saline
Pharmacological
- Cap Amoxycillin 250-500 mg 3 times a day for 5 days
Or
Tab Ciprofloxacin 250-500 mg twice a day for 5 days - Tab Ibuprofen 400 mg 3 times a day for 3-5 days
Or
Tab Nimesulide 100 mg 2 times a day for relief of pain
References
- Andreasen, J O, Andreasen, F M, Balkland L K, Flores, M T. In: Traumatic Dental Injuries – A Manual 1st edition Munksgaard 1999, pp 40.
- Cohen S, Burns R C. In: Pathways of the Pulp. 5th Edition, Mosby 1991, pp 479.
Categories: Dental Conditions Tags: