Dental viva voice questions in Impression Materials

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Dental viva voice questions in Impression Materials

Impression materials Viva voice questions

  • what is syneresis?

fluid exuded from the impression seen as droplets on surface are called syneresis

  • What is imbibition?

Absorption of water by the impression when placed in water is called imbibition.

  • which impression shows least dimensional change upon disinfection?

Addition silicones have very little residual polymerization, making them the most dimensional you stable of all the dental materials. They are also highly biocompatible impression materials.

  • what is suspension?

Larger, visible, non-soluble particles in solvent. It exists as 2-phase system.

  • what is Emulsion?

Liquid droplets which are suspended in water.

  • Define colloids or Sols?

A solid, liquid, or a gaseous substance made up of large molecules or masses of small molecules that remain in suspension in a surrounding continuous medium of different matter.img_1337

  • what is Accelerator?

A compound that speeds up the reaction; also refers to the component called the catalyst in the reaction of impression materials.

  • what is Cast?

A dimensionally accurate reproduction of a part or parts of the oral cavity or extra oral facial structures produced in a durable hard material.

  • Define Addition reaction? 

A polymerisation reaction in which each polymer chain grows to a maximum length in sequence and no reaction byproduct is formed.

  • Define Condensation reaction?

A polymerisation process in which the polymer chains grow simultaneously and a reaction by-product is formed with associated shrinkage.

  • What is Cure? 

The reaction process that takes place primarily during the setting of a polymer but continues after setting.

  • Define Working time?

The total time from the start of mixing to the final time at which an impression tray can be fully seated without distortion.

  • Define Setting time?

The elapsed time from the star of mixing until the impression material becomes firm enough to resist permanent deformation .

  • what is permanent Deformation?

Irreversible change in shape that occurs when the polymer responds as a viscous liquid under an applied pressure.

  • what is pseudo plastic behaviour?

Characteristic of a material to become more fluid when an applied force is increased; this behaviour involves shear thinning and is strain rate dependent.

  • what is dashpot?

An element of the viscoeladtic model describing the viscous response of a polymer.

  • what are the ideal properties of an Impression material?
  1. They should be fluid enough to adapt to the oral tissue.
  2. they should be viscous enough to be contained in the tray that is seated in the mouth.
  3. while in the mouth, they should be transform into a rubbery or a rigid solid in a reasonable amount of time. Ideally the total Setting time should be less than 7 minutes
  4. The set impression should not distort or tear when removed from the mouth
  5. the impression should maintain itsdimensional stability after removal of a cast so that a second or third cast can be made from the same impression.
  6. The materials should be biocompatible
  7. The materials, associated processing equipment, and processing time should be cost-effective.

Periodontal pockets Classification, symptoms and Treatment

Periodontal pockets are caused by microorganism so and their products, which produces pathological tissue changes that lead to the depending of the gingival sulcus. Pocket formation starts as an inflammatory change in the connective tissue wall of the gingival sulcus.

Periodontal pocket

Classification of periodontal pockets

Gingival pocket

It is also known as pseudo pocket or relative pocket or false pocket. It is formed by gingival enlargement, without destruction of the underlying periodontal tissues. The sulcus is deepened because of the increased bulk of the gingiva.

Periodontal pocket

It is also known as absolute or true pocket. There is destruction of the supporting periodontal tissue; progressive pocket deepening leads to destruction of the supporting periodontal tissues and loosening and exfoliation of the teeth.

Supra bony pocket:

Also known as supracrestal or supra alveolar pocket. Bottom of the pocket is coronal to the underlying alveolar bone. Bone destruction pattern is horizontal.

Infrabony pocket:

Also known as subcrestal or intraalveolar pocket. Bottom  of the pocket is apical to the level of the adjacent alveolar bone. Bone destruction pattern is vertical.

classification based on tooth surfaces involved:

Simple pocket:

only one tooth surface involved

complex pocket:

involves more than one surface

compound or spiral pocket:

Originating on one tooth surface and twisting around the tooth to involve one or more additional surfaces.

Signs and symptoms

  • Gingival bleeding
  • Gingival suppurations
  • Tooth mobility
  • In some cases pus may be expressed by applying digital pressure.
  • Localised pain or deep pain in the bone.
  • There may be bluish red vertical zone from the gingival margin to the alveolar mucosa.

    How to manage periodontal pockets?

  • Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it’s important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.
  • pocket irrigation- devices like squeeze bottles and blunt hypodermic needles can be used to irrigate the pocket with chemotherapeutic agents.
  • flap surgery to eliminate pockets.

Dental Materials Viva Voice Questions for 1st year BDS

Physical properties of Dental materials

dental viva

  1. What is the goal of the dentistry?

The goal of the dentistry is to maintain or improve the quality of life of the dental patients. This goal can be accomplished by preventing disease, relieving pain, improving mastication efficiency, enhancing speech and improving appearance.

  1. What are the dental materials used in dentistry?

The four groups of materials used in dentistry today are metals, ceramics, polymers and composites.

  1. What are the qualities of ideal restorative material?

An ideal restorative material would be

  • Be biocompatible
  • Bond permanently to tooth structure or bone
  • Match the natural appearance of tooth structure and other visible tissues
  • Exhibit properties similar to those of tooth enamel, dentin and other tissues
  • Be capable of initiating tissue repair or regeneration of missing or damaged tissues

 

  1. What is Acid-etching technique?

It is a process of roughening a solid surface by exposing it to an acid and thoroughly rinsing the residue to promote micromechanical bonding of an adhesive to the surface

  1. What is Adhesion?

When two substances are brought i9nto intimate contact each other, the molecules of one substance adhere or attracted to, molecules of the other substance. This force is called as adhesion. Adhesion may occur as a chemical or physical or a combination of both types

  1. What is Cohesion?

Force of molecular attraction between molecules or atoms of the same species.

  1. Define Coefficient of thermal expansion?

It is defined as the change in length per unit of the original length of a material when its temperature is raised 1 degree kelvin

  1. Define stress and what are the types of stresses?

Stress is defined as an internal force opposing an applied load.

Compressive stress:- internal resistance to a load that tends to compress or shorten a body

Tensile stress:– internal resistance to a load that tends to stretch or elongate a body

Shear stress:- a stress that tends to resist a twisting motion, or a sliding of one portion of a body over another is a shear or shearing stress

  1. What is strain?

Strain is defined as a deformation resulting from an applied load. Strain has no units to measure

  1. Define proportional limit?

It is defined as the maximum stress that can be induced without permanent deformation

  1. What is young’s modulus or modulus of elasticity?

Stress/strain ratio within the proportional limit is called elastic modulus or young’s modulus. It measures the relative rigidity or stiffness of material

  1. What are the different hardness tests?

Macro hardness tests:- Brinnel and Rockwell tests are classified as macro hardness tests and they are not suitable for brittle materials

Micro hardness tests:– the Knoop and Vickers tests are classified as micro hardness tests. Both of these tests employ loads less than 9.8 N

The SHORE and the BARCOL tests are used for measuring the hardness of rubbers and plastics

  1. What is Smear layer?

After the dentist has completed a tooth preparation for a filling, tenacious microscopic debris covers the enamel and dentin surfaces. This surface contamination, called the smear layer.

  1. What is Creep?

Time-dependent plastic strain of a material under a static load or constant stress

  1. Define Flow?

Flow is the deformation under a small static load even that associated with its own mass. Flow describes the behavior of amorphous material such as waxes.

  1. What is Hue?

Dominant color of an object

  1. What is Value?

Relative lightness of darkness of a color

  1. What is Chroma?

Degree of saturation of a particular hue

  1. Define Hardness?

The ability of a material to resist abrasion or wear

  1. What is Ductility?

Relative ability of a material to deform plastically under a tensile stress before it fractures

  1. What is Elastic modulus or Young’s modulus?

It is the ratio of elastic stress to elastic strain

  1. Define Plastic strain?

Deformation that is not recoverable when the externally applied force is removed

  1. Define Corrosion?

Chemical or electrochemical process in which a solid; usually a metal, is attacked by an environmental agent, resulting in partial or complete dissolution.

  1. What is Tarnish?

Surface discoloration on a metal, or as a slight loss or alteration of the surface finish or luster

  1. What is viscosity?

Resistance of a fluid to flow

 

 

 

 

 

Lasers in Conservative Dentistry and Endodontic

Laser technology has been developed rapidly in the last decade. New lasers with a wide range of characteristics are available now which are being used in various branches of dentistry. The application of these new technologies in endodontics has always been challenging. Today more experience and knowledge in applying lasers in operative dentistry and endodontics is available.

The interest in endodontic use of dental laser systems is increasing. There are several studies performed which prove the benefits of using a dental laser for cavity preparation over conventional rotary abrasives. Dental lasers are now set to perform almost every dental procedure which is to be carried out in the field of conservative dentistry and endodontics.

Conservative Dentistry:-

lasers in conservative dentistry

Cavity preparation:-

The science of conservative dentistry aims at saving natural teeth that have defects due to dental caries, trauma, abrasion or attrition and esthetic disharmony including developmental anomalies or tooth discoloration, as well as pulpal and or periapical diseases to maintain their inherent masticatory, phonetic and esthetic function and the physiologic integrity in harmonious relationship with the adjacent hard and soft tissues through diagnosis, treatment, post op evaluation and prevention.

One of the most commonly performed procedures in conservative dentistry is cavity preparation which done so that the diseased tooth is rid of all its infection and can receive a suitable restorative material. Cavity preparation is done conventionally by using a rotary abrasive. This results in a cavity form, which is irregular, and it damages the natural morphology of the dental hard tissues. The enamel prisms are destroyed and the dentinal tubules are packed with debris and dentinal muds.

Using a dental laser for this procedure has obvious advantages. The hard tissue dental laser such as the Er:YAG would retain the natural morphology of the dental hard tissues during cavity preparation. The Er:YAG laser radiation appears to be a promising alternative in treating dental hard tissues due to its thermo mechanical ablation properties and the lack o thermal side effects.. The laser cavity preparation results in clean, open and patent dentinal tubules and hence the step of acid-etch which is used in the conventional procedures can be skipped while using a dental laser. As there is absence of smear layer and debris in a laser cavity preparation, it can also be called a sterile cavity preparation as there is almost a 0% possibility of infections.

Tooth etching:-

Acid etching is widely used in clinical dentistry to facilitate the mechanical retention of resin based materials to teeth, in particular enamel surfaces. Several laser systems have been developed with the aim of modifying dental hard tissues and the Er:YAG laser may offer possible alternative to the acid etching technique. Even cementation of resin bonded partial dentures can be facilitated by the use of laser for etching the tooth surface.

Endodontic therapy:-

The endodontic therapy lasers have been used as treatment coadjuvant with refrence to0 both, low intensity laser therapy and high intensity laser treatment to increase the success rate of the clinical procedure. Low intensity laser therapy has the ability to produce analgesic, anti-inflammatory and biomodulation effects on the irradiated soft tissue thereby improving the wound healing process and giving the patient a better condition of the postoperative experience. High intensity laser irradiation on a soft tissue in a defocused mode could have similar effects to low intensity laser therapy. Depending on the wavelength, high intensity laser irradiation may be used on hard dental tissues such as on the root canal dentin cut surface after apicoectomy to produce structrural morphological changes, to remove the smear layer, to melt and recrystallize dentine or to expose dentinal tubules.

Disinfection of the root canal system:-

While the mechanical and manual challenges of root canal debridement and obturation remain, it has become increasingly clear that the largest proportion of endodontic disease, both pulpal and periradicular, is due to the presence of microorganisms. Therefore, treatment success is related very closely to the ability to remove these irritants and to prevent reinfection.

Application of Er:YAG laser radiation through a flexible waveguide helps to attain antibacterial effect, not only in the root canal walls, but also in the surrounding tissues. Therapeutic doses of laser radiation guarantee one-step disinfection, including of anaerobic microorganisms.

 

LASER Teeth whitening Procedure to get instant Teeth whitening

One of the biggest dental concerns that people face relates to the color of their teeth. Ideally, teeth should be a bright white but unfortunately this is often not the case. Stained teeth occur overtime and although this condition does not have any adverse health effects, it creates an unpleasant effect on a person’s smile. A great smile is an asset that everybody wants to have and the presence of yellow or brown cause people to become insecure about their smile. BY obtaining teeth whiteners, a person becomes much more confident in their smile, which will only have positive benefits socially.

Laser Bleaching:-

laser bleaching

 

The professional teeth whitening process begins with a minor cleaning and removal of any plaque along the gum line. Once this has been accomplished, a peroxide based gel is applied to the teeth. This gel contains a professional strength formula that ensures the laser accomplishes the maximum possible amount of teeth whitening.

Next, a special light is used to activate the gel. The process usually takes about an hour, and whitens teeth by as many as 10 shades. The laser tooth whitening process is usually accomplished in a single visit, reducing the need for repeated uses of the bleaching gel. This provides a great solution for people with sensitive teeth, and those who want instantaneous results.

Your dentist will then use a fluoride treatment on your teeth once the process in complete. This both strengthens your teeth and leaves a lustrous shimmer in its wake. Laser whitening is in the top tier in terms of tooth whitening costs, but this is more than made up for by the convenience and speed at which it can be accomplished.

As with any teeth whitening process, the effects will last based on how you take care of your teeth after optimal color has been reached. Dentists recommend the total avoidance of the top five culprits of tooth-tarnish: coffee, tea, blueberries, tobacco and dark soda. These should be abstained from completely for the first week.

Gingival Enlargement Causes, Symptoms and Treatment

Gingival enlargement is usually caused by local conditions such as poor oral hygiene, food impaction or mouth breathing. Systemic conditions such as hormonal changes, drug therapy or tumor infiltrates may complicate the process or even set the stage for the development of unfavorable local conditions that lead to food impaction and difficulty with oral hygiene, functional and esthetic problems.

gingival enlargement

1.    Inflammatory Gingival Enlargement

Causes:-

  • Lack of oral hygiene
  • Common in adults, greater predilection during puberty
  • Females are affected more than males. Higher risk during pregnancy and treatment with oral contraceptive pills
  • Predisposing factors-Tooth crowding, mouth breathing, overhanging restorations, cervical cavities, orthodontic appliances

Symptoms:-

  • Diffuse involvement and ballooning of the marginal and papillary gingiva.
  • Glossy, smooth edematous gingiva with blunting of margins and fetid odour
  • Coral pink color of gingiva becomes light red
  • Loss of stippling
  • Bleeding on probing
  • Painful in acute stages

Treatment:-

  • Removal of causative factors, elimination of mouth breathing habit, oral prophylaxis
  • Use of anti-plaque agents-Chlorhexidine
  • Patient education for maintenance of oral hygiene

2.    Drug induced Gingival Enlargement

Cause:-

There is a positive correlation between poor oral hygiene anddrug induced gingival hyperplasia the enlaqrgement occurs after 1-3 months of initiation of treatment

Mainly 3 drugs are implicated

  • Predisposing factors- cyclosporine. It is an immunosuppressor. Cyclosporine causes epithelial interaction and leads to gingival enlargement.
  • Nifedipine-anti hypertensive drug
  • Dilantin (Phynytoin)- anti-epileptic drug. Phenytoin may induce a decrease in collagen degradation as a result of production of an inactive fibroblastic collagenase. Phynytoin increasesthe numbee ofcell surface EGFreceptori9n human gingival fibroblasts which contribute to alteration of gingival connective tissue.

Symptoms:-

  • Painless bead like granular enlargement
  • Mulberry shaped, firm, resilient, pale pink with a lobulated surface
  • It begins with the involvement of papillary gingiva and gradual lingual, facial and Occlusal extension cover the crowns of involved teeth interfering with speech and chewing
  • Stippli9ng present
  • Bleeding on probing if superimposed with inflammation

Treatment:-

  • Physician’s consultation for alternative drugs
  • Patient education and maintenance of oral hygiene
  • Gingivectomy and gingivoplasty
  • The enlarged gingiva spontaneously disappears after 3-6 months of discontinuation of the drug

3.    Leukemic gingival Enlargement

Monocytic leukemia has a greater tendency to present as gingival enlargement due to tumor infiltrations.

Symptoms:-

  • Diffuse, marginal or discrete tumour like masses due infiltration of leukemic cells
  • Fiery red, friable, boggy shiny edematous surface
  • Teeth may be completely covered
  • Localized infiltrations are greenish brown in color
  • Necrotic ulcerations of the gingiva, pallor and lymphadenopathy are characteristic features
  • Anemia and tendency for infections

Treatment:-

  • Oral hygiene instructions
  • Specific treatment-chemotherapy

4.    Scorbutic Gingival Enlargement

Cause:-

Vitamin C an essential nutrient for the development of intercellular substance and collagen synthesis can sometimes presenta typical picture of gingival enlargement. Such enlargement is a conditioned response to plaque.

Symptoms:-

  • Purplish spongy gingiva with a smooth shiny friable surface
  • Marginal gingiva is affected first
  • Absence of stippling
  • Bleeds easily with psuedomembrane formation
  • Involvement of connective tissue of the periodontal ligament of teeth may lead to their mobility
  • Subperiosteal and perifollicularhaemorrhage
  • Patients may complain of joint pain

Treatment:-

Vitamin C supplements

5.    Granulomatous Gingival Enlargement

Causes:-

Local/systemic diseases:

  • Crohn’s disease
  • Sarcoidosis wegners granulomatosis
  • Melkerson-Rosenthal syndrome
  • Allergy to food stuffs

Symptoms:-

  • Distinct small irregular, edematous bluish red swelling affecting the interdental papilla, marginal and attached gingiva
  • Loss of stippling
  • Associated painless labial and facial swelling is strongly associated with Melkerson-Rosenthal Syndrome

Treatment:-

This does not regress despite good oral hygiene and the mainstay o treatment is gingivectomy. Steroids

6.    Idiopathic gingival Enlargement

Symptoms:-

  • Usually occurs before 20 years of age
  • Exuberantfirm,painless enlargement leading to partial or fullcoverageofthe crowns of teeth, impeding their eruption and interfering withspeech and lip closure
  • Stippling present with numerous papill;ary projections and a pebbled surface and a leathery consistency
  • Marginal, attached and papillary gingivaare affected

Treatment:-

If gingivectomy does not help much, because of a tendency for recurrence, then extraction of teeth followed by dentures

 

 

Saliva- Nature’s Mouthwash

Saliva- Nature’s Mouthwash

Saliva is a clear liquid made by several glands in your mouth area.Saliva is an important part of a healthy body. It is mostly made of water. But saliva also contains important substances that your body needs to digest food and keep your teeth strong.

Three major paired glands- the parotids, submandibular and sublingual and numerous minor glands throughout the mouth normally produce saliva. There is much debate about the amount of saliva that is produced in a healthy person per day; estimates range from 0.75 to 1.5 liters per day while it is generally accepted that during sleep the amount drops to almost zero. In humans, the submandibular gland contributes around 70–75% of secretion, while the parotid gland secretes about 20–25% and small amounts are secreted from the other salivary glands.

The oral cavity is almost constantly flushed with saliva, which floats away food debris and keeps the mouth relatively clean. Saliva also contains lysozyme, an enzyme that lyses many bacteria and prevents overgrowth of oral microbial populations.

saliva

Composition of Saliva:-

Produced in salivary glands, human saliva is 99.5% water, but it contains many important substances, including electrolytes, mucus, antibacterial compounds and various enzymes.

It is a fluid containing:

  • Water
  • Electrolytes
    • 2–21 mmol/L sodium(lower than blood plasma)
    • 10–36 mmol/L potassium (higher than plasma)
    • 1.2–2.8 mmol/L calcium (similar to plasma)
    • 0.08–0.5 mmol/L magnesium
    • 5–40 mmol/L chloride (lower than plasma)
    • 25 mmol/L bicarbonate (higher than plasma)
    • 1.4–39 mmol/L phosphate
    • Iodine (mmol/L concentration is usually higher than plasma, but dependent variable according to dietary iodine intake)
  • Mucus (mucus in saliva mainly consists of mucopolysaccharides and glycoproteins
  • Antibacterial compounds (thiocyanate, hydrogen peroxide, and secretory immunoglobulin A
  • Epidermal growth factor (EGF)
  • Various enzymes; there are three major enzymes found in saliva:
    • α-amylase (EC3.2.1.1), or ptyalin, secreted by the acinar cells of the parotid and submandibular glands, starts the digestion of starch before the food is even swallowed; it has a pH optimum of 7.4
    • Lingual lipase, which is secreted by the acinar cells of the sublingual gland; has a pH optimum around 4.0 so it is not activated until entering the acidic environment of the stomach
    • Kallikrein, an enzyme that proteolytically cleaves high-molecular-weight kininogen to produce bradykinin, which is a vasodilator; it is secreted by the acinar cells of all three major salivary glands
    • Antimicrobial enzymes that kill bacteria
      • Lysozyme
      • Salivary lactoperoxidase
      • Lactoferrin
      • Immunoglobulin A
    • Proline-rich proteins (function in enamel formation, Ca2+-binding, microbe killing and lubrication)[12]
    • Minor enzymes include salivary acid phosphatases A+B, N-acetylmuramoyl-L-alanine amidase
  • Cells: possibly as many as 8 million human and 500 million bacterial cells per mL. The presence of bacterial products (small organic acids, amines, and thiols) causes saliva to sometimes exhibit foul odor
  • Opiorphin, a pain-killing substance found in human saliva
  • Haptocorrin, a protein which binds to Vitamin B12 to protect it against degradation in the stomach, before it binds to intrinsic factor

What are the Function of the saliva?

  1. Chemical digestion: breaks down starch by the function of “salivary amylase”
  2. Helps chewing and swallowing
  3. Lubricating effect: moisturizes the inside of the mouth and creates smoother speech
  4. Solvent effect: dissolves food and allows the tongue to taste food
  5. Cleaning effect: washes away food debris and bacteria remaining in the mouth
  6. Antibacterial effect: Lysozyme, peroxidase and lactoferrin fight against pathogenic microorganisms
  7. pH buffering effect: Prevents sudden changes in pH
  8. Supplies minerals, including calcium and phosphorus, to teeth
  9. Helps keep dentures securely in place
  10. Has proteins and minerals that protect tooth enamel and prevent tooth decay and gum disease

A very important fact to remember when battling bad breath is that saliva is our friend. Flow of saliva diminishes considerably during sleep, allow populations of bacteria to build up in the mouth- the result is dragon breath in the morning. A dry mouth represents the perfect environment for odor causing bacteria. Sali9va acts as nature’s mouth wash by keeping the mouth moist, washing away bacteria, and dissolving foul smelling volatile sulfur compounds.

Conditions which reduce saliva flow or which make our mouth dry can therefore lead to bad breath. In fact, the morning breath which many people experience after a long night of sleep is caused by the reduction in saliva flow that occurs when we sleep.

Dieting, fasting, or talking for long periods of time reduce saliva flow and contribute to bad breath. In addition, certain medications, alcohol consumption, and breathing through the mouth during exercise cause dry mouth contributing to the problem.

How do you make sure your Saliva flow is adequate and that your mouth stays moist?

  • Drink water. Saliva flow increases when we eat or drink. If you are dieting or fasting, drinking water is a good way to stimulate the flow of saliva. The water will also help to wash away food and bacteria.
  • Placing a drop of lemon juice on the tip of your tongue or chewing sugarless gum are also effective ways to stimulate saliva flow. It is commonly held notion in the medical community that mints and breath freshening gums work not by masking odor but by stimulating saliva flow.
  • Eat fibrous foods. Here’s another reason for eating an apple a day: Crunchy, fibrous fruits and vegetables like apples, carrots, and celery are mildly abrasive, so they sweep bacteria and plaque off teeth.
  • Taking soup at room temperature can also increase saliva secretion, especially if you add fresh tomato slices or a little tomato juice. Sipping some water with a little vitamin C powder added, sucking on ice-cubes or chewing gum containing xylitol may also help.

Periodontal disease-a treatable cause of Bad Breath

Your dentist should be able to detect the periodontal pockets during routine exam. These areas are difficult to keep clean and may create a continuous supply of sulfur gases. The more areas that you have harboring these bacteria, the worse the breath will be.

bad breath

If you try:

  • Staying away from certain foods that are known to cause bad breath
  • Removing bacteria and food particles by brushing your teeth and flossing
  • Removing plaque from the tongue by tongue scraping
  • Making sure that your mouth does not become too dry

And still have bad breath; you may want to see your dentist. This is because anaerobic bacteria in your mouth may have found special places to hide. Normally there is a small 1-3 mm space bet6ween your gums and teeth. This is known as periodontal pocket or pocket for short. When pockets get to be 5mm or more they create deeper and more secluded hiding places for bacteria.

What creates these widened pockets which harbor bacteria? These deep pockets often result from the breakdown of the gums caused by periodontal disease.

If you have persistent bad breath, you should definitely see your dentist to find out if you have periodontal disease. Other symptoms of periodontal disease include

  • Tender gums
  • Swollen or bleeding gums
  • Loosening and shifting teeth
  • Sensitive teeth
  • Pain upon chewing
  • Receding gums or longer appearing teeth

If you have periodontal disease, your dentist can help you treat it and consequently treat the bad breath associated with it.

How can I keep my teeth and gums healthy?

  • Brush your teeth twice a day (with a fluoride toothpaste).
  • Floss regularly to remove plaque from between teeth. Or use a device such as a special brush or wooden or plastic pick recommended by a dental professional.
  • Visit the dentist routinely for a check-up and professional cleaning.
  • Don’t smoke

 

 

Sodium Functions, Sources and Deficiency symptoms

About 50% of body sodium is present in the bones, 40% in the extracellular fluid and the remaining 10% in the soft tissues. Sodium helps control blood pressure and regulates the function of muscles and nerves, which is why sodium concentrations are carefully controlled by the body. Without enough sodium in your body, your cellular function and neural communication shut down. However, most people consume far more sodium than their bodies need. Unlike other vitamins and minerals, heat has no effect on sodium. Therefore, it can be used in different ways and preparations without losing its effects. Also, it is an important constituent of nerves and helps regulate muscle contractions.

What are the functions of sodium in the body?

  • In association with chloride and bicarbonate, sodium regulates the body’s acid-base balance
  • Sodium is required for the maintenance of osmotic pressure and fluid balance
  • It is necessary for the normal muscle irritability and cell permeability
  • Sodium is involved in the intestinal absorption of glucose, galactose and amino acids
  • It is necessary for initiating and maintaining heart beat

What is the recommended dietary allowance of Sodium?

The daily consumption of sodium is generally higher than required due to its flavor. Healthy adults should limit sodium intake to 2,300 mg per day. Adults with high blood pressure should have no more than 1,500 mg per day. Those with congestive heart failure, liver cirrhosis, and kidney disease may need much lower amounts.

There are no specific recommended amounts of sodium for infants, children, and teens. Eating habits and attitudes about food that are formed during childhood are likely to influence eating habits for life.

What are the food sources of sodium?

Sodium occurs naturally in most foods. The most common form of sodium is sodium chloride, which is table salt.

The common table salt used in the cooking medium is the major source of sodium. The good sources of sodium include

  • bread
  • whole grains
  • leafy vegetables
  • nuts
  • eggs
  • milk

What are the diseases associated with Sodium?

Your body regulates sodium levels carefully to prevent levels from getting too high or too low. The kidneys are responsible for controlling sodium concentrations and retain sodium when your levels are low and excrete sodium in the urine when levels are high. However, people with kidney problems may be more susceptible to dangerous changes in sodium levels due to kidney dysfunction. Your body can also lose sodium in the form of sweat. This means that people who sweat a lot, such as endurance athletes, are susceptible to hyponatremia during periods of increased physical activity.

sodium

Hyponatremia:- this is a condition in which the serum sodium level falls below the normal. Hyponatre,mia may occur due to diarrhea, vomiting, chronic renal diseases, Adison’s disease. Administration of salt free fluids to patients may also cause hyponatremia. This is due to overhydration. Decreased serum sodium concentration is also observed in edema which occurs in ciorrhosis or congestive heart failure. The manifestations of hyponatremia include reduced blood pressure and circulatory failure.

Hypernatremia:- this condition is characterized by an elevation in the serum sodium level. It may occur due to hyperactivity of adrenal cortex, prolonged administration of cortisone, ACTH and /or sex hormones. Loss o0f water from the body causing dehydration, as it occurs in diabetes inspidus, results in hypernatremia. The symptoms of hypernatremia include increase in blood volume and blood pressure

Dental Management of the Mentally Handicapped Children

There are many definitions of mental retardation. The most commonly used by all the professionals is the one given by American Association of Mental Retardation. Mental retardation or mental handicap refers to a conditio9n that slows down mental and physical growth. A mentally retarded child is slow or lacking in the development of mental function, when compared to those children of his age level. Therefore, a ten year old mentally retarded child may exhibit behavior like that of a three or four year old child depending on his/her level of retardation.

The number of new special schools for the children with mental retardation is increasing with concern for proper transits, planning and preschool programs. Mental retardation is not an illness. It is a state of arrested development of intelligence, originating in the development period and is associated with diminished adaptive behavior.

d.management

What are the causes of mental retardation?

Mental retardation can be caused by many factors: accordingly before birth, at birth or child’s early years.

  1. Prenatal: causes that occur before birth
  2. Perinatal: causes that occur during the birth process
  3. Postnatal: causes that happen after birth or during childhood

Prenatal causes exert their effects before birth. Examples include genetic and heredity, toxins taken by the pregnant mother, disease, and neural tube defects. Genetics and heredity include conditions such as fragile X syndrome and Down syndrome, as well as phenylketonuria (PKU). Prenatal toxins include alcohol, tobacco, and drug exposure resulting from the behavior of the mother during pregnancy. Diseases and infection, such as HIV/AIDS, can devastate an unborn baby. Neural tube disorders, such as anencephaly (where most of the child’s brain is missing at birth) and spina bifida (incomplete closure of the spinal column), are also prenatal causes of mental retardation.

Perinatal causes occur during the birthing process. They include birth injuries due to oxygen deprivation (anoxia or asphyxia), umbilical cord accidents, obstetrical trauma, and head trauma. They also include low birth weight.

Postnatal causes occur after birth. The environment is a major factor in many of these situations. Child abuse and neglect, environmental toxins, and accidents are examples of postnatal causes. An additional reason for being identified as having mental retardation is societal biases, particularly toward diverse students.

How to prevent dental problems in mentally handicapped children?

Creating awareness of the importance of oral hygiene is a step to be undertaken, to ensure lower incidence of dental problems in the mentally handicapped. This can be achieved by bringing the prevention of dental disorders to the forefront. Primary prevention is a prophylactic measure to prevent the onset of the illness, while secondary prevention is to prevent the symptoms of illness at its earliest. The former can be achieved by giving training for proper cleaning of teeth; the latter enhances the resistance of the body to prevent co-morbid conditions affecting ear, nose, throat and sinus. It is to be noted that gingival disorders are found to be more common in mentally handicapped with problems like the Downs syndrome. The bigger size of the tongue prevents full closure of the mouth, thereby encouraging mouth breathing resulting in dry gums and increasing chances of infection. Poor vascularity, plaque and calculus enhance permanent damage.

Thus the saying, “prevention is better than cure” is an idea, which needs to be emphasized to the parents so that there is an organized effort on their part to give attention to proper oral hygiene. In case of children, the parents can star by helping them hold the toothbrush and clean their teeth. Subsequently, allow the child to clean the front teeth without support and then help clean the back teeth and the sides. Finally, watch whether the child properly does so; if the child does well, some incentives can be given to make the routine dental care a habit

Dental management of the mentally handicapped children

Patient management in the case of the mentally handicapped might cause problems because of the lack of co-operation and ineffective communication. There are certain requirements, which cannot be overlooked. It is to be understood that those children lacking logical thinking can be non-co-operative and may require special treatment chairs with belts etc, to restrain them. In extreme cases of non-acceptance, partial sedation may also be required.

Therefore, special facilities and dental care within familiar surroundings like school premises could help soothe their apprehensions, which, in turn, help in giving treatment effectively. Based on the facts mentioned above, the IDA believes that a permanent setup for free check-up and treatment for these unfortunate children by dental surgeons at a school or an institution is a matter that requires urgent attention.

Gum Cancer Causes | Symptoms & Treatment Methods

Gum Cancer

Carcinoma of the gingiva constitutes an extremely important group of cancers. The similarity of early cancerous lesions of the gingiva to common dental infections has frequently led to delay in diagnosis or even misdiagnosis. Hence institution of treatment has been delayed, and the ultimate prognosis of the patient is poorer.

Approximately 10% of all malignant tumors of the oral cavity occur on the gingiva. This is essentially a disease of elderly persons, since only 2% of the tumors occurred in patients under the age of 40 years. It is more common in men than women.

Gum Cancer Causes

The exact cause of gum cancer is not known. However several risk factors are known to cause gum cancer. A number of factors increase the risk of developing gum cancer. Not all the people with risk factors will get gum cancer.

Risk factors:-
  • Smoking or use of other tobacco products
  • Alcohol consumption
  • Chronic irritation of the mouth
  • Diet low in vegetables and fruits
  • Human papilloma virus infection
  • Poor oral hygiene
  • Occasionally, cases of gingival cancer appear to arise after extraction of a tooth. An unusual situation arises in some instances after extraction of a tooth in that a carcinoma appears to develop rapidly and proliferate up out of the socket.

Gum Cancer Symptoms

Carcinoma of the gingiva usually is manifested initially as an area of ulceration which may be a purely erosive lesion or may exhibit an exophytic, granular verrucous type of growth. Many times, carcinoma of the gingiva does not does not have the clinical appearance of a malignant neoplasm.

  • Sore/lesion on the gums that does not heal within 2 weeks. This lesion can bleed easily
  • Painful/painless lump on the gums
  • The tumor arises more commonly in edentulous areas although it may develop in a site in which teeth are present
  • The fixed gingiva is more frequently involved than the free gingiva
  • Thickening or discolored lump on the gums
  • Difficulty in swallowing
  • Problem with speaking and chewing
  • Swollen lymph nodes especially in the neck
  • Altered sense of taste
  • Unintended weight loss

In the maxilla, gingival carcinoma often invades into the maxillary sinus, or it may extend onto the palate or into the tonsillar pillar. In the mandible, extension into the floor of the mouth or laterally into the cheek as well as deep into the bone is rather common. Metastasis is a common sequel of gum cancer. Cancer of the mandibular gingiva metastasizes more frequently than cancer of the maxillary gingiva.

Gum CancerGum Cancer Treatment

Gum cancer is most treatable and curable if caught in the earliest stage of the disease. Gum cancer grows relatively slowly, but untreated and advanced gum cancer can spread into the deeper tissues of the mouth and neck. In advanced stages, gum cancer can spread through the lymph nodes and blood to other parts of the body where the cancer cells can form another cancerous tumor. Gum cancer and other forms of oral cancer have a high risk of recurring after treatment.

Gum cancer treatment includes

  • Chemotherapy
  • Radiation therapy
  • Surgery

Tongue Cancer Causes, Symptoms and Treatment

Cancer of the tongue comprises between 25 and 50% of all intraoral cancer. It is less common in women than in men except in certain geographic localities, chiefly the Scandinavian countries, where the incidence of all intraoral cancer in women is high incidence of a preexisting Plummer-Vinson syndrome. There are two parts to your tongue, the oral tongue and the base of the tongue. The front two third of the tongue is oral part. Cancers that develops in this part is called as mouth or oral cancer. The base of the tongue is the back third of the tongue. Cancers that develop in this part are called as oropharyngeal cancer.

Tongue Cancer Causes

  • Leukoplakia is a common lesion of the tongue which has been observed many times to be associated with tongue cancer.
  • Smoking tobacco or drinking a lot of alcohol are the main risk factors for cancers of head and neck
  • Other factors which have been thought to contribute to the development of carcinoma of the tongue include poor oral hygiene, chronic trauma and the use of alcohol and tobacco

Tongue Cancer Symptoms

The most common presenting sign of carcinoma of the tongue is a painless mass or ulcer, although in most patients the lesion ultimately becomes painful, especially when it becomes secondarily infected. The tumor may begin as a superficially indurated ulcer with slightly raised borders and may proceed either to develop a fun gating, exophytic mass or to infiltrate the deep layers of the tongue, producing fixation and induration without much surface change

The symptoms of tongue cancer may include

  • A red or white patch on the tongue, that will not go away
  • A sore throat that does not go away
  • Ulcer or lump on the tongue that does not go away
  • Pain when swallowing
  • Numbness in the tongue that will not go away
  • Unexplained bleeding from the tongue
  • Rare cases pain in the ear
  • Usually painless initially. The patient may develop a burning sensation or pain when the tumor is advanced

What is the Treatment for Tongue Cancer?

The treatment of cancer of tongue is a difficult problem. The treatment depends on the size of the cancer. The treatment procedures are

  • Surgery
  • Radiotherapy
  • Chemotherapy

One of these or combination of these treatments may be required. The best treatment for very small tongue cancers is surgery. For larger tumors that have spread to the lymph nodes in the neck, then the combination of surgery and radiotherapy are required.

  • Glossectomy:- the procedure of removing the part of the tongue or total tongue is called as glossectomy. This can cause problems with the speech and changes in eating and drinking.
  • Many radiotherapists prefer the use of radium needles or radon seeds to x-ray radiation because they are able with these devices to limit the radiation to the tumor, sparing adjacent normal tissue. Dry, sore mouth and taste changes may result due to the radiation therapy.
  • Metastatic nodes are highly complicating factors, but treating them without controlling the primary lesion is useless.