Category Archive Dental Care

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


  • 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


  • 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


  • 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


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.


  • 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


  • 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.


  • 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


  • Oral hygiene instructions
  • Specific treatment-chemotherapy

4.    Scorbutic Gingival Enlargement


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.


  • 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


Vitamin C supplements

5.    Granulomatous Gingival Enlargement


Local/systemic diseases:

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


  • 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


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

6.    Idiopathic gingival Enlargement


  • 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


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.


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.


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.

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

Gum Cancer Causes | Symptoms & Treatment Methods

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

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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.

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Teething problems

Teething Problems in Infants & Toddlers

In most children the eruption of primary teeth is preceded by increased salivation, restlessness and a tendency to place objects like finger in mouth. This observation may be the only indication that teeth will soon erupt. Many conditions including fever, diarrhea, convulsions, and primary herpetic gingiva-stomatitis have been incorrectly attributed to eruption. In fact teething does not increase the incidence of infection, nor does it cause any rise in temperature, white blood cell count but it does cause day time restlessness, an increase in the amount of finger sucking or rubbing of the gums, an increase in drooling and possibly some loss of appetite.

What are the Teething Problems? How to manage them?

Symptoms can last for just a few days, right around the time a new tooth is emerging or for as long as several months if a lot of teeth come through all at once. In some babies teething doesn’t cause any noticeable signs at all.

If your baby has diarrhea, fever or a runny nose, don’t dismiss it as a sign of teething, especially if the symptoms last for more than 24 hours. There is no scientific proof that these are linked to teething but the explanation for these symptoms is that teething babies frequently put things in their mouth to sooth their gums, so they come into contact with more viruses and other germs.

  1. Disturbed Sleep:- teething can be a painful process and this can keep your baby awake at night. So if your baby is suddenly finding it hard to settle down and rest, teething could be the cause. Try to stick to your baby’s bed time routine and give them comfort if they are unsettled.
  2. Drooling:- all babies drool a little, but a teething baby will often end up with a very wet chin. Extra drool can make your baby’s chin sore, so wipe with a clean soft cloth or put a smear of petroleum jelly on your baby’s chin for extra protection.
  3. Chewing Fingers:- chewing fingers or objects helps to relieve the pain and pressure of teething. Try to keep your baby’s hands clean so that the baby doesn’t swallow any germs.Teething ri9ng is a option but a crust of bread, bread stick, or a peeled carrot may work as well. Teething ri9ng can be cooled in the fridge, but should not be frozen. Don’t dip the ring in sugar substances.
  4. Swollen Gums:- swollen, red gums are asure sign of tething. Gentle rub with a clean finger can help to sooth them. A cool sugar free drink can help to sooth a baby’s gums. Water is best. Teething gels are also available which contains anesthetic and antiseptic but it should be used after 4-7 months.
  5. Appearance of Tooth buds:- if you look into your baby’s mouth, you can observe the little tooth buds look like small bumps along your baby’s gums. If you run a finger over them, you may be able to feel the hard tooth underneath.
  6. Eruption hematoma:- eruption hematoma also called as eruption cyst. A bluish purple, elevated area of tissue, commonly called eruption hematoma, occasionally develops few weeks before the eruption of primary or permanent tooth. The blood filled cyst is most frequently seen in the primary second molar or permanent first molar region. This condition develops as a result of trauma to the soft tissue during function and is self-limiting.
  7. Eruption sequestrum:– The eruption sequestrum is seen occasionally in children at the time of the eruption of the first permanent molar. This is seen at the time of eruption of the permanent molar or immediately after the emergenence of the tips of the cuspa through the oral mucosa. Regardless of its origin, the hard tissue fragment is generally overlying the central fossa of the associated tooth embedded and contoured within the soft tissue. As the tooth erupts and cusp emerges, the fragment sequestrates.
  8. Ectopic eruption:– Inadequate arch length or a variety of local factors may influence a tooth to erupt in a position other than normal.
  9. Natal and neonatal teeth:– natal teeth are the teeth that are present at birth; neonatal teeth are those that erupt within one month after birth.

What is the eruption sequence of primary teeth?

Normally the first tooth appears between the age of 4 to 7 months, but it’s also perfectly normal up to 10 months to 1 year. If your kid reaches 18 months with no tooth in sight, then consult pedodontist. Most children have a full set of primary teeth by the age of 3 years.

Upper teeth:-Teething problems

Central incisors 8 – 12 months
Lateral incisors 9 – 13 months
Canines 16 – 22 months
First molars 13 – 19 months
Second molars 25 – 33 months

Lower teeth:-

Central incisors 6  – 10 months
Lateral incisors 10 – 16 months
Canines 17 – 23 months
 first molars 14 – 18 months
Second molars 23 – 31 months

What is the Total number of Primary Teeth?

Primary teeth

  • Upper incisors=4
  • Lower incisors=4
  • Upper canines=2
  • Lower canines=2
  • Upper molars=4
  • Lower molars=4

Total number of Primary teeth=20 and Premolars are absent in the primary dentition.

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Functions Sources and Deficiency Symptoms of Vitamin B12

Vitamin B12 also called as Cobalamin. It is a water soluble vitamin. Vitamin B12 plays a key role in the normal functioning of the brain and nervous system and for the formation of the blood. It is a unique vitamin, synthesized by only microorganisms and not by animals and plants. The two coenzyme forms of vitamin B12 are Methylcobalamin and 5’-Deoxyadenosyl Cobalamin. The vitamin B12 is present in the diet in a bound form to proteins.

What are the Functions of Vitamin B12?

  • Vitamin B12 normally involved in the metabolism of every cell of the human body especially affecting DNA synthesis and regulation , fatty acid metabolism and amino acid metabolism
  • Vitamin B12 acts as a cofactor for methionine synthase and L-methyl malonyl-coenzyme A mutase
  • Vitamin B12 is vital for the formation of red blood cells
  • Vitamin B12 plays important role in the normal functioning of the brain and nervous system
  • Vitamin B12 is necessary for the synthesis of metrhionine from homocysteine

What is the RDA for vitamin B12?

Recommended dietary allowance (RDA):-average daily level of intake sufficient to meet the nutrient requirements of nearly all healthy individuals.

  • 0-6 months                               0.4 mcg
  • 7-12 months                             0.5 mcg
  • 1-3 years                                     0.9 mcg
  • 4-8 years                                     1.2 mcg
  • 9-13 years                                   1.8 mcg
  • 14-18 years                                 2.4 mcg
  • 19+years                                     2.4 mcg
  • Pregnancy                                   2.6 mcg
  • Lactating women                       2.8 mcg

What are the sources of Vitamin B12?

Vitamin B12 is found naturally in a wide variety of animal foods. Foods of animal origin are the only sources for vitamin B12. Curd is a better source than milk, due to the synthesis of B12 by Lactobacillus. Vitamin B12 is synthesized only by micro-organisms. Plant foods have no vitamin B12 unless they are fortified. The best way to meet your body’s vitamin B12 needs is to eat a wide variety of animal products.

  • Organ meats (beef liver)
  • Shellfish
  • Meat, poultry, eggs and milk
  • Fortified soy products
  • Fortified cereals
  • Red meat
  • Swiss cheese

What are the Deficiency Symptoms of Vitamin B12?

The most important disease associated with vitamin B12 deficiency is pernicious anemia. It is characterized by low hemoglobin levels, decreased number of erythrocytes and neurological manifestations.

  • B 12 deficiency anemia:-in B12 deficiency the body produces larger than normal blood cells.
  • Weakness, tiredness or light headedness
  • Rapid heartbeat and breathing
  • Pale skin
  • Easy bruising or bleeding, bleeding gums, mouth ulcers
  • Stomach upset and weight loss
  • Diarrhea and constipation
  • Yellowing of the skin
  • Sore, red tongue
  • Mouth ulcers
  • Mood changes, irritability, depression or psychosis
  • Tinnitus (ringing in the ears)

vitamin b12What are the causes of Vitamin B12 Deficiency?

In healthy adults, vitamin B12 deficiency is uncommon. Deficiency is more common mainly because of impaired intestinal absorption that can result in marginal to severe vitamin B12 deficiency in this population.

  • The most common cause of vitamin B12 deficiency is Pernicious anemia, an autoimmune condition caused by a lack of a protein called intrinsic factor that’s needed to absorb vitamin B12 from food into the body from the gastrointestinal tract.
  • Intestinal malabsorption:-absorption of vitamin B12 from food requires normal function of the stomach, pancreas and small intestine.
  • Atrophic gastritis:-this condition is frequently associated with the presence of autoantibodies directed towards stomach cells. Diminished gastric function in individuals with a atrophic gastritis can result in bacterial over growth in the small intestine and cause food bound B12 malabsorption
  • Vitamin B12 levels in serum, plasma and gastric fluids are significantly decreased in individuals with Hpylori infection
  • Surgical resection of the stomach or portion of the small intestine where receptors for the IF-B12 complex are located
  • Chronic alcoholism:- reduced in absorption of vitamin B12
  • Digestive conditions such as Crohn’s disease, Coeliac disease
  • Medication including proton pump inhibitors for indigestion

What is the Treatment for Vitamin B12 Deficiency?

Vitamin B12 deficiency treatment depends on the cause. If pernicious anemia or a problem with absorption is the cause, you will need to replace B12 usually by injection or by prescription. For most people treatment resolves the problem. But any nerve damage that happened due to the deficiency could be permanent. A combined therapy of vitamin B12 and folic acid is generally employed to treat the patients with megaloblastic anemia.

How to Prevent Vitamin B12 Deficiency?

  • Vitamin B12 deficiency can be prevent by eating enough meat, sea food, dairy products and eggs
  • Vegetarians can get vitamin B12 by taking cereal fortified with vitamin B12
  • Consult your doctor for the B12 supplements.
  • For people who cannot absorb B12, the condition cannot be presented. However, once it is diagnosed, regular injection of vitamin B12 will prevent symptoms from returning

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enlarge tongue causes

Enlarged Tongue Causes, Symptoms and Treatment

Enlarged tongue also called as Macroglossia or tongue hypertrophy or prolapses of the tongue. Macroglossia, meaning large tongue, has been a documented anatomical anomaly for several centuries. Severe enlargement of the tongue can cause cosmetic and functional difficulties including in speaking, eating, swallowing and sleeping. Macroglossia is uncommon and usually occurs in children. The exact incidence of Macroglossia is unknown because the causes are too numerous to quantify. In Beckwith-Weidman syndrome, 97.5% of patients have macroglossia. Macroglossia has an extensive list of possible causes. Its treatment has been largely surgical in the modern era

What are the Symptoms of Macroglossia?

  • Dyspnea-difficult noisy breathing, obstructive sleep apnea (airway obstruction)
  • Dysphagia-difficulty in swallowing and eating
  • Dysphonia-disrupted speech, possibly manifest as lisping
  • Sores ate the corners of the mouth
  • Marks or indentations on the lateral border of the tongue caused by pressure from the teeth
  • Open bite, orthodontic abnormalities including diastema and tooth spacing
  • mandibular prognathism
  • Mouth breathing
  • A tongue that constantly protrudes from the mouth is vulnerable to drying out, ulceration, infection or even necrosis.

What are the Causes of Macroglossia?

Two types of Macroglossia are present

1.      True Macroglossia:-

True macroglossia is associated with definitive histopathological findings. True macroglossia may be primary—characterized by hypertrophy or hyperplasia of the tongue muscles and it may be secondary-the result of infiltration of normal tissue with anomalous elements.

Causes of true macroglossia include congenital and acquired causes

Congenital causes:-

  • Idiopathic muscle hypertrophy
  • Lymphangioma
  • Hemangioma
  • Down syndrome
  • Trisomy 22
  • Laband syndrome
  • Chromosomal abnormalities including Beckwith-Weidmann syndrome
  • Lingual thyroid
  • Autosomal dominant inheritance
  • Transient neonatal diabetes
  • Tollner syndrome

Acquired causes:-

  • Metabolic\endocrine-hypothyroidism, cretinism, diabetes
  • Inflammatory/infectious-syphilis, amebic dysentery, Ludwig angina, pneumonia, typhoid, scurvy, pellagra, candidiasis, tuberculosis, rheumatic fever, smallpox
  • Systemic medical conditions-uremi9a, myxedema, hypertrophy, acromegaly, neurofibromatosis
  • Traumatic-surgery, hemorrhage, direct trauma, radiation therapy, intubation injury
  • Neop[lastic-lingual thyroid, lymphangioma, Hemangioma, carcinoma,plasmacytoma
  • Infiltrative-amyloidosis, sarcoidosis

2.      Pseudo Macroglossia:-

In Pseudomacroglossia, an individual has a normal sized tongue that, as a result of oral or skeletal abnormalities. It includes any of the following conditions, which force the tongue to sit in an abnormal position

  • Habitual posturing of the tongue
  • Enlarged tonsils and or adenoids displacing tongue
  • Low palate and decreased oral cavity volume displacing the tongue
  • Severe mandibular deficiency
  • Neoplasms displacing the tongue
  • Hypotonia of the tongue

enlarge tongue causesWhat is the Treatment for Macroglossia/Enlarged Tongue?

Treatment of Macroglossia depends upon its cause and also upon the severity of the enlargement and symptoms it is causing. No treatment may be required for mild cases or cases with minimal symptoms. Surgery is indicated for the severe cases. The goal of the surgery is to reduce tongue size and thereby improve function. Those main functions include chewing, swallowing, protection of the airway, and gustation. Treatment may also involve correction of orthodontic abnormalities that may have been caused by enlarged tongue. Treatment o0f any underlying systemic disease may be required.

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How to Brush Your Teeth Properly | 10 Step Guide

Brushing teeth is something most of the people do every day. It’s an essential part of the morning routine that we must complete adequately. This easy task deserves more attention than we usually give it to be fully favorable. An extra care while brushing and thinking about it seriously will give healthier teeth, and save the cost and pain of a procedure at the dentist’s office. Brushing teeth is a simple process. It doesn’t take much of your time or materials. Things needed for a perfect brush is a sink, a cup, and a toothbrush and toothpaste, which can easily be purchased from any store. When buying toothpaste, find the one that is right for you. There are many options: whitening, tartar control, cavity protection, and many more. The steps for brushing teeth are as follows:

  1. Wetting the toothbrush by holding the bristles under water from the faucet just long enough to moisten it. The toothpaste sticks a little better to the brush when the bristles are wet first.
  2. Squeeze out enough toothpaste to cover half of the bristles and begin the brushing process.
  3. Now place the head of the toothbrush in the mouth in such a way that the bristles are touching the crowns of the bottom teeth.
  4. Brush back and forth gently all along the bottom teeth to remove any small pieces of food or sugars that might have been stuck in the grooves.
  5. Then, move to the inside of the lower teeth. Slowly angle the bristles along the meeting point of the tooth and gum in a way that the brush can completely remove plaque sitting on top of the gum line.
  6. Now move to the outside part, repeating the same brushing technique gently.
  7. Now begin to brush the upper teeth. Brush gently on the surfaces used to chew and switch to the inside and outside enamel.
  8. Focus on the front teeth because those are what others see.
  9. Once the brushing has been done thoroughly for about two minutes, rinse out the toothbrush under the faucet and rinse out your mouth with a cup of water.
  10. Don’t swallow the toothpaste which often happens with children brushing teeth. If you consume a significant amount, consult a doctor immediately.

Brushing should be done twice in a day for healthier teeth. Cavities in the teeth are mainly caused when bacteria eat the food particles and sugars and on the teeth, along with the enamel. Therefore, brushing teeth before bed is especially important since the bacteria and germs could potentially remain on the teeth for a longer time.

how to brush your teeth properlyWhenever a dentist asks, “how do you brush your teeth,” we reply that it is just a simple task, not involving any technique. Brushing is also advised for children who don’t have teeth yet. Parents can clean their gums with just water. This process has to be done gently without causing any bleeding in their mouth. Parents can keep their child from getting gum problems and tooth decay by starting their dental care early. The above-mentioned steps for brushing apply for children also.

Children have to be encouraged for brushing. Photographs of children brushing teeth can be shown to educate them of the procedure. The only care to be taken is that very less amount of toothpaste is to be used and toothbrush with very soft bristles. Brushing should also be done slowly and gently without any trouble or irritation to the child.

Brushing is essential to prevent gum problems and tooth decay as well as to remove the growth of plaque on exposed surfaces of the teeth. No skills or training is required in the proper cleaning of teeth, only following of simple steps of brushing teeth will do. Brushing should occur after waking up, as well as at bedtime. Floss is also recommended after brushing, at least once to clean the plaque between teeth where a brush can’t reach. Visiting a dentist every six months for teeth cleaning is a harmless way to make sure that you have a healthy mouth. Brushing is a simple and quick task that must not be overlooked

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