BLEEDING GUMS

The primary cause of bleeding gum is gingivitis i.e. inflammation of the gum . Inflammation of the gum results from reaction of the gum tissue to harmful stimuli such as plaque, calculus and oral microorganisms .In gingivitis, evidence of inflammation is observed which include redness, swelling and occasional tenderness of the gum.

An inflamed gum may bleed spontaneously, upon probing or at the time of tooth brushing.

Progression of gingivitis leads to periodontitis, an advanced disease of the periodontium in which bone supporting the tooth is lost with resultant mobility and eventual loss of tooth.

The most common cause of bleeding gum is poor oral hygiene from plague and calculus accumulation. If your gum bleeds, make an appointment with your dentist to know the cause and get treatment.

Local causes

1.      Plaque and calculus (tartar) accumulation

2.      Improper brushing and flossing technique.

3.       ill-fitting denture

4.      Smoking

5.      Trauma from fish bone.

6.      Periodontal abscess.

Systemic causes

Leukemia

Bleeding disorder

Pregnancy

Vitamin C or K deficiency

YOU NEED SCALING AND POLISHING

Scaling and polishing of the teeth is a mechanical method of removing adherent dirts on the teeth and gum which can not be removed with toothbrushing.
Following examination of your mouth by a dentist,a treatment plan of scaling and polishing is pronounced by your dentist if he sees stains,plaque and calculus accumulation at the base of your teeth.These deposits are a admixture of dirts,food debris and microorganisms.
If you have not consulted a dentist ,stand in front of the mirror ,look into your opened mouth.
If you see stains of any colour in your mouth or anything close to what is observed in the patient shown below ,then you need scaling and polishing to avoid the dangers associated with poor oral hygiene.

calculus accumulation on the teeth

The effect of this accumulation include:
1. Mouth odor.
2. Bleeding of gum while brushing the teeth.
3. Tooth discolouration.
4. Destruction of bone around the the teeth(periodontitis).
5. Tooth loss.
6. Worsens diabetic condition of a diabetic patient.
Prevention of calculus accumulation
1. Twice daily proper tooth brushing.
2. Scaling and polishing 6monthly.

USE DENTAL FLOSS NOT TOOTHPICK

dental floss

Dental floss with a plastic holder

Dental floss is a thin filament or nylon used to clean in between the teeth (interdental cleaning). It gets rid of food debris and plague which may serve as breeding ground for microbes and subsequent decalcification of teeth and destruction of the periodontium. Interdental cleaning can be done with the aid of interdental toothbrushes as well as dental floss however dental floss offers the best option in an easy and hygienic form at home and at the dental office. Dental floss is made in nylon, silk, and dispensed in plastics as ropes or attached to plastic holders for ease of application on the teeth.

The traditional way of cleaning in between the teeth involves the use of toothpick after food especially when meat stuck in between the teeth. Toothpicks are made from wood with two sharp ends. The use of toothpick can be detrimental to the health of oral soft and hard (gum &teeth) tissues due to improper use.

Importance of flossing

-Due to its width and flexibility it can pass in between the teeth with ease irrespective of the degree of crowding to clean the debris stuck to the teeth.

-Lack of interdental cleaning increases susceptibility to interdental caries and periodontal diseases which are the commonest forms of chronic dental diseases.

-Advanced restorative procedures like bridge and implants require utmost cleanliness of the oral cavity to prevent failure.

-Orthodontic appliances in the mouth increases susceptibility to plaque formation, this needs to be cleaned regularly with both tooth brush and interdental cleaning towards the success of the treatment.

Disadvantages of tooth picking

-Tooth pick hygiene is queried in terms of manufacturing and keeping.

-several improvised toothpicks exist with varying thickness that can damage the gum.

-improper use of tooth pick causes periodontal bone destruction, this in turn allows for spread of infection into the periodontium, hence abscess formation and eventual tooth loss.

 

Toothpicks

Caution

Be careful when you floss as improper technique of use may cause your gum to bleed.

Though it stops immediately, it is advisable to follow your dentist’s instructions on flossing.

Daily flossing is recommended.

DANGERS OF PIERCING ORAL STRUCTRES



Multiple piercing of tongue

Pierced lip

 

Oral piercing involves the insertion of an object usually metal into/through the oral structures. Commonly pierced site include the tongue, lips, cheek, frenum, uvula (Moore, 2005)

The uvula and side of the tongue are the two most dangerous sites of oral piercing due to the risk of airway obstruction by the jewelry and abundant blood vessels respectively.

The presence of oral jewelry predisposes to retention of food remains thus creating an ideal

environment for a large accumulation of plaque and calculus (Berenguer,et al.,2006).

Often times it is seen in young adults as a results of peer group pressure for esthetics reasons. Decoration, memory of a particular event and a sign of identification were other reasons documented by Inchingolo,et al.(2011) for oral piercing.

The procedure is usually done by untrained individuals with no knowledge of the human anatomy hence complications which vary from nerve damage to damage to blood vessels.

Procedures carried out under septic condition results in infection of the pierced site and adjacent structures. Severe illnesses from spread of infection have also been documented. The oral structures are not the only mutilated sites for esthetics, the eyebrow, nose and belly button have also been noted. The ear piercing is regarded as normal for female children in certain customs however extremism in its use exists amongst the youth in which case several holes carrying multiple ear-rings are pierced for “esthetics” reasons. Occasionally, males are also seen with pierced ears.

Effects of oral piercing

The most common dental problem registered was chipping of the teeth, especially in association with tongue piercing. Gingival recession was seen as a result of lip piercing with studs.

-Excessive bleeding from traumatized blood vessels.

-Damaged to nerves which causes persistent pain.

-Sepsis i.e. infection from contaminated instruments for piercing oral structures.

-Pathologic migration of teeth as from habits of inserting the stud between teeth.

 

-Death can result from sepsis

-Transmission of diseases e.g. Hepatitis, HIV

 

-Taste disturbance
 

-Allergy to metal used

 

-Increase salivary flow

 

-speech defect

-Moore,et al.,2005 reported chipping of the teeth as the most common dental problem associated with tonque piercing .

In Nigeria, oral piercing is not as rampant as in the developed countries however owing to the fact that Nigerians are fond of following the western worlds in words and deeds. It is advisable that this act be regarded as something not worth the troubles that can be associated with it.

Avoid oral piercing as that oral cavity is of best esthetics as made by its creator and use it for the most important purpose for which it is made strictly FEEDING towards a healthy you.

 

 

References:

1. Inchingolo F, Tatullo M, Abenavoli FM, Marrelli M, Inchingolo AD, Palladino A, Inchingolo AM, Dipalma G. Oral Piercing and Oral Diseases: A Short Time Retrospective Study. Int J Med Sci 2011; 8(8):649-652.

2. R J G De Moor, A M J C De Witte, K I M Delmé, M A A De Bruyne, G M G Hommez & D Goyvaerts(2005): Dental and oral complications of lip and tongue piercings. British Dental Journal 199, 506 – 509

3. Berenguer G, Forrest A, Horning GM, Towle HJ, Karpinia K (2006): Localized periodontitis as a long-term effect of oral piercing: a case report. Compend Contin Educ Dent. 2006;27(1):24–7.

4. N Escudero-Castaño, M.A Perea-García, J Campo-Trapero, Cano-Sánchez, and A Bascones-Martínez(2008): Oral and Perioral Piercing Complications. Open Dent J. 2008; 2: 133–136.

 

WHY DO YOU DELAY TO PRESENT YOUR FACIAL SWELLINGS (TUMOURS)?

Advanced tumour growth in a child

Advanced tumour growth in adult

The above cases could have presented when the swelling started which is usually like a small nodule. It increases in size over a long period of time if benign and rapid growth rate is associated with malignancies. Both patients could have presented at an early stage like this man  below did in order to benefit from an easier ,cheaper and less discomforting treatment.

Ignorance and poverty were on top of the list of reasons patients with maxillofacial swellings gave for presenting late at the dental clinic majority of which were from the lower class while the middle and upper class ones gave marital problems and a sense of despair as reasons for the delay in seeking treatment (Oji,1999).

WHY DO YOU DELAY?

Other people have visited the herbalists, pastors and imam and made doctors the last to know about their problems at which point little or no help is an available option from medical point of view .Oji, (1999) called for emphasis on early presentation for effective treatment of these tumours.

This blog aims at educating and informing its readers on the benefits of early presentation as well as help those who need and ask for help. www.dentistng.com/comment box

Reference:

Oji C (1999): Late presentation of orofacial tumours. J Craniomaxillofac Surg. 1999 Apr; 27(2):94-9.

WISDOM TOOTH (3RD MOLAR)

The last tooth in the series of teeth in the upper and lower jaws is called wisdom tooth. They are four in number, one on each side of the upper and lower jaws.

This tooth is the last of all the teeth to erupt into the mouth between the age of 17 and 25years, beyond this age it is not likely to erupt into the mouth hence the term impaction.

Impaction can be due to soft tissue (gingivae) or hard tissue (jaw bone).

While some people have their wisdom tooth completely erupted into the oral cavity but covered with gingivae(gum),some other people have theirs partially erupted into the mouth with impaction against the jaw bone while others  have theirs completely buried within  the jaw bone.

Causes of impacted wisdom tooth

1. When the teeth are large, they occupy more space than required; this prevents the last tooth from erupting fully as there is limited available space.

2. When the teeth are of normal size but the jaw size is small.

3. Tooth ankylosis

4. Cyst/Tumour

Effects of impacted wisdom tooth

When partially erupted they cause recurrent infection due to communication between the oral cavity (filled with microbes and food debris) and the jaw bone. The infection is termed pericoronitis.

Pericoronitis:



Impacted wisdom tooth

 

 

 

 

 

 

 

 

Is the inflammation of the gum around the wisdom tooth; commonly seen in adolescents and young adult.

Symptoms

Fever, headache, dysphagia, pain and discomfort

Signs

1. Trismus (limitation in mouth opening)

2. Fetor oris (bad breath)

3. Redness of the gum around the tooth and tenderness

4. Pus discharge

The severity of this lesion depends on the stage at presentation



Radiograph of an impacted wisdom tooth



 

 

Treatment:

Debridement of the area

Operculectomy

Surgical disimpaction

Cyst/Tumour formation:
 

Recurrent pericoronitis over a long period of time may stimulate cyst formation and possible eventual tumour formation. Noguchi, et al.(2013) reported a cystic lesion with impacted wisdom tooth  which turned out to be an ameloblastoma (jaw tumour).

 



Cyst formation around an impacted wisdom tooth



 

 

 

It is advisable to heed your dentist’s advice on the specified treatment for your case in order to avoid complications that may arise from wisdom tooth impaction.

References:

Kazuma Noguchi, Hiromitsu Kishimoto, Koji Yamanegi, Kuniyasu Moridera, Kazuki Takaoka

and Masahiro Urade (2013): Unicystic ameloblastoma metastasizing to multiple cervical

lymph nodes. JSCR 2013.

FREE CLEFT REPAIR



Cleft of the lip



Repaired cleft lip

If you have a child or neighbour with this congenital deformity, kindly inform them of free cleft repair courtesy of Smile Train, an organization based in New York City, USA. It’s the world’s largest cleft charity with a mission of empowering local medical teams to provide free, safe surgery for poor patients with cleft lip and/or palate. If you are in Nigeria contact us for details: insidedental@gmail.com

 

Cleft of the lip, palate or both is a congenital anomaly of the face and oral tissues.

It is seen in children at birth and associated with a lot of challenges which includes feeding, speech, esthetics, susceptibility to infection, hearing loss, psychological and dental anomalies.

Certain societal believe can be cruel to the child. Hence this wakeup call to parents and relations of baby born with this defect. It is not the work of the devil neither is the baby a devil. Its' only an abnormality that resulted during the process of formation of the baby while in the womb.

Treatment is available, please do not hide or kill the baby rather seek treatment.

Currently free surgical operation is available in Nigeria courtesy of Smile train.

Causes of clefts

Genetics and Environmental factors.

Genetics

Familiar tendency exists in the developments of orofacial cleft, when an individual has a cleft there is tendency for another person in the same family to develop cleft, however susceptibility varies with degree of kinship.

Environmental factors that predisposes to clefts include:

1.     Advanced age of mother or both parents.

2.     Maternal life style and illnesses are associated with clefts

a .Drugs taking by mother e.g. Talidomide, Carbamazepine, phenytoin, amphetamine

b. Nutritional deficiency e. g. Folic acid deficiency

c. Infection during pregnancy e.g syphilis, Rubella

d.     Obesity

e.     Habits e.g smoking

f.       Irradiation during the first trimester

3.     Low socioeconomic status

Management

Surgical repair by the oral and maxillofacial or plastic surgeons coupled with efforts from other medical disciplines for a comprehensive treatment.

 

 



 

 

FREE DENTAL TREATMENT

 DO YOU HAVE A GUM DISEASE?
And you are not hypertensive, diabetic or a smoker.
This opportunity to receive free dental treatment is for you.
For enquiries :email us on insidedental@gmail.com

 

 

MIDLINE DIASTEMA(GAP TOOTH):A MALOCCLUSION




Diastema in an adult

 

 

 

Diastema is the space btw two teeth when seen in more than one spot in the dentition it is pluralized (diastemata). It can be seen between any two teeth in the dentition .

The most common site and recognized is that found between the two upper anterior teeth. It can also exist between the two lower anterior teeth. Diastema occurs in the dentition of children and adults. While it is considered a normal occurrence in children because it closes up as the bigger permanent teeth erupt into the mouth.

Diastema in a child

 

In dentistry, diastema seen in adult dentition is considered a malocclusion which may necessitate closure while some societies see it as fashionable.

In Nigeria it is associated with fashion especially when seen in women. Some women have patronized nonprofessionals to have this gap tooth created for them on the premise that it adds to their beauty however the danger inherent in creation of an artificial diastema is not known to them.

 

Dentists are not trained to create diastema rather trained to close the gap to correct the malocclusion when requested by patients.

Causes of diastema

1.     Genetics

There is a familiar tendency to have diastema, in which case it occurs in members of same family.

2.     Jaw size /tooth discrepancy

When the jaw size is big and the teeth sizes are small hence spaces in between the teeth. Jaw size could be of normal proportion while the teeth are smaller.

3.     Frenal attachment

Low frenal attachment

4.     Habit

Tongue trusting habit exerts pressure on the upper anteriors or lower anteriors depending on the direction of the force.

5.     Periodontal diseases

This involves bone loss around the teeth hence drifting which can create gap between teeth.

Dangers of creating an artificial gap tooth

The layers of the teeth have varying thickness

Enamel is the outermost protective layer and the hardest substance in the human body-

Dentine is the inner layer which is the sensitive part of the tooth

Pulp is the innermost layer containing the blood vessels and nerves “life” of the tooth

When artificial gap tooth is created, part of the protective layer of tooth is striped thus nearness to the dentine if not exposed.

Improper calculative removal of enamel may leave it unsupported which leaves it prone to fracture. An exposed dentine becomes sensitive to air, drinks (hot/cold) and over a long time pulp may get infected. The tooth may eventually die, then progresses to an abscess, cellulitis and probably eventual loss of the tooth.

Effects of diastema

1.     Speech impairment

In cases when the diastema is too wide it causes speech defect, proper pronunciations become difficult

2.     It makes space unavailable for the eruption of the last teeth (wisdom teeth) hence impaction which predisposes to pericoronitis, cyst and tumour formation.

TREATMENT: Depends on the cause

Genetics

If there is no associated difficulty with speech, you may leave alone.

If you feel uncomfortable with your smile /speech you could close the gap with orthodontic treatment, crown placement or veneers and dental bonding depending on the best option suitable for your case.

Low frenal attachment

Frenectomy suffices.

Periodontal diseases

Periodontal treatment is indicated

 Jaw/tooth disproportion

Jacket crowns, veneers and dental bonding will play major roles

Habits

Habit breaker is indicated

Tooth loss

Replace missing tooth

Orthodontic closure of diastema

 

WHAT IS THE CAUSE OF YOUR DIASTEMA?

ARE YOU COMFORTABLE WITH YOUR DIASTEMA?

HAVE YOU THOUGHT OF CREATING A DIASTEMA?

Hear your thoughts and opinion.

 

 

 

 

ORAL SELF EXAMINATION/RESULTS

 

 

 

 

 

 

 

Stand in front of a mirror

Open your mouth

Did you notice a white/red patch on any part of your mouth?

Did you see an ulcer?

Did you feel a peppery sensation anywhere in your mouth?

Is there a swelling?

What about a single discolored tooth?

Is it a single fractured tooth?

Or a hole in your tooth/teeth?

Look at the side close to the tongue, is there a yellow/green discolorations around all or almost all your teeth?

Look at your last teeth; are they out in your mouth completely or partially?

What about your jaw bone, is it swollen?

Get a cup of cold water and drink; do you feel a shocking sensation?

What about with hot tea or while chewing?

WHAT CAN YOU SEE? WHAT HAVE YOU EXPERIENCED?

Let’s talk about it now through the comment box.