DELAYED DENTAL CONSULTATION               

The dental office is usually a nice looking space with a beautiful long dental chair on which patients lie comfortably for examination and possible treatment, there are often enough illumination which brightens up the space, decorations and mirrors which often attract the child patients.

However, despite this nice appearance of the office, it is often dreaded by people of all calibers hence not many patients present for routine dental check up or active dental treatment by patients who truely need it.

Rather, patients present at the time when the worse has happened to the teeth and its surroundings.

          Imagine a tooth with pain for a period of 6 years!

   

This patient chose to present today because pain disturbed sleep, then ran to the dentist for help.

Note that the kind of help/ treatment that will be rendered will depend on the severity of the case which is dependent on the duration of the happenings to the tooth. Early presentation of dental problems makes treatment easy for the patient and the dentist. It is also cheaper to treat cases early before it get advanced necesitating advanced treatment in terms of cost and technicalities

DENTISTRY: A COURSE OF STUDY AT THE HIGHER INSTITUTION

 

The thought of the course to study at the university never crossed my mind until my final year in secondary school. I simply filled in medicine in my jamb form as I knew next to nothing about the next level of my life post secondary school education.

I was only moving to the next stage; all I knew a science student could study was medicine and the jamb brochure identified it as medicine and surgery.

My success in the jamb examination determined my fate.

I was offered dentistry by my school of first choice because I scored short of the required for medicine, and dentistry was considered the sister course. Hmm, dentistry! I wondered what it was as it was new to my hearing besides i didn’t know what any course entailed at the time, other than the fact that anyone who studied medicine would be a doctor.

The only understanding that I had was that the doctor gave the injection, as I encountered that several times.

I accepted to study dentistry as I had no choice. Unknown to me, my father had made enquiries from his dentist who fabricated a removable partial denture to replace his missing upper centrals. He received encouraging information on dentistry as a good choice of course to study at the University and he reassured my daddy of goodness after my graduation.

My older sister also made findings from her friends who were twins, one of them was studying medicine and the other was in dentistry, they were in their second year when I was in my first year. The information she received was not different from what my dad got but neither of them disclosed this to me until later that I got to know.

To the glory of God, I graduated after 7 years of training to earn a ‘Bachelor of Dental Surgery’

It’s been 20 years of practice of dentistry in Nigeria and I am proud of what I have become in my career and family life.

It has given me enough and I am living a fulfilled life despite the odds in my country Nigeria.

To anyone who wishes to study dentistry, feel free to join the train, you will definitely enjoy it. Parents should also encourage their children to study dentistry as opportunities are numerous.

Dental degree: not a limiting factor in your career and life successes

The success stories of Nigerian dentists abound. Let us explore a few of them

Professor Joel Akinosi, rose to a great height from BDS Nigeria to the invention of a dental injection technique for tooth extraction and retired as a Maxillofacial surgeon of repute. The nonagenarian is alive in good health.

Professor Ogunbodede a community dentist, researcher of repute and excellent administrator

recently completed his tenure as the number one staff (Vice Chancellor) of Obafemi Awolowo University Ile Ife  in Osun state.

Professor Onatolu, Odukoya a renowned dentist, academician per excellence and clinician of repute. From BDS Lagos Nigeria through Harvard University to the number one (Chief Medical Director) person that directed the affairs of the foremost health facility in Nigeria; Lagos University Teaching Hospital (LUTH) from 1999-2007 and retired in 2020 in the Department of Oral Biology and Oral Pathology LUTH. He is alive and well

Professor Adeyemo Wasiu Lanre is a dentist and specialist in Oral and Maxillofacial Surgery. He is the current Chief Medical Director of the popular Lagos University Teaching Hospital, a tertiary health centre in Nigeria that is a force to reckon with in health care delivery in Nigeria. The Nigerian Senate committee recently commended his leadership on hospital resource management.

Dr Tahjudeen Adisa B. Sanusi, a dentist recently concluded his 5-year tenure as the registrar of the Medical and Dental Council of Nigeria (MDCN). The body that regulates the practice of Medicine, Dentistry and Alternative Medicine in Nigeria. He performed brilliantly well to handover to the current registrar.

Professor Abdulazeez Butali, a dentist has performed a lot of wonders with his BDS Lagos degree to become an international researcher who resides in the US. He has won several grants in the area of genomics and is still active in the business of dental research

Dr Folashade Yemi Esan a University of Ibadan-trained dentist is the current head of civil service in Nigeria with outstanding performance in her line of duties.

There are many more successful dentists in Nigeria, and too numerous to mention. Many of them operate the best dental care facilities like SCHUBBS Dental Clinic with many branches in Lagos owned by Dr Bode Karunwi and the age long dental care facility of Mrs Angela Patricia Giwa Osagie also located in Lagos Nigeria.

The majority of Nigerian dentists are professors and Drs. in Nigerian dental schools.

In essence, Dentistry as a career path is a good one with an abundance of opportunities, it does not limit anyone to be whom and what one wishes to be, and rather it can propel one to a great height.

NON-HEALING ORAL ULCER : MAY BE AN EARLY SIGN OF ORAL CANCER

Oral Ulcer is a breach in the oral mucous lining. Commonly called mouth sore.

Presentations of oral ulcers: This varies with causes, size, number, location, duration, and time of healing. It may appear as a pinhead sized lesion and multiple; referred to as herpetiform ulcers. 

2 to 6 in number of a 2 mm sized ulceration in any part of the mouth; called minor aphthous ulcer. While a single solitary or occasionally 2 large sized ulcer on the tongue, palate or gingiva called major aphthous ulcer. This appears raised with a rolled edge and yellow flow.

Causes of oral ulcers: Oral ulcer can be caused by a wide range of causes, which includes:

1. Nutritional deficiency

2. Stress- academic/physical exertion/emotional

3. Trauma-from teeth or foreign objects

4. Immunological reaction

5. Hormone mediated-menstruation/

5. Familiar tendencies

6. Systemic disease

7. Early cancer

Treatment:

This is based on the cause of the oral ulcer, as removal of causes allows for regression of the sore.

Warm water salt solution mouth rinse 6-8 times daily will heal herpetiform and minor apthous ulcer.

Vitamin C tablets 100 mg, 3 times daily will go a long way to promote healing

For large sized lesions that is not healing within 2 weeks, present to a dentist for assessment and management.

WARNING:

Late presentation of sinister cases can be fatal in case it is a cancer because oral cancer can begin as an ulceration, and early treatment can be lifesaving.

The picture shown below is a case of oral cancer, which started as a small ulceration. It did not heal for weeks and patient did not present to the hospital.

Patient eventually presented when condition was worse after 8 months, then the cancer had destroyed the upper jawbone and floor of the eye. He needs advanced treatment than he would have received if he had presented earlier. 

ORAL CANCER

                                                    A stitch in time saves nine!!!

PHOTO OF THE DAY

Beautiful pic!

HOW YOUR TEETH CAN SECURE YOU A JOB

 

 

Here are tips towards a smile that gets you noticed for employment.

1. Daily brushing after breakfast and the last thing at bed time.

2. Use dental floss for interdental cleaning after meal/mouth rinsing.

3. Fix your fractured or discoloured anterior tooth/teeth for an improved outlook.

4. Whiten your teeth with bleaching if they are discoloured.

5. Fix the haphazard arrangement of your teeth with orthodontics treatment.

AT THE INTERVIEW

Flash your radiant smile to all and respond with confidence. This is sure to earn you the job. For help on this matter, contact dental news.

Do not attend a job interview with the following funny looking teeth:

 

 

 

ORAL CANDIDIASIS

The oral cavity (mouth) forms normal habitat to a number of organisms; bacteria and fungi. They are considered normal oral commensals that cause no harm in the mouth as they are kept in check by the body immune system. In case of a suppressed immunity, these organisms may begin to cause harm as seen in candidiasis.

Candidiasis/Oral thrush is a fungal infection of the mouth and it’s environ, throat inclusive. It is caused by overgrowth of the fungi commonly candida albicans in the mouth in immunocompromised states as seen in:

1.      Diabetes Mellitus: In this condition, sugar in saliva acts as food for fungal growth.

2.       Prolonged/high dose antibiotic treatment: This condition kills the normal oral bacteria that keeps fungal growth in the oral cavity in check

3.      HIV infection

4.      Renal failure

5.      Use of immune suppressant drugs

6.      Long term steroid treatment

7.      Other forms of immune suppression states

8.      Neonates and elderly

9.      Ill-fitting dentures

10.  Xerostomia i.e. dry mouth

Candidiasis affects all age groups depending on the immune status.

The very young neonates acquire oral thrush during passage through the birth canal in mothers with vaginal candidiasis due to immaturity of the immune response. This clears within 2 weeks however if it persists, baby needs a pediatrician assessment.

Oral presentation of candidiasis

Whitish coat on any part of the mouth, tongue and throat inclusive.

 It may also present as soft, friable, and creamy coloured plaques on the oral mucosa.

This creamish /whitish plague can be easily wiped off, to expose an erythematous /reddish mucosa.

 

whitish plagues on surfaces of the mouth

coated tongue with whitish plagues

If you notice any stange and persistent coating of your mouth,consult a dentist for evaluation and treatment.

REQUIREMENTS FOR TOOTHBRUSING/TECHNIQUES

REQUIREMENTS FOR TOOTHBRUSHING

1. A medium textured toothbrush preferably one with a small head and  angulated handle  for accessibility to posterior teeth.

2. Fluoride containing toothpaste

3. Clean water 

 

                                                Smear’ – under 2 years.    Pea-sized’ – 2-5 years

 

 

 

 

The above illustration is good for children to prevent them from swallowing toothpaste.

Note that children should use a soft textured toothbrush to prevent gum damage.

Tooth brushing technique:  

Several technique are available but the  bass method is recommended.

This involves brushing the teeth surface with vertical strokes, brush the top surfaces of teeth and the inside (lingual surfaces) followed by the tongue.

Common mistakes during tooth brushing

1. More people brush with horizontal strokes, this causes damage to teeth and gum and presents with cervical abrasion and gingival recession

 

 

Cervical abrasion



gingival recession



 

 

2. Other people brush the teeth surface very well and ignore the lingual surface ,this results in accumulated plague and calculus on the inside of the teeth as demonstrated by this patient below

 

 

 

 

BLEACH YOUR TEETH AND NOT YOUR SKIN

Here is good news for those people with generalized yellow, orange, or light brown extrinsic discoloration. Teeth bleaching/Whitening procedure offer you whitening of your stained/discoloured teeth within 2 hours to 4weeks depending on the method employed.
Teeth whitening is a safe and conservative treatment method for mild to moderate disoloured teeth.  The likes of Tonto Dikeh will benefit from this treatment.

Teeth whitening techniques can be as simple as scaling and polishing in case of accumulated dirts being the cause of teeth stains. It is a simple procedure necessitating patient’s cooperation. It can be done in the dental office and at home under strict supervision/instruction of a dentist. Either home or office bleaching can be utilized likewise the combination of the two in cases with darker stains

Available teeth whitening methods include:

-Use of whitening toothpaste

-Whitening strips

-In office bleaching method

-Home bleaching method

before bleaching

after bleaching

 

 

See procedure after the cut.

Tonto Dikeh says "Look wat tobacco can do to ur Teeth.....".

Note the brown stains on her anterior teeth

HOW NURSING MOTHERS DESTROY THEIR CHILDREN'S TEETH

Nursing mothers engage in the use of pacifiers to prevent their children from crying, however the use of wrong pacifiers are employed hence rampant caries in which almost all the baby teeth are destroyed by caries. This condition is referred to as Rampant caries, Nursing bottle caries or early childhood caries (ECC) depending on the affected teeth , location on tooth and number of affected teeth. Rampant caries is an aggressive and rapidly progressing type of disease (Silverstone et al, 1981) necessitating caution in feeding habits and oral health care of children. The contents of the feeding bottles of babies are almost always sweet liquid, majority of which are refined carbohydrates which serves as substrates for microbial action and eventual caries formation. As the feeding bottle or breast lies in baby’s mouth while baby sleeps off, continuous presence of carbohydrate in the mouth in the presence of the teeth over a period of time completes the requirement of formation of dental caries. Caries form on many of the teeth and presents as yellow or black coloration in baby’s mouth at the same time.


Rampant caries

Routes of Transmission
1. The causative organism, mostly Strept. mutans may be transmitted vertically from mother/ caregiver to child through salivary contact. This is affected by the frequency and amount of exposure as well as levels of strept. mutans in the mouths of mother/caregiver.
2. Horizontal transmission (e.g. between other members of a family or children in daycare) also occurs.
The effects of early childhood caries (ECC) include:
- Higher risk of new carious lesions in both the primary and permanent dentitions
-Hospitalizations and emergency room visits
-Increased treatment costs
-Risk for delayed physical growth and development
-loss of school days and increased days with restricted activity
-Diminished ability to learn
-Diminished oral health related quality of life
Prevention of early childhood caries
1. Milk or water should constitute the majority of drinks given to young children
2. Serve sweet drinks only at meal time
3. Do not leave infants alone with any drink
4. Never use drinks on a dummy as a pacifier
5. Avoid the use of feeding bottle,and replace it with a spoon and cup
6. Do not give drinks at bedtime or during the night.
7. Brush their children’s teeth with a small pea sized amount of a low dose fluoride toothpaste .

References

1. http://www.edinburghdentist.co.uk/Dental%20PDF%20files/rampant.pd

 

2. http://www.aapd.org/media/Policies_Guidelines/P_ECCClassifications.pdf

 

3. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. A collaborative effort of the American Academy of Pedodontics and the American Academy of Pediatrics

4. Berkowitz RJ. Mutans streptococci: Acquisition and transmission. Pediatr Dent 2006;28(2):106-9.

WHO SHARES YOUR TOOTHBRUSH?

Is it your spouse,twin,child or siblings? This is a a wrong way to show love as it is neither healthy for you nor those you share your toothbrush with. Sharing toothbrushes lead to transmission of infection from one person to another. It's better to clean the mouth with toothpaste only than share a toothbrush. Take this seriously and ensure your house help is not sharing with your children. Will expanciate on this later.

YOUR ORAL HEALTH:A REFLECTION OF YOUR MENTAL STATUS

Aside the utterances of a depressed or mentally ill person which is usually incoherent, the oral health through the condition of the oral cavity (mouth) speak volume about the mental status of an individual. With regular dental checkup, a dentist can be helpful in the early diagnosis of mental illness as oral lesions may be the first or only manifestation of a mental health problem.

Findings such as poor oral hygiene, generalized cervical abrasion, erosion of palatal surfaces of teeth, temporomandibular joint dysfuction syndrome, are pointers to mental instability.

Forms of Mental illness

-Anxiety/depression

-Bulimia and anorexia nervosa

-schizophrenia.

-psychosis

others

Common complaints at the dental office

-Bad breathe

-worm in my teeth

-severe pain which does not disturb eating and sleeping

Features of depression

-Increase carbohydrate consumption from decrease serotonin metabolism

-Impaired function of the immune system

-Both depression and antidepressant medication have been associated with xerostomia (Reese, 2003)

Effects of mental illness/medication on oral health

1.     A number of mentally ill present with poor oral hygiene while some engage in scrupulous cleaning. Force is exerted on cleaning the mouth thus causing wearing away of the cervical aspects of teeth, resulting in dentine sensitivity and its sequelae.

2.     Chronic facial pain in form of temporomandibular joint dysfunction syndrome.

3.     Bad breath where it does not exist (psychogenic halitosis)

4.     Dry mouth (xerostomia) thus superimposed infection, ulceration and mouth odour.

5.     Palatal erosion in condition of bulimia nervosa. Induced vomiting causes the acid from the stomach to dissolve the enamel of the teeth this leads to dentine exposure and its sensitivity.

6.     Antipsychotic drugs predisposes to dry mouth thus hindering the effect of saliva which include ease of swallowing and chewing, antibacterial effect and washing away of food debris.

7.     Caries and periodontal diseases

References

1.     Elter JR, White BA, Gaynes BN, Bader JD (2002): Relationship of clinical depression to periodontal treatment outcome. J Periodontol 73(4):441-9.

2.     Lieutenant Randy Reese (2003): Depression and dental health.Clinical update,vol.25 No 1.

EFFECT OF YOUR LOOK ON YOUR SELF ESTEEM

Your teeth form part of your appearance therefore there arrangement matters for an utmost outlook, confidence  and self esteem.

Malocclusion is the haphazard arrangement/malalignment of the teeth within the jaw bones.

It results from disproportion of teeth, jaw bone and soft tissues of the mouth and comprises one or more of these:

-proclined anterior teeth

-overlapping teeth (crowding)

-generalised spacing

-presence of diastema /diastemata

-abnormal positioning of teeth

-rotation of teeth

How happy are you with your teeth arrangement? Do you know that you can get your teeth rearranged to have a better look, function properly and prevent pain?

A 23 year old Nigerian undergraduate

The above appearance in a bride to be is not nice, consult a dentist for correction of this malocclusion for a better look to restore your confidence .

Causes of malocclusion

-Genetically inherited

Jaw disproportion

-Too large teeth responsible for crowding due to inadequate space on the jaw to accommodate the teeth.

-Too small teeth in a normal jaw or normal teeth size in a large jaw causes generalized spacing

-Too small jaw responsible for crowding due to bigger teeth than the jaw can accommodate

-Too large jaw is responsible for generalized spacing

Cleft of the lip/palate or both

While some teeth are missing, some are malformed and others may be malpositioned

-Acquired

 Habits of sucking thumb/tongue

Tooth loss without replacement

Effects of malocclusion

Prones the proclined teeth to fracture and its sequelae

Difficult mastication and eventual malnutrition

Temporomandibular joint pain

Impaired esthetics

Psychosocial problems from reduced self esteem

Treatment

Orthodontic treatment which utilizes appliances in form of devices and wires to rearrange the teeth.

Advantages of orthodontic treatment

-Reduces risk of tooth decay

-Reliefs TMJ pain

-Esthetic improvement

-Restores self-esteem and confidence

For more information contact us.

LIFE STYLE EFFECT ON ORAL HEALTH

Smoking

The habit of smoking is common in the society despite the warning packed with its advertisement. While many have attributed its use to “stress relieve” some engage in it as juvenile delinquency from peer group. Tobacco smoking habit exists in all categories of people irrespective of their social and economic status. Age and tribe are no barriers to smoking. It is good to know the ills associated with smoking and decide to be ready for its consequences otherwise don’t smoke. In some individuals smoking and alcohol consumption is preferred to smoking only and in this case it is more dangerous because the alcohol serves as a solvent to dissolve the nicotine in cigarette which irritates the oral mucosa and subsequent damage.

Smoking has damaging effects on the oral and general health of human.

Research has demonstrated the habit of smoking to be linked with stains, plague, calculus accumulation, periodontitis, smokers’ palate and ultimately oral cancer. Betel quid and smokeless tobacco engaged in by some tribes are associated with premalignant lesions, elevated blood pressure and worsening periodontal disease. Smoking can be active or passive. An active smoking is that engaged by an individual while passive smoking is one in close contact with smoke be it from cooking or smokers. All forms of tobacco smoking have been strongly linked to oral cancer (Regezi, et al., 2008).Tuberculosis, and other respiratory illnesses are predisposed to by smoking. The addictive effect of nicotine constituent of cigarrete makes it difficult for cessation while its carcinogenic effect predisposes smokers to cancer.

Alcohol consumption

Alcohol irritates the mucosa and acts as solvent for cancer causing substances e.g. tobacco thus increasing its chances of causing oral cancer. Aside oral cancer, alcohol consumption is associated with many ill health conditions e.g. alcoholism, malnutrition, chronic pancreatitis, alcoholic liver disease, and cancer (wikipedia)

Chewing Kolanut

Kola stains the teeth with black colour; the stains attract plague and calculus accumulation hence poor oral hygiene and eventual bad breathe (mouth odour).

Bruxism i.e. grinding the teeth unconsciously or in anger

This causes wearing away of the top surfaces of the teeth hence reduced occlusal vertical dimension thus causing pain at the temporomandibular joint (Joint in the region of the ears).

Consumption of carbonated drinks, soft drinks and fruit juices without use of straw causes erosion of teeth thus yellow colouration of surfaces of teeth from dentine exposure and subsequent dentine sensitivity to cold or hot drinks.

Sedentary lifestyle

This is an act of inactivity and dangerous to health as it is linked with high rate of heart attack and stroke. Muscle atrophy of disuse which makes daily activities of bathing and washing difficult. People with sedentary lifestyle are also prone to hypertension (James H. Rimmer, 2006)  

 Tooth picking

Is associated with periodontitis as discussed at dentistng.com

Some individuals are fond of picking their teeth with or without food. Improper tooth picking technique causes trauma to the gum and bone around the teeth. The teeth may become mobile, infected and later fall off on their own. Make use of dental floss instead of tooth pick.
Win yourself off detrimental habits to health.

 

DOES YOUR CHILD SUCK THE THUMB/TONGUE?

Digit (Finger) sucking is a relatively common oral habit behaviour engaged in by children. Other habits include, lip sucking and biting, nail-biting, bruxism, cheek biting, mouth breathing, and tongue thrusting .It starts from infancy and persists for years in some children. It is advisable that parents discourage their children and seek dental professional help when uncontrollable to avoid the damaging effects on their jaws, function of chewing, facial outlook and above all their self-esteem. Oral habits, especially if they persist beyond the preschool age, have been implicated as an important environmental etiological factor associated with the development of malocclusion (Shetty ,et al.,2013).

 A number of treatment options are available for this group of people which ranges from counseling to the use of a device. This is important in order to avoid severe malocclusion that can result from oral habits. Severe malocclusion in child will cost more and take a longer time to correct in adulthood.

        Effects of digit/tongue

1. Proclined anterior teeth

2. Anterior open bite





Proclined anterior teeth/anterior open bite due to thumb sucking

 

 

These  anterior teeth are prone to fracture and its sequelae which include abscess formation, Cellulitis and tooth loss.

6yr old Nigerian child with persistent thumb sucking



 

This child cannot cut food because the teeth cannot meet due to the gap formed by sucking the tongue/thumb thus impaired function of mastication.

3. Words escape through that space hence impaired speech

4. Temporomandiblar joint pain

Because the teeth are not in occlusion, there is pain from the two joints that holds the upper and lower jaws together found in the region of the ears.

5. Skeletal disproportion of the jaws

 

The upper jaw may be set far ahead of the lower jaw thus placing the upper teeth further protruded hence the risk of fracture and its sequelae.

6. Others

Tooth malposition, disturbed breathing habits, difficulties in speech, upset balance in the facial musculature and psychological problems (Singh,2009)

Consult a dentist today for an effective oral habit cessation to prevent malocclusion.

Reference

1.     Raghavendra Manjunath Shetty, Manoj Shetty, Nailady Sridhar Shetty, Hanumanth Reddy, Sunaina Shetty, Anil Agrawal(2013): Oral Habits in children of Rajnandgaon, Chhattisgarh, India- A prevalence study. Int JOPHD Vol 4 No 1.

2.     Dr Surinder Singh(2009): DELETERIOUS EFFECTS OF ORAL HABITS. Indian Journal of Dental Sciences Vol. 1 Issue 2