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It may not be entirely your fault that you have a lot of cavities. Mothers are the primary source of cavity causing bacteria in infants, according to UDA Action, the Utah Dental Association. These bacteria (mutans streptococcus, e.g.) colonizes the mouth of the infant between the middle of the second year to the end of the third year of life. During this “window of infectivity” colonization will occur even though few or no teeth have erupted yet. It has also been shown by studies that the higher the mother’s level of cavity causing bacteria is, the more percentage of children become infected. The bacteria will settle in the mouth permanently, and contribute to development of dental decay throughout the life of the patient. Bacteria is an indispensable link to the formation of dental decay because they convert sugar to acid, which then demineralize the dental enamel. Sufficient demineralization leads to breakdown of the enamel, which then exposes the soft organic structure underneath to chemical and bacterial attack. Eventually this process leads to infection of the dental nerve and consequent toothaches.

This new information regarding the “window of infectivity” is good news, because now it is possible to break the chain of infection, rather than wait to treat the cavities after they have developed. Since the primary source of cavity causing bacteria is the mother, it is especially important to lower the germ count in the mother during the critical infectious period. This is first of all accomplished by the mother maintaining a high level of dental hygiene at home. Thorough brushing and flossing, two or three times a day, is especially recommended. Since the back part of the tongue is a major source of bacteria, it would be helpful to use a tongue scraper for cleaning the tongue on a daily basis. Naturally, all cavities, big and small, should be filled so that bacteria can be deprived of hospitable habitats. Regular visits to the dental office will allow the dentist to evaluate effectiveness of dental hygiene habits, help the patient refine oral hygiene skills, apply fluoride, and fill any new cavities or replace any broken down fillings. The dentist may also prescribe anti-bacterial to lower the germ count, and fluoride rinses to fortify dental enamel against acidic demineralization.

Adult-to-infant transmission can be minimized without limiting normal nurturing activities. Utensils should be thoroughly cleaned and washed before they are used for the infant, and should not be shared. This general rule of hygiene prevents unnecessary exposure of the infant to infectious disease of all kinds, not just cavity causing bacteria. For instance, you may want to question the common practice of pre-tasting the food on the spoon before feeding it to the baby. Perhaps tasting the food with another spoon will do just as well. These precautionary practices should not damper in any way natural expressions of affection.

Adult-to-infant transmission can be minimized without limiting normal nurturing activities. Utensils should be thoroughly cleaned and washed before they are used for the infant, and should not be shared. This general rule of hygiene prevents unnecessary exposure of the infant to infectious disease of all kinds, not just cavity causing bacteria. For instance, you may want to question the common practice of pre-tasting the food on the spoon before feeding it to the baby. Perhaps tasting the food with another spoon will do just as well. These precautionary practices should not damper in any way natural expressions of affection.

Incidentally, be careful not to create “baby bottle syndrome,” a condition where the baby has severe cavities in the front teeth that is caused by giving the baby a milk bottle while going to sleep. Milk or sweetened fluid will lead to corrosion of the enamel if exposure is for a prolonged period of time. Baby bottle syndrome is often treated with either extensive “pulpotomies” (baby root canals) and crowns or extractions. Either way the baby is subjected to avoidable treatment. It is generally advisable to use oral or intravenous sedation to avoid traumatizing the baby.

Transmission of dental bacteria can also be minimized by parents cleaning the baby’s mouth with ultra-soft brushes or a soft, damp cloth, even before teeth have erupted. This will also tend to lower the germ count and retard the colonization process. When teeth have erupted, brushing with an ultra-soft brush is recommended.

It is now recommended that by one and half years of age, you should consult your dentist regarding dental care for your baby. Feel free to discuss the above described topics so that you can give your baby a great start in having healthy teeth and a great smile for a lifetime.

        

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Common treatment options
If you elect to be treated, there is often more than one way to proceed.
There are no dental treatments for alcoholism, however, dental treatment (especially surgical treatment) may be complicated by chronic alcohol consumption. Patients who are suspected to have problems controlling alcohol consumption may be counseled to see help through support networks such as "Alcoholics Anonymous".

Common related diagnoses
This diagnosis may be part of a larger problem. Treating the condition may not treat the cause. This condition may also lead to other problems.
Alcoholism may be accompanied by poor nutrition, and personal neglect, including poor oral hygiene. It can also predispose patients to gingivitis, periodontitis, and certain bleeding disorders. Sometimes the fruity breath of diabetics can be mistaken for the smell of alcohol on a patient’s breath.

        

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General Surgical Warnings:

Pain. As it is a surgical procedure, there will be soreness
after the tooth removal. This can last for several days.
Painkillers such as ibuprofen, paracetamol, Solpadeine or
Nurofen Plus are very effective. Obviously, the painkiller
you use is dependent on your medical history & the ease of
the operation.

Swelling. There will be swelling afterwards. This can last
up to a week. Use of an icepack or a bag of frozen peas
pressed against the cheek adjacent to the tooth removed
will help to decrease the swelling. Avoidance in the first
few hours post-op, of alcohol, exercise or hot foods/drinks
will decrease the degree of swelling that will develop.

Bruising & Bleeding into Cheeks. Some people are prone
to bruise. Older people, people on aspirin or steroids will
also bruise that much more easily. The bruising can look
quite florid; this will eventually resolve but can take several
weeks (in the worst cases).

Swelling that does not resolve within a few days may be
due to bleeding into the cheek. The cheek swelling will feel
quite firm. Coupled with this, there may be limitation to
mouth opening and bruising. Both the swelling, bruising
and mouth opening will resolve with time.

Stitches. The coronectomy site will often be closed with
stitches. These dissolve and will ‘fall out’ within 10 – 14
days.

Limited Mouth Opening. Often the chewing muscles and
the jaw joints are sore after the procedure so that mouth
opening can be limited for the next few days. If you are
unlucky enough to develop an infection afterwards in the
socket, this can make the limited mouth opening worse and
last for longer (up to a week or so).

Post-op Infection. You may develop an infection in the
socket after the operation. This tends to occur 2 – 4 days
later and is characterised by a deep-seated throbbing pain,
bad breath and an unpleasant taste in the mouth. This
infection is more likely to occur if you are a smoker, are on
the contraceptive pill, on drugs such as steroids and if bone
has to be removed to facilitate tooth extraction.

If antibiotics are given, they are likely to react with alcohol
and / or the Contraceptive Pill (that is, the ‘Pill’ will not be
providing protection).

Surrounding Teeth. The surrounding teeth may be sore
after the extraction; they may even be slightly wobbly but
the teeth should settle down with time. It is possible that
the fillings or crowns of the surrounding teeth may come
out, fracture or become loose. If this is the case, you will
need to go back to your dentist to have these sorted out.
Every effort will be made to make sure this doesn’t
happen. In very rare instances, the surrounding teeth may
actually come out as well as the intended tooth.

Failure of Anaesthesia. In rare cases, the tooth can be
difficult to ‘numb up’. This can be due to a number of
reasons. The more common ones include inflammation ±
infection associated with the tooth, anatomical differences
& apprehension. If the tooth fails to ‘numb up’ then its
removal will be rescheduled with antibiotic cover or
perhaps done under sedation or even a GA.

        

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Coronectomy / Intentional Partial OdontectomySpecific
Warnings:

Antibiotics (pre- & post-op). These are recommended to
lower the chance of infection either in the socket or the
tooth pulp. These will be given at the clinicians’ discretion.

Primary Closure. The retained roots are covered over by
the gum to facilitate healing of the pulp, socket and to
lessen the chance of operation site infection.

Root Canal Treatment of retained roots is not necessary.

Osteo-cementum Growth.
The root margins are trimmed
several millimetres below the crest of the socket to
encourage bone & osteo-cementum formation over the
retained roots, sealing off the roots from the mouth.

Roots inadvertently removed at the time of attempted
coronectomy.
When it came to removing the crown, it was
found that the roots as well were mobile. This ranges from
3 – 9%. If the roots are mobile, we are obliged to remove
them and there is obviously the risk to the IAN (which this
procedure was trying to avoid).

Numbness of Chin, Lip ± Tongue.
The Inferior Alveolar &
Lingual Nerves may still be damaged during the procedure
resulting in numbness affecting the tongue +/- the chin and
lower lip. The numbness of the tongue seems to be quite
short-lived and has a low incidence. The numbness of the
chin ± lip tended to occur when on attempting the
coronectomy, the roots were found to be mobile and had
to be removed.

Root Migration.
Subsequent migration of the roots away
from the IAN occurred in 14 – 81% of cases.

Later Removal of Roots.
This can happen in up to a 2 –
6% of cases. If the roots irritate overlying tissues or the
adjacent tooth or otherwise become symptomatic, they
may need to be removed. Even though a 2nd surgery
would be needed, the possibility of nerve damage should
be negligible since the roots would have migrated away
from its original resting place next to the IAN. Since the
purpose of the coronectomy is to avoid this damage, this
goal would have been accomplished even though a 2nd
surgical procedure was necessary to remove the remaining
root.

        

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Teeth whitening is the best thing to have happened for people with stained and discolored teeth. People have been able to make their teeth whiter by taking advantage of the various teeth whitening products and teeth whitening methods available. However, like all good things, teeth whitening has its own set of disadvantages. People who have opted for tooth whitening have experienced different complications that range from mild irritations to severe pain.

In a craze for getting that flashy Hollywood style smile, the majority of people rush into teeth bleaching without realizing if there are repercussions. Although it isn’t too dangerious, teeth bleaching can cause problems. People who use various kinds of home remedies for teeth whitening may incur indirect effects to tooth enamel and gums. When people use home remedies, they usually rely on acidic properties of certain fruits. This acid can deteriorate your teeth’s enamel and make a person’s smile worse than ever.

In regards to over the counter and dental whitening products, prolonged bleaching can lead to severe irritation in the teeth and gums. Teeth whitening products make use of chemicals like Hydrogen Peroxide that need to be used in the right concentration and right quantities to have the desired effects. People who use tooth whitening products at home do not pay much attention to their correct usage. Teeth whitening, like any other treatment or surgery, needs to be done under the supervision of an expert. A dentist is the right person to consult regarding this subject. If done properly, which requires consulting a dental expert, teeth whitening is harmless. It is only when people buy teeth whitening products over the counter and use them without following the proper directions that it is dangerous.

First and foremost, the chemicals that the tooth whitening products use like hydrogen peroxide can cause irritation to the delicate and soft tissues in your mouth. When teeth bleaching is done in a dentist’s office, the dentist takes care of this by placing a dental dam to prevent the chemicals from getting in contact with anything besides the teeth. Many people have reported a prolonged and increased sensitivity in their teeth to hot and cold things like coffee or colas. Gum irritation is not uncommon. There is a probability of the teeth whitening product being ingested by the patients, causing nausea, vomiting or a burning sensation.

Recently, there has been talk about a study done in Georgetown University, which says hydrogen peroxide may cause tongue cancer. This study is based on the results of two people in their 20’s getting cancer. It is important to note that the study looked at only 19 people who used teeth whiteners. Researchers theorize that when hydrogen peroxide in the gel leaks from trays it releases cancer-causing "free radical" cells, which may have caused the tongue cancer.

However, Dr. Gerard Kugel, from Tufts Dental School says:

“It’s been looked at many times over the years in animal studies and in human retrospective studies and there is no evidence of any link between peroxide and oral cancer. We’ve bleached millions of people, I mean it’s almost amazing how many people whiten their teeth with so few problems related to it in contrast to other things we do in dentistry or medicine. To me, it’s one of the safest things we do at this time in dentistry. ”

Remember, if you are using over the counter teeth whitening products, follow the directions, do not over-use, and use a reputable company.

        

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WHY DO SOME DENTISTS STATE THAT SMALL-DIAMETER IMPLANTS ARE NOT SUCCESSFUL?
Many of the same surgical dentists now condemning SDIs stated 40 years ago that conventional root from implants would not work. It appears that their opinion is that anything new is automatically bad! SDIs are new, but they are proving themselves.

This section is probably the most important part of this article. Some SDIs fail. We have experienced a few failures ourselves over the past 9 years of use. These failures were almost always related to one or more of the following errors:
Too much thickness of the soft tissue. If the ratio of the coronal portion of the SDI to the portion placed in the bone is excessive, a long lever arm is present. This situation stresses the SDI and may lead to failure of the implant. If the soft tissue, through which the SDI is to be placed, is thicker than about 2 mm, it should be reduced by taking a wedge of tissue from the coronal portion of the ridge. This can be done before the implants are placed, allowing for adequate healing, or at the time of implant placement. This surgery may be done with a scalpel, or some lasers may be used around implants to accomplish this task without causing damage to the implant osseointegration potential.
Improper parallelism of implants. SDIs should be as parallel as possible. If these implants are much more than 15° from parallelism, technical difficulty at placement of the prosthesis and subsequent potential clinical failure can be anticipated.
Inadequate preoperative radiographs. Poor bone is commonly present in some areas of edentulous patients. We discourage using only 2-dimensional conventional panoramic radiographs, because you cannot determine the quality or quantity of the bone in a facial-lingual dimension. Coarsely trabeculated bone is not appropriate for SDIs. The more dense the bone, the better. To determine the density of the bone, facial-lingual oriented radiographs are strongly suggested. These include tomograph or cone beam radiographs. Most communities now have accessibility to some form of the suggested facial-lingual orientation radiographs at moderate cost.
Poor bone density in the posterior maxillary tuberosity areas. Usually, the dense Type I bone of the resorbed anterior mandible is excellent for SDIs. The worst bone, contraindicated for SDI placement by most experienced practitioners is the posterior maxillary tuberosity, with its porous type IV bone. A careful analysis of the density of the bone in any other part of the oral cavity is suggested, as they too may have poor bone density contraindicating SDIs.
Too few SDIs are often placed. It has been suggested in both empirical and research reports that the minimal number of SDIs for edentulous mandibles is 4, evenly spaced from the left canine area to the right canine area. This is double the minimal number of implants suggested for conventional diameter implants. The ratio appears to be 2 SDIs where one conventional diameter implant would usually be used. Some companies are suggesting 6 SDIs instead of 4 for edentulous maxillas, evenly spaced from the canine area to the opposite canine areas. However, the more dense the bone, the fewer SDIs that are needed.
SDIs are too short. The most popular average length for SDIs is 13 mm. It appears from both clinical observation and research that this is a predictable and successful length. The implants must be used in adequate bone, according to the literature of reported successful use of thousands of SDIs and to the discussions with manufacturers about clinician reports to them.
Poorly adjusted occlusion, or loading the implants too soon. Most SDIs are loaded immediately on placement. Occlusion needs to be adjusted perfectly on placement of the prosthesis. Allowing heavy occlusion to traumatize these small implants is asking for early failure. If questionable bone quality or quantity is present, soft denture reline material may be placed in the denture around the area of the implants for several weeks to ensure that they have optimum time for initiation of osseointegration.

SUMMARY AND CONCLUSION
SDIs that are treatment planned correctly, placed and loaded properly, and are within a well-adjusted occlusion, are working in an excellent manner for the patients described in this article. It is time for those practitioners unfamiliar with SDIs and their uses to discontinue their discouragement of this technique. SDIs are easily placed, minimally invasive, and a true service to those patients described. They do not replace conventional diameter implants; however, they are a significant and important augmentation to the original root-form implant concept. There is obvious evidence of the growing acceptance of small-diameter implants by both general practitioners and specialists.

Table.
Use of SDIs in Approximate Order of Decreasing Frequency of Use
Edentulous mandible
Removable partial denture
Edentulous maxilla (this use has higher failure rate than edentulous mandibles)
Augmentation of fixed prosthesis
Sole support of fixed prosthesis
Salvage of previously made prosthesis

        

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The use of photography in general dental practice has increased so much that clinicians are even taking hands on for digital photography..A good resolution digital camera is a must for a dental clinic..

        

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FILLERS
Industrial composites use glass, kevlar, graphite, mica, wood, hollow glass spheres, or the like to modify resin. Dental composites require materials that match tooth color and translucency so an optical index of 1.5 is required. Materials such as strontium glass, barium glass, quartz, borosilicate glass, ceramic, silica, prepolymerized resin, or the like are used.

Fillers are placed in dental composites to reduce shrinkage upon curing. Physical properties of composite are improved by fillers, however, composite characteristics change based on filler material, surface, size, load, shape, surface modifiers, optical index, filler load and size distribution.

Fillers are classified by material, shape and size. Fillers are irregular or spherical in shape depending on the mode of manufacture. Spherical particles are easier to incorporate into a resin mix and to fill more space leaving less resin. One size spherical particle occupies a certain space. Adding smaller particles fills the space between the larger particles to take up more space. There is less resin remaining and therefore, less shrinkage on curing the more size particles used in proper distribution.

One micron is a critical filler size. Fillers greater than one micron are visible to the human eye. As resin matrix around filler particles wears, the filler becomes prominent and visible so the composite surface looks rough. Fillers less than one micron do not produce a rough appearing surface with aging. Fillers greater than one micron are referred to as macrofills and fillers less than one micron are referred to as microfills. A new classification of filler is the nano particles. The nano particles fill between all other particles to further reduce shrinkage. A mixture of different particle sizes is referred to as a hybrid.

Distribution of filler particles can be uniform or distributed over a bell curve so a microfill composite might contain many particles greater than one micron but the predominance of particles are one micron or less.

        

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Visit the link below to learn the way of effective flossing..
http://www.youtube.com/watch?v=N7TJevl2RVo

        

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