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Medical questions and answers

Medical questions and answers

Halitosis/Bad Breath

Answered by: DoctorNDTV Team
Q. What on earth is Halitosis
A.  What on earth is Halitosis

Sir William Osler: “The mouth is the mirror disease!”It is said that 120 multi-system diseases are often manifested in the oral cavity.In simple terms it is bad breath.No one appreciate it or points it out. Everyone despises it. Bad breath is one of the common causes of social embarrassment, broken relationships apart from being the ominous sign of poor health.
What are its causes

A) Diet is the commonest: garlic, onions, a significantly non-vegetarian diet devoid of fruits and vegetables often result in bad breath.
B) Habits like alcohol intake, smoking and smokeless tobacco intake result in a malodour that raises quite a stink from the person’s mouth/makes quite a stench.
C) Neglect: Poor brushing, flossing or mouthwashing habits.
D) Dental causes: Decayed and broken Teeth, gum disease, very old and broken fillings, open root canals, tartar and calculus are also some other common factors.
E) Less common are; sinusitis with a postnasal drip, uncontrolled diabetes (the ketone breath), kidney failure, gastrointestinal disturbances, lung diseases (bronchitis and related disorders), cancer of the mouth, pharynx, throat area and the gastrointestinal tract may also cause halitosis.
F) Dry mouth or Xerostomia, where salivary flow reduces due to reasons like ingestion of multiple medications, salivary gland disease, diabetes etc. are also implicated.

How can I treat and/or prevent it

A) Enjoying a sensible diet with lots of fruits and vegetables
B) Drinking 2-4 litres of water every day
C) Total abstinence from tobacco both the smoking and smokeless variety

Maintaining a disciplined oral care regimen that includes:

Twice a day brushing with a useful preferably fluoridated (unless otherwise contraindicated) or gumcare toothpaste.
Regular scaling and polishing (to eliminate tartar, calculus) and restoring the mouth by visiting your dentist are mandatory.
If indicated periodontal surgery may need to be performed.
Flossing and mouth washing at your dentist’s recommendation is important too.
Maintaining good general health with appropriate blood tests, X-rays and therapy as suggested by a competent medical professional is equally important.

An ounce of prevention is better than a pound of cure


Saliva and its importance
Answered by: DoctorNDTV Team
Q. Is saliva important

A.  Why is saliva so important to us

That thin transparent fluid that is emitted as spittle/spit, the best and least understood protective barrier against oral diseases and for the early digestion of food (via salivary amylase) is saliva.
It is relevant for smooth speech too.
Secretion of the parotid and other salivary glands protects your teeth against decay, and sensitivity by neutralising acids in the mouth after virtually any and every intake of food substances.
It works to prevent bad breath too.
Poor quality saliva can worsen oral health and make everything from breath to taste to speech a difficult daily trek.

What are the reasons for poor quality Saliva

Poor quality saliva is seen in

A) Old age
B) In people who are under lots of medication
C) High alcohol, tobacco, recreational drugs and caffeine intake
D) Severely acidogenic foods
E) Poor general health
F) Dehydration in any form exertion e.g.as sporting and running
G) Oral diseases of salivary glands and mouth cancer, Sjogren’s syndrome etc.
H) Cancer patients and after radiation and/or chemotherapy.

What are Signs and Symptoms of salivary gland disease I should look for

A) Dry mouth
B) Food sticking in the mouth and difficulty in swallowing
C) Altered taste of usual foods
D) Halitosis/bad breathe

Ask your dentist to:

A) Prescribe useful preferably fluoridated toothpaste, mouthwash, floss, interdental brushes
B) Recommend sugar-free gum
C) Artificial saliva substitute in case of severe dry mouth due to disease or multiple medication therapy
D) High fluoride mouthwashes and toothpastes in medically indicated cases
E) Early dental/periodontal intervention to minimize discomfort, early loss of teeth and expensive dental care

An ounce of prevention is better than a pound of cure



Answered by: DoctorNDTV Team

Q. What is tooth sensitivity

A.  What is tooth sensitivity
When hot and cold air or food or drinks create a sensation of pain and discomfort in your teeth either some or all –you are experiencing tooth sensitivity.

What causes it

A) Hard brushes, hard brushing and excessive brushing.
B) Parafunction like night grinding, bruxism, gnashing of teeth.
C) Excessive use of acidic foods especially citrus fruits and juices, cola beverages.
D) Severe Acidity and gastric efflux disorder.
E) Use of other agents for oral care.

How does one prevent it

A) Brush gently with a soft or ultrasoft toothbrush for 3-5 minutes twice daily.
B) Change your toothbrush every 4-6 weeks.

Your dentist will:

A) Clinically examine and diagnose.
B) Thoroughly clean and polish your teeth.
C) Recommend an appropriate mouthwash and anti-hypersensitivity toothpaste based on your problem.
D) In severe cases treat it in the dental office with other methods/modalities.

An ounce of prevention is better than a pound of cure



Answered by: DoctorNDTV Team

Q. Wouldn’t it be nice to look better feel younger. And enhance your confidence profile many times over?
A.  Why do teeth discolour

Discoloration of teeth is either external (coffee, tea, wine, saffron in food etc) or internal (due to fluoride in water, use of antibiotics in childhood e.g.: tetracycline), trauma leading to nerve death, or due to genetic factors/conditions that affect enamel and/or dentin or plain age–related.

If you are unhappy with the colour or state of your front teeth—veneers might be for you.

Doc: What happens and what do I do

A) Have your dentist diagnose your problem.
B) If indicated, a wafer –thin porcelain/composite veneer will be advised for a few or many teeth after slight removal of your enamel—0.5-1.5mm.
C) Your dentist will then take a measurement and colour-match your teeth.
D) He will then send it to a competent laboratory which will then design and make a beautiful, life-like set of veneer based on his instructions.
E) Your dentist will then cement them onto your teeth with a special cement (also tooth coloured) and voila –you now have a fresh new smile.

Doc: What is better composite or a porcelain veneer

A composite veneer needs less tooth-reduction, is shorter –lived and can discolour a bit more easily.
A porcelain veneer is more colour-stable and longer-lasting. But it is more expensive.

Doc: What precautions do I have to take?

A) Avoid exceptionally hard foods e.g.: Toblerone from the fridge and some chikki.
B) No contact sport for you either.
C) Maintain excellent oral hygiene by brushing twice daily with a fluoride (preferable unless otherwise contraindicated), floss regularly.
D) Visit your dentist regularly.

Remember: An ounce of prevention is better than a pound of cure


Dental Caries

Answered by: DoctorNDTV Team

Q. The science behind what causes our tooth decay
A.  Dental caries and pain related to it whether due to a “cavity” or “nerve problem” is every person’s nightmare.

Tooth decay is one of the greatest causes of discomfort, unwarranted expense plus loss of man-hours and is an eminently preventable condition.

What happens
Acid attack on teeth causes them enamel –the hardest structure in the body to dissolve over a period of time... This is followed by dentinal dissolution exposing the nerve/s in the tooth with and sometimes, without associated pain necessitating/ leading to root canal treatment.

What are the symptoms
. Sensitivity to hot/cold
. Pain which comes and goes
. Severe throbbing that can keep you awake at night
. Swelling in and around the jaws

Why does it happen
. Very worn out teeth or Mutilated dentition due to oral habits like tobacco chewing or bruxism and nightgrinding.
. fractured/broken teeth
. Trauma may cause a tooth to fracture and/or the nerve to die necessitating a root canal job.
. Decay due to poor dietary factors [high refined carbohydrate/ sugary food intake.
. Neglected/inadequate or improper brushing.
. Health disorders make one prone too: diabetes, dry mouth, multiple medications.
. When decay reaches the nerve.

What Do I do and how do I prevent it
. Regular Dental checkups and proactive early intervention.
. Early preventive care such as fillings (amalgam/composite/monomers as deemed essential by your dentist or Pedodontist).
. Renewal of old fillings.
. Proper brushing technique and frequency (twice a day); watching one’s diet (reduction of highly acidogenic foods, cola beverages, sugary foods).
. Use of an appropriate toothpaste (preferably fluoridated unless otherwise contraindicated).
. Topical fluoride application and mouth washes only in susceptible cases.
. Flossing the teeth one wants to keep.
. Use of interdental brushes in cases of gum recession and /or post surgical situations.

What is Root canal treatment
In root canal treatment your dentist will clean out the nerve or nerves or inflamed and dead tissue from the centre of your tooth and render it sterile. Then the root canal/s will be filled up with a bio inert material followed by a filling and/or a post in the crown of your tooth.

When your dentist is satisfied with the healing he/she will place a cap or a crown with or without a post in the tooth based on clinical necessity. Sometimes antibiotics may be necessary if infection is perceived/ detected and painkillers may be prescribed if pain is expected.

Root canal treatment may take between 1-5 sittings. Your dentist decides that based on the status of the tooth.
Remember: an ounce of prevention is better than a pound of cure!


Tooth Whitening

Answered by: DoctorNDTV Team

Q. Do you want a bright, sparkling smile that makes you look younger than your years, and revitalized
A.  Then Tooth Whitening is for you

What Is Bleaching

Bleaching of vital teeth is a simple, non-invasive procedure that whitens your existing teeth making them look cleaner, fresher and indeed more alive. Who should do it?

Almost anyone whose teeth are in the yellow to yellow-brown range [they bleach the best]

Extrinsic stains due to beverages, smoking tobacco [provided they are done away with], and some due to medications respond best.

Grayish white and very unevenly marked, mottled teeth respond poorly Intrinsic stains and genetic disorders of he teeth may need veneers/laminates or dentine bonding.

Those wishing to look better particularly before marriage or for professionals in the public eye e.g.: Models, actors, TV anchors etc.

What are the methods

There are three:

A] In-office
B] At-home bleaching
C] Use of whitening toothpastes

What are the advantages and disadvantages of each

In-office bleaching is a simple approximately one-hour chairside procedure that involves the application of a bleaching material on the front upper and lower 10-12 teeth[based on smile width] on the outer surfaces after a protective shield is applied to your oral tissues. A bleaching arc or laser light is often used to hasten and deepen the bleaching effect

After 2-3 such applications of 20 minutes each and in immediate succession a shade upgrade of 2-8 [upwards] can be appreciated.

The disadvantages are:

A] It may not act all [in a very small percentage of cases].
b] A mild to moderate transient sensitivity may be felt.
C] An allergic response [very rare] may be elicited.
D] Gum irritation due to the bleach may last a few hours leaving no residual effects. However your oral health care professional is competent enough to handle any of the above eventualities.

At-Home Bleaching involves the use of trays made by your dentist and a self-application of a lower concentrate of a bleaching10-12% car amide peroxide] that need to be used over a period of time [7-14 days].The advantages are a lowered cost but compliance and lack of supervision to ensure uniformity may sometimes pose a challenge.

Whitening toothpastes are commercial, over- the-counter products that are available for a mild very transient effect [as they contain very low concentrates of bleaching gels due to regulatory reasons]. Follow-up visits with your dentist and use of a whitening toothpaste after in-office bleaching helps in maintenance. Remember: Brushing twice a day with toothpaste [preferably fluoridated unless otherwise contraindicated] is still the gold standard of prevention.

For detailed information read the topic on 'Teething' on our web site http://doctor.ndtv.com/ under the 'A-Z Topics' section



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