advance dental care: February 2012

Dental Plaque

Dental Plaque is a sticky, colorless film of bacteria and their substance that forms naturally on the teeth. It is complex with more than 400 bacterial species. Plaque forms all the time and is very harmful to teeth and gums if it is not removed.

How and Why it occurs?

When carbohydrate foods sugars and starches remain on teeth, plaque is developed. Bacteria of plaque make acids and other chemicals. Over a period of time, these acids destroy tooth enamel. Thus it causes Tooth Caries. Plaque can also form on the roots of teeth under the gum. In this case, it Causes breakdown of the alveolar bone supporting the tooth.

What are the factors predisposing to Plaque accumulation?

Inadequate oral hygiene: One of the most powerful factors that directly influencing the plaque accumulation on tooth surface. It is due to inadequate maintenance of oral hygiene.

Tooth Malalignment: Gingivitis is more common and severe around malaligned teeth because they are difficult to clean.

Restoration: Overhanging restoration, defective margin and rough surface of the restoration are more predisposed to plaque accumulation and has a profound effect on the periodontal disease.

Prosthesis: Patients provided with partial dentures, fixed prosthesis accumulate more plaque on abutment teeth along with the denture margins.

Calculus: The surface texture of the calculus promotes plaque accumulation and retention, not the calculus by itself.

How can Plaque formation be prevented?

Practicing good oral hygiene is necessary for its Prevention.

Read here- How To Practice Good Oral Hygiene?

Read also-

Tooth Caries

Oral Cancer

Cancer of the mouth is called oral cancer. It may occur on the lips, tongue, gums, inside lining of the cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx, is sometimes called Oral Cancer or Oral Cavity Cancer. It most commonly occurs on the lips or the tongue.

Why it occurs?

Causes are-

Smoking
Tobacco use
Drinking excessive alcohL
Family history of cancer
Excessive exposure to sun

Other factors that may increase the risk:

Human papilloma virus infection
Chronic irritation
Poor dental and oral hygiene
Drugs that weaken the immune system

What are the Signs and Symptoms?

Lump or thickening of the skin or lining of your mouth
White (leukoplakia), red (erythroplakia) or a mixture of red and white patches(erythroleukoplakia) on the inside of your mouth or on your lips
A sore that doesn't heal
A Bleeding in your mouth
Chewing difficulty
Mouth sores
Pain with swallowing
Difficulty wearing dentures
Speech difficulties
Swallowing problem
Swollen lymph nodes in the neck
Tongue pain
Jaw pain
Sore throat
An earache
Weight loss

What are the Complications?

Metastasis or, spreading of the cancer to other part of body
Radiation therapy causes dry mouth and swallowing difficulty
After surgery, disfigurement of the head, face and neck

Read also-

Dental Problems

Obstructive Sleep Apnea

Breathing interruptions or reduction or pause of breathing (airflow) during sleep, is called sleep apnea which is common among adulŧ. Types of sleep apnea are-

Obstructive Sleep Apnea
Central sleep apnea
Mixed sleep apnea

Obstructive sleep apnea is the most common type of sleep apnea.

Why it occurs?

Obstructive sleep apnea occurs when muscles in the back of your throat relax too much and airway becomes obstructed or collapsed. It may occur many times during sleep.

Other causes are-

Swollen of filters in the nose
Deviated septum
Shorter lower jaw than the upper jaw (retrognathia)
Long palate
In children, large tonsils and adenoids
Obesity
Large tongue
Large neck or collar size
Sometimes during laying flat on their backs

What are the Symptoms?

Disrupts sleep
During sleep observed episodes of breathing cessation
Awakening with sore throat or dry mouth
Loud bursts of snoring
High blood pressure controlling difficulty
Headaches
Daytime sleepiness/ fall asleep suddenly
Difficulty concentrating
Unusual irritability in the daytime
Fatigue
Frequent naps
Insomnia
Poor memory

What can happen if it left untreated?

Untreated obstructive sleep apnea may cause heart disease or, if you have heart disease, it will leads to serious conditions, such as- High blood pressure, Cardiac arrhythmias, Heart failure, Stroke.
Because of insufficient sleeps, daytime sleepiness/ fall asleep suddenly/ difficulty concentrating occur which may leads to a serious road accident when you are outside home (walking/ driving).
Eye problems
Complications with and surgery and medications

Temporomandibular Joint Disorders

Temporomandibular joint disorders are group of complex problems which affect the jaw joint.

Why it occurs?

Problems can be for muscles working the joint or joint itself. Causes are-

Bruxism/Teeth clenching
Dental Problems
Malocclusion
Teeth grinding
Stress
Jaw injury
Habitual gum chewing
Wear and tear to the inside of the joint
Arthritis
Fingernail biting

What are the Symptoms?

Popping, grinding or crunching sounds: It is very common in people. It is medically termed crepitus. If you have problem, you can hear the sound (feel like arising from the joint) at the time of opening/ closing your mouth.
Difficulty opening the mouth because it feels locked or painful
Pain in the chewing muscles or joint
Dizziness
Fullness of the ear
Recurring headaches
Ear pain
Tinnitus/ Ringing in the ear
Pain may spread to the face, neck, or shoulders

Muscle Cramp

A Muscle Cramp is a sudden, involuntarily and forcibly contracted muscle that does not relax. A muscle that involuntarily contracts without our consciously willing it is called a spasm. It is usually harmless.

Why it occurs?

Hyper-excitability of the nerves that stimulate the muscles cause it. In many cases reason is usually unknown. Important Causes are-

Overuse of a muscle
Dehydration
Muscle strain or simply holding a position for a prolonged period of time
Inadequate blood supply
Vitamin (B1, B5, B6) deficiency
Nerve compression
Mineral depletion
Some medicines used to lower cholesterol
Some medical problems that can causes it are-
Thyroid Problems
Kidney Problems
Nerve disorders
Hormone disorders
Diabetes Mellitus
Anemia

What are the Signs and Symptoms?

Sudden, harshly painful tightening of a muscle/ tenderness and firmness of the involved muscle
Disturbances of the function of the involved extremity e.g. difficulty in writing or grasping (if hand muscle is affected) or, difficulty walking (if muscles of the calf or foot are affected).
A muscle that is hard
In severe cases- soreness and swelling
In some cases, visible twitching of the muscle

Tendinitis

Tendinitis is inflammation or irritation of a tendon. Tendons are fibrous connective tissue that joins muscles to bones. Elbow, heel, shoulder, wrist are commonly affected site.

Some common names for various tendinitis problems are:

Tennis elbow

Golfer's elbow

Pitcher's shoulder

Swimmer's shoulder

Jumper's knee

If this problem is severe and leads to the rupture of a tendon, you may need surgical repair. But most cases can be successfully treated with rest, physical therapy and medications to reduce pain.

Why it occurs?

Causes are-

Injury
Overuse and repetitive motion

What are the Signs and Symptoms?

Pain (dull ache) and tenderness around a joint, often worse with movement and activity, can also be present at rest
Pain at night
Muscle spasms
Mild swelling

What can happen if it left untreated?

Tendon rupture leads to surgical repair.

Osteoporosis

Thinning of bone tissue and loss of bone density over time is called Osteoporosis. It causes bones to become weak and brittle.

Why it occurs?

Causes are-

Vitamin D deficiency
Calcium deficiency
Being confined to a bed
Chronic rheumatoid arthritis
Prolong corticosteroid medications
Chronic kidney disease
Eating disorders
Hyperparathyroidism
Low body weight
Absence of periods for long periods of time in women
Drinking a large amount of alcohL
Genetic
Hormone treatment for prostate cancer or breast cancer
Smokn

What are the Signs and Symptoms?

Bone pain or tenderness
A broken bone (commonly in the spine, hip, ribs, or wrist)
Becoming round-shouldered and stooped; loss of height (usually after the age of 70)
Severe backache (due to fractures of the spinal bones)
Loss of height over time
Fractures of the spinal bones cause neck pain
Kyphosis

What can happen if it left untreated?

Following Complications may occur-

Bone fractures (especially in the spine, wrist or hip)
Severely weakened bones causes disability
Loss of ability to walk

Arthritis

Arthritis is a joint disorder featuring inflammation or literally means inflammation of one or more joints. There are many types of arthritis. Over 100 types are identified, and new types are being discovered day by day. From these following are common:

Rheumatoid Arthritis

Osteoarthritis

Rheumatoid Arthritis

Rheumatoid Arthritis is a chronic autoimmune disease. It can cause chronic inflammation of the joints and other areas of the body. It damages the joints of the body. It is one of the common types of Arthritis.

Why it occurs?

The cause is unknown. But may be it can be for infectious agents such as viruses, bacteria, and fungi. None has been proven as the cause. But, it occur when immune system attacks the synovium.

What are the Signs and Symptoms?

Symptoms can come and go. It depends on the degree of tissue inflammation. Symptoms are-

Joints frequently become painful and tender. The area around the affected joint is red, swollen and puffy that may feel warm.
Stiffness in the morning
Myalgias/ muscle aches
Weight loss
Low fever
Loss of appetite
Malaise
Fatigue
Weakness or loss of energy
Skin lumps, usually on the elbows, fingers, or buttocks
Dry eyes and mouth
Chest pain with deep breathing, shortness of breath, or coughing

What can happen if it left untreated?

Following Complications may occur-

Osteoporosis
Carpal tunnel syndrome
Heart problems
Lung disease

Osteoarthritis

Osteoarthritis is inflammation of joint that results from cartilage degeneration. It features the breakdown and eventual loss of the cartilage of one or more joints. It is one of the common types of Arthritis.

Why Osteoarthritis occurs?

Causes are-

Natural aging of the joint
Water content of the cartilage increases
Loss of the cartilage cushion
Genetic
Obesity
Gout
Diabetes Mellitus
Repeated trauma or surgery to the joint structures
Abnormal joints at birth (congenital abnormalities)
Other hormone disorders

What are the Signs and Symptoms?

Pain in the affected joints that gets worse by movement
Joints that can be affected are- fingers and hands, hip, knees and spine
Swelling, warmth, and creaking of the affected joints
Knobby growths on the joints of the fingers
After long periods of inactivity, pain and stiffness of the joints
Friction between bones, causing pain even at rest or pain with limited motion (in severe cases)

What can happen if it left untreated?

Conditions become worsen with time. Joint pain and stiffness may become severe. Some people are no longer able to work. In some cases, joint replacement surgery is required.

Chronic Bronchitis

Chronic bronchitis is the chronic inflammation of the bronchi. It is one type of Chronic Obstructive Pulmonary Disease.

Why it occurs?

Cigareŧte smokế is the one of the most common causes.

Underlying medical problems e.g. Asthma, immunodeficiency, cystic fibrosis, Congestive Heart Failure, congenital or acquired dilation of the bronchioles, familial genetic predisposition to bronchitis known as bronchiectasis.

What are the Symptoms?

Cough and sputum- occur daily that is usually last for at least 3 months, appearance of sputum- clear, greenish, yellowish or occasionally, blood-tinged.
Regular morning cough
Wheezing and shortness of breath
Almost nonstop coughing and wheezing in the final stages
Chest pain

Others-

Headaches
Fatigue
Muscle aches
Nasal congestion
Sore throat

Acute Bronchitis

Acute bronchitis is the inflammation of the bronchi caused by viruses.

Why it occurs?

Causes are-

Viral infection e.g. rhinovirus, respiratory syncytial virus, , influenza (common)

Bacteria and chemicals (less common)

What are the Symptoms?

Constant, hacking, dry or wet cough
Production of sputum which can be clear, white, yellowish-gray or green in color
Slight fever and chills
Headache
Wheezing and shortness of breath
Pain in the upper chest, made worse by fits of coughing
Fatigue
Malaise

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common lung diseases. Common types are-

Stroke

A Stroke occurs when blood supply to part of the brain is disrupted or, severely reduced, causing brain cells to die.

Why Does Stroke Occur?

The most common cause of a stroke is blockage of an artery in the brain by thrombosis due to Hypertension, high cholesterol, Diabetes Mellitus, smoking etc.
Cerebral hemorrhage/ rupture of blood vessel in the brain
Subarachnoid hemorrhage
Migraine headache
Vasculitis

What are the Signs and Symptoms of Stroke?

Stroke symptoms occur suddenly. So, patient can not take necessary steps. So, family member or, person who is with the patient should be aware of it and take preventive measures and call a doctor. Signs and Symptoms are-

Dizziness, unsteadiness
Sudden loss of consciousness
Abrupt weakness or numbness of the face, arm, or leg, especially on one side of the body
Weakness in the muscles of the face
Loss of speech or difficulty speaking or understanding speech
Sudden difficulty seeing or loss of vision, particularly in only one eye.
Sudden and severe headache.
Trouble with walking or, coordination problems

When to make an appointment with doctor?

Never ever wait to see if symptoms go away. If you have signs and symptoms of stroke, seek emergency medical care immediately. Otherwise, serious complication may occur, even patient may die.

How can Stroke be Diagnosed?

Doctor will take a medical history, listen to symptoms from patient’s relatives and performs a physical examination of the patient. He/she will check blood pressure, pulse and other necessary things. He/she may order following tests-

Angiogram of the head
Blood tests including Bleeding time, Blood cholesterol and sugar, Blood clotting tests (prothrombin time or partial thromboplastin time), Complete blood count (CBC)
CT scan of the brain
MRI scan of the brain
Magnetic resonance angiography
Echocardiogram
Carotid duplex (ultrasound)
Electrocardiogram (ECG)

What are the Complications of Stroke?

Paralysis or loss of muscle movement
Breathing food into the airway
Memory loss
Poor nutrition
Pressure sores
Difficulty swallowing
Dementia
Emotional problems
Pain, numbness or other strange sensations in parts of your bodies affected by stroke
Changes in behavior
Speaking problems
Falls
Loss of mobility
Muscle spasticity
Problems thinking, understanding or focusing

What is the way of Stroke Prevention?

Control high blood pressure.
Control your cholesterol.
Control diabetes.
Exercise regularly.
Stop smoking or never smoke.
Maintain a healthy weight.
Drinking alcohol in moderation or don’t drink.
Avoid cocaine and other illegal drugs.
Know the symptoms of stroke
Talk to your doctor about the risk of birth control pills.
Choose a diet rich in fruits, vegetables, and whole grains.
Eat lean proteins, such as chicken, fish, beans and legumes.
Eat low-fat dairy products, fewer animal products and foods that contain cheese, cream, or eggs.
Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods.

Palpitation

Palpitation is unpleasant sensations of rapid, irregular and/or forceful heartbeat. It is not always Medical Problems. But sometimes it is associated with few diseases.

Why it occurs?

Causes are-

Strong emotional responses, such as stress or anxiety
Exercise
Fever
Caffeine
AlcohL
Nicotine
Hormone changes
Menstruation
Pregnancy
Menopause
Taking few medications such as asthma inhaler, some cold and cough medications etc
Some serious Medical Problems cause Palpitation such as-

Hyperthyroidism or Thyrotoxicosis
Arrhythmia- it includes very fast heart rates (tachycardia) or slow heart rates (bradycardia) or an irregular heart rhythm (atrial fibrillation)
Heart valve abnormalities

What are the Symptoms?

Fluttering heartbeats
Skipped heartbeats
An uneasy, persistent awareness of your heartbeat
A thumping, fluttering, pounding, or racing beat in your chest.
Feeling of heartbeat in your throat or neck as well aas your chest
Shortness of breath
Slow heart rate
Chest pain
Light-headedness or fainting
Too fast heartbeats
Heartbeats that are pumping harder than usual
Nausea

What are the Complications?

There's risk of complications, if the reason of palpitation is for underlying heart condition. In this case, Complications are-

Cardiac arrest
Stroke
Heart Failure
Fainting

Heart Failure

Heart failure is a condition in which heart's pumping power become weaker than normal. It is also known as Congestive Heart Failure.

When and why it occurs?

It occurs when heart muscle can not eject blood from the heart very well (systolic heart failure) or heart muscles are stiff and do not fill up with blood easily (diastolic heart failure). So, diseases which weaken the heart muscle cause it usually. The most common Cause from them is coronary artery disease. Other important problems of heart or blood vessel that cause it are-

Cardiomyopathy
Heart Attack
High blood pressure or Hypertension
Valve disease
Thyroid Problems
Diabetes Mellitus
Myocarditis
Heart defects present at birth
Kidney disease
Hemochromatosis or amyloidosis
Severe Anemia

What are the Symptoms?

Shortness of breath during physical activity is the common symptom. It occurs even if you perform light physical activity or lying down. This may cause wheezing. Many people think it asthma. But, they are wrong. Because of this you can wake up from sleep after a couple of hours.
Dizziness, fatigue and weakness
Persistent cough with foamy, blood specked mucus
Dull pain in the chest
Pulse that feels fast or irregular/ Palpitation
Fluid retention and swelling in the feet, ankles, and legs.
Accumulation of fluid in the liver and intestines
Feeling of abdominal fullness
Weight gain from fluid retention
Nausea and vomiting
Frequent need to urinate, especially at night
Swelling of neck veins
Loss of appetite

What are the Complications?

Arrhythmias
Cardiac Cachexia
Congestion
Liver Damage
Kidney Damage
Angina and Heart Attack
Depression
Death

Gas and Bloating

During digestion process, intestinal Gas is produced normally. Our body can not digest certain forms of carbohydrates like starch and fiber containing foods. Bacteria ferments these undigested carbohydrates and form gas in intestine. But, when too much of gas is formed, it leads to a painful condition. Usually, it is not a serious problem. But, it makes uncomfortable, when it continues for a long time.

What are the common causes of Gas?

Swallowed air
Constipation
Foods and snacks that are sweetened with fructose (fruit sugar) or sorbitol (an artificial sweetener)
High-fiber foods
Crohn's disease
Medicines or nutritional supplements
Overeating
Eating so quickly
Carbonated drinks, chewing gum, and drinking through a straw
Common for women to have bloating right before their periods

What are the Symptoms?

Abdominal pain
Belching
Flatulence
Abdominal Bloating

Heartburn

Heartburn is a feeling of burning in chest. It felt in chest, but, it is not any heart problems.

How it occurs?

Stomach is protected by mucous-barrier against stomach acid. But, esophagus which lies above stomach has no such protection. There is a sphincter between lower part of esophagus and stomach, called lower esophageal sphincter. It prevents foods to enter backward to esophagus from stomach. If it does not close completely, stomach acid enters into esophagus and the lower part of the esophagus can be damaged by stomach acid. It causes heartburn. Reasons of not closing of the sphincter are-

Body's position- lying down or bending over
Few foods and drinks such as fatty foods, chocolate, peppermint, alcohL, caffeine-containing beverages e. g. coffee, tea and soft drinks.
Obesity
Large meal portions
Coughing
Tight clothing
Lifting
Straining
Pregnancy
Medical Problems that increase heartburn are- Diabetes Mellitus, Hiatal hernia, Scleroderma, CREST syndrome, Raynaud phenomenon.
Medicines such as- anti-inflammatory drugs, steroids etc
Some foods cause heartburn such as- spicy foods, citrus fruits and juices, tomatoes and tomato sauces etc.

What are the Symptoms?

Chest pain, worsen when lying down and bending forward.
A burning feeling in the chest (usually 30-60 minutes after meals, especially at night) that lasts from a few minutes to several hours
Burning in the throat; or acidic, hot, sour or salty-tasting fluid at the back of the throat
Mild pain in the upper abdomen
Dysphagia or Swallowing Difficulty
Feeling like food sticking in the middle of the chest or throat
Belching (sometimes)

What are the Complications?

Erosive Esophagitis
Barrett's Esophagus (most serious)
Ulcers and Bleeding in the esophagus
Esophageal Cancer
Esophageal Strictures
Tooth Erosion

Swallowing Difficulty

Swallowing Difficulty or Dysphagia means it takes more time and effort to move food or liquid from mouth to stomach. It is felt that food is "sticking" in throat or chest which is usually a sign of a problem with throat or esophagus.

Why it occurs?

A blockage throat or esophagus due to:

Gastroesophageal reflux disease
Esophagitis
Esophageal webs
Cervical spine disease
Emotional or anxiety disorder
Diverticula
Narrowings as a result of radiation, chemicals, medications, chronic inflammation, or ulcers
Food or object stuck in your throat or esophagus
Tumors

Problems of nerve and muscle that help food to move through the throat and esophagus such as:

Stroke
Brain or spinal cord injury
Certain problems with your nervous system e.g. achalasia, sclerosis, muscular dystrophy, post-polio syndrome, multiple or parkinson's disease
Polymyositis or dermatomyositis
Scleroderma
Esophageal spasm
Syphilis
Myasthenia gravis

What are the Symptoms?

Serious discomfort, pain or coughing during swallowing, problems getting food or liquids to go down
Feeling of food getting stuck in throat or chest
Hoarseness
Have pain or pressure in chest
Have food or liquids come back up through throat, mouth or nose after swallowing
Heartburn
Unexplained Weight Loss

What are the Complications?

Respiratory Problems
For lack of taking enough foods and water cause malnutrition and dehydration