Health Blog

Regressive alterations are the group of retrogressive changes in the teeth, which occur due to non-bacterial causes and results in wear and tear of the tooth structures with impairment of function.

Attrition:
Wear of the tooth substance on restoration as a result of tooth to tooth contact during mastication or Para function. Older teeth often exhibit more attrition as compared to the young. Attrition depends on varied factors such as diet quality, dentition, force of masticatory muscles and chewing habits etc.

Causes of attrition:

• Tooth loss
• Abnormal occlusion
• Abnormal chewing habits

Chemical features of attrition:

• Attrition occurs on the tip of the cusps, incisal edges and on the proximal contact areas of the teeth.
• In advanced cases, attrition may lead to severe reduction in the cuspal height.
• When dentin becomes exposed it generally becomes discolored brown.
• When the enamel is lost on the occlusal surface, the dentin becomes attrited at a faster rate.
• Normally men often show more severe attritions of teeth than women.
• Exposure of dentinal tubules in severe cases of attrition may lead to hyper-sensibility.
• Attrition may even possibly lead to fracture of the cusps of teeth or restoration.

Treatment:

• Treatment of attrition is difficult. However, certain things can be done to reduce further tooth wear.
• Corrections of developmental abnormality.
• Corrections of parafunctional chewing habits.
• Protection of tooth by metal or metal ceramic crowns where structural defect exist.

Abrasion:

Abrasion is the pathological wearing of dental tissues by friction with the foreign substances independent of occlusion.

Etiology & Pathogenesis:
 
It is the most common type of abrasion associated with faulty tooth brushing technique.
Abrasion occurs when the tooth brushing is done in a horizontal rather than a vertical direction and excessive force is applied during brushing. The condition is made even worse when an abrasive dentifrice or toothpaste or toothpowder is used.

Habitual pipe smokers may develop abrasion on the incisal edges of upper and lower ant teeth. Improper and habitual use of tooth prick or dental floss etc. can cause abrasion on the proximal surfaces of teeth.
Occupational abrasion is developed when instruments are habitually held between the teeth by people during work.
Faulty clasp design in removable partial dentures-prosthesis may also cause abrasion of tooth.

Clinical features of Abrasion:

• Toothbrush abrasions commonly occur in the cervical regions of the labial surfaces of incisors, canines and premolars.
• Maxillary teeth are more commonly affected than mandibular teeth.
• Toothbrush abrasion may also cause gingival recession.
• For pipe smokers, abrasion develops on incisal surfaces of upper & lowers anterior teeth.

Treatment:
Avoidance of abnormal brushing habits prevents abrasions. However, in already developed cases restorative treatments help to keep tooth surface intact and also it prevents further tooth wear.

Erosion:
Erosion can be defined as progressive irreversible loss of hard dental tissues by some chemical process that does not involve bacterial action.

Etiology factors for erosion:

• Contact with acid
• Carbonated soft drinks and sports drinks are also very acidic in nature
• Some medicines can be highly acidic in nature
• Erosion of tooth include gastroesophagal reflex diseases
• Patients with hyperthyroidism can have erosion of teeth
• Patients with chronic vomiting can cause erosion

Treatment: 
Identification of etiology is important in the management of erosion. Proper counseling is needed in case the patient is consuming excessive amount of carbonated beverages. Patients with chronic vomiting are to be referred to concerned specialists for initiation of proper therapy.
In case of already developed erosion of teeth, restoration treatment can be undertaken to maintain the structural integrity of the eroded teeth.

Sometimes, the often harmless toothbrush may also cause us some discomfort in the form of injuries. Toothbrush injuries are caused by chronic physical irritation from the toothbrush bristles to the marginal and attached gingival.
Although any area of the entire dental arch can be involved, these lesions are more seen in maxillary gingival over the premolar and canine region (since these are the locations where maximum pressure is exerted during brushing). Moreover, lesions can develop more frequently on left sided gingiva if the patient is right handed or vice versa.

Clinical Features:

• The lesions commonly appear as superficial linear erosions
• Some lesions might appear as white, red or ulcerated areas.
• Most lesions produce pain, especially during taking food and some of them can be infected secondarily.
• When the injury is very severe, it can produce deep clefts on the gingival margin with severe gingival recession.
• In long standing cases, there may be irreversible loss of the underlying alveolar bone in the gingival.

Histopathology:

• The traumatic lesion of the gingival histologically shows ulceration with focal loss of overlying epithelium.
• The adjacent normal epithelium at the border of the ulcer exhibits hyper-parateratosis and acanthosis.
• The ulcerated area is covered by a superficial zone of granulation tissue.
• The underlying connective tissue shows chronic inflammatory cell infiltration by lymphocytes and plasma cells.

Treatment:

Elimination of local factors causing injury (development of proper brushing habit) and symptomatic treatment of the injured area by specialist is the best way to treat toothbrush injuries.

Hello folks

I am finally free to blog again though I still have lots of things to do till February,2009. I did a blogpost about my professional training on my education blog. So today I’ll talk about Ghost Teeth.

Regional Odontodysplasia is an uncommon but unique non-hereditary developmental disturbance of teeth characterized by defective formation of enamel and dentln in addition to abnormal pulp and follicle calcifications.

The etiology of Regional Odontodysplasia is not fully understood but it is suggested that the disease develops due to some local ischemic change in the tissue during odontogenesis.

Both permanent and deciduous definitions are affected in this disease although it is more common in permanent dentition. But it is true there is no sex predilection in case of Regional Odontodysplasia. Also in this case the maxilla is affected more than mandible. The disease is called regional because it affects several contiguous teeth in a single quadrant. It also frequently occurs unilaterally, often affecting certain parts of the maxilla. The central and lateral incisors and the cuspids in the maxillary are also affected. The affected teeth show either delayed eruption or a complete failure of eruption. These teeth are often deformed, have a soft leathery surface and are yellowish brown in color.

The teeth having Regional Odontodysplasia have often been described as “ghost teeth”, since there is marked decrease in the rado density of these teeth as a result of defective mineralization.

The enamel teeth and dentin are very thin and radiographic distinction between these two structures is almost impossible. This accounts for the subdued or “ghostly” appearance of involved teeth. The pulp chambers of teeth are also extremely large and open and often contain pulp stones.

In case of Regional Odontodysplasia, the enamel layer is attenuated and disrupted. Dentin is very thin and globular and exhibits irregular tubules and a wide pre-dentin layer. Large pulp chamber exhibits numerous pulpal calcifications. The reduced epithelium persists and the follicular connective tissue contains numerous clusters of tiny droplet Calcifications.

Extraction of the affected teeth and fabrication of a suitable prosthesis is usually recommended in case of Regional Odontoldysplasia.

Headache hits most of us and almost everybody gets it at one time or another during their lifetime. In fact general practitioners say it is a very common cause of concern. Head pain can be described as debilitating, humming, vague, rhythmic, throbbing, and steady. They can interfere with your ability to work and to play, but rarely life threatening, if they exist by themselves. Headaches can also be because of some medications like dilators or nitrates for heart disease; anti-hypertensive; calcium channel blocker; acidity and ulcer H2 blocker; hormone replacement drugs; contraceptives and many others.
However, headaches can also be caused by serious organic disorder which is why one needs to go through proper evaluation by competent doctors.

Different types of headache:

Tension Headache:
It is the most common type. Tension headache causes mild to moderate pain and feels like tightening of a band around the head. It can last from 30 minutes to 7 days and affect the whole head. But it does not cause nausea or vomiting. Physical activity does not worsen the pain.
This type of headache can be controlled with OTC pain relievers, anti-depressant, muscle relaxant, ice packs, heat treatment, massage, meditation or yoga.

Migraine:
It hits women more than the men between the age of 20 and 45. It may cause moderate to severe pain and usually the pain is felt on one side of the head. The pain gets worsened by sound, light, physical activity. It can also cause nausea and vomiting. It occurs after many weeks, months or even years and may last four hours to three days.
It can be controlled by avoiding trigger foods, stress and with OTC pain relievers like paracetamol and anti-nausea medication. Ultrasound physiotherapy and Biofeedback is also helpful.

Cluster Headache:
This occurs specially among men between 30 and 50 years of age. Such headache causes severe and piercing pain focused around a single eye. It lasts for 15 minutes to 3 hours and occurs in clusters, separated by pain free periods. On the same side of the pain, the nostril runs, the eye waters, eyelid drops, lower eye area swells. But it does not cause nausea or vomiting and is not worsened by lights or sounds.
If you have it consults your physician.

There are other types of headaches as well.

Hypertension:
It causes severe high blood pressure (over 160/110), occurs in spasms and felt at the back or top of the head. The pain is most severe in the morning. If it happens to you, consult with a specialist.

Eye Disorders:
Eye disorders might also cause headache. In this case the pain can be moderate to severe and worsen after using the eyes. The pain is felt at the front of the head or in/over the eyes.
Consult an eye specialist.

Sinusitis:
This is a condition when inflammation happens on hollowed out areas of bone at the front of the skull with openings into the back of the nose. The pain is severe, dull or sharp and felt around nasal area, one or both eyebrows. It may happen suddenly and last for few minutes or may happen gradually and be persistent. The pain worsens when you look down and in day time.
One can try steam inhalation or hot towel over eyes to shrink or unblock sinuses along with using some painkillers. Surgical drainage is the last option.

Brain Tumor:
The pain initially is mild but as the tumor grows, it gets from severe to unbearable. It occurs frequently and with time becomes constant.
The only way for relief is to see specialists.

Brain Abscess:
The pain and patterns are much like brain tumor except if it ruptures when meningitis occurs. The pain may be felt on one spot or all over the head.
Surgery is the only way for permanent relief.

Meningitis:
It is a condition when inflammation of the thin membrane that covers brain and spinal cord. Intense and constant pain is felt all over the head and it travels to neck which becomes stiff and makes bending to rest chin on neck difficult. It is accompanied by high fever and vomiting.
Immediately consult your physician and get admitted into hospital if possible.

Temporal Arthritis:
It happens when inflammation occurs on large arteries on the side of the scalp. It usually hits older people. This might cause disturbances or loss of vision. One might feel the pain while brushing hair or the jaw may hurt when eating or talking.
Steroids, Prednisone can be used to stop inflammation and prevent blindness.

There are many other conditions and disorders like TB, Syphilis, Sarcoidosis, Cryptococcosis that can affect the brain and cause headache. Best way to get relief is to see a doctor as early as possible and get proper diagnosis and treatment. Remember, early detection or diagnosis of a disease at its nascent stage might save a lot of trouble.

Infertility in female is a condition where a female is potentially capable to become a mother, but unable to become one due to some problem. Sterility is a condition where a female does not produce eggs or ova. Her egg count is zero. Due to absence of eggs the female is unable to conceive.

But advancement of modern medical sciences have made it curable to a great extent. At first conventional methods of treatment should be tried, medical management, certain lifestyle changes like stopping smoking and alcohol, regular sleep, regular moderate exercise, supplementation of vitamins and minerals are advised. Male partner should also be investigated and treated, if some problem is found. If after investigations it found that the male partner is normal and the female partner does not have eggs, at that time artificial insemination is done with eggs from donor.

Artificial insemination is the last management form in treatment of infertility and sterility. Artificial insemination is done by fertilizing the donated eggs with the sperms of the male partner. Artificial insemination can be done vivo (inside the body) or in vitro (out side the body in test tube). After in vitro fertilization, the fertilized egg is transferred to the womb of the female.

In most countries, egg donation is strictly controlled by Government agencies, and has to follow very strict norms. Both egg donor’s identity and the recipient’s identity are kept secret. The egg donor has to be a healthy person and without known genetic deformity. The egg donor should not be suffering from AIDS or other viral and bacterial infectious disease. Consent of both the partners is mandatory for egg receipt from egg donor.