Dentistry

How to care for your baby's gums and emerging teeth

There’s nothing more heartwarming than a baby’s toothless grin. Except maybe the smile of a baby with healthy teeth and gums. After all, just because we call them ‘baby teeth’ doesn’t mean they don’t require dental care.

All babies are actually born with a complete set of these baby or ‘milk’ teeth. These early teeth are present within the gums and start to appear when the baby is about 6 to 10 months old, sometimes earlier and sometimes later. Hence it is very important to take good care of your baby’s gums.

How to keep your baby’s gums healthy?

Gums or gum pads are generally one of the most commonly neglected areas in terms of hygiene in babies, owing to assumptions of  ‘no teeth so no need to clean’.  On the contrary, it’s very important to keep them clean and healthy. Wiping them with a piece of gauze or muslin cloth dipped in plain water will help in wiping away any milk or food debris stuck on to the gums. Clean gum pads and good oral hygiene right from the beginning will ensure a positive environment for the erupting teeth in a later stage. 

What should you know about your baby’s first tooth?

Your baby’s first tooth can erupt anytime as early as 6-7 months or as late as 12-13 months. There is no ‘exact’ age that can be decided for the eruption of the first tooth and it will vary from one child to other.

Most often it will be the lower front teeth that will first appear in the mouth. During this period of eruption, there is a chance your child may show signs of irritation, frequent desire to bite things, putting hard objects into the mouth, redness of the gums , thumb-sucking, gum rubbing, rashes, etc. There can be loss of appetite, crying, increased salivation, drooling, irritability, wakefulness. This is normal and is referred to as teething. Give your child something cold to bite on, like a cold carrot or teething rings that are commercially available, but make sure that these toys are cleaned and sterilized before and after every use.

It is very important to keep the mouth clean at all times at this stage to prevent germs from staying in the mouth or travelling to the stomach. As soon as the first tooth erupts, you can start the brushing process. Parents should brush their child’s teeth twice a day with a soft, age-appropriate toothbrush and gentle toothpaste designed for infants and toddlers.

It would be ideal to visit a paediatric dentist at this age, as they will be able to guide you through the correct way of keeping your child’s mouth healthy. Remember that it is always better to initiate preventive procedures early on, rather than going through reparative procedures later due to neglect at this stage.

Another important thing to be aware of is that sometimes your child may be born with a tooth in the mouth or a tooth may appear within the first 2-3 months. In such a scenario, contact a pediatric dentist as soon as possible and they will guide you through the caretaking process.

7 signs that your child has dental infection

Occurrence of cavities in children is considered a disease called EARLY CHILDHOOD CARIES. Signs and symptoms include:

1. Appearance of dark color on the tooth (brown or black).
2. Sensitivity/pain on chewing food or eating sweet foods.
3. Severe toothache, toothache at night.
4. Swollen gums, a small pus filled swelling near the tooth on the gums.
5. Not allowing you to brush his/her teeth due to sensitivity, weakening or chipping of teeth.
6. Inability to eat, refraining from eating hard food items
7. In severe cases, fever with swelling that restricts normal functions of mouth.

Remember that a child will not be able to express discomfort like an adult; therefore it is the responsibility of the parent to carefully note for any of the above changes at an early stage and bring it to the dentist’s notice.

Decay in children is not only because of sweets or chocolate. Consistent oral hygiene measures can avoid all kinds of dental infection.

Few things you may not know about paediatric dentistry

Paediatric dentistry is a branch of dentistry which is dedicated to providing care for children from infancy to adolescence. We also cater to children with any special healthcare needs.

Paediatric dentistry aims at providing preventive oral health care, to prevent cavities from occurring in the delicate milk teeth so that your children can grow into adults with a strong permanent set of teeth.

A lot of dental problems such as malalignment of teeth can be identified at an earlier age by the paediatric dentist, and can be corrected early and the future need for braces or severity of orthodontic treatment may be reduced.

Since paediatric dentists are specially trained in handling children, the type of treatment and management of patient in the clinic is very different from adults. We understand that kids are not merely ‘small adults’ and need special kind of care. We also understand your concern as a parent and do our best to reassure and guide parents on good oral hygiene for their child.

Prevent gum disease for a perfect smile

Gingivitis is a condition in which there is inflammation of the gums or gingiva. It is caused by a layer of plaque or bacteria accumulating on the teeth. Gingivitis is a common type of periodontal disease. It can progress to gum infection called periodontitis which is serious and can eventually lead to loss of teeth.

Signs of GINGIVITIS include red, swollen gums that bleed easily when the person brushes their teeth. Gingivitis treatment can be initiated by improving oral hygiene, such as brushing and flossing regularly. Gingivitis symptoms are mild in the beginning but the condition should be taken seriously and addressed immediately.

There are two main types of Gingival diseases:

1. Dental plaque-induced gum disease caused by plaque accumulation, medications or malnutrition.

2. Non-plaque induced gum disease which can - develop due to a number of different causes such as a bacterial, viral, or fungal infection; genetic factors, systemic conditions, wounds, or reactions to foreign bodies. 

Causes of Gingivitis

1. Gingivitis is a condition in which there is a build-up of bacterial plaque over the teeth. The plaque sets off an immune response which causes the destruction of gum tissue. As it progresses,  it can lead to further complications, including tooth decay and loss of teeth.

2. Dental plaque is a thin layer of biofilm that accumulates naturally on the teeth. This plaque is generated by bacteria that attempt to adhere to the tooth surface.

These biofilm bacteria might help to protect the mouth from the colonization of harmful microorganisms, but dental plaque can also cause tooth decay, and periodontal problems such as gingivitis and chronic periodontitis, a gum infection.

When plaque is not removed adequately, it turns into calculus, or tartar, which collects at the base of the teeth, near the gums. Tartar has a yellow colour and it can only be removed professionally by a periodontist.
Plaque and tartar irritate the gums, causing gum infection and inflammation around the base of the teeth which causes bleeding gums.

Other causes and risk factors

1. Hormonal changes: This may occur during puberty, menopause, the menstrual cycle, and pregnancy. The gingiva might become more sensitive, raising the risk of inflammation.

2. Diseases: certain cancers, diabetes, heart disease, and autoimmune conditions.

3. Drugs: Oral health may be affected by some medications, especially if saliva flow is reduced. Dilantin, an anticonvulsant, and some antianginal medications can cause abnormal growth of gum tissue.

4. Smoking: Regular smokers more commonly develop gingivitis.

5. Age: The risk of gingivitis increases with age.

6. Poor diet: A vitamin-C deficiency is linked to gum disease.

7. Family history: Those with a family history of gingivitis have a higher risk of developing it. This is thought to be due to the type of bacteria we acquire during our early life.

Signs You Need to See a Periodontist

Do you think you might have the gum disease?  Take the Gum Disease Test!

How does gum disease arise?

When bacteria start to form along the gum line and between the teeth where it cannot be clearly seen is how gum disease is formed. As these bacteria start to multiply, they release toxins that can cause the gums to move away from teeth, exposing more of the teeth to plaque and tartar. This is one of the early stages of gum disease.
If not treated at an early stage and the bacteria spread to below the gum line and to the tooth area,  then it cannot be avoided with just brushing and flossing, as this is an advanced stage of gum disease where you can even lose a tooth.

How can I tell if I need to see a Periodontist?

Some of these symptoms or signs that you can look out for are:-

1. One of the first and most common signs of gum disease is when you brush and floss your gums become red and swollen or even start to bleed.

2. After you have brushed your teeth if you still have a bad breath or an unpleasant taste in your mouth it is a sign of the beginning of gum disease because the toxins released are which cause the bad breath or an unpleasant taste in your mouth.

3. Your gums start to pull away and form deep pockets between your teeth and gums.

4. Your teeth begin to shift out of their normal alignment or they feel loose.

5. You can notice changes in your bite pattern, as in your teeth become loose so they can cause differences in the way your mouth “feels” while biting or chewing food.

6. You can feel a lot of pain while eating. This is because the bacterial infection around your teeth has increased and when you bite down it puts pressure on the teeth which have the infection causing the pain.

7. When your gums start to pull away and your root area is exposed the teeth become very sensitive especially to extreme temperature and changes.

8. If you have a family history of gum disease, studies have shown some factors that contribute to gum disease may run in the family. If your parents, grandparents or a sibling have with gum disease, you should consult a periodontist

9. Dentists also say that smoking can also cause gum disease as it decreases the oxygen and nutrients needed for the gums to stay healthy. If they are not in optimal health, the gums cannot stop the infection or bacterial invasion making them more to the disease.

10. Diabetic patients tend to have high levels of sugar in their saliva and the bacteria that cause the gum disease thrive on sugar. Diabetes also decreases circulation to the gums to keep them healthy.

The Center for Disease Control and Prevention says 50% of the adults above the age of 30 years have some form of gum disease.

Even if you are younger than 30 years or above 30 years of age, if you haven’t yet consulted a periodontist you should get your gums checked for the disease, and get the right gum disease treatment before the disease worsens.

Why Tooth Replacement Matters

We wish that teeth behaved like the rest of our body, healing and repairing themselves naturally. But unfortunately, it doesn’t work that way. Unlike a broken bone that will eventually heal, you need professional intervention to restore the look and function after you’ve suffered from tooth loss as an adult.

But why does it matter whether or not you replace missing teeth? Here are a few of the ways missing teeth can affect your life:

-You aren’t able to eat healthy foods because you’ve lost the ability to chew certain foods.
-You avoid social interaction out of embarrassment about your smile and suffer the loneliness of that isolation.
-You’re in constant pain due to missing teeth or having to chew on only one side.
-You’re constantly worried about embarrassing shifting of loose-fitting dentures.
-You’ve lost bone mass, other teeth, or are at a risk for losing other teeth.

When you’re missing several teeth or you wear dentures that simply sit on the top of your gum line, you’re not able to engage your jawbone to its full potential. As a result, your bone and gums can deteriorate and cause a chain reaction of other devastating oral health problems.

Technology Allows More Options in Tooth Replacement

Dental Implants

With our advanced technology, our dentists can place dental implants into your jaw that fuse with your bone and encourage healthier bone growth. The implant is covered with a natural-looking dental restoration that will give you almost as strong a bite force as a normal, healthy tooth.

You can also choose metal-free zirconium dental implants if you’re interested in tooth replacement that’s made of more biocompatible material.

Implant-Supported Dentures

Because dentures rest on your gums, all the adhesive in the world won’t give you the security you need to live free of limitations. You can’t enjoy life if you’re always worried about potentially embarrassing slips while you eat, laugh, and speak around others. Dentures have to be replaced and refitted over the years, as well.

With implant-supported dentures, you have a full set of beautiful teeth anchored by incredibly strong dental implants that allow you to do all the things you could before you lost any teeth.

Non-Implant Option for Replacing a Single Tooth

A predominant alternative to dental-implant supported single tooth restoration is a tooth- supported fixed-bridge. It has several disadvantages when compared to dental implants. Placement of a tooth-supported bridge involves grinding away – or damaging – healthy, adjacent teeth, which will be attached to, and used to support, the bridge. Natural bone underneath a tooth-supported bridge may worsen over time, changing the appearance of your smile and face as it isn’t as stimulated as under an implanted tooth.

Removable partial dentures don't require grinding down adjacent teeth but are not nearly as stable or comfortable as dental implants and can affect speech and eating. This type of restoration is cheaper in terms of cost but fails to look as natural or work as well as an implant-supported ceramic crown. Removable partial dentures may also affect your speech and be eating in ways that are embarrassing. It should also be kept in mind that the bone underneath a removable partial denture may worsen over time changing the way of your smile and face appear to others.

Lasers- a Boon for Dentistry

What is laser dentistry? An innovative tool in the face of modern dental practice - Laser dentistry is a minimally invasive option when you’re facing gum surgery, cavity treatment, or other oral issues. 

Medical professionals use lasers, which are extremely focused light beams, to alter or remove tissues in small amounts. Laser surgery is not just limited to dentistry, but despite that not many people have heard of laser dentistry before having it done. Dentists use lasers in a variety of procedures involving the inside of the mouth, be it to remove an overgrown tissue, to reshape gums, or to whiten the teeth.

What Laser Dentistry Can Treat

Most issues laser dentistry treats are related to gums. Some of these include:

1. Canker sore and cold sore pain treatments.
2. Treating root canal infections.
3. Treating gum disease.
4. Removing gum inflammation.
5. Gum reshaping.
6. Biopsies.
7. Exposing wisdom teeth.
8. Removing benign oral tumour.

Benefits of Laser Dentistry

Dentists choose laser dentistry because of distinct benefits that make the procedures go more smoothly, and also reduce discomfort and healing time for patients.

1. The chances of patients ending up with sutures are very less
2. The requirement of anesthesia may vary with situations 
3. The usage of laser will keep the infection at bay by sterilizing the gum
4. It will ensure fast recovery by causing minimal damaging to the gum
5. The loss of blood is going to be lesser here than in a traditional surgery

What Happens During Laser Gum Surgery or Other Dentistry?

When you come for your laser dentistry appointment, you might be surprised to discover that the process is very similar to other dentistry appointments, like tooth fillings. You receive anesthesia, though it might not be as much as you’re used to receiving. 

During the procedure, you won’t feel any vibrations or discomfort from the laser like you do from the drill. Any bleeding that occurs gets wiped away, just like before. Your mouth will be popped open as the dentist works with the laser to treat your issues.

Post-Operative Expectations

If you’ve ever had gum surgery done without a laser, you can expect that your post-operative experience after laser dentistry will be comparatively smoother. This is going to ensure you have a relatively convenient experience as laser causes lesser bleeding than a scalpel. You won’t have an open and bleeding wound the way you would with a scalpel procedure.

Your susceptibility to infection here is much lesser, though you must adhere to the cleaning and care instructions to the letter. You also won’t typically experience the pain and discomfort associated with scalpel surgery because your post-op irritation is likely to be minor.

What are Dental Crowns and Tooth Bridges?

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?

A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

1. Replace a large filling when there isn't enough tooth remaining
2. Protect a weak tooth from fracturing
3. Restore a fractured tooth
4. Attach a bridge
5. Cover a dental implant
6. Cover a discolored or poorly shaped tooth
7. Cover a tooth that has had root canal treatment

How do Bridges Work?

A bridge may be recommended if you're missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

How are Crowns and Bridges Made?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How long does Crowns and Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.
To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.

Everything you should know about Dentures

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available -- complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Types of Dentures

1. Complete Dentures: can be either "conventional" or "immediate." Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.

Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums      shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate   dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.

2. Partial Dentures: A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is sometimes connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This "bridge" is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.

Are There Alternatives to Dentures?

Yes, dental implants can be used to support cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth. Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants. Consult your dentist for advice.

How Are Dentures Made?

The denture development process takes a few weeks and several appointments. Once your dentist or prosthodontist (a dentist who specializes in the restoration and replacement of teeth) determines what type of appliance is best for you, the general steps are to:

1. Make a series of impressions of your jaw and take measurements of how your jaws relate to one another and how much space is between them.

2. Create models, wax forms, and/or plastic patterns in the exact shape and position of the denture to be made. You will "try in" this model several times and the denture will be assessed for color, shape, and fit before the final denture is cast.

3. Cast a final denture

4. Adjustments will be made as necessary

What Do New Dentures Feel Like?

New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks and tongue learn to keep them in place and you get comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase when you first start wearing dentures, but these problems will diminish as the mouth adjusts.

Will Dentures Make Me Look Different?

Dentures are made to closely resemble your natural teeth so there should be only a small noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.

Will Eating With New Dentures Be Difficult?

Eating with new dentures will take a little practice and may be uncomfortable for some wearers for a few weeks. To get used to the new denture, start with soft foods cut into small pieces. Chew slowly using both sides of your mouth. As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. You should also avoid chewing gum while you wear the denture. Also, don't use toothpicks while wearing dentures.

Will Dentures Change How I Speak?

After getting dentures, you may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures.

If dentures "click" while you're talking, contact your dentist. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.

Are Dentures Worn 24 Hours a Day?

Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them. During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep. Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, you should remove dentures before going to bed. This allows gum tissues to rest and allows normal stimulation and cleansing by the tongue and saliva. The denture can be put back in the mouth in the morning.

Should I Use a Denture Adhesive?

A denture adhesive may be considered under the following circumstances:

1. To enhance satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and an individual's sense of security.

2. To assist individuals with dry mouth conditions that lessen denture adherence, such as individuals taking cold medications, those with neurologic disabilities including strokes, and the elderly.

3. To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.

How Are Denture Adhesives Applied?

1. Here are some tips to consider when applying denture adhesives:

2. Use the minimum amount necessary to provide the maximum benefit. Apply less than you think you need, and then gradually increase the amount until you feel comfortable.

3. Distribute the adhesive evenly on the tissue bearing surface of the denture.

4. Apply or reapply when necessary to provide the desired effect.

5. Always apply the adhesive to a thoroughly clean denture.

6. Remember adhesives work best with a well-fitting denture.

What Are the Types of Denture Adhesives?

1. Paste application. Apply this denture adhesive to a dry or preferably wet denture. Avoid placing adhesive close to the denture borders. If the adhesive oozes, use less of the product. For dentures on the upper jaw, apply three short strips of adhesive -- or a series of small dots -- along the ridge area and one down the center. For dentures on the lower jaw, apply three short strips of adhesive -- or a series of small dots -- in the center of the ridge area.

2. Powder application. Sprinkle a thin, uniform layer throughout the tissue-bearing surface of the denture. Shake off excess powder and press the denture into place. Powders may be preferred over pastes because they are easier to clean off the denture and tissue. In addition, they don't have the same tendency as pastes do to "shim" (keep the denture away from the tissue).

Are Denture Adhesives Safe?

Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no ill effects. If adhesives are used excessively to fill voids for an ill-fitting denture, they can be harmful to the underlying soft and hard tissues. Occasionally, in these cases, inflammation of the soft tissues can result. In addition, because of its movement on the soft tissue and underlying bone, an ill-fitting denture can cause bone loss.