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Bell’s Palsy

Overview

Bell’s palsy is a condition in which the muscles on one side of your face become weak or paralyzed.

Bell’s palsy causes sudden, temporary weakness in your facial muscles. This makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing.

Bell’s palsy, can occur at any age. The exact cause is unknown. It’s believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it might be a reaction that occurs after a viral infection.

For most people, Bell’s palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell’s palsy symptoms for life. Rarely, Bell’s palsy can recur.

Symptoms

Facial paralysis

Signs and symptoms of Bell’s palsy come on suddenly and may include:

  • Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days
  • Facial droop and difficulty making facial expressions, such as closing your eye or smiling
  • Drooling
  • Pain around the jaw or in or behind your ear on the affected side
  • Increased sensitivity to sound on the affected side
  • Headache
  • A decrease in your ability to taste
  • Changes in the amount of tears and saliva you produce

In rare cases, Bell’s palsy can affect the nerves on both sides of your face

 

Diagnosis

There’s no specific test for Bell’s palsy. Your doctor will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.

Treatment

Most people with Bell’s palsy recover fully — with or without treatment. There’s no one-size-fits-all treatment for Bell’s palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell’s palsy.

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Post and core

A post and core crown is a type of dental restorstion required where there is an inadequate amount of sound tooth tissue remaining to retain a conventional crown. A post is cemented into a prepared root canal, which retains a core restoration, which retains the final crown.

When deciding whether or not a tooth requires a post and core crown rather than a conventional crown, the following must be established.

  1. Presence of adequate tooth structure
  2. Sufficient length of canal to retain a post
  3. Curvature and overall anatomy of root canal system
  4. Sufficient root (radicular) dentine thickness for post preparation
  5. Restorability of tooth

Structure

A post and core consists of two parts :

  • The post

The post is a small rod, usually metal, that is inserted into the root space of the tooth and protrudes from the root a couple of millimetres. The post is then used to hold the core or a filling in place.

Because the post is inserted into the root canal, a post and core can only be made for a tooth that has had root canal treatment.

 

Image result for post and core

The core

The core replaces missing tooth structure in preparation for making a new dental crown. The core is then utilized to hold a dental crown in place.

 

Why are post and cores needed ?

A great deal of a dental crown stability depends on the amount of tooth structure that extends into its interior. If very little tooth structure occupies this space, the crown will be easily dislodged, especially by forces directed at its side.

Basically, the core is rebuilding the tooth so it is closer to its original dimensions. Hence, the crown’s stability will greatly increase, and therefore its long-term chances for success are maximized.

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inlays/onlays

Dental Onlays.  Onlays also fit inside the tooth, but extend onto the chewing surface of a back tooth to replace one or more cusps. … It is difficult to determine when inlays or onlays can be used instead of crowns or caps. Ask your prosthodontist if you are a candidate for a tooth-colored inlay or onlay.

 

There are times when a tooth suffers damage (from decay, for example) that is too extensive to be treated with a simple filling — but not extensive enough to need a full-coverage crown. In these cases, the best option for restoring the tooth may be an inlay or onlay.

Image result for inlay onlay

Both inlays and onlays are considered “indirect” fillings, meaning that they are fabricated outside the mouth (generally at a dental laboratory), and then bonded to the tooth by the dentist. This is in contrast to a “direct” filling, which is applied directly to the cavity by the dentist in one office visit.

How It Works

The first steps in getting an inlay or onlay are numbing the tooth and surrounding area with a local anesthetic, and then removing the decay. This is done in order to prevent the decay, which is actually a type of infection, from progressing deeper into the tooth.

Once the tooth has been prepared, an impression of it is made (either digitally or with a putty-like material) and sent to the dental laboratory. There, the impression is used to make a model of your tooth for the creation of your inlay/onlay. The final restoration can be made out of gold or a tooth-colored ceramic or resin.

Before you leave the office, a temporary filling will be attached to your tooth to protect it until the permanent restoration is ready. At your second visit, the permanent inlay/onlay will be attached to your tooth with either a resin that hardens when exposed to a special light source, or a type of permanent cement.

Inlays and onlays are strong, long-lasting, and require no greater level of care than any other tooth. Conscientious daily brushing and flossing, and regular professional cleanings at the dental office are all you need to make sure your restoration lasts for years to come.

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Implant:An option for tooth replacement

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge.

Advantages-

  1. Long term fixed replacement of missing teeth without cutting adjacent teeth (done for fixed bridges or FPD).
  2. Dental implants can restore oral health, form and function of the dentition, improve esthetics.

When you should consider getting dental implants?

Implants can be placed anytime after tooth loss depending upon other factors;

Replacing a single tooth  If you are missing a single tooth, one implant and a crown can replace it.

Replacing Several Teeth   If you are missing several teeth, implant-supported bridges can replace them.

Replacing All of Your Teeth   If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them.

BENEFITS

  • Next best thing to healthy, natural teeth. Strong and stable, a dental implant restores a lost tooth so that it looks, feels, fits and functions like a natural tooth. Other options can lead to bone deterioration, and may interfere with eating, smiling, speaking and other activities of everyday life.
  • Built to last. Dental implants are a long-term solution.
  • Retain your natural face shape, and smile.
  • Protect healthy bone.
  • Keep your teeth in your mouth – not in a cup. You don’t have to keep your removable dentures in a cup.
  • They are in your mouth comfortably.
  • Speak easy.
  • Eat your favourite foods! Taste and enjoy the foods you love without hesitation. You can bite naturally, eat virtually anything you want and, unlike removable dentures that can feel uncomfortable, you can experience the full taste of the food you eat with dental implants, too.
  • Cavities can’t occur in an implant-restored crown, or replacement tooth
  • Keep teeth in place – silently.
  • Protect your healthy teeth.
  • More predictable than other repair and restoration methods.

 

 

Sjögren’s(SHOW-grins) Syndrome

 

Sjögren’s (SHOW-grins) syndrome is an autoimmune disorder that reduces the amount of tears in the eyes and saliva in the mouth.Immune cells mistakenly attack and destroy healthy cells in the glands that produce tears and saliva.  As a result, people with Sjögren’s syndrome have dry mouth and dry eyes.

Sjögren’s syndrome affects 1 – 4 million people in the United States and occurs in all races and ethnicities.

Symptoms

The main symptoms of Sjögren’s syndrome are:

  • Dry mouth. Your tongue and your throat will feel dry and chewing and swallowing may be difficult or painful.
  • Dry eyes. Your eyes may burn or itch or feel as if you have a piece of sand in your eye. Vision may be blurry or you could be bothered by bright light.

Sjögren’s syndrome can also affect other parts of the body, causing symptoms such as:

  • Joint and muscle pain
  • Dry skin
  • Rashes on the skin of hands or feet
  • Numbness or tingling in the hands or feet
  • Vaginal dryness
  • Dry cough that doesn’t go away
  • Fatigue that doesn’t go away

If you have Sjögren’s syndrome you may only have mild symptoms of dry eyes and mouth, or you could experience cycles of mild symptoms followed by more severe symptoms.

Diagnosis

A doctor diagnoses Sjögren’s syndrome using your medical history, a physical exam, and the results from clinical or laboratory tests. Depending on what the doctor finds during the medical history and physical exam, he or she may want you to take more tests or refer you to a specialist.

Treatment

There is still no cure for Sjögren’s syndrome. Treatment can vary from person to person, depending on what parts of the body are affected. Moisture replacement therapies such as eye drops and ointments may relieve dryness in the eyes. There are saliva substitutes and prescription drugs to help increase saliva production. Simply drinking small sips of water regularly throughout the day may also help. If you have joint pain, nonsteroidal anti-inflammatory drugs may offer some relief. If symptoms are severe, corticosteroids or immunosuppressive drugs may be prescribed.

 

Salivary Glands

 

Salivary glands are located in the mouth. There are three pairs of large salivary glands. Parotid glands are found in front of and just below each ear. Submandibular glands are below the jaw. Sublingual glands are under the tongue. There are also hundreds of smaller glands. These glands make saliva (spit) and empty it into the mouth through openings called ducts. Saliva makes food moist, which helps chewing and swallowing and the digestion of food. Saliva also keeps the mouth clean and healthy because it contains antibodies that kill germs.

If the salivary glands are damaged or aren’t producing enough saliva it can affect taste, make chewing and swallowing more difficult, and increase the risk for cavities, tooth loss, and infections in the mouth.

Causes

Obstruction

Infection

Tumors

Diseases such as HIV-AIDS, and autoimmune disorders such as Sjögren’s syndrome and rheumatoid arthritis, can make the salivary glands inflamed and painful. Diabetes may also cause enlargement of the salivary glands. Alcoholics may have salivary gland swelling, usually on both sides.

Symptoms

Problems with salivary glands can cause them to become irritated and swollen. You may have symptoms such as:

  • a bad taste in your mouth
  • difficulty opening your mouth
  • dry mouth
  • pain in your face or mouth
  • swelling of your face or neck or under your tongue

Diagnosis

A doctor uses your medical history, a physical examination, and laboratory tests to make a diagnosis of a salivary disorder.

If your doctor suspects your pain and inflammation are the result of an obstruction in one of the glands, he or she may order X-rays or ultrasound to identify where the obstruction is and what might be causing it.

If a mass is found in the salivary gland, your doctor will suggest a CT scan or an MRI to get a better look at the problem. Your doctor might also use a fine needle aspiration biopsy to explore further. A lip biopsy of minor salivary glands may be needed to identify certain autoimmune diseases, such as Sjögren’s syndrome.

Treatment

Salivary disorders are treated according to what is causing them, using medical or surgical treatments.

Image result for salivary glands

 

 

Tooth decay (dental caries)

 

Tooth decay (dental caries) is damage to a tooth that can happen when decay-causing bacteria in your mouth make acids that attack the tooth’s surface, or enamel. This can lead to a small hole in a tooth, called a cavity. If tooth decay is not treated, it can cause pain, infection, and even tooth loss.

When decay-causing bacteria come into contact with sugars and starches from foods and drinks, they form an acid. This acid can attack the tooth’s enamel causing it to lose minerals.

This can happen if you eat or drink often, especially foods and drinks containing sugar and starches. The repeated cycles of these “acid attacks” will cause the enamel to continue to lose minerals. Over time, the enamel is weakened and then destroyed, forming a cavity.

 

Symptoms

In early tooth decay, there are not usually any symptoms. As tooth decay advances, it can cause a toothache (tooth pain) or tooth sensitivity to sweets, hot, or cold. If the tooth becomes infected, an abscess, or pocket of pus, can form that can cause pain, facial swelling, and fever.

Diagnosis

Tooth decay can be found during a regular dental check-up. Early tooth decay may look like a white spot on the tooth. If the decay is more advanced, it may appear as a darker spot or a hole in the tooth. The dentist can also check the teeth for soft or sticky areas or take an x-ray, which can show decay.

Treatment

Dentists commonly treat cavities by filling them. A dentist will remove the decayed tooth tissue and then restore the tooth by filling it with a filling material.

 

Helpful Tips

  • Use fluoride, a mineral that can prevent tooth decay from progressing, and even reverse, or stop, early tooth decay. You can get fluoride by
    • Brushing with fluoride toothpaste.
    • Drinking tap water with fluoride.
    • Using fluoride mouth rinse.
  • Have good oral hygiene routine. Brush teeth twice a day and regularly clean between teeth with floss or another interdental (between-the-teeth) cleaner.
  • Make smart food choices that limit foods high in sugars and starches. Eat nutritious and balanced meals and limit snacking.
  • Do not use tobacco products, including smokeless tobacco. If you currently use tobacco, consider quitting.
  • See a dentist for regular check-ups and professional cleanings.

 

 

More about crowns and bridges

What are Dental Crowns and Tooth Bridges?
Both crowns and most bridges are fixed prosthetic devices. Crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?
Your dentist may recommend a crown to:

  • Replace a large filling when there isn’t enough tooth remaining
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discolored or poorly shaped tooth
  • 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 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.

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.

How Long do Crowns and Bridges Last?
While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Most important is to practice good oral hygine. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily.

Image result for crowns and bridges

 

Crowns and Bridges

 

Bridges and crowns are fixed prosthetic devices that are cemented onto existing teeth or implants, by a dentist or prosthodontist. Crowns are used most commonly to entirely cover or “cap” a damaged tooth or cover an implant. Your dentist may recommend a crown to:

  • Replace a large filling when there isn’t enough tooth remaining
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discolored or poorly shaped tooth
  • Cover a tooth that has had root canal treatment
  • Gaps left by missing teeth eventually cause the remaining teeth to shift resulting in a bad bite. This can also lead to gum disease and TMJ disorders. Bridges are commonly used if you’re missing one or more teeth. They cover the space where the teeth are missing and are cemented to natural teeth or implants surrounding the space.

 

Types of Dental Crown Materials
There are four different types of materials used for dental crowns:

  1. All ceramic (porcelain-based).
  2. Porcelain fused to metal.
  3. Gold alloys.
  4. Base metal alloys.

Care

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 is to practice good oral hygiene. Keep your gums and teeth healthy by brushing with fluoride toothpaste twice a day and flossing daily. See your dentist regularly for checkups and professional cleanings.

To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.

Procedure

All ceramic and porcelain fused to metal crowns can be matched to the color of your natural teeth. A bridge is mounted onto a space where teeth are missing and is attached onto adjacent teeth. These teeth, called abutments, serve as anchors for the bridge. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which is best for you, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost.

 

Dental-Crowns-and-Bridges

Fluorosis

Fluorosis is a cosmetic condition that affects the teeth. It’s caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed.

After the teeth come in, the teeth of those affected by fluorosis may appear mildly discolored. For instance, there may be lacy white markings that only dentists can detect. In more severe cases, however, the teeth may have:-

  • Stains ranging from yellow to dark brown
  • Surface irregularities
  • Pits that are highly noticeable

Fluorosis Causes

A major cause of fluorosis is the inappropriate use of fluoride-containing dental products such as toothpaste and mouth rinses. Sometimes, children enjoy the taste of fluoridated toothpaste so much that they swallow it instead of spitting it out.

But there are other causes of fluorosis. For example, taking a higher-than-prescribed amount of a fluoride supplement during early childhood can cause it. So can taking a fluoride supplement when fluoridated drinking water or fluoride-fortified fruit juices and soft drinks already proviFluorosis Symptoms

 

 Fluorosis Treatments

In many cases, fluorosis is so mild that no treatment is needed. Or, it may only affect the back teeth where it can’t be seen.

The appearance of teeth affected by moderate-to-severe fluorosis can be significantly improved by a variety of techniques. Most of them are aimed at masking the stains.

Such techniques may include:

  • Tooth whitening and other procedures to remove surface stains; note that bleaching teeth may temporarily worsen the appearance of fluorosis.
  • Bonding, which coats the tooth with a hard resin that bonds to the enamel
  • Crowns
  • Veneers, which are custom-made shells that cover the front of the teeth to improve their appearance; these are used in cases of severe fluorosis.
  • MI Paste, a calcium phosphate product that is sometimes combined with methods like microabrasion to minimize tooth discoloration.

 

Image result for fluorosis

 

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