Tuesday, April 12, 2011

Sensitive Teeth

Sensitive Teeth



       Teeth become sensitive when the enamel wears out or gums recede exposing the nerve fibres to the external environment. Hypersensitivity means a signal that the dentin is exposed and the pulp is vulnerable to damage.


Dentinal hypersensitivity, or cervical dentinal sensitivity, is a significant clinical problem. It is defined as pain arising from exposed dentine typically in response to thermal, chemical, tactile or osmotic stimuli.



Tooth sensitivity is due to the wasting diseases of teeth, namely attrition, abrasion,erosion and abfraction. These diseases cause loss of tooth structure causing the dentin nerve fibres to get exposed, thus triggering sensitivity.Gum recession is also another reason for hypersensitivity.

Attrition
Attrition is the loss of teeth structure by mechanical forces from opposing teeth. Attrition initially affects the enamel and, if unchecked, may proceed to the underlying dentin. Once past the enamel, attrition quickly destroys the softer dentin. Gradually it affects the whole teeth. Wear due to pressure from the other teeth is termed as attrition. The wear and tear usually initiates on the incisal or occlusal surfaces. 




Abrasion
At times hard toothbrushes, toothpicks, floss or any dental appliance wear the enamel. It generally affects the junction between the tooth and the gums - cementoenamel junction. The loss of tooth caused due to these external elements is described as abrasion. The teeth most affected due to abrasion are premolars and canines. 





Erosion
Intake of various acidic foods and drinks act on the teeth causing erosion of the enamel. If left unchecked it proceeds to the dentin and then the loss of the entire tooth . Dental erosion the most common disease observed in children between 5- 17 years.
In general foods and drinks with a pH below 5.0 - 5.7 trigger dental erosion. Soft drinks such as fruit drinks, fruit juices and carbonated drinks such as colas cause erosion. Wine with pH value 3.0 - 3.8 too is observed to erode teeth. Other sources include chlorinated water from the swimming pool and regurgitation of gastric acids.

Abfraction 

Sometimes a tooth under pressure face diverse forces at one time. One side of the tooth can be under tension while the other side under compression. This causes V-shaped depressions under tension and C-shaped depression under compression. The outcome is the loss of tooth from flexural forces termed Abfraction. 

This concept has not been supported by dental research but has been hypothesised. Research still continues to prove abfraction as one of the causes of tooth destruction.

Treatment:


Treatment would be the sealing of the exposed tubules using agents in severe cases using dental cements or composites.


It can also be reduced by using toothpastes specially made for sensitive teeth. Dentists also suggest application of fluoride sealant on the crown of the teeth. The sealant covers the exposed dentin and as a barrier against pain. If the above treatments are not effective then root canal therapy is recommended. This can make the tooth non vital to pain and protected by crowning it.


In severe cases the restoration of the tooth is done with dental cements or composites.

Pit and Fissure Sealants

Pit and Fissure Sealants

Pit and fissure sealant is also called sealant for gap of pit and fissure. This treatment doesn't wipe off the tissue on the surface of occlusion. It applies a layer of adhesive resin and fills the gaps of pit and fissure to prevent enamel from erosion by bacteria and metabolism substance and effectively defend teeth from being decayed.


As teeth develop, deep crevices called "fissures" evolve. When two or more fissures join, a pit is created. Although daily brushing, rinsing and flossing can eliminate remaining food particles and plaque from the surfaces of the teeth; toothbrushes do not always reach the deeper pits leaving these areas once again exposed to harmful bacteria’s and their resulting acids. This is where tooth sealants can help.

Bleaching / Whitening

Bleaching / Whitening


                         Whether you want to add an extra sparkle to your smile for that special occasion or simply perfect you look, whitening is simple, affordable, and safe. Nothing makes you look "WOW" like a white smile and nothing whitens teeth like deep bleaching. Deep bleaching works by revitalizing the tooth's ability to absorb oxygen. Oxygen is absorbed into the tooth and breaks down large dark stain molecules to small white particles. The results are amazing.






                   Talking of oral hygiene, most of us would have the periodical visit to the dentists. However, the kind of life style we have now that gets us to drink lots of soda, coffee, tea and smoke a lot of cigarettes  other eatables that leaves the teeth yellow is the biggest challenge we have today especially amongst the youth. The only way of getting of the attack of the highly pigmented eatables is teeth whitening or bleaching teeth. Even aging can make your teeth look clumsy despite of regular dental visits and brushing of teeth twice a day. Teeth whitening or bleaching of teeth ensures sparkling white teeth. Taking that yellow pigment off your teeth and empowering you with sparkling white teeth.

Lumineers (Processed Composite)

Lumineers (Processed Composite)

                             The newest form of esthetic dentistry involves bonding ultra-thin porcelain veneers, generally without anesthetic, to unprepared or lightly prepared teeth. This has been made possible because of a new innovation in dental materials. LUMINEERS BY CERINATE is a cosmetic solution for permanently stained, chipped, discolored and misaligned teeth. It may even be used to revitalize old crowns and bridgework. LUMINEERS are a porcelain veneer that can be made as thin as a contact lens and are placed over existing teeth, most of the time without requiring the removal of sensitive tooth structure.


Periodontal surgery

Periodontal surgery


                          Gingivectomy is periodontal surgery that removes and reforms diseased gum tissue or other gingival buildup related to serious underlying conditions. For more chronic gingival conditions, gingivectomy is utilized after other non-surgical methods have been tried, and before gum disease has advanced enough to jeopardize the ligaments and bone supporting the teeth. Performed in a dentist's office, the surgery is primarily done one quadrant of the mouth at a time under local anesthetic. Clinical attachment levels of the gum to teeth and supporting structures determine the success of the surgery. Surgery required beyond gingivectomy involves the regeneration of attachment structures through tissue and bone grafts.

Oro-Antral Fistula closure

Oro-Antral Fistula closure

                           Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. The literature review revealed various procedures for the closure of oroantral fistulas. These procedures may be subdivided into local flap, distant flap and grafting. Procedures involving local flaps are usually adequate to close minor to moderate size defects.