Thursday, November 22, 2012

Information on Dry mouth (Xerostomia)


 Causes of Dry Mouth: 


  • Certain prescription drugs
  • Certain over-the-counter medications
  • Tobacco
  • Mouth breathing
  • Anxiety
  • Depression
  • Alcohol
  • Caffeine
  • Spicy or salty foods
  • Breathing unusually dry, cold, dusty, or dirty air
  • Stress
  • Vitamin deficiencies
  • Simply not drinking enough water
  • Radiation and chemotherapy
  • Arthritis
  • Diabetes
  • Menopause
  • Sjogren's Syndrome
  • Lupus
  • Parkinson’s disease






What drugs and medications can cause dry mouth? 


  • High blood pressure medicines
  • Antidepressants
  • Tranquilizers
  • Antihistamines
  • Anti-Parkinson agents
  • Antipsychotics
  • Decongestants
  • Narcotic pain relievers
  • Chemotherapy
  • Antidiarrheals
  • Bronchodilators




What problems may develop because of dry mouth
  • Rapid development of tooth decay
  • Sore tissues
  • Worsening periodontal disease
  • Sore spots and ulcers under dentures
  • Difficulty wearing dentures
  • Mouth sores in non-denture wearers
  • Breath doesn’t feel as fresh
  • Difficulty chewing and swallowing  normal foods
  • Difficulty tasting normal foods
  • Difficulty speaking
  • Burning sensation in the mouth
  • Dry or painful tongue


How can I avoid destruction from rapid tooth decay?


  • Avoid hidden sugars, such as cough drops, lemon drops, hard candy, breath mints, chewing gum, soda pop, etc.  People with dry mouths can get literally dozens of cavities in a matter of a few months.
  • Use a prescription fluoride preparation.  These get more fluoride to the teeth than regular fluoride toothpaste.  They are available as a mouthrinse, brush-on gel, or a gel applied in a custom-made mouth tray.  Ask your dentist for prescriptions, or construction of a custom fluoride tray.  Prevident and Gel-Kam are examples.
  • Maintain superior oral hygiene habits:  brush at least twice a day for two minutes per brushing, floss every day, and have your teeth cleaned/checked twice a year.



What will help relieve my dry mouth?

  • Increase water intake throughout the day, and take frequent small sips
  • Add moisture to the air with a humidifier.
  • Protect lips with a balm.
  • In cold weather keep mouth and nose covered with a scarf when outdoors.
  • Don’t use tobacco or alcohol.
  • Avoid strong toothpastes.
  • Avoid mouthwashes containing alcohol.
  • Use only toothpastes and mouthwashes that don’t contain sodium laurel sulfate.
  • Avoid spicy and salty foods, and products containing cinnamon, peppermint, or wintergreen.
  • Take a daily multi-vitamin.
  • Use oral products that contains Xylitol.
  • Be sure your doctors and pharmacist are aware of all the medications you are taking.
  • Ask your doctor if your medications can be adjusted or changed.
  • Use a saliva substitute or mouth moisturizers.
  • Use sugarless hard candies to stimulate saliva flow.

What products  are available?
Mouthwashes
Oasis
BetaCell Oral Rinse
Biotene Mouthwash
TheraBrite Oral Rinse
Tom’s of Maine Natural Mouthwash, Oral Moistening
Sprays
Moi-Stir Mouth Moistener spray (carboxymethylcellulose)
Mouth Kote mouth spray
Salivart Oral Moisturizer spray (carboxymethylcellulose)
Stoppers 4 Dry Mouth Spray (glycerin)
Thayers Dry Mouth Spray (glycerin)
                Toothpastes
Biotene Dry Mouth Toothpaste
Rembrandt Toothpaste for Canker Sore Sufferers
TheraBreath Oxygenating Toothpaste
Tom’s of Maine Natural Anticavity & Dry Mouth Toothpaste
                Gums, 
                                Mints
Biotene Dry Mouth Gum
XyliChew mints
                Gels
Orajel Dry Mouth Moisturizing Gel
Oral Balance Mouth Moisturizing Gel, by Biotene
Saliva Substitute, by Roxane
Spry Dry Mouth Tooth Gel
                Other
Biotene Dry Mouth Denture Grip
Moi-Stir Oral Swabsticks (carboxymethylcellulose)
Salagen Tablets, 5mg (pilocarpine HCl); by prescription only

Where can I find these products?
  • Stores carry a variety of products, but there is no one store that has them all.  Keep trying different stores.
  • The pharmacist can help you locate some of these products.

Friday, November 9, 2012

Free Download Crown, Bridges and Veneer Wall Chart (Poster)

I needed some wall charts to hand on my clinic. I have searched days and days on internet to find some good posters about "Crowns", "Bridges", and "Veneers". But I couldn't make any. Finally I have decided to make my own posters. I think I have done something very interesting. So I printed them and pasted on the walls of my clinic. After that I thought of uploading them to my blog where everyone can download them. Here are those posters.

Free Download Dental Crown, Bridges and Veneer Wall Chart (Poster)

Dental BRIDGE Wall chart (Poster)

A Bridge is a Dental prosthesis which fills a space that a tooth previously occupied.


Dental CROWN Wall chart (Poster)

Crown is a permenent covering that fits over an original tooth that is earlier decayed, damaged or cracked. 
 
 Dental VENEER Wall chart (Poster)

A Veneer is a thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface. 
 

Monday, August 13, 2012

Intraoral Radiographic Techniques (Digital Radiology)-Chapter 6

Digital Radiology
Digital imaging was introduced into dentistry in 1987. Digital sensors are used instead of x-ray film. Sensors can be wired or wireless depending on the system used. (Figures 77 and 78) Sensors and tube head placement are the same for digital imaging as film and tube head placement is for traditional radiology. Most standard radiographic machines can be converted to acquire digital images. Digital imaging still uses ionizing radiation, and therefore, before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar. The apron must be properly placed to avoid interference with the radiographic exposure.
The sensors are slightly thicker than a regular film. Modified film holders must be utilized in the placement of the sensors. These modified holders can be purchased from any major dental supply company. The sensors can be reused several times. Proper use of intraoral barrier and OSHA techniques must be observed.
The advantages of digital radiology are decreased exposure time to the patient, elimination of darkroom processing time and exposure to processing chemicals, immediate viewing, and ability to easily and cost effectively transmit directly to third party facilities or affiliating dental offices. Additional computerized advantages include the ability to enhance the image for viewing. Once an image is in the computer, brightness and contrast and image reversal can be enhanced for optimal viewing of tissue and bone levels. The radiograph can be rotated and magnified to enhance details. An additional feature shows embossed images creating a stacked effect of the oral tissues.
The main disadvantages are substantial start up costs including machinery and operatory computer technology, and compatibility with other software program and RAM capacity. Considerations must also be noted that although your office may utilize digital radiography, other facilities may not and the transfer of images between them could be more difficult.

Figure 77
Figure 78

Summary
Proper film and tube head placement are a critical component of the total radiographic procedure.
Periapical, bitewing, and occlusal surveys are critical components of diagnosis and treatment of dental patients. Because of the exposure to ionizing radiation, proper techniques must be employed to reduce radiation exposure to the patient through the use of lead aprons, high speed film, and proper technique; thus decreasing additional film retakes. As technology advances in dental radiology operators must maintain current knowledge and adapt their abilities for the best treatment of the patient.
 

Friday, August 10, 2012

Intraoral Radiographic Techniques (Intraoral Occlusal Radiography)-Chapter 5

Intraoral Occlusal Radiography

Maxillary Topographical Occlusal
This projection (Figure 63) shows the palate (roof of the mouth), zygomatic process of the maxilla (a projection from the maxilla), antero-inferior aspects of each antrum (in this case, the maxillary sinuses), nasolacrimal canals (tear ducts), teeth from the left second molars to the central incisors, and the nasal septum (cartilage dividing the nose).

 
Figure 63

Uses:  To view the maxilla for anterior alveolar fractures, cysts, supernumerary teeth and impacted canines, and to view pathology at the apices of the incisors.  It is not used to diagnose peridontal conditions.
Patient positioning:  The patient is seated with the sagittal plane perpendicular to the floor and the occlusal plane parallel to the floor.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure.

Film placement:  With the tube side of the film (size #4) toward the maxilla, the film is placed crosswise in the mouth, like a sandwich.  It is gently pushed backwards until it contacts the anterior border of the mandibular ramus.  The patient bites down gently to maintain position.

Exposure factors:  Follow the recommendations of the film and equipment manufacturer. 

Direction of the central ray:  The central ray is directed at the center of the film with a vertical angulation of +65 degrees and a horizontal angulation of 0 degrees.  In this case, the central ray will pass through the bridge of the nose, as in Figure 64.

 
Figure 64

Mandibular Topographical Occlusal
Uses:  To view the anterior portion of the mandible for fractures, cysts, root tip and periapical pathology.  It provides a very good view of the symphysis region of the mandible. (Figure 65)
 
Figure 65

Patient positioning:  The patient is seated with the head tilting slightly backward, so that the occlusal plane (ala-tragus line) is 45 degrees above the horizontal plane.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure.
Film placement:  With the tube side of the film (size #4) toward the mandible, the film is placed crosswise in the mouth, like a sandwich.  It is gently pushed backwards until it contacts the anterior border of the mandibular ramus.  The patient bites down gently to maintain position.
Exposure factors:  Follow the recommendations of the film and equipment manufacturer.
Direction of the central ray:  The central ray is directed between the apices of the mandibular central incisors and the tube is angled at -55 degrees relative to the film plane, as in Figure 66.
 
Figure 66


Maxillary Vertex Occlusal
 
Uses:  To view the buccopalatal relationships of unerupted teeth in the dental arch. (Figure 67)
 
Figure 67

Patient positioning:  The patient is seated with the sagittal plane perpendicular to the floor and the occlusal plane parallel to the floor.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure.

Film placement:  The film (size #4) is placed in the same manner as the Maxillary Topographical Occlusal.

Exposure factors:  Follow the recommendations of the film and equipment manufacturer.

Direction of the central ray:  The central ray is directed through the top of the skull (hence the name vertex occlusal). Since the beam must penetrate a considerable amount of bone and soft tissue, the exposure time must be increased.  The central ray is perpendicular to the film plane and is directed to the center of the film as in Figure 68.

 
Figure 68 

Mandibular Cross-Sectional Occlusal
 
Uses:  To view the entire mandible for fractures, foreign bodies, root tips, salivary calculi, tori, etc. (Figure 69)
 
Figure 69

Patient positioning:  The patient’s head may be in any comfortable position that allows the central ray to be directed perpendicular to the plane of the film packet.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure.

Film placement:  The film (size #4) is placed in the same manner as the Mandibular Topographical Occlusal.

Exposure factors:  Follow the recommendations of the film and equipment manufacturer.

Direction of the central ray:  The central ray is perpendicular to the film plane and is directed to the center of the film as in Figure 70.
 
Figure 70


Posterior Oblique Maxillary Occlusal
 
Uses:  To view the maxillary posterior region and provide a topographical view of the maxillary sinus.  The projection may be used in place of periapical films in patients who have a tendency to gag and for examining periapical pathology and root tips. (Figure 71)
 
Figure 71

Patient positioning:  The patient is seated with the occlusal plane parallel to the floor and the sagittal plane perpendicular to the floor.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure. 

Film placement:  The film (size #4) plane should be parallel to the floor, and the packet should be pushed posteriorly as far as possible.  The lateral border of the film should be positioned parallel to the buccal surfaces of the posterior teeth and extend laterally approximately one-half inch past the buccal cusps on the side of interest.  The patient should bite down gently to maintain film position.

Exposure factors:  Follow the recommendations of the film and equipment manufacturer.
Direction of the central ray:  The tube is directed at right angles to the curve of the arch, and strikes the center of the film packet as in Figure 72.
 
Figure 72

Posterior Oblique Mandibular Occlusal
Uses:  The projection is used to view the posterior teeth of the mandible to locate cysts, fractures, supernumerary teeth, and periapical pathology.  It can be used in place of posterior periapical films. (Figure 73)
 
Figure 73
Patient positioning: The patient is seated with the occlusal plane parallel to the floor and the sagittal plane perpendicular to the floor.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure.
Film placement: The film (size #4) plane should be parallel to the floor, and the packet should be pushed posteriorly as far as possible.  The lateral border of the film should be positioned parallel to the buccal surfaces of the posterior teeth and extend laterally approximately one-half inch past the buccal cusps on the side of interest.  The patient should bite down gently to maintain film position.
Exposure factors:  Follow the recommendations of the film and equipment manufacturer.
Direction of the central ray:  The tube is directed at the apex of the mandibular second premolar, and the central ray should strike the center of the film packet.  The vertical angulation is -50 degrees as in Figure 74.
 
Figure 74


Modified Oblique Posterior Mandibular Occlusal
Uses:  This projection is especially useful to detect calculi in the submandibular gland.  Calculi are often difficult to detect on conventional radiographs due to superimposition of the mandibular bone. (Figure 75)
 
Figure 75

Patient positioning and film placement:  With the tube side of the film (size #4) toward the mandible the film is placed in the patient’s mouth crosswise like a sandwich.  The film plane should be parallel to the floor, and the packet should be pushed posteriorly as far as possible.  The lateral border of the film should be positioned parallel to the buccal surfaces of the posterior teeth and extend laterally approximately one-half inch past the buccal cusps on the side of interest.  The patient’s head is then rotated to the side and lifted up.  Before any radiographs are exposed, the patient must be protected with a lead apron and thyroid collar.  The apron must be properly placed to avoid interference with the radiographic exposure.
Exposure factors:  Follow the recommendations of the film and equipment manufacturer.
Direction of the central ray:  The tube is positioned under and behind the mandible and the central ray is directed onto the center of the film so that it passes inside the ascending ramus so that the submandibular gland will be between the tube and the film as in Figure 76.
 
Figure 76


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