CLINICAL EXAMINATION OF DENTIN HYPERSENSITIVITY

  1. Evidence of dentin exposure (gingival recession, loss of enamel)
  2. Sensitivity or pain on tactile examination of suspected teeth
  3. Evaporative stimulus: Suspected tooth is isolated using cotton rolls. If a momentary blast of air from air/water syringe causes sensitivity. It can confirm DH
  4. percussion sensitivity
  5. Pain lingering after the stimulus is removed
  6. Vitality tests to rule out pulpal involvement
  7. Radiographic examination to check for caries, pulpal or periodontal involvement
  8. Signs of fractured, leaky or poor restorative margins.

Reference: Clinical operative dentistry-principles and practice : Ramya Raghu, Raghu Srinivasan

DENTAL PLAQUE

Plaque is a sticky film of bacteria that constantly forms on teeth. Bacteria in plaque produce acids after you eat or drink.These acids can destroy tooth enamel and cause cavities and gingivitis

Untreated plaque can harden into (tough to remove ) tartar. Proper oral hygiene, including daily brushing and flossing gets rid of plaque

SYMPTOMS AND CAUSES

● plaque forms when bacteria present in mouth mixes with sugary or starchy foods such as milk, juice, bread ,pasta and soft drinks. These bacteria release acids that breakdown carbohydrates in food and drinks.

● Symptoms : A fuzzy feeling on teeth is the top sign of plaque. Other indicators include halitosis( bad breath ) and red , swollen , tender gums that bleed after brushing.

COMPLICATIONS

Plaque and tartar can lead to

• Cavities

• Gingivitis and periodontal disease

• Tooth decay and loss

• Tooth infection ( Abcessed tooth)

DIAGNOSIS

Since plaque can cause cavities, dental X rays to check cavities. Dental hygienest uses instruments during regular checkups to find and remove plaque

MANAGEMENT AND TREATMENT

Good oral hygiene includes regular brushing and flossing, removes plaque and prevents tartar buildup.

● Fluoride treatments : to slow the growth of plaque causing bacteria and stop tooth decay

● Chlorhexidine Mouthwash

● Dry mouth medication : to increase saliva production

PREVENTION

Plaque can be prevented by :

● Floss daily: Floss once a day with dental Floss or water flosser to get rid of food and plaque stuck between teeth. Studies shows that flossing before brushing teeth removes more plaque

● Brush twice a day: brush for 2 minutes with soft bristled toothbrush and fluoride toothpaste

● Use mouthwash : rinse with an over the counter or prescription antiseptic mouth wash

● Choose healthy food: Cut down sugary, starchy foods and drinks

Source: healthline.com

Ortho Case 2.18

13 year old patient presents complaining of the appearance of his teeth, in terms of UR1.

The problem list:

• Discoloured, ankylosed UR1
• Mild skeletal class III pattern
• Increased vertical proportions
• Mild crowding in the upper and lower arches
• Evidence of dento-alveolar compensation in the lower arch, with a retroclined lower labial segment

What is the long-term prognosis for the UR1? How will this affect the management of this patient’s malocclusion? What changes in the patient’s malocclusion may occur with future growth? Whilst monitoring the patient’s developing malocclusion, how would you manage the ankylosed tooth?

Link: https://drive.google.com/file/d/1oRT2nA2n3Oh3qVjy85bML6drS7Yskxv2/view?usp=drivesdk