Teething is a term limited by common usage to eruption
of primary dentition. Since the time of Hippocrates (460-
377 BC) teething is blamed for ailments such as fever, convulsions, bronchitis, otitis media and diarrhea, for
causing 12% of the deaths in children under four years.
Complete opposite views are also available. It is seen
that these local and systemic factors are associated with
the disease somewhere else also and just as a coinci-
dence appear with teething.

Eruption of primary dentition usually begins in the 4-6th month of a child’s life. The appearance of normal teeth is eagerly awaited by the parents since it represents an important early milestone in development. In most cases eruption of teeth causes no distress to the child or parents, but sometimes the process causes local
irritation, which is usually minor but which may be severe enough to interfere with the child’s sleep.

CLINICAL FEATURES OF TEETHING

LOCAL SIGNS

1. Hyperemia or swelling of the mucosa overlying theerupting teeth.
2. Patches of erythema on the cheeks.
3. Flushing may also occur in the skin of the adjacen cheek.

SYSTEMIC SIGNS

1.General irritability and crying
2.Loss of appetit.

3.Sleeplessness

4.Increased salivation and drooling

5.Insanity
6.Meningitis

7.Increased thirst
8.Circumoral rash
9.Cough

Associated Problems
Systemic

Fever,convsions, diarrhea,vomiting, bronchitis, cholera, tetanus

Local

Eruption hematoma, eruption sequestrum, ectopic eruption, transmigration , transposition

MANAGEMENT

PREVENTIVE MEASURES

1. Maintain child’s oral and general body health.

2.Gums should be wiped after each meal with cotton soaked in a weak antiseptic.

3. Adequate quantities of vitamins, minerals , proteins, are given to the child for increasing body’s resistance .

GENERAL MANAGEMENT

1. Hard , non sweetened rusks

2. Use of toasted bread helps in providing gingival stimulation.

3. Use of hard fruits such as appleor guava .

MEDICAL MANAGEMENT

demulcent and mild antiseptic.

1. Topical application of glycerin: It acts as a protective demulcent and mild antiseptic.
2. Topical application of lignocaine hydrochloride which provide relief in the interval before the analgesic is effective .
3. Topical application of benzyl alcohol can also be effective.

SURGICAL MANAGEMENT

Surgical treatment is sometimes recommended for the relief of pain from an eruption cyst or a hematoma. The technique advocates is to make 2 semilinar incisions over the crowns of the tooth , which meet at their extremities. The intervening portion of the tissue , which lies over the occlusal surface of unerupted tooth is then removed with a pair of tissue foreceps.

REFERENCES:TEXTBOOK OF PEDODONTICS SHOBHA TANDON 2ND EDITION

• Decrease Thyroid hormones

Classification

• primary hypothyroidism – due to cause within the thyroid gland itself.

• secondary hypothyroidism – due to failure of TSH production following pituitary or hypothalamic disease.

Causes

• spontaneous atropic thyroidism

• iodine deficiency

• iodine therapy

• thyroidectomy

• hashimoto’s thyroiditis

• dyshormonogenesis

• drug-induced ( lithium , amiodrone etc)

• radiation therapy

clinical features

A. Thyroid gland enlargement

B. Gastrointestinal

• weight gain

• decrease in appetite

• constipation

• acsite

C. Cardiorespiratory

• angina

• bradycardia

• hypertension

• pericardial effusion

• Pleural effusion

• cardiac failure

D. Neuromuscular

•ache and pain

•muscle stiffness

•carpal tunnel syndrome

•delayed relaxation of tendon reflex • •depression

•psychosis

•cerebral ataxia

•myotonia

•deafness

E. Dermatological

• mycoderma(non- pitting edema of skin of hands , feet and eyelid)

• dry flaky skin and hair

• Alopecia

• purplish lips

• malar flush

• xanthelasma

• carotenaemia

F. Reproduction

• menorrhagia

• infertility

• galacoma

• impotence

G. Haemtological & miscellaneous

• macrocytosis

• anaemia

• cold intolerance

• tiredness

• harseness of voice

• low pitched sound

Slurred speech

Investigation

• serum T4 decrease; TSH increase ( > 20mU/l)

• serum cholesterol & triglycerides increase

• serum LDH, Ck increase

• serum Na+ decrease

• ECG – sinus bradycardia, low voltage QRS complex, ST – T wave abnormalities

• chest radiograph – Enlargement of cardiac shadow

Treatment

D.o.c – Thyroxine – 50 microgram/day for 3 weeks

then

100microgram/day for 3weeks

then

150microgram/day for maintenance dose

• pt with heart disease angina may worsen with thyroxine therapy -treated with beta block and vasodilators or CABG

It’s hard to believe that a sheet of rubber can make you feel more comfortable during a dental treatment and allow dentists to do better, but a “RUBBER DAM” can . S.C. BARNUM

It is a direct method of isolation. It is a safeguard against the bacterial contamination from saliva and accidental swallowing of instruments.

HISTORY :

ADVANTAGES:

• Dry , aseptic working field
• Patient and operator protection
• Improved visibility and access to working area.
• Minimum interference of saliva
• Prevents aspiration of instruments .
• Maximum tissue retraction.

INDICATIONS:

ARMAMENTARIUM:

1. RUBBER DAM SHEET:

• SIZE: “5*5” and “6*6”
• COLOR: black ,blue , green , translucent
• SURFACES: Shiny (tissue), dull(occlusal)
• MATERIAL : Latex or non latex
• THICKNESS:

2, RUBBER DAM CLAMPS:

• Devices that hold the rubber dam in place .
• TYPES: winged and wingless.
• winged have projections at the jaw whereas wingless dont

3. RUBBER DAM PUNCH :

It is an instrument which have a metal table and a tapered , sharp, pointed plunger to produce clear cuts holes on the rubber dam sheet so that the teeth can be isolated. It is of 2 types: Single hole punch and multi hole punch.

4. RUBBER DAM FRAME:

• Retracts soft tissues
• Improves access
• Maintains borders of rubber dam in position.
• TWO TYPES : Plastic and Stainless steel

5. RUBBER DAM FORCEPS:

• Used to carry the rubber dam clamp to the tooth.
• DESIGNS USED : Ash or stokes pattern, Ivory pattern, Washington pattern.

6. RUBBER DAM TEMPLATE:

• It provides a very efficient and convenient way of marking the dam for punching of a particular tooth .
• The holes in the rubber dam should be made approximately over the centre of the incisal or occlusal surface of the teeth to be engaged using a rubber dam template under the rubber dam sheet.

7. RUBBER DAM NAPKIN :

• Placed between rubber dam and the patient’s skin .
• Avoid allergic reactions.

8. WEDGET CORDS:

• Elastic, flexible cord
• Used to stabilize inter-proximal area of rubber dam .

9. FLOSS:

• Required for testing inter-dental contacts
• Aids in flossing the rubber dam through tight contacts.
• Safety measure during removal of clamp.

REFERENCE: GROSS-MAN’S ENDODONTIC PRACTICE 13TH EDITION .

In NEET MDS Preparation process, your Oral pathology knowledge needs to be sound. Without knowledge in oral pathology, a lot of your final year may not make sense. A lot of overlaps exist between oral pathology, oral medicine, periodontics, and endodontics. In this article, we bring you the standard books to refer & most important topics which cater under the topic Oral Pathology & Medicine along with few preparation tips.

Given below are the list of Questions MERITERS experts will answer that are essential for an effective and efficient preparation:

1. What is the subject wise Weightage?
2. Which Books to refer?
3. How much Time should be allocated to the subject?
4. How much Time should be allocated to each Topic?
5. How many times should the subject be Revised?
6. What is the Ideal time to Start the subject?
7. What are the Important Topics for NEET MDS?
8. Types of Questions asked?

What is the subject wise Weightage?

20-22/240 Questions (9%)

Standard books to refer:

Shafer’s Textbook of Oral Pathology

Author : B Sivapathasundharam

INR 1,750 Buy on Amazon

Oral and Maxillofacial Pathology, 3e (Neville, Oral and Maxillofacial Pathology)

Author : Brad W. Neville DDS, Douglas D. Damm DDS, Carl M. Allen DDS MSD, Jerry Bouquot DDS MSD 

INR 1,995 Buy on Amazon

Burket’s Oral Medicine 

Author : Michael Glick

INR 1,753 Buy on Amazon

How much Time should be allocated for the Subject?

• Theory reading – 4 Days
• MCQ Practice- 20 Days

How much Time should be allocated to each Topic?

• Theory reading – 4-5 Hours
• MCQ Practice-  8-10 Hours

How many Times should the subject be Revised?

• 8-10 times revision is required

What is the Ideal time to Start the subject?

• Mid way in the preparation 
• After completing 7-10 subjects

Oral Pathology & Medicine – Important Topics

UNIT	MOST IMPORTANT TOPICS
Developmental Disturbances	Developmental disturbances of TeethDevelopmental disturbances sizeShape Developmental disturbances of FaceDevelopmental disturbances of TongueTongueDevelopmental disturbances of FaceDevelopmmental disturbances of Jaw
Benign And Malignant Tumours Of Oral Cavity	General considerationPrecancerous lesions and conditions Basal cell carcinoma Squamous cell carcinoma TNM staging Treatment modalities Verrucous carcinoma Hemangioma KAPOSI ‘s sarcoma Nevi Melanoma Neoplasm of Muscles, Nerve tissue Multiple myeloma Connective tissue tuomours of Jaw Burkitt’s lymphoma
Diseases Of Salivary Glands	Mucocele and Ranula Mickulz’s disease and Sjogren syndrome Pleomorphic adenoma Warthin’s tumor Cylindroma Oncocytic adenoma
Dental Caries	Theories of dental caries Etiologies of dental caries Stephan’s curve Classification of dental caries Histopathological zones of Dentine Histopathology od dental caries (Enamel caries)
Pulp And Periapical Infections	Classification of periapical infection Cellulitis Ludwig’s angina Osteomyelitis
Physical And Chemical Injuries	Physical And Chemical InjuriesPigmentationsRegressive alterations of teethMucocele Other physical and Chemical Injuries.
Diseases Of Bones & joints	Osteogenesis imperfectaOsteopetrosis Achondroplasia Osteoporosis CherubismFibrous dysplasia Paget’s disease Cleidocranial dysplasia CGCGSyndromes associated with bone Osteosarcoma
Diseases Of Nerves & Muscles	Trigeminal Neuralgia Glossopharyngela neuralgia Bells palsy Syndromes associated with nerve pathology Disease of  Muscular or connective tissue origin
Skin And Vesiculobullous Lesions	Skin lesions Ectodermal dysplasia Lichen planus Erythema multiforme Classification of vesiculobullous lesions 5Psoriasis Miscellaneous
Bacterial Infections	Sinus Botryomycosis Sarcoidosis Syphilis Actinomycosis Leprosy
Viral Infections	Herpes Simplex Virus Herpes Zoster Cox sackie virus Paramyxovirus Apthous ulcers
Mycotic Infections	Candidiasis Histoplasmosis Mucormycosis Phycomycosis
Oral Aspects Of Metabolic Diseases	Vitamin D deficiency HyperparathyroidismHyperpituitarism Hand Schullar christian disease Hypophosphatasia Amyloidoisosi and other disease
Tongue Disorders	Tongue Disorders
Pigmentation	Pigmentation
Diseases Of Blood	Hemophilia Von Willebrand’s diseaseTypes of anaemia Aplastic anaemia Thrombocytopenic purpura Leukemia Miscellaneous
Miscellaneous	Miscellaneous

What Type of Questions were asked in NEET?

1. Single best answer

• Case Based
• Fact Based (Memory)
• Concept based
• Numerical/Value Based

2. Image based questions

3. True or false type questions

Please watch the above featured video for more detailed explanation about this article.

We hope this blog will assist you in preparing this subject meticulously for MDS entrance exams.
Prepare judiciously..

SOURCE: MERITERS!!