CHECKED BRUXISM

ARE YOU GRINDING TEETH?

Bruxism is involuntary habitual grinding of the teeth, typically during sleep.

Several commonly associated symptoms with bruxism are hypersensitivity of teeth, jaw muscles soreness, headaches, wearing off teeth, damage to dental fillings and crown and overall damage to teeth.

Teeth grinding or bruxism is very common in children as well as adults and people may not realize it initially until their dentist spots out the symptoms in their mouth.

There are two main types of bruxism: during sleep (sleep bruxism) and during wakefulness (awake bruxism). Bruxism may be mild or aggressive.

 

SIGNS

  • Attrition means flattening of the occlusal surface, and Abfraction is where notches/grooves are formed at the neck of the teeth near the gum-line.
  • Fracture of teeth and repetitive failure of dental restorations including crowns.
  • Teeth Hypersensitivity due to wearing away of the protective layer of dentin and enamel.
  • Loosening of the teeth due to inflammation of periodontium due to excessive pressure.
  • Cheek biting/linea alba, or lip biting.
  • Indentations on the tongue.
  • Tenderness, fatigue or pain of the muscles of mastication, mainly masseter.
  • Trismus(restricted mouth opening).
  • Pain and clicking of TMJ

SYMPTOMS

  • Tooth wear
  • Tooth mobility
  • Pain

TREATMENTS

  • First of all the patient needs reassurance that the condition is not that serious that may lead to anxiety.
  • Specially made night guard to wear while sleeping to avoid clenching.
  • Orthodontic correction of teeth if the misaligned teeth are the cause for clenching.
  • Avoiding smoking and alcohol and having a healthy lifestyle.
  • Other interventions include relaxation techniques, stress management, behavioural modification and habit reversal.

 

 

For more information, you can book an appointment at Dr Sachdeva’s  Dental Aesthetic & Implant Center I 101 Ashok Vihar Phase 1, Delhi- 110052

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What Are Dental Emergencies? How To Deal With Them

 

  • Are you suffering from severe pain?
  • Does your mouth bleed while brushing?
  • Are your teeth mobile/loose?
  • Do you have any swelling in your mouth inside or outside?

Dental emergencies are very common, but one should have the knowledge to handle the situation in case of stress or emergency. Proper maintenance of oral hygiene and regular visit to dentist can help to reduce the chances of experiencing a dental emergency.

The most common dental emergencies may include teeth that are –

Forced out of position causing loosening of tooth

  • Facial trauma
  • Fractured facial bones.
  • Chipped, Broken or fractured tooth
  • Infection indicating an abscess

Treatment will depend on the severity of the damage. For example a chipped tooth is slightly damaged; it can be corrected by smoothening, of maybe restoring the tooth by bond and composite filling material. If the damage is beyond dentin and pulp involvement with severe pain, then the tooth should be treated (RCT).

Here are few scenarios where you may prevent the symptoms before they get worse, or even you get an idea that the time is right to see a dentist now:

  1. Chipped Tooth Or Broken Tooth

If it fairly visible and you are afraid about your looks then call your dentist and explain the situation.

Try to find and retain the chipped particle or any pieces and place it in a moist cloth with a few drops of water or saliva (If kept in good condition, it may be possible to reattach it).

  1. What To Do When Tooth Is Knocked Out Of Socket?

If your tooth is knocked out due to a blunt force trauma causing severe facial injury, try first to find the lost tooth. If the appropriate emergency steps are followed immediately after the tooth has been knocked out, the chances are very good that the tooth can be reinserted and preserved by a dentist.

  • Handle the tooth only by the crown not by the root. If you try to touch the root, u may damage the fragile cells on the root necessary for its reattachment back into the bone.
  • If the tooth is dirty, very gently rinse it in water to ensure that the tooth is clean but do not scrub the tooth or remove any tissue attachment.
  • If you want to then try placing the clean tooth gently back in the socket without touching the root and make sure that the tooth is facing the right direction. Do not force it into the socket. If it is not possible to put the tooth back in position then wrap it in a clean cloth or gauze. Soak it in a container of cold milk or if milk is not available, put the tooth in water that contains a pinch of table salt.
  • It is important to see the dentist for an emergency appointment for the best chances of retaining the tooth.

 

  1. What To Do When Tooth Is Fractured Or Cracked?


  • Rinse your mouth immediately to clean the area with warm water.
  • Take medication prescribed by your physician or dentist.
  • Do not attempt to put any painkiller directly on the site of injury to avoid any burning sensation, it may worsen the situation.
  • Avoid chewing with the injured site and always avoid extreme temperatures that may affect the already traumatized area.
  • Immediately contact your dentist as only he can tell how bad the condition is. The dentist might need to do an X-ray for evaluation of the severity of the situation.
  • See your dentist as soon as possible. Not receiving the proper treatment may result in progression of infection or further decay or damage.

IN CASE OF:

 

Lost Filling

As a temporary measure, you stick a piece of softened sugarless chewing gum at the place where filling is missing.  You should be sure that the gum is truly sugarless, as sugar can cause pain when in contact with the tooth and can lead to bacterial infections in the area.
See your dentist as soon as possible for the proper treatment and care.

Lost Crown

If you dropped out a crown of the mouth, make sure to visit your dentist as soon as possible without waiting for extra days. The tooth portion now exposed that has lost its support could easily be damaged or break off or crumble.

Keep the crown in a cool, safe place because if the crown is not damaged your dentist can reinsert it.

If the crown is out of the mouth for a long period of time, the teeth may shift causing further damage and the old crown will not fit at this stage.

Broken or Loose Brackets, Wires Or Bands

If a wire breaks or sticks out of a bracket it may cause discomfort by poke in cheeks, tongue, or gum.

Try to cover the pointed end with something soft substance like orthodontic wax, sugarless gum, or piece of gauze to avoid discomfort until you visit your orthodontist.

You should never try to cut the wire as you could swallow it or breathe it into your lungs.

Abscess

 

Dental abscess or tooth abscess is an accumulation of pus inside the teeth or gums. It should not be ignored as the infection may spread into nearby spaces affecting other teeth as well.

You may try to gargle with pinch of table salt in lukewarm water for a brief time for some relief.

Contact your dentist for proper care and treatment for the dental abscess before the infection spreads.

Possible Broken Jaw

To control the swelling in the traumatized area apply cold compressions. Stabilize the jaw with bandage wrapped beneath the jaw and tied on top of the head.
A broken or dislocated jaw may cause breathing problems or significant bleeding. If it is not treated properly, a broken jaw can leave you with devastating effects on a person’s ability to eat and breathe.

Sip on ice water and hold for sometime in your mouth until you see your dentist.

 

For more information, you can book an appointment at Dr. Sachdeva’s Dental Aesthetic & Implant Center  I 101 Ashok Vihar Phase 1, Delhi- 110052

Contact us at

Post-Operative Complications of Implant Placement

With the increasing acceptance of dental implants as a viable tooth replacement therapy, complications & failure rates have also increased proportionately.

A range of possible post-operative complications & their prevention are described below:

  1. Infection: Implants are made of titanium, which is strong & biocompatible, which means that is not rejected by the body. So the chances of developing post-operative infection are extremely rare. At times when dentist do not follow effective & strict protocol of sterilization, patient might be vulnerable to post operative infection.

Post-operative infection causes pain & discomfort to the patient, reason being- bacterial contamination of implant or surgical site during the procedure.

If the infection is limited to the soft tissue, a small gum boil will be noticed over the implant site. It can be punctured using a sharp probe & irrigated with chlorhexidine solution or citric acid. It heals & the pain subsides within 24hrs.                                                                                        In case of continuous pus discharge & severe pain which is not relieved by analgesics, this depicts that the infection has reached to the bone-implant body interface.

Prevention: one should follow strict protocol of sterilization in the operatory in order to avoid any bacterial contamination. Also, in such cases, the implant should be removed immediately & prescribe good antibiotic like tab Augmentin 1000mg twice a day for 5-7 days. A new implant can be inserted when the site gets healed in 6 weeks.

  1. Post-operative Edema: Post-operative edema develops in cases of traumatic implant placement. High speed drilling & no constant stream of chilled saline causes bone to overheat & this leads to accumulation of fluids in tissue spaces i.e. edema.

 

Prevention: Unnecessary trauma to the bone must be avoided during osteotomy preparation. Drilling speed must be set according to the density of bone along with a pumping motion of the drill should be employed during drilling to allow the saline to cool down the bone. This prevents overheating & necrosis of the bone.

Patient must be advised to apply an ice pack over the facial   skin of the surgical site intermittently for 45 min to cool down the bone in order to suppress heat generation & inflammatory oedema.

        prevention

  1. Pressure necrosis: results in cases where implant has been inserted & screwed at a very high torque, it may lead to pressure necrosis of the surrounding bone & the patient will complain of continuous pain not relieved by analgesics, for weeks after the surgery.

 

Prevention: Drilling at higher speed with maximum amount of chilled saline irrigation flow to cool down the bone. Use of final drill with the diameter only 0.2mm less than the implant diameter along with the use of bone tap to prepare threads in the bone to accommodate implant threads. Following these instructions help in reduction of post-operative pressure necrosis.

  1. Suture line opening: leads to exposure of implant threads in the oral environment & may cause the collection of plaque over the exposed rough surface of the implant, which may further cause peri-implantitis & loss of hard & soft tissue around the implant.

 

Causes of implant thread exposure

  • Suture line opening & loss of graft in cases where simultaneous bone grafting has been performed with implant placement also leads to implant exposure.
  • More superficial implant placement.
  • Thin mobile soft tissue recedes with muscle pull.

        Management:

  • Tension free sutures should be used to avoid the suture line opening because of the tension in the flap.
  • The open suture line should not be re-sutured but the patient should be instructed to keep it clean, as it heals by secondary intention in 2-3 weeks.
  • If soft tissue healing has not covered the exposed threads, either cover the threads using soft tissue grafting with or without simultaneous bone grafting, or adequate grinding & polishing should be done to make the surface smooth & prevent accumulation of plaque.

  1. Bone resorption: one of the most common complication in dental implantology. When occlusal forces are not distributed equally i.e. is off-axis to the implant prosthesis leads to resorption. Also, when implant with a wider platform is placed into the narrow crestal bone causes crestal bone resorption.

 

Prevention: Implant must be placed along the axis of the future prosthesis. For large mesio-distal diameter two implants should be placed with narrow occlusal table of prosthesis. Along with the maintenance of oral hygiene, soft tissue grafting for compromised soft tissue around the implant must be addressed.

  1. Peri-implantitis: is an inflammatory reaction with the loss of supporting bone in the tissues surrounding a functioning implant. Peri-implantitis is characterized by bleeding/suppuration on probing, together with loss of supporting bone.

The peri-implantitis lesion exhibits histopathological features that similar, but not identical, to those in periodontitis. Similar to periodontitis, the treatment of peri-implantitis must be based on infection control. Under these conditions, progression of the disease may be arrested & subsequent, lost peri-implant tissues may be generated by bone augmentation & soft tissue grafting procedures.

peri-implantitis

With this increasing trend of replacing the lost tooth with an implant, at Dr. Sachdeva’s Dental Institute, we incorporate several associated procedures like bone augmentation to provide this therapy to the maximum number of patients. We follow strict protocol for sterilization & restore implants to minimize postoperative or post loading complications.

SMILE MAKEOVER: DON’T FORGET TO SMILE IN YOUR MARRIAGE

                                                                                        By : Dr.Rajat Sachdeva

Every time you smile at someone, it is an action of love, a gift to that person, a beautiful thing – Mother Teresa

Say cheese: Every wedding has one thing in common: photos. And there are a lot of them. Nothing is more stunning than a lovely bride in an attractive dress with a gorgeous smile. We all want to look our best at our marriage. On your Marriage Day, all eyes will be upon you. You may never be photographed and video shoot more than on this day, and we want to ensure you have a bright, beautiful celebrity smile! Remember, those photos and video will last forever.

If you think your smile will mar pictures or make you self conscious, then your wedding is the right reason to have a smile makeover. Ranging from basic cleaning procedures, new whitening techniques, dental jewellery and smile designing procedures to porcelain veneers and other restorative dental work, the smile of your dreams is within your reach come your wedding day.

Right time to visit dentist: It’s true that some smile makeovers will require a little more time. An initial consultation with a dentist even before you get engaged is important. If you do it too close to your wedding day and anything goes wrong, there is no leeway. Cosmetic dental procedures should be performed with as much time as possible to make sure it’s done right, and to give yourself time to enjoy your new smile and get used to it. Various procedures can be undertaken as:

Scaling and Polishing:

A quick basic cleaning may be the perfect touch-up solution. Often, our teeth sustain daily wear and tear which can lead to the formation of plaque. Over time, tooth decay can set in. If you have the problem of bleeding gums, you may need a course of antibiotics prior to the cleaning procedure and multiple sittings of cleaning. Getting teeth cleaned before your wedding day not only keeps them healthy, but can curbs bad breath.

Bad Breath (Halitosis) Management

Poor oral / dental hygiene and dental problems are not the only reasons for bad breath. There are several other factors contributing to the condition. Consulting your dentist and correct management is the solution.

Bleaching- White Teeth Whiter Smile

You will be the centre of attention on this day, it is also important to get that splendid and most beautiful smile which is captured for your entire life in the photographs. You always want a brighter smile and hence, tooth whitening (bleaching) is a procedure which can be performed before wedding. Depending on the value (dark or light) of your teeth bleaching procedure varies from simple to advance.

 

Cosmetic Tooth Contouring Before the Wedding

Tooth contouring or tooth reshaping is a procedure to correct minor defects in the shape and appearance of a tooth. The procedure is not painful and is pretty much simple. Cosmetic contouring dealt with the longer, pointed or chip tooth that needs to be smoothen out.

 smile dentist, smile dentistry

Restorative Procedure before The Wedding

Presence of diastema or space between two teeth, and such problems can be easily solved by bonding. Bonding is a simple, non-invasive and conservative procedure, which can also improve the appearance of teeth that are chipped, broken, cracked or stained. With bonding, tooth-coloured materials are applied, or bonded, to the tooth surface.

Ask Dr.Rajat Sachdeva For Veneers And Laminates: The most popular and effective aesthetic treatments are porcelain veneers or Cerinate Lumineers, both of which are applied over your existing teeth to give you a natural-looking, white, straight, gleaming, beautiful smile. These thin, custom-made shells cover the front side of teeth, and can be used to treat spaces between teeth and teeth that are chipped or worn, permanently stained, poorly shaped or slightly crooked.

smile dentistry

Braces before The Wedding

Braces are not just for kids. Braces can help straighten crooked teeth, reduce crowding or fill in spaces where teeth do not meet properly. Considering aesthetics, there are more pleasing, clear and even invisible braces are available. Start as early as you can if you want a perfectly straight smile by your wedding day.