Smile SenseA guide to your smile!

Burning mouth syndrome is a painful condition where you feel a scalding sensation on your tongue, lips and roof of the mouth.It’s often associated with medical or dental conditions nutritional deficiencies, a dry mouth , allergies or as a side effect of medication.

Other terms used are Glossodynia, Glossopyrosis, Stomatodynia.

Symptoms:

Symptoms tend to come in late in the morning, peak at noon and ease of by night.

• Soreness
• Swelling
• Tingling or numbness of tip of tongue
• Bitter or metallic taste of mouth
• Dry mouth
• Continuous pain
• Aggravated by spicy  or acidic food

Caused by:

Local factors -

• Denture
• Mechanical factors
• Habits – Bruxism
• Allergic stomatitis – Dental restorations, food, preservatives, additives
• Bacterial, fungal or viral infection.

Systemic factors -

• Deficiencies – Iron, Vit B12, Folate, Zinc
• Endocrine  – Diabetes, Thyroid, Hormones
• Decreased salivation
• Medications
• Depression, anxiety

What to do to help?

• Avoid alcohol
• Avoid tobacco
• Sip water frequently
• Chew sugar free chewing gum
• Suck on ice cubes.

Also the systemic and local factors should be eliminated first.

• Don’t eat ice cubes. It might be refreshing but can cause tooth fracture.
• To clean the sulcus ( below your gumline) rotate the toothbrush in a 45° angle and get the bristles in there.
• To clean a deep pocket , tie one or two knots on your floss to catch the food particle.
• When you outer bristles of your toothbrush flare, get a new toothbrush.
• After you eat a sweet snack and can’t brush, rinse with water at least.

To read more on toothbrushing, CLICK HERE

To read more on flossing, CLICK HERE

People experiencing sensitivity while eating or drinking hot or cold food or beverages due to worn tooth enamel or gum recession can be treated with desensitizing toothpaste.

Such toothpastes has compounds that block sensation from traveling from tooth surface to nerve endings. Their use should be restricted and not used in cases where patient is experiencing pain due to caries/ cavities or due to tooth fracture.

Use of desensitizing toothpaste in every situation of dental pain can mask the cause, neglecting the proper cause and aggravating the situation.

Once you have gone through the following list of 15 food items your conception of ‘healthy’ food is going  change forever.

1. Doughnuts and pastries – Doughnuts have trans fat which can lead to heart issues. huge amount of sugar can also cause diabetes,obesity and heart disease.
2. McDonald’s Chicken select – It has 630 calories and 11 grams of artery clogging fat.
3. Sugary soda – 12 ounces of soda contain 6-10 teaspoon of sugar. It’s acidic content can break down dental enamel too.
4. Juice – Juice is devoid of fiber and hence not worth it.You can give the child a whole fruit instead.
5. Candy – A Hershey bar for example contains 8 teaspoon of sugar, which can cause cavities.
6. Cap n’ Crunch cereal – A cereal contains 8 grams of sugar per serving.
7. Potato / tortilla chips – Some of them have trans fat, some cooked at very high temperatures and hence contain carcinogenic substances. It also have high amount of sodium and is very difficult to stop at just one serving.
8. French fries – They contain 610 calories,29 grams of fat and 77 grams of carbohydrates. Instead have a medium baked potato, which has 161 calories, ZERO fat and 37 grams of carbohydrates.
9. Oscar Meyer maxed out Turkey & Cheddar cracker combo lunchables – It has 61 grams of sugar and 22 grams of fat. Need I say more.
10. Sonic wacky pack – 830 calories in just a grilled cheese sandwich, fries and slushie.
11. Aunt Jemima Biscuit Sandwiches – Packed biscuits contain saturated fats, trans fats and sodium.
12. White bread – It only increases the fat content only. Instead go for Whole wheat bread.
13. Jimmy dean Pancake and sausage links breakfast bowls – It contains refined carbohydrates equal to 1 and 1/2 Hershey bars.
14. Red dye no 40 – It causes allergy, hyperactivity, Attention Deficit Disorder, Inability to focus and learn and decreased energy levels in children. It is banned in many European countries but not in US.
15. TGI’s friday loaded potato skins – It alone can take care of 80% of your child’s total daily calorie needs. And it’s only an appetizer.

Image Credit : flickr

Toothpaste in the form of paste or gel is used as an accessory to aid in the cleaning of the tooth and gums. The cleaning is done by the mechanical action of the toothbrush and toothpaste aids in cleaning, masking bad breath or deliver certain active agents like fluoride or xylitol. Toothpaste does contain some toxic ingredients and hence is not meant to be swallowed.

Ingredients / Composition:

• Mild Abrasive – 15 -45% – Mechanically cleans the teeth – Silicon oxide, calcium carbonate, calcium phosphate, aluminium oxide, granular PVC
• Water – 20 -38% – Vehicle and solvent
• Humectants – 25 – 40% – Maintain consistency of paste – Sorbitol, mannitol,propylene glycol.
• Detergents – 1 – 5% – Removes loose debris – Sodium lauryl sulfate, sodium N-lauryl sarcosinat
• Binding agent – Upto 2% – Binds solids in paste form – Synthetic cellulose
• Flavoring agents – Upto 1% – Peppermint oil, spearmint oil, Oil of Wintergreen
• Sweetening agents – Upto 2% – Saccharin
• Therapeutic agents

1. Anti bacterial agent – Triclosan, Delmopinol,metallic cons, zinc citrate trihydrate, xylitol
2. Anti caries agent – Sodium monoflurophosphate, sodium fluoride,stannous fluoride
3. Anti calculus agent – Tetrasodium pryophosphates, zinc citrate, zinc chloride, gautrez acid.
4. Desensitizing agent – Potassium nitrate, strontium chloride, potassium citrate.
5. Whitening agent – Sodium bicarbonate, hydrogen peroxide.

• Preservatives Upto 0.5% – Benzoic acid
• Colouring agents – Upto 0.5% – Titanium dioxide gives white colour. Dyes are used to get, red, blue or other colours.

Recent Developments:

Depending on the various therapeutic agents, toothpaste are classified into

• Toothpaste for kids ( Have fluorides)
• Natural / Herbal toothpastes
• Whitening toothpastes ( Contains abrasive silica particles and not suitable for regular use)
• Breath freshening tooth pastes.

Image credit : Wikipedia

So you are traveling and don’t have time for proper oral hygiene. You should understand that while you are busy, the bacteria in the gums and tooth are also busy causing harm to you. You should hence carry a few basic tools for proper oral hygiene.

Your travel kit:

• Toothbrush.
• Toothpaste
• Dental floss ( it is always better to carry this rather than use other objects like toothpick, pins to clean your teeth).
• Mouth-rinse ( If you can carry a small bottle it will do).

If you can, prepare a similar kit for your workplace where you do spend a considerable time and end up taking a few meals and snacks.

Fluorides and sealants are the two procedures advocated for prevention of dental decay or caries. Sealants were developed in the 1970′s and have helped protect a number of teeth from cavities.

Dental sealants are plastic resins that are applied to the grooves of the chewing surfaces of back teeth (molars) to prevent caries.

Where is dental sealant placed?

Some back tooth, specially molars ( and some premolars) have narrow and deep grooves which are difficult to brush, can be sealed with the help of dental sealants so as not to allow food and plaque to accumulate in the grooves and cause decay or cavities. Not all tooth require sealants and such a diagnosis can be made by a dentist.

When is dental sealant placed?

Sealants are best used for children in the age group of 6-15 years of age as they are most caries prone. It can also be placed in an adult.

How is dental sealant placed?

It is a painless procedure which doesn’t require any drilling.

• The tooth is cleaned, dried and isolated with rubber dam/ cotton to prevent contamination from saliva.
• A solution containing a acid is placed on the grooves. This makes the surface of the tooth rough for better adhesion to the sealant.
• The acid solution is washed off and the tooth dried.
• Sealant is carefully applied on to the pits & grooves. Some sealants harden on it own ( self cure), some require a Blue light ( light cure).
• The occlusion is checked for any difficulty in biting and the patient can be ready for daily life immediately.

How long does dental sealant last?

Usually dental sealants are known to last for around 5 years. Some cases of it lasting for around 10 years have also been noted. The sealant is lost by natural wear and tear and hence might be required to be replaced if lost. If you notice a part of the sealant has broken or chipped, it is better to get it redone, as a broken or chipped sealant will not provide protection to your teeth.

How much does dental sealant cost?

In US it costs anywhere between $ 25 -50. In places like India is can cost US$ 10 – 20. Most dental insurance covers sealant for a child below the age of 15 years. Mostly adults are NOT covered for sealants in dental insurance.

Long – term effects of dental sealants:

• Natural wear and tear can give rise to chipped or broken sealant leading to cavities forming below the sealant.
• There are 12 brands of sealants available in the market. Each have ADA (American Dental Association) seal on them. According to recent safety studies performed on them, none of them proved to be hazardous for use. Resins are known to be made from BPA. The amount of BPA that leaches from the sealants are negligible on a daily basis. The levels of BPA present in the saliva ( not any trace is found in the blood) is 50000 times lower than what is required to cause toxicity eve in animals.

So it is safe to assume that sealants are perfectly safe for use in children and their preventive effect on dental decay is alone worth it. Sealants are underused even after their obvious positive effects on future dental conditions.

It can be often difficult distinguishing dental pain from pain arising due to sinusitis, especially if the pain is localized in the region of the upper back teeth.

Just above the upper back teeth ( premolars and molars) lies the maxillary sinus. They are separated from each other by a bony wall but numerous blood vessels can provide a pathway for spread of bacteria from sinus to tooth and vice versa. Clinical studies have shown that people with periodontal disease ( gum disease) are twice as likely to have sinus disease.

If the tooth hurts ( upper premolar and molar ) while chewing, it can be either tooth pain or sinus pain. But if the pain is initiated or intensified by eating hot or cold food, it is a dental pain.

So what to do?

If you feel pain in the upper side of your face / mouth, visit your dentist first. He/ she will determine and eliminate any dental source of infection. If the pain is due to your sinus infection, you will be referred to an ENT specialist for further treatment after resolving any gum disease present in the region.

The pain in the upper side of face can be :

• Tooth abscess
• Sinus Infection
• Myofacial pain dysfunction syndrome ( Pain related to TMJ )

Making your kid brush his/her tooth is a very difficult job if you know what I mean.

Following is a list of things you can do to make brushing interesting and correct for your kid:

• Brush twice daily, once AFTER breakfast and again BEFORE bedtime
• Brush all the tooth and not just the front ones
• Spend 2-3 minutes each time while brushing. You can play your kids favourite music to help them pass time.
• Use toothbrush with SOFT bristles.
• Teach him/her how to floss.
• Brush the tongue to keep the breath fresh.
• Ask your dentist if a anti-bacterial mouth-rinse is required.
• Visit the dentist twice a year.
• Besides brushing and flossing, your kid should avoid sugar. Try to give him more of fruits, vegetables and water instead of soda.
• Lastly, don’t forget to smile.

Mouth rinses are generally used to freshen our mouth and also to prevent cavities and plaque build up in most cases. In some cases though, it masks the symptoms of gum disease thereby causing greater harm.

Types of Mouth Rinses:

• Cosmetic – This type of rinse will mask the bad break and freshen up your mouth.
• Therapeutic – This type of rinse has an active ingredient which improves the oral hygiene condition by decreasing the chance of cavity or gum disease.
• Combination of both

Advantages of Mouth Rinse :

• Improves the health of gum
• Reduces cavities
• Kills germ ( bacteria)
• Freshens the mouth

Disadvantages of Mouth Rinse :

• Tooth staining
• Burning sensation of mouth
• Altered taste
• Ulcers
• Drying of oral tissues

Ingredients of Mouth Rinse :

• Active ingredient – Thymol, Eucalyptol, Hexitidine, Methyl salicylate, Menthol, Chlorhexidine gluconate, Benzalkonium chloride, Cetylpyridinium chloride, Methylparaben, Hydrogen peroxide, Fluoride, Calcium.
• Zinc chloride – Reduces bad breath
• Sweetners – Sorbitol, Sodium saccharine, Xylitol
• Alcohol ( Up to 27%)
• Water

Recent studies have shown alcohol based mouth rinses having a role behind increase in incidence of oral cancers. Also, a alcohol based mouth rinse can be lethal for a child who weighs less than 26 pounds. Most current mouth rinses are alcohol free to eliminate the above effects.

Chlorhexidine gluconate has been found to be the most effective component of mouth rinse which prevents plaque formation. Mouth rinses containing fluorides also have shown a 50 % decrease in caries. It is advised to rinse with a mouth rinse containing Chlorhexidine gluoconate only after 60 minutes of brushing with a sodium laurate containing toothpaste ( most commonly available), as sodium laurate deactivates Chlorhexidine gluconate.

How to Rinse :

You should rinse with 20 ml of mouth rinse 2 times a day after brushing. You should swish the mouth rinse for 30 seconds and spit it out.Do not rinse your mouth immediately, thereby letting the mouth rinse to act for a longer period of time on your gums.

Commonly found Mouth Rinses:

1. LISTERINE antiseptic rinse – Alcohol based
2. Peridex, PerioGard, Hexidine, Rexidine, Corsodyl – Chlorhexidine gluoconate ( Anti septic, fungicidal and disinfectant)
3. Fluorigard, Act, Oral B anti cavity rinse, LISTERINE anti-cavity fluoride rinse – Fluoride mouth rinse
4. Plax – Anti plaque
5. Cepacol, Rembrandt,Lavoris, Scope, Signal, Clear choice – Freshens mouth primarily.