The word LASER is an acronym for Light Amplification by Stimulated Emission of Radiation.

Currently lasers used in dentistry are grouped as:

• Hard tissue lasers
• Soft tissue lasers

Dental laser systems:

• Nd:YAG system  – 532 nm, 1064 nm
• KTP ( Potassium titanyl phosphate) – 532 nm
• Er,Cr:YSGG laser – 2780 nm
• Diode laser – 800 to 980 nm
• Er:YAG laser – 2940 nm
• Carbon dioxide laser – 10600 nm

Uses in dentistry:

• Caries detection – Certain biological pigments absorb laser light and fluorescence, leading to detection of caries.
• Incisions and excisions – Laser transforms it’s heat light energy to heat on contact with tissues leading to hemostasis.
• Curing of composite resin
• Acceleration of teeth whitening.
• Removal of small caries – Er:YAG laser is used.
• Disinfection of periodontal pockets and endodontic canals.
• Minor surgeries like frenectomy, crown lengthening, gum surgeries.
• Also be used to provide emergence profile to pontics in bridge prosthesis.
• Rapid wound healing, pain relief and anti – inflammatory actions.

Clinical use:

Soft tissue growth

Immediately after excision with Er:YAG laser

Disadvantage:

• Cost – It costs anywhere between $25,000 – $45,000. With it’s limited use, it might not integrate to being a cost effective situation for every dentist.
• No one laser fits all conditions.
• Excessive heat generation.
• Air embolism as air and water spray is used to cool the ‘laser cutting’ area.

This was seen in 80 % of male smokers while 87% of female smokers also agreed to it. 2 /3 rd of the 1000 respondent to the survey also conceded that smoking was a real ‘put – off ‘.

Available:

They are available in different sizes, colours and shapes.

The most common materials are:

• Diamonds
• Gold
• White gold
• Swarovski ™ crystals
• Gems and stones

Once you have selected your jewel, it is very simple procedure to apply to your teeth. It is usually placed on the canine. It can also be placed on another teeth or even multiple jewels can be placed on the same tooth. It takes any where between 5 – 20 minutes for the dentist to fix the jewel on your teeth.

• It involves NO drilling
• The surface of the tooth or crown is treated to accept the jewel.
• A little amount of the adhesive is applied on both the tooth and the back of the jewel and the jewel is fixed.
• The adhesive can bond chemically or after application of blue light.
• The whole procedure is reversible enabling you to change your jewel as and when you want.

Cost:

The jewel can cost any where between $ 20 – $ 200, depending on the type and size of jewel selected.

Symptoms:

• Sore jaw specially in the morning.
• Chipped enamel, which can’t be explained otherwise.
• Flat ( Abrasion) surfaces of the posterior ( back ) teeth.
• Head ache or ear ache.
• Chipped or broken fillings.
• Tooth sensitivity.
• Chronic facial pain.
• Unconscious teeth clenching or grinding.

Causes or factors behind Bruxism:

Usually, it is very difficult to state a single cause behind such habit.

A general overview has been presented as follows:

• Irregular teeth or malocclusion.
• Anxiety, stress or tension.
• Drug abuse.
• Alcohol or tobacco ( smoking ) abuse.
• Sleep disorders.

Treatments:

Treatment is usually elimination of the cause of bruxism. For example, Bruxer should try to lead a tension – free life. Or treating the sleep disorder or drug abuse. Other than treating the cause, other treatments are also available.

1. Mouth guards and splints – This prevents further abrasion of the tooth surface. It also cushions the Temporomandibular joint against heavy clenching. Use of splints can also correct minor malocclusion. They are usually worn at night during sleep.
2. Bio feed back – When the patient clenches his / her teeth beyond a certain set level, this machine delivers a small amount of electric current like a shock.

Other treatments like use of drugs and dental crowns to prevent damage to the tooth surface has also been tried. Even botox has been used to treat bruxism.

Some countries have advocated preventive removal of all the wisdom tooth once they start erupting or are erupted into the mouth. Some dentists also offers you the option of getting it removed along with some other dental procedure if the procedure is being done under general anesthesia. Some dentist will also ask you to get it restored. If the wisdom tooth is not impacted, it can be restored or filled to prolong it’s longevity. If the wisdom teeth is impacted, it should be removed as a impacted tooth can never be used to chew your food and so of no use to you.

Why do you need to get your wisdom to removed?

• It pains in the tooth and surrounding area.
• Food gets lodged in the area.
• The tooth is partially broken

How to you know if the tooth is impacted?

You will need to take a Orthopantamogram or a IOPA X-ray to find out if the tooth is impacted.

How to get the wisdom tooth removed?

You will have to contact your dentist or a Oral Surgeon. This procedure can be done under General anesthesia ( GA), in which all the four wisdom tooth can be removed at one go. This is the least traumatic way of getting it done. This though requires admission to the hospital.

You can also get it done under Local anesthesia (LA). This will require 2 sittings as upper and opposing lower wisdom teeth of one side can be removed on one day under this procedure. The other side has to be done in the next sitting. Getting the wisdom teeth removed under LA is a bit more traumatic and emotionally and physically tiring for the patient. This can be done in a dental office with or without sedation ( sedation is preferred).

In most of the cases, removal of wisdom teeth will require drilling into the bone to remove the tooth.

What to do and no to do?

• You will have to follow the post op instructions meticulously.
• Medications will be prescribed which has to be taken as prescribed.
• Take a day off from work or school or schedule the appointment to fall during a holiday period.
• It is preferable not to involve in work related to giving long speeches for the next 7 days.

NOTE: In my personal opinion, extraction of asymptomatic wisdom tooth should not be done. This will avoid any complication or discomfort to the patient.

To read more about complications of extraction, CLICK HERE

To read more about Dry Socket, CLICK HERE

In some people wisdom teeth may erupt earlier or later or even may fail to erupt at all.

With evolution of human beings,we are loosing our third molars / wisdom teeth as we stop chewing hard food with our last tooth. So many of us may never have to endure the eruption of wisdom tooth late in our teens as they may be completely absent.

When the third molar erupts, it is associated with teething. There can be pain over the gums and fever in certain cases.

In certain cases, the tooth can be impacted.

What is impaction?

When the tooth fails to erupt to it’s correct position in the mouth, the tooth is known to be impacted.

It is mostly seen to be present in wisdom tooth and in canines.

Types of wisdom tooth impaction:

• Mesioangular impaction
• Distoangular impaction
• Horizontal impaction
• Vertical impaction

An impacted wisdom tooth can give rise to various problems, starting from, food lodging, caries, pain, pocket formation to even causing resorption of adjacent tooth.The OPG X-Ray shows that the lower wisdom tooth are impacted and need to be removed.

Treatment of Wisdom Tooth:

The most prevalent treatment is extraction of third molars. In some developed countries, practice of preventive removal of all third molars is also done. In some cases, when certain dental procedure is undertaken under general anesthesia, the patient is given the option of getting all the wisdom teeth removed at the same time.

To know more about wisdom tooth removal, CLICK HERE

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.

A team of European scientist, placed α MSH onto fibroblasts, the primary kind of cell in the dental pulp. It not only significantly reduced inflammation but also increased the growth of new fibroblasts. Dentists believe this is a breakthrough that could revitalize damaged tooth and make root canal redundant.

Churchill needed complicated dental procedure all throughout his childhood. His dentist Wilfred Fish who worked with Cudlipp to fabricate a denture so that his lisp is hidden when he delivered speech to the nation over the wireless.

Churchill is known to have not allowed his dentist to be drafted into the army. Churchill was so fond of his dentist that he nominated him for knighthood.

Churchill was always known to carry 2 dentures on him.

What can a Dental Hygienist do?

• Cleaning or scaling of gums
• Whitening of the teeth
• Simple fillings under supervision of the dentist
• Fluoride applications.
• Application of dental pit and fissure sealants
• Taking diagnostic X-rays.
• Extraction of milk teeth under Local anesthesia spray / solution under supervision of the dentist.

Usually to become a dental hygienist it takes a 2 year degree or diploma. A dental hygienist is a well respected profession with good opportunities of remuneration.

To learn more about dental hygienist in United States, CLICK HERE

To learn more about dental hygienist in Australia, CLICK HERE

To learn more about dental hygienist in Canada, CLICK HERE

To learn more about dental hygienist in Europe, CLICK HERE