4 GUIDE FOR DENTISTS

    4 GUIDE FOR DENTISTS

     Dentistry is a branch of medicine that deals with teeth and its surrounding structures with its attendant problems. It is necessary that all health workers know about some common diseases of the teeth so as to be able to refer such cases to the dentist.

            STRUCTURE OF THE TOOTH

The tooth has three longitudinal parts
-The crown : Visible part of the tooth in the mouth .
-The neck :-Junction of the crown and the root .
-The root :-Invisible part of the tooth in the mouth .
       The enamel is the part of the tooth that we brush. It is
lifeless and insensitive. The dentine lies under the enamel.
The pulp is the innermost layer. It is made up of blood vessel and nerve cells. 
     There are four different types of teeth in man, they are the Incissors, Canine, Premolars and molar. 
Incissor-used for cutting .
Canine-used for tearing .
Premolar-used for chewing and grinding
Molar - used for chewing and grinding
     There are thirty-two teeth in man. The dental formular
in man is as follow

m¡= 2/2, c=1/1, pm=2/2, m=3/3

COMMON DENTAL PROBLEMS 

1. Dental plaque and dental calculus
2. Dental caries
3.Gum diseases (gingivitis)
4. mouth odour

1.     DENTAL PLAQUE AND DENTAL.                                  CALCULUS 

         In the present day, plaque is regarded as all visible soft deposit or firmly adherent bacterial masses on the teeth.
        The formation of dental plaque is divided into two stages
-formation of an initial non-bacterial plague matrix.
-Proliferation of micro-organisms within the plaque matrix.
        The initial plaque matrix consists of an accumulation of protein and carbohydrate partly endogenous and partly exogenous.
Endogenous from saliva and product of tissue metabolism
and catabolism and exogenous derived from diet.
This acts as a substrate for higher concentration of micro-organism than are found generally in other areas of the oral
cavity.
It should be noted that micro-organism form about seventy percent of the bulk of plaque

CALCULUS 

          This is a hard deposit formed by the mineralization of plaque. It consists of organic and inorganic fractions. The treatment for dental plaque and calculus is scaling and polishing.

SCALING AND POLISHING 

         This is a dental procedure that removes plaque and tartars around a healthy gum and polishing the teeth to
prevent plaque build-up.
         The procedure can be done manually or with a machine. It is painless, bloodless and cheap.
        It is recommended to all every six months or once in a year to see the dentist.

2.          DENTAL CARIES 

              Dental caries is the development of a cavity in a tooth.
It is a very common dental problem that occur in any age group. Three factors combine to cause its development in the
teeth.
-Constant presence of germs in the mouth cavity .
-Protracted contact of food remnant with the teeth .
-Inherent susceptibility of the teeth to dental decay
            The interaction of germs with food remnants in the mouth produce acid which dissolve calcium content in the enamel of the teeth. The food remnant that is implicated is sugar and refined food. It is therefore necessary to consult the dentist who will determine the type of treatment needed.
            The treatment is usually filling or extra ction depending
on the extent of the cavity. The best way to prevent tooth
decay is to brush with fluoride tooth paste and drink
fluorinated water.
            Fluoride is the best defense against tooth decay
-Flouride makes the teeth more resistant to decay .
-It repairs tiny areas of decay before they become big
-caries.-Make germs in the mouth less able to cause decay.
-Filling rather than extraction is done at this stage.


3. FILLING AND FILLING MATERIALS 

         Filling is the insertion of filling materials into the cavity to restore the original contour of the tooth attacked by dental caries.
       There are different types of filling materials in dental use :
a. Zinc phosphate (Oxyphosphate) cement : This type is widely 
used in dentistry both as a protective base in deep cavities. Its disadvantage is lhat it causes irritation when placed in the base
of deep cavities.
b. Amalgam : most widely used in dentistry
C. Eugenol + Zinc oxide : least injurious of all filling material to the dental pulp. It causes no irritation. It also exerts a palliative and sedative effect on mildly damaged pulp.
           Filling materials serve as bacteriostatic agent. It improves marginal seal of certain restorative materials by
preventing microbes and saliva along the tooth and restoration of deleterious constituents of material into the dentine and pulp.

4. DENTAL EXTRACTION 


           This is a surgical procedure of removing the tooth from the bone socket with a special instruments. Extraction or pulling of the tooth is one of the primary roles of a dentist.
         When a tooth has a hole due to dental caries for a long time and left untreated the hole becomes bigger and deeper.
Soon the hole affects a larger portion of the tooth. The only available option is to removes the tooth by extraction.
         It is advised very strongly that when one notices pain on taking sugary food and or pain on drinking cold or hot water.
then one must report to the dental clinic as this is a sign of tooth decay or caries.

RULES (PRECAUTIONS) AFTER TOOTH EXTRACTION 

-keep swallowing saliva on the day of extraction and do not spite out.
-Do not rinse mouth or brush so as not to disturb the site of extraction with the tongue.
-Avoid hot meal, only cold and soft food is recommended.
-rest is of vital importance after extra ction. However one can still go to work after extraction but it depends on the type of
work.
-Use your drugs as prescribed by the dentist,
-From the next day rinse your mouth with warm water and salt six times a day for the next five days.


B. GUM DISEASES 


A normal healthy gum is pink in colour, firm and does not bleed on brushing. If the gum becomes red, swollen, puffy and bleeds occasionally on brushing, it has
a disease.
          When this painless disease that is destroying is left untreated, the tooth becomes loose and mobile.
          Gum disease is preventable and because some are painless, many patients usually do not visit the dentist.
The commonest gum disease is gingivitis. This is the inflammation of the gingival tissue. It may occur in an acute, subacute and chronic forms. The acute and
subacute forms is not common and rarely occur in a person who is in robust health. The chronic form is relatively common especially in older children.

          What causes gingivitis may be divided into local and systemic factor,
Local factors :-

-Calculus
-Food impaction
-Micro organism
-Chemical or drug application
-Tooth mal position
System factors :
-Nutritional disorders
-Drug action
-Allergy
-Hereditory
The best bet is to refer the patient to the dentist. 




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