Root Canal Treatment (RCT)

Root canal treatment is a method to clean roots by gaining access from the tooth with the help of Dental instruments and specific equipments. When the carious lesion reaches pulp (where all blood vessels are present), then the only option left is RCT. Sometimes carious lesion even extend from root to apex (where root ends), then extraction is advisable as RCT will have poor prognosis in this case.
Time taken or sittings involved during RCT depends upon the extent of infection in tooth.
Steps involved in RCT are as follows:
Gaining Access to Root canals: Access from the surface of the tooth(crown) is gained with the help of Drilling instrument . Normally there are 3 canals in molars, 2 canals in premolars and 1 canal in Incisors and canine. Number of root canals can vary in tooth from person to person, it is never fixed.
Cleaning and Shaping of Root canals: Once the access is gained, then with the help of instrument known as files as shown in figure, Canals are cleaned. To avoid friction and proper cleaning disinfectant solution known as sodium hypochlorite is used. It removes all the debris and infection from the canals and makes them sterile. It usually takes 2 sittings, but if infection is less than it can be completed in 1 sitting also. After the thorough cleaning, temporary filling is placed in tooth and patient is asked to come after 2 days.

Filling of Root canals: Once the canals are cleaned, and then canals are properly dried with the help of paper points and filled. Canals are filled tightly with Gutta percha points (GP points). After filling of root canals, Permanent filling is placed in tooth; normally permanent filling does not last long. Always Crown is mandatory after RCT as tooth becomes weak from inside. To avoid further fracture of tooth, crown is mandatory.
Some frequently asked questions regarding RCT:

Is RCT Painful ?
No, RCT  is not painful. Before starting the procedure dentist always anaesthetize the tooth to make it convenient for patient and as well as for Doctor.

Is RCT Safe ?
Yes, RCT is safe. When carious lesion reaches deep inside the tooth then RCT is only option to save the toth.

How many sittings are normally involved in RCT ?
If tooth is not infected then RCT can even be completed in single sitting. But, if infection is more then it normally takes 3 sittings and even more depends on the extent of infection.

Can Pregnant Women Undergo RCT ?
No, It is not at all recommended. RCT should be postponed until the birth of baby.

Is Crown Mandatory after RCT ?
Yes, Crown is mandatory after RCT to make tooth stronger and last longer. Without crown tooth can fracture anytime and after fracture, Extraction is the only option.

Does Pain Exists After RCT ?
If through cleaning and infection is removed during procedure then pain vanishes. But, if cleaning and filling of root canal is not done properly by the Dentist then surely patient will complain of pain again and again.

How Many X-Rays Are Involved In RCT ?
Normally one X-Ray before starting the procedure and one at the end of the procedure. It depends upon the Dentist, as he is a better judge of the condition involved during the procedure.

Do All Carious Tooth Need RCT ?
No, only the tooth in which carious lesion extends deep inside the pulp need RCT. Otherwise, fillings can be done to save the tooth.

Why Root Canal Treated Tooth Is Known As Dead Tooth ?
In Root canal procedure, Pulp(where blood supply of tooth is present) is removed and canals are cleaned properly. Main indication of RCT is when carious lesion reaches pulp and infects that area, then to relieve patient from pain it is removed. Tooth will no doubt remain in its position only the difference comes is it becomes non - sensitive, for this reason it is known as dead tooth.

Oral Cancer

What is oral cancer?
Excessive cell growth results in enlarged mass known as tumor. There are no strict boundaries of tumor, it slowly and slowly extends to surrounding healthy tissues and make them infected. Oral cancer generally invades throat, head and neck. Generally all oral cancers begin in squamous cells, therefore known as squamous cell carcinomas.
What are the causes of Oral Cancer?
Excessive smoking: Cigarettes contains tar which is harmful for the system of human being. If you practically smoke cigarette on white clean surface it will turn that surface yellow. Slowly and slowly tar keeps on depositing in our lungs and makes them even difficult to work. Excessive smoking results in limited mouth opening because of bands formation in cheek area. Eventually this condition turns into carcinoma formation.
Tobacco chewing: Tobacco chewers are in habit of keeping tobacco in between the cheeks or below tongue which makes that area infected. Heavy deposition of tobacco and prolonged habit is the main cause of oral cancer.
Excessive exposure to sunlight: Excessive exposure to sunlight causes cancers of oral cavity. Normally lower lip gets infected. Before going in sunlight always carry umbrella or apply sunscreen.
Exposure to X-Rays: High duration and prolonged exposure to x - rays can cause oral cancer.
Hereditary: Hereditary is one of the major factor in causing oral cancer. Inherited genes makes cells more sensitive to exposure to sunlight, x - rays and eventually result in cancer.
Sharp Tooth: Sharp tooth which keeps on irritating the tongue, if left neglected can turn into cancer in a period of time.
What are the prevention measures of oral cancer?

• Limit the frequency of smoking and slowly and slowly stop completely. It is not at all healthy habit for oral cavity and body system as well.
• If you are sensitive to exposure of x - rays, its patient duty to priory inform the dentist so that Dentist will treat accordingly.
• If you are going in scorching heat then always carry sunscreen, apply lipstick or lip balm which has SPF in it.
• Regular follow up checkups are recommended to treat condition in early stages.

What are the methods of treatment?

• Chemotherapy
• Radiation therapy
• Surgery

Dentures

What are Dentures?
Dentures are the artificial prosthesis which is the substitute of missing teeth.  Dentures take support of surrounding soft tissues and teeth to stabilize in oral cavity.
How many types of dentures are there?
There are two types of dentures:
• Partial dentures
• Complete dentures

What are partial Dentures?
When some teeth are present and few are missing then Partial denture is fabricated.

How many types of partial dentures are present?
Partial dentures are of two types:

• Removable partial denture(RPD)
• Fixed Partial Denture(FPD)

What are the advantages of Removable partial denture?

1. Removable partial denture can be easily removed by patient and can easily be cleaned.
2. It is less expensive
3. Removable partial dentures are fully tooth supported and helps in normal chewing.
What are the disadvantages of Removable partial denture?
1. Since removable partial denture are fully tooth supported, sometimes cause injury to tooth supported gums.
2. If patient does not maintain proper oral hygiene, RPD can be harmful for other remaining natural teeth.
3. Due to removing RPD again and again it sometimes becomes loose.

What are the advantages of fixed partial denture?
1. These dentures are attached to natural teeth, roots or implants and cannot be removed by patient.
2. FPD has high retention as compared to removable partial denture.
3. Patient feels FPD like his natural teeth. Hence less compliance factor.
What are the disadvantages of FPD?
1. It is expensive procedure.
2. More time consuming and regular checkups are advisable.
3. If patient’s supportive teeth are not strong enough to bear forces offered by FPD, then it has poor prognosis.
4. If RCT of supportive teeth fails and patient come back with pain in supporting tooth then whole FPD has to be removed and placed again.
5. If FPD is not fixed properly or some space is left while fitting then food lodgment continues and results in bad smell from mouth.

What are the steps to be taken care of after placing partial denture in mouth?
• Patient should maintain proper oral hygiene.
• Regular flossing is advisable.
• Patient should not bite hard from artificial teeth.
• Regular follow up checkups are recommended.
• Always put RPD in water after removing from mouth.
• Do not wash RPD with bleaching agent or detergent. Special cleansing agents are available to wash RPD.

What is complete denture?
When all the teeth are missing (edentulous) then complete denture is fabricated. Below are images of maxillary complete denture and mandibular complete denture. They vary in shape according to the shape of oral cavity.
How many teeth are present in complete denture?
Normally 28 teeth are present in Complete Denture, but sometimes we have to miss second premolar in case of small jaw size.
How much time is required to fabricate complete denture?
At least 1 week time is optimum for complete denture
Why dentist ask to carry old photo while adjusting teeth in Denture?
After having a look of old photograph Dentist gets an idea of the shape and setting of teeth. To minimize the patient compliance and to have a natural look old photograph is mandatory.
Can patient start immediately eating with complete denture?
First patient should start with liquids and then with soft food and then finally with normal daily routine food items. Surrounding soft tissues and tongue takes time to adjust with new thing in mouth. May be for few days patient find some speech problem as well. Once you oral cavity get use to denture then everything gets fine.
Can patient brush complete denture?
Yes, patient should daily brush the teeth of denture in a same way like his natural teeth. After every meal cleaning is mandatory. Special cleaning tablets are available which are used to remove satins from the denture.

Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum—the first part of the small intestine. This gland secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct.

There are two types of Pancreatitis:

1. Acute Pancreatitis
2. Chronic Pancreatitis

1. Acute Pancreatitis:

Acute Pancreatitis is inflammation of the pancreas that occurs suddenly and the condition will be normal with in  few days after treatment. The causes of acute Pancreatitis are abdominal trauma, certain medications, bacterial infections, tumors and genetic problems.

Symptoms:

Acute Pancreatitis usually begins with slight upper abdomen pain that some times extends through the back. The pain is more after eating. People with acute Pancreatitis usually look and feel very ill and needs immediate medical attention. Other symptoms may include:

• A swollen and tender abdomen
• Vomiting and Nausea
• Fever
• Rapid and irregular pulse

Diagnosis:

Depending upon the condition of the patient the doctor will order a blood test to assist the diagnosis. During Acute Pancreatitis, the blood contains at least three times the normal amount of amylase and lipase, digestive enzymes formed in the pancreas. Once the patient condition is normal the levels come to normal. The doctor will order some more tests depending upon the condition of the patient like Abdominal ultra sound, CT Scan, Endoscope ultrasound, MRCP.

Treatment:

Treatment for acute Pancreatitis requires a few days stay in the hospital for intravenous (IV) fluids, antibiotics, and medication to relieve pain. After the patient got recovered with Acute Pancreatitis the doctor advised not to smoke, drink alcoholic beverages, or don’t eat fatty meals.

2. Chronic Pancreatitis:

Chronic Pancreatitis is inflammation of the pancreas that leads to permanent damage. Chronic Pancreatitis is severe when compared to acute Pancreatitis. The main cause of chronic Pancreatitis is the use of heavy alcohols. Other causes of chronic Pancreatitis are:

• Medications
• Hypercalcemia - high levels of calcium in the blood.
• Certain Autoimmune conditions
• Cystic fibrosis
• Hereditary disorders of pancreas

Symptoms:

The symptoms are same as like the Acute Pancreatitis. Other symptoms include

• Nausea
• Vomiting
• Weight loss
• Diarrhea
• Oily stools

Diagnosis:

Chronic Pancreatitis is often confused with acute Pancreatitis because the symptoms are similar. In advanced stage of Pancreatitis malabsorption and diabetes can occur. The common diagnosis tests are

• Abdominal ultra sound
• CT Scan
• Endoscope ultrasound
• MRCP

Treatment:

People with chronic Pancreatitis treated with pain medications, fluids given trough a vein (IV). Diet plays an important role for people with chronic Pancreatitis.

• Drinking plenty of liquids
• Eating a low fat diet
• Limiting caffeine
• Taking vitamin rich supplement diet.

Heart and Circulation » Heart Attack

Heart attack occurs when the supply of blood and oxygen to an area on the heart muscle is blocked, usually by a clot in the coronary artery. Heart attack is the leading cause of death for both men and women worldwide. However, if the indications are recognized early and proper medications are given, the person’s life can be saved to a large extent.
The indications for a heart attack include:
• Pain or discomfort in the center of the chest that can last for more than few minutes.
• The chest discomfort may come and go and can have a feeling of uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in the other areas of the upper body which may include one or both arms, the back, neck, jaw or the stomach.
 • Sudden weekness followed with sweating and fainting.
• Shortness of breath
• Cold
• Nausea
• Lightheadness

Hernia

Hernia is often referred to as a 'rupture'. The term hernia is most commonly used to describe to the protrusion of the intestine through a weak area in the abdominal wall. This will cause bulging of the abdominal wall. This bulging increases the pressure in the abdomen.

Types: The types of  Hernia relates to its location on the body. These include:

Inguinal Hernias: This type of hernias are more common in men than women because the canal is bigger. These are the common type of hernia. The canal contains the spermatic cord and blood vessels. When an inguinal hernia occurs part of the intestine protrude down the canal and into the scrotum.

Femoral Hernias: This type of hernia is more common in women, femoral hernias occur when part of the intestine protrudes through the femoral canal and protrudes at the top of the thigh.

Umbilical Hernias: An umbilical hernia occurs when the abdominal wall is weakened at the point of umbilical cord. Umbilical hernias are most common in children.

Obtuator Hernias: The Obtuator hernia occurs when part of the intestine passes through the gap between the bones of the front of the pelvis.

Risk factors of Hernia:

Any person can get hernia from children to old age. Some of the factors which increases the risk of Hernia are:

1. Obesity
2. Previous abdominal surgery or abdominal injury
3. Straining to lift heavy objects
4. Because of constipation straining during bowel movements.
5. A chronic cough, such as smokers cough
6. Male are 12 times more prone to hernia when compared to females

Symptoms: Symptoms of a hernia include pain or discomfort and a localized swelling somewhere on the surface of the abdomen or in the groin area.

Treatment: The best treatment of hernia is by surgical repair. There are no drug treatments for this condition. Surgery gives relief to the pain and swelling. There are no side effects for surgery.

Prevention: Life style modifications can prevent hernias. Regular exercise can prevent hernia. Another important factor is avoid risk factors which is mainly involved in hernia.

Blood Pressure

Blood pressure is actually the pressure of blood against the walls of the arteries. Blood pressure is measured in mm Hg. Typical values for a healthy adult human are approximately 120/80. But, if the blood pressure reading is equal to or above 140 over 90 mm Hg, then that means the concerned person is suffering from high blood pressure or hypertension. Hypertension has been called the "silent killer" because it usually produces no symptoms. Untreated hypertension increases slowly over the years. Hypertension can cause certain organs (called target organs), including the kidney, eyes, and heart, to deteriorate over time. Malignant hypertension, an emergency condition resulting from untreated primary hypertension, can be lethal. It is important, therefore, for anyone with risk factors to have their blood pressure checked regularly and to make appropriate lifestyle changes.
   Symptoms of high blood pressure include drowsiness, confusion, headache, nausea, loss of vision.  Some basic steps that may be followed to check High Blood Pressure or Hypertension:
  - Be physical active by regular exercise, walking, yoga etc.
  - Maintain a healthy body weight.
  - Follow a healthy eating plan that emphasizes fruits, vegetables and low fat dairy foods.
  - Avoid alcoholic beverages.
  - Quit smoking.
  - Have a low salt intake.

Anemia

»   Beetroot are also rich in iron and various other minerals.so,person who is suffering anemia should include it in his diet to treat anemia.

  »   Leafy vegetables contains high grade iron it helps in formation of hemoglobin and red blood cells.

  »   Apple contain high amount of iron eat one apple every day it is effective remedy for anemia.

  »   Eat organic meat like liver and kidney to treat anemia.

  »   Cold water bath is also helps in curing anemia. A person with anemia must have at least two cold water baths a day.

Importance of calcium rich foods

Calcium is needed for growth and bone development. Deficiency of calcium leads to osteoporosis. Osteoporosis makes the bones thin. It is more common in women. More calcium is required during pregnancy, lactation. Even children and elderly require more amounts of calcium. Milk, curd, nuts, milk products, green leafy vegetables and ragi are some of the sources of calcium. Doing exercise reduces calcium loss from bones.

Antiaging Nutrition

     

Aging is characterized by memory loss, wrinkles , may have increased risk of diseases such as cardiovascular, diabetes, osteoporosis, kidney disorders Having proper nutrition can extend your life and make you feel younger and look younger. Physical activity also plays a significant role. Antioxidants in your diet play an important role.

Nutrition tips:

* Drink adequate water. Water prevents from dehydration.
* Choose high fiber foods. A fiber rich food helps in lowering age related diseases.
* Instead of 3 meals in a day have 6 small frequent meals. Improves metabolism.
* Reduce the intake of fat foods and junk foods.
* Reduce sugar and salt intake.
* Avoid drugs, cigarettes, caffeine and alcohol.
* Avoid processed foods. Processed foods don't have enough nutrients as they lose in processing. They also lack fiber.
* Choose good amount of fruits and vegetables. Fresh fruits and vegetables supply vitamins and minerals. They are also rich in antioxidants.
* Take vitamin supplements. As we age body doesn't produce nutrients efficiently resulting in the need for us to increase nutrients intake. Vitamin B requirement increases. Homocysteine levels should be maintained properly, if homesysteine levels rise in blood then it may lead to heart diseases. Vitamin B6 and B12 keeps the homesysteine levels low in blood.
* Eat calcium rich foods. Especially in women as they age there may be risk for osteoporosis, so the calcium intake should be increased. After menopause if you are on hormone replacement therapy 1200 mg of calcium is recommended. If not on hormone replacement therapy 1500 mg of calcium is recommended.

Foods that cause aging: Processed foods, food additives, sugars, high carbohydrates, artificial sweeteners, alcohol, hydrogenated fats, fried foods, preserved meat, monosodium glutamate, refined flours, cigarettes, margarine.