Archive for November, 2014

TMJ Problems

TMJ Problems

Temporomandibular Joint (TMJ) is the hinge which connects the lower jaw i.e. mandible with the temporal bones of the skull. The function of TMJ is very essential in day to day life like chewing, talking as well other mouth activities. TMJ problems can be said to occur when these functions cannot be carried out properly by the patient.For more details,please login to

The causes of TMJ problems or temporomandibular joint disorders are not very prominent or proved but dentists find the following mentioned factors to be the causes for the same. Some of them are blowing air with mouth heavily, clenching, grinding of teeth, rheumatoid arthritis or osteoarthritis in the TMJ, movement of disc, tightening of the facial muscles due to stress.

TMJ problems usually tend to cause discomfort and severe pain. Tenderness on opening of mouth, trying to speak, chewing and other oral activities which involve the temporomandibular joint usually occur in the TMJ problems. The clicking sound of TMJ while opening the mouth is one of the characteristic signs of TMJ problems. Therefore, clicking sound is given much importance while taking case history in a dental patient. Patient has difficulty in chewing of the foodstuffs due to lack of proper masticatory movements of upper and lower teeth. There is swelling on the affected side of the face and also the patient has a tiring look. Some other secondary problems which can also occur include hearing difficulty, headaches and upper shoulder pain.

Diagnosis of TMJ problems is done by the dentist once the patient complains of some difficulty in the TMJ region. Many a times, the dentist diagnoses such problems even during the normal case history. Presence of pain or tenderness is first checked by the dentist. Then the dentist checks for the clicking sound. Functioning of the jaw i.e. by opening and closing is then checked in order to detect the presence of lock of the joint before the activity is completed. The dentist asks the patient to bite so that he can detect any abnormality in the facial muscles or structures associated with it.  Magnetic Resonance Imaging (MRI) and CT scan are the recommended diagnostic techniques for the TMJ problems. These diagnostic procedures actually are helpful in knowing the condition of the TMJ and its surrounding structures.

The treatment of TMJ problems is done according to the condition of the patient and experience of the dentist. Analgesics are the primary ones. Ultrasound, transcutaneous electrical nerve stimulation (TENS), anesthesia or pain killers are injected in the areas which actually trigger pain, laser therapy of low levels and radio wave therapy. If the patient is not cured with these techniques then the dentist recommends surgery. Arthrocentesis, Arthroscopy and Open-joint surgery are the procedures which are used in order to treat the patient with TMJ problems. Arthrocentesis is the simplest of the above procedures and it can be carried out at the dentist’s clinic by the dentist himself. Arthroscopy is the procedure which is carried out with the help of arthroscope. Open-joint surgery is the last treatment option when none of the above treatment procedures are unsuccessful. Thus, TMJ problems can be treated successfully.cs_tmj_dualscreen shot 2013-11-05 at 1.05.53 pm

Orthognathic surgery

Orthognathic surgery is a procedure which is done to correct various conditions of jaw and face. These include TMJ disorders, malocclusion or other orthodontic problems, problems related to growth and sleep apnea. Orthognathic surgery can also be used as a secondary option in the congenital disorders like cleft lip and palate. Here the correction of the jaw is done successfully, so as to bring the patient’s face and jaws to the normal condition and also improve the esthetics. Therefore, orthognathic surgery is also called corrective surgery.For more details,please login to

Orthognathic surgery is indicated in the cases of gross jaw discrepancies, conditions involving sleep apnea, soft tissue, temporomandibular joint problems as well as airway defects. An oral surgeon and orthodontist play an important role in the success of an orthognathic surgery. Before and after the surgery there is a requirement of the brace as well as retainer so as to stabilize the condition of the patient. Moreover, if the patient has undergone surgery for the cleft lip and palate then orthognathic surgery is done. During the whole procedure, the orthodontists along with the oral surgeon make sure that the teeth are fit correctly after surgery. Thus the esthetics and functional properties of the teeth and other oral structures are maintained.

In orthognathic surgery, planning plays a very important role. Oral surgeons and orthodontists should team up with ENT specialists, plastic surgeons as well as speech therapists. The team focuses mainly on achieving a correct bite, proper esthetics as well as sufficient airway space. General anesthetic is given to the patient during the treatment. Intubation is used via nose instead of an oral tube so that the teeth arrangement can be done properly by the orthodontist during the surgery. When the bone is cut, it is called as osteotomy. If both the sides of the maxilla are used, then bi-maxillary osteotomy is done. Various modern techniques are being used at the time of surgery in order to get the best results from the procedure. Stainless wires are used in order to join the parts of the bone at the completion of the procedure.

Post operative measures are to be taken so that the patient heals in the right way. For us, the diet of the patient is modified. Initially, semi-liquid diet is recommended and gradually hard foods are given to the patient. The recovery pain is possible in the areas of minor nerve damage. For this, the patient should visit then doctor on regular basis and follow his advice and recommendations. The patient should avoid chewing unless and until the dentist advices him to do so. This will prevent any kind of obstructions in the process of healing of the patient. In case the dentist observes the improper bending of the bone, then he can recommend another surgery to improve the healing period keeping in mind about the results of the second surgery. This indicates that orthognathic surgery is a very delicate and needs to be handled properly to get the right results.


Oral Cancer

Oral Cancer

Oral cancer is the uncontrollable growth of the cells in the areas associated with the oral cavity. Oral cancer includes cancer of mouth, lips, sinuses, soft palate, hard palate and pharynx.For more details,please login to

Oral cancer is seen more in men than in women due to the kind of lifestyle and habits men possess. Smoking is done on a larger scale in men across the world than the women. So chances of occurrence of oral cancers are more in males.  Tobacco users who consume tobacco in a non-smoking form develop cancer of the lips, cheeks and gums than the smokers. Alcohol consumption increases the chances of the occurrence of oral cancer in an individual. If an individual has family members or relatives with oral cancers then there are good chances for the occurrence of the oral cancers in the individual too. Sun exposure at the young age in excessive quantities is also a major cause for the occurrence of oral cancer in a patient. The survival rates decreases with the increase of the time period. So the patient is informed about his expected remaining life time in order to keep him mentally and emotionally ready for the day.

The symptoms of oral cancer are quite prominent and a good differential diagnosis can be given by the dentist. Swellings can be seen on the lips, on the buccal mucosa as well as gums, sudden bleeding inside the mouth, reduced healing ability, development of red and white patches i.e. erythroplakia and leukoplakia respectively. Soreness of the throat, ear pain, and change in the way dentures fit can be seen as symptoms in the patients.

The diagnosis of oral cancer is done by the dentist. First, a thorough oral checkup is done by the dentist to find any other symptom or change in the normal functioning in the mouth. Then the patient is sent for oral cancer screening. Moreover, if the dentist finds some structure or tissue which is questionable then the sample of the structure is sent for diagnosis. The reports of the biopsy play an important role in the detection of the oral cancer. Brush biopsy and scalpel biopsy are the two types of biopsies which can be done by the patient.

Oral cancers are treated by the removal of the cancerous growth from the location of the occurrence of the cancer. This is followed chemotherapy and/or radiotherapy whichever is felt to be suitable by the dentist for the patient. This increases the life time period of the patient.

Being aware of the causative factors of oral cancer is important for the patient. In order to prevent from oral cancer it’s important to live a healthy lifestyle by following proper diet and keeping the body away from every kind of toxic substances. Self assessment should be done to look for any abnormal finding in the mouth. Regular dental checkups are necessary as many of the dental diseases are diagnosed in these routine checkups.


Jaw Tumors

Jaw Tumors

Jaw tumors are overgrowth of the parts in and around the jaws due to increase in the number or size of the cells. Jaw tumors are more common in the mandible than the maxilla. So whenever jaw tumor is in the differential diagnosis of a disorder, the radiographs of the mandible are taken. Jaw tumors are mainly classified into benign and malignant tumors. Benign tumors are more common than the malignant tumors. Metastasis is usually common in the malignant tumors. Malignant tumors occur when the tumor spreads from the original occurrence location and the malignancy reaches to some other location. Here, the malignant tumor occurs. Most common jaw tumor is the squamous cell carcinoma. Ameloblastoma is the most common odontogenic tumor. It invades slowly and occurs usually in the posterior portion of the mandible. Just like the jaw cysts, the jaw tumors are also classified into odontogenic and non-odontogenic tumors.For more details,please login to

There are various factors which cause the jaw tumors. Individuals who consume more amounts of tobacco and alcohol on daily basis are more prone to the occurrence of the jaw tumors. The tobacco and alcohol habits are much worse in males than in females. So in the recent times, men are more prone to jaw tumors with eventual consumption if not controlled and ceased before it’s too late. Poor oral hygiene like lack of rinsing after eating, lack of brushing two times daily, not using proper dental and interdental aids also lead to the increase in the chances of the occurrence of the jaw tumors. Poor nutrition, lack of maintenance after getting dental treatment, ill-fitting dentures as well as teeth problems are the other causes which lead to the occurrence of the jaw tumors.

Symptoms of the jaw tumors include difficulty in chewing of food, bleeding of sore, delayed healing, hoarseness, chronic sore throat. Reddish and whitish patches are known as erythroplakia and leukoplakia. These are one of the prime symptoms of the occurrence of jaw tumors.

Diagnosis of jaw tumors is made only after taking a proper medical case history in order to find out any genetic relation or systemic occurrence of the signs in the patient. Thorough examination of the patient’s dental health with respect to the teeth and periodontium will help the dentist to find out any further signs and symptoms. This can help in the diagnosis of the jaw tumor in the patient. Magnetic Resonance imaging (MRI) and CT scan are the most important diagnostic procedures for detecting and confirming the occurrence of the jaw tumors in the patient. For further classification of the jaw tumor, i.e. benign and malignant, biopsies are done so that the dentist can according plan a treatment for the patient.

Treatment of jaw tumors mainly involves the removal of the jaw tumor. With this, chemotherapy as well as radiation therapy is done in cases where there are cases of the occurrence or progression into cancer so as to increase the life span of the patient and improve his health.Jaw tumors have been on rise in the recent times so there is lot of awareness been created in order to make people understand the importance of maintaining a healthy lifestyle. .girl-729-420x0DSC_0115

Jaw Cyst

Jaw Cyst

Jaw cyst is a cavity which is filled with fluid or soft material. It is basically, lined by an epithelium. The fluid exerts pressure which is internal for the cyst and therefore there is growth of the cyst. Cyst in the human body are most prevalent in the jaws i.e. maxilla and mandible. So jaw cysts are the most important pathological disorders in dentistry.For more details,please login to

Tooth impactions and various dental infections increase the chances of the occurrence of jaw cysts.

Jaw cysts are mainly classified into odontogenic and non-odontogenic cysts. Non-odontogenic cysts are also called as developmental cysts. Some of the important and commonly occurring odontogenic jaw cysts are radicular cyst, dentigerous cyst and odontogenic keratocyst. Developmental jaw cysts are further classified into cysts of jaws, cysts including the soft tissues and cysts with unknown etiology. Nasopalatine duct cyst is the most common developmental cyst.

Cysts of the jaws are of great importance because they usually do not show any prominent signs and symptoms. They come into the picture once they are secondarily infected. In case, the cyst has not expanded beyond the anatomical structures in and around the jaws there is no prominence seen externally by the dentist. So it becomes quite difficult to diagnose the presence of any cyst. Due to increased pressure a part of cortical plate is also affected in the initial stages. Then with the progression of the cyst it becomes prominent externally in the later stages. A cyst can become acutely infected due to which there can be discharge of the pus into the oral cavity. This causes some discomfort to the patient in the later stages. There will be no altered sensation when the cyst expands slowly. Inferior alveolar nerve supplies the lower lip and chin. So, due to the increase in the size of the cyst, the inferior alveolar canal gets covered in the later stages. In the cysts of aggressive nature, the sensation of the nerves in the area of the cysts is badly affected.

The diagnosis of the cysts in the jaws is done with the help of the radiographs. The preferred radiographic methods are routine radiographs. On the radiographs, the cyst is seen dark i.e. radiolucent and the boundaries are seen as white line i.e. radiopaque around the dark areas. This provides a clear look and easy diagnosis of the cyst in the jaws. Aspirating fluid from the cyst also helps in diagnosing the presence of the cyst and its type as most of the cysts has characteristic fluid color and texture which can be seen on aspiration.

When the treatment of the cysts is considered then marsupialization and enucleation is considered. Marsupialization involves the creation of the window in the affected area. The fluid or soft content in the cyst is drained and then the window is left to get closed. With time eventually it gets closed on its own. Enucleation is the complete removal of the cyst. In case of large cysts and complicated cases, enucleation is followed by the marsupialization. Curettage is also used with enucleation when there is a need of removal of a part of the surrounding bone.sbc1

Facial Trauma

Facial trauma is also known as maxillofacial trauma. It is basically, any physical trauma to the face. Some of the most common causes of facial trauma are vehicle crashers, sports injuries, falls and assaults. Blows from objects as well as war time injuries can cause facial trauma. Work related injuries, animal injuries also cause facial trauma. Vehicle accidents or crashes are one of the most common causes of facial trauma in the recent times.For more details,please login to

Signs and symptoms of facial trauma are quite visible. The area affected is usually swollen, bruised and easily diagnosed. In severe cases, the facial bones are affected and even fractures can occur. Normal functioning of nose and mouth are affected. Some teeth are also broken in many cases. Double vision occurs in the patient due to the swelling around eyes and improper eye functioning. Fractures of nose, maxilla or base of skull can be present along with profuse nosebleeds. Many of the times, the cheekbone depression can be seen which indicates that there is a chance of some facial bone fracture which can be detected with the help of radiographs.

When the patient arrives at the dental clinic, the dentist examines the patient. This is done checking the presence of bleeding, lacerations, damage to the normal structure of the face. Diagnosis of facial trauma is usually made with radiography. This is accompanied by angiography in order to locate the areas of bleeding initiation. This is useful in cases where there are more chances of profuse bleeding with the occurrence of fractures. CT scan is recommended when complex bones and tissues are involved in the fractures. This helps in the understanding the case clearly and determine the right treatment for the patient. Moreover, CT scan is actually the best in order to detect the facial trauma.

Facial trauma can be categorized according to the occurrence in the children or adults. This is due to the fact that both of the facial traumas are different as children don’t have fully developed face. So special care is taken by the doctors so that there is no complication in future and the healing can take place along with the growth of the face of the child. Facial trauma is much less common in children. Less than 5 percent of the children are affected by the facial trauma. Even if it occurs the main cause is falling on the ground or some place usually while playing. For children who are above 5 years of age, vehicle accidents are one of the main causes. But due to various preventive measures taken like correct usage of car seats and seat belts.

Treatment of facial trauma is done by focusing mainly on the esthetics as well as functioning of the parts affected. Most important aim is to control bleeding. This is done by the surgeon by taking proper measures at the time of surgery. Care is taken to prevent any obstruction in the airway of the patient. One this is done then broken bone segments are fixed with the help of titanium plates and screws. Treating the fracture and leaving the minimal scars to make the esthetically confident. Doctor should be alert and immediate treatment action must be taken to avoid any complications.


Facial Reconstruction

Facial reconstruction is an important aspect of maxillofacial surgery. When any serious facial problem occurs with the patient then the dentists and surgeon prefer for a facial reconstruction procedure. This helps in restoring the precious features and modifying the present condition by turning the appearance of the patient into a positive one. Facial reconstruction is quite common nowadays with various options available to the patients. The advancement of technology in the field of dentistry has made most of the procedures much easier than before. This motivates the patients to undergo the procedure with confidence. For facial reconstruction, experienced surgeons and dentists are appointed in order to get the best results out of the procedure.For more details,please log in to

In the facial reconstruction a team of doctors is appointed which includes plastic surgeons, neurosurgeons and dentists. The procedure usually involves a lot of complications, so the specialists ensure that if any emergency comes up then it can be handled in the minimum time and successfully accomplished. The procedure is very sensitive and can take hours. So to be on the safer side, general anesthesia is given to the patient so as to keep the patient unconscious confirmatively during the whole procedure. The time duration can extend till several hours due to the in depth procedure done by the specialists. As the results are usually much appreciable the hard work given by the team during the procedure is also worth appreciation. The blood supply and tissues of the areas are properly checked and then brought according to the anatomy and functioning ability. When the cases are very complicated involving vital organs then it becomes important for the team to hold patience and then carry out the procedure.

Bone grafting is a commonly done procedure which ensures that the bone loss in the facial region. Bone pieces are taken from the body of the individual. During the procedure bone cut is also done. So prevent the deterioration of the area in which the anatomical structures have been brought to normal condition. Facial reconstruction is very important as the brain in the head is near to the facial structures. Any mistake in the procedure can threaten the life of the patient. So, extreme care is taken by the team of doctors so as to complete the procedure successfully without harming the patient.

The facial reconstruction procedure can lead to the adverse effects like swelling of neck, mouth or face. This can continue for few weeks. The airway of the patient is blocked. So tracheostomy is done on temporary basis. This provides a help to the patient to breath properly. There are risks which are associated with this procedure. So, care must be taken that the patient is not harmed by any step as a small mistake can cost the life of the patient. Facial reconstruction is boon to the patients who wan their esthetics back.Complications of the procedure can be commonly seen in patients having smoking habits, poor nutrition, and nerve damage in the past and poor blood circulation.facial-reconstruction11

Facial Deformity

Facial deformity is the status of the patient in which the normal anatomical structures of the patient have changed aesthetically as well as functionally. Facial deformity is quite commonly used in maxillofacial surgery.For more details,please log in to

Some of the main causes of facial deformity are genetic factors, damage to the fetus during the gestation period, various bone disorders like arthritis, surgeries involving massive exposure of anatomical structures of the body as well as hormone disorder. Cleft lip, cleft palate, severe burns, Treacher Collins syndrome, road traffic accidents, penetrating injury as well as maxillary hypoplasia are the medical conditions which have been seen to be causative factors of facial deformity. Most of these medical conditions have facial deformity as a prime clinical feature. The areas of the facial deformity vary from one medical condition to the other. The area affected is closely related to the causative factor of the facial deformity.

The symptoms of facial deformities can be prominently seen in the patient who has suffered from the above factors. Any abnormalities in the normal features of the human being are considered to be in facial deformity. Moreover, many of the facial deformities are congenital in nature. These facial deformities are present from the time of birth. For instance, cleft lip and cleft palate can be seen and diagnosed just by seeing the newborn just after the birth. The patient is then referred to the dentists for the further treatment in order to avoid any further complications in future. When a facial deformity is caused due to over exposure to radiations for long period of time, then the symptoms will be more superficial. The severity will vary according to the patient’s condition ad affect from the environmental factors.The dentist or physician checks the facial deformity in detail. A good medical history is taken in order to find out some clues and hints which may have been a strong link for the patient’s condition. Many a times, some of the diagnostic points can be found out easily with the help of thorough analysis of the patient. Diagnosis of facial deformities can be done with the radiographs in order to find the cause of the deformity in detail. Radiographs show any internal problem in the affected area. This helps a lot in the whole treatment plan of the patient.

Facial deformities are associated with cases of mortalities which are actually possible in the cases of the patients who have severe facial deformities, chances of getting infectious diseases, increased susceptibility to injuries as well as affect on vital organs.Facial deformities are actually a state of discomfort for the patient suffering with it. So it’s important for the dentist to understand the patient’s psychological state and treat him the best in the least possible time. This will help the patient to gain confidence. Surgery of the affected area is done in order to correct the defects..ContempClinDent_2011_2_3_245_86480_f2 1290577788

Cleft Lip/Palate

Cleft Lip/Palate

Cleft lip and cleft palate are congenital defects which are caused by abnormal facial development during gestation period. Cleft lip and cleft palate are also known as cheiloschisis and palatoschisis. The ratio of the occurrence of these disorders is very less i.e. 1 out of every 700 has been recorded..For more details,please log in to

The causes of the occurrence of cleft lip and cleft palate are mainly genetic and environmental factors. In the initial two months of pregnancy, the head of the embryo is formed. When the primitive tissue lobes fail to join in the initial stages then the cleft lip and palate formation occurs. Here, front nasal, maxillary and mandibular prominences fail to function to their best. Due to this the formation of upper lip, lower lip or cheeks can occur. Greater is the failure of the fusion of these tissue lobes, more is the severity of the cleft lip and palate. This can be seen at the time of the birth of the child. The formation of palate is the last step of the fusion of the primary tissue lobes and this makes this step vulnerable to various environmental factors the mother faces, nutritional imbalance of the mother as well as pollutants in the atmosphere.

The signs and symptoms of cleft lip and palate are quite easily seen. The cleft is actually present from the upper lip and does not affect the lower lip. Unilateral incomplete type of cleft lip and palate does not reach up to the nose and affects the upper lip and middle area in between the upper lip and nostrils. Unilateral complete type extends up to the nostrils thereby creating a prominent cleft on one side. Bilateral complete type extends to both the nostrils thereby creating a combination of two clefts.

Cleft lip and palate complications actually cause much difficulty for the newborn. Due to the difference in the normal features of the lip and palate the baby has difficulty in sucking the milk as there he cannot put proper suction force. So, the baby is provided with customized bottle feeders and made to sit so that with the help of gravitational force he can take the milk. Cleft lip and palate are associated with the hearing problems. In many of the patients, the Eustachian tubes are affected so as the baby cannot hear he is unable to try and speak till proper treatment is done at the right time.

Treatment of cleft lip and palate is done by experienced dentists and surgeons. The main aim is to bring the normal features of the cleft lip and palate. In this way, the patient will gain self confidence and esthetic features will be created. Kindergarten rhinoplasty i.e. nose surgery is the most recommended procedure for curing cleft lip and palate. Also, orthodontic intervention, alveolar bone grafts, jaw surgery, implants and bridges are the treatment procedures which are carried out .cleftlip_small.cleft_palate

Root Canal

Root canal is an endodontic procedure which is carried when there is excessive pain in the patients’ tooth and it cannot be treated with a simple cavity preparation and filling. It is famously known as ‘RCT’. Some of the common causes of the root canal procedures are difficulty and pain on chewing food, swelling around the tooth, inability to tolerate extreme hold or cold stimulus conditions and tooth affected by trauma. Root canal is a good option for the extraction of teeth as it saves the teeth as well as reliefs the pain. Root Canal is accompanied by cavity filling later. First a cavity is prepared, the root canal procedure is carried out and finally the restoration of the cavity is done. If patient is concerned about the esthetics of the tooth then the crown for particular teeth can be done.For more details,please log in to

Root canal procedures are carried out by trained dental specialists. Usually a root canal procedure for a single tooth is done in 30 minutes. So, one can see that the procedure is not tiring and takes the average time for the dentist to complete it successfully. If the patient has no more time then one can have more than one tooth’s root canal treatment in one appointment.

The procedure is quite less time consuming. Firstly, an opening is created in the tooth to enter into the teeth. This is done either from the back of the anterior teeth or from the occlusal area of the molar or premolar teeth. Then, pulpectomy is done in order to remove the pulp affected in the teeth. After this, proper cleaning is done. The cleaning is done mainly of the root canals and the pulp chambers. If the filling is not possible in first appointment then the patient is recalled for another appointment. Then in the next appointment the temporary filling or restoration is removed. A material known as gutta-percha is inserted and then the pulp chamber is sealed with cement. Gutta-percha is rubbery and tapered in nature. Many a times, in order to support this material a plastic or metal rod is inserted. Finally, the permanent restoration is done. Usually a patient prefers for the crown to be placed on the tooth treated with root canal treatment. Few appointments will be needed after the root canal treatment to get the tooth corrected if required and crown fixed on the tooth.

Proper care must be taken for the treated tooth as the caries can occur or reoccur in the particular teeth. As there is no pulp present alive inside the teeth, so it is important to understand that the teeth can fracture. This is the reason that regular dental check ups and proper oral care are recommended to patients treated with root canal treatment. The dentist will tell the patient the condition of the teeth after the treatment with the help of an X-ray. The amount of bone present before and after the treatment is also compared and decided with the help of before and after treatment x-rays.root_canal