BDS INSIGHTS by Dr Manish Khazane

By Laura McMullen Oh, you don't love spending time and money as a stranger picks, buffs, scrapes, fills or pulls your teeth? Join the club. No one says you ought to enjoy dental appointments, but that doesn't mean you should skip them. It's through the mouth that we breathe, eat , communicate and kiss, so it's usually worth 45 minutes of discomfort to keep your mouth healthy. If you're not convinced, we've debunked three popular excuses for skipping appointments. Dental work is too expensive. Many of us have dropped a swollen, drool-soaked jaw upon leaving a dental appointment and hearing the cost of the procedure. In fact, more than one in three Americans delays dental care because of their financial situation, according to a 2013 survey by ORC International and Aspen Dental , which also shows that 61 percent of workers making less than $...

A pulp polyp , also called as Chronic Hyperplastic Pulpitis, is found in an open carious lesion, fractured tooth or when a dental restoration is missing. Due to lack of intrapulpal pressure in an open lesion pulp necrosis does not take place as would have occurred in a closed caries case. Also a good vascular and immune supply is necessary, therefore found in adults. It is a productive pulpal inflammation where the development of granulation tissue is seen. Causes Causes of a pulp polyp include the following: Carious tooth with significant loss of tooth structure Loss of a dental restoration that results in pulpal exposure Fractured tooth due to trauma with a pulpal exposure Pulpal tissue with access to a good blood supply Possible hormonal (estrogen and progesterone) influence Clinical features : 1. Occurs mostly in children and young adults , who possess a high degree of resistance and reactivity. 2.It involves teeth with large,open carious lesions. ...

Dental pulp testing is a useful and essential diagnostic aid in endodontics.Pulp sensibility tests include thermal and electric tests, which extrapolate pulp health from sensory response. Traditional electronic pulp testers work by passing a current into the tooth and measuring how much current is required to cause a sensation. Unfortunately, the diagnosis is often made on a tooth that has or is near a metal tooth filling, which can change the path of the current in unpredictable ways. Clinically, this has led to false-positive readings. University of Oxford researchers have designed a magnetic analog of this device that aims to alleviate this issue.                                         Dental pulp tests are investigations that provide valuable diagnostic and treatment planning info...

Cemento-ossifying fibromas (COFs) are benign lesions affecting the jaws and other craniofacial bones. They commonly affect adult females between the third and fourth decade of life, predominantly occurring in the premolar/molar region of the mandible. Most of the lesions typically show slow and often expansile growth, centrally within the jaw and characteristically behave in a benign form, but occasionally they may present as an aggressive gigantiform lesion. Radiographically, they appear as well-defined unilocular or multilocular intraosseous masses. The lesion is invariably encapsulated and of mixed radiolucent densities. The tumor may grow quite extensively; thus, the term "aggressive" is sometimes applied. Surgical resection is the treatment of choice.  The cemento-ossifying fibroma is hard and fibrous, most frequently seen in the jaw or mouth , sometimes in connection with a fracture or another type of injury . The histology was that of a benign fibr...

Langerhans cell Histiocytosis ( LCH ) is a rare disease involving clonal proliferation of Langerhans cells , abnormal cells deriving from bone marrow and capable of migrating from skin to lymph nodes . Clinically, its manifestations range from isolated bone lesions to multisystem disease . LCH is part of a group of clinical syndromes called histiocytoses , which are characterized by an abnormal proliferation of histiocytes (an archaic term for activated dendritic cells and macrophages ). These diseases are related to other forms of abnormal proliferation of white blood cells , such as leukemias and lymphomas . The disease has gone by several names, including Hand-Schüller-Christian disease , Abt-Letterer-Siwe disease , and histiocytosis X , until it was renamed in 1985 by the Histiocyte Society. Causes, incidence, and risk factors Histiocytosis X has typically been thought of as a cancer-like condition. More recently researchers have begun to suspect that it is actua...

Lichen planus is a fairly common condition that affects the oral mucosa. This idiopathic condition is believed to be an immunologically mediated. The name likely comes from the appearance of the lesion which resembles that of a lichen. A lichen is a symbiotic organism composed of an algae and fungi. There are medications that may induce a reaction in the oral mucosa that appears like the idiopathic form of lichen planus. The medication induced form of the this condition is referred to as "lichenoid mucositis" or "lichenoid dermatitis". Lichen planus can cause skin lesions as well as oral lesions. Skin lesions are usually purple, pruritic, polygonal papules. Skin papules may exhibit Wickham's straie (lacelike network of white lines). Oral lesions may be reticular or erosive. Reticular lichen planus is most common. It usually causes no symptoms. Wickham's straie are seen throughout. The lesions may "wax and wane" over time. I...

Methamphetamine Use and Oral Health (Meth Mouth) Methamphetamine use is on the rise in the World because Meth is cheap, easy to make and causes a high that lasts up to 12 hours.   Dental health professionals need to be aware of this trend and be prepared to handle cases of Meth Mouth that come into their practices.   Meth use has been linked to severe oral health effects along with being a potent central nervous system stimulant that can cause brain damage that can be permanent.   Dental health professionals should be prepared to recognize the signs of Meth mouth and understand the treatment considerations for users of this drug. What Dental Professionals should be prepared to look for:         Decay in teenagers and young adults that is unaccounted for and accelerated. A pattern of decay that is distinctive, often on the buccal smooth surface of the teeth and the interproximal surfaces of anterior teeth. Patients who have...

Notched incisors, domed or mulberry molars- CONGENITAL SYPHILIS Keratotic lichenoid patches often with painful mucosal atrophy - GRAFT versus HOST DISEASE (GVHD) Multiple impacted supernumerary teeth and osteomas - GARDNER'S SYNDROME Hairy Leukoplakia (white, vertical folds on the lateral edge of tongue) - HIV transforming into AIDS High arch palate - MARFAN SYNDROME Red to reddish purple collections of oral telangiectases - OSLER-WEBER-RENDU SYNDROME (HTT) Violaceous patches -AIDS, KAPOSI SARCOMA Reddish discoloration of teeth - CONGENITAL ERYTHROPOIETIC PORPHYRIA Dark pigmentation, especially the lining of the mouth --Addison's Disease, Peutz-Jeghers syndrome, Smoker's melanosis and Hemochromatosis. Atrophic glossitis - IRON DEFICIENCY Candidiasis - AIDS, Diabetes, Immunosuppression disorders (Neutropenia, Agranulocytosis, Leukemia and leukocyte dysfunction), and use of antibiotics. Magenta tongue - VITAMIN B12 DEFICIENCY Painful atrophy of oral mucosa or surface of...

For details of the case, please refer to ORAL & MAXILLOFACIAL PATHOLOGY: A Rationale for Diagnosis and treatment by Robert E. Marx, Diane Stern

This is also known as benign migratory glossitis. This is usually not painful but this may lead to sensitivity problems and discomfort.Geographic tongue is a harmless condition which affects only the tongue surface. In normal tongue there are small, pink bump like structures which are called papillae. With geographic tongue these papillae lost and that area looks smooth and reddish in colour. Also these areas are appeared to be like small islands which surround slight raised borders. Sometimes these raised borders may be in white. This can persist for more than a month. These lesions may move around the tongue. This movement is very rapid. The lesion heals and moves to another area of the tongue causing the same appearance. Due to this movement of these lesions it is known as geographic tongue. The exact cause for geographic tongue is unknown. Vitamin B deficiency may be involved. This condition may occur due to irritations from hot and spicy foods or from alcohols. But...