Magic of Orthodontics.

Magic of OrthodonticsMagic of Orthodontics

Orthodontics is the advanced training in a sphere of dentistry mainly concerned with the study as well as treatment of malocclusion, irregular positioning and disproportionate relationship of jaws. The word orthodontics is derived from the Greek language Ortho, meaning straight and Odont, meaning tooth. Orthodontic treatment has mainly two aims; pragmatic – to improve irregular positioning of teeth causing various issues like bite problems, occlusion, etc. and cosmetic – to design a healthy and beautiful smile over a period of time thereby the appearance of the face.


Orthodontists should be fully aware how the teeth work and its affects and effects an oral wellbeing.

Orthodontists base their understanding of mechanics of tooth movement on three principles:

1.       Development and growth of jaws and teeth.

2.      Teeth alignment within dental arch.

3.      Occlusion of teeth and its functions. 

Smile design in a unique way through Orthodontics

Through orthodontic treatment, proper positioning and teeth alignment is one of the prerequisite methods to design a beautiful smile. 

Diagnosis by orthodontist

Orthodontists will evaluate and determine the recommended age for orthodontic treatment. This plays a crucial role in the plan and assessment of the treatment. All medical, dental history of a client is required prior to undergoing orthodontic treatment. 

First step would be taking an impression with which moulds of the teeth will be made. Articulator is a study model placed in an articulator to study and replicate jaw movement of the patient. Next, jaw and teeth x-ray with specialized radiograph are captured through a computer. Records are extremely important for images and it also helps an orthodontist determine the treatment plan. Details of records are also necessary for teeth stabilization and also to prevent the relapse of teeth after orthodontic treatment. The main motive is to give them a healthy smile for life.

Teeth movement

Orthodontist uses appliances with small brackets placed on the teeth through which flexible wire is threaded within the braces. Flexible wire tends to place light forces on the teeth and tends to move their teeth in order to straighten without any distortion. Movement of teeth is due to the characteristics of periodontal ligament which is elastic and attaches to the bone of the teeth. The living tissues in our mouth are remodelling and changing constantly. When mild force is applied in a controlled way on the tooth due to tension cementum, ligament and bone are formed. Tension is mainly due to pulling side whereas on the pressure side, in order to allow tooth to move, even cell will remove ligament and bone. Overall, the outcome of orthodontic treatment is taken into consideration that is to aim for function, stability and aesthetics. The discrepancies in the position of tooth and bite problems are considered to be basic modality. It is equally important to determine where the position of teeth must be, the methodology used for moving the teeth, stabilisation and retention as the treatment is completed. So, orthodontic experience is found to be vital in determining the orthodontic treatment plan.

Orthodontic appliances

There are several options to select appliances whilst undergoing orthodontic treatment. In fixed appliances, the patient cannot remove the braces on their own. The primary one is such that for posterior teeth, orthodontic band and anterior teeth, bonded bracket and it is known as a traditional bracket. An individual who intends to have aesthetic appliances may go for clear brackets which are less visible. During the course of treatment, it is highly recommended to avoid hard foods. Fixed appliances are used in comprehensive and complex cases. A clear aligner is a choice of treatment for reposition of teeth and it is known as removable appliances. It gives the teeth a better alignment since each one is different from preceding one. Removable appliances are used in cases which are milder and for tipping movements of the tooth. Simple movements of teeth may take at the most few months whereas complex movements may take 18 to 24 months or more, depending on severity and depth of the case. The diagnosis and careful assessment are considered to be the important factor in choosing an appropriate choice of appliance used for the treatment procedure.

Dental Surgery

Dental surgery is a type of dental treatment combined with surgery done to correct jaw and face, concerned with growth, structure, skeletal discrepancies and TMJ disorders. Orthodontist, combined with oral and Maxillofacial Surgeon focuses on treating craniofacial complexes related to skull, face, jaw and mouth. It is essentially needed when the jaws align improperly and proper bite results cannot be achieved by orthodontics alone. Orthodontic surgery can be done only when the jaw growth is complete; in females at 16 years and in males at 18 years. So, orthodontic surgery aligns the jaws and braces by the treatment which is used to move the teeth into proper position.

This treatment is one of the most important scientific discovery in the field of dentistry since it impacts all of oral health. It also enables your teeth to move into proper position which has a great influence psychologically.

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DISCLAIMER : “Views expressed above are the author’s own.”

Seven deadliest medical conditions related to oral health

Seven deadliest medical conditions related to oral healthSeven deadliest medical conditions related to oral health

In the modern era there have been lot of aspects associated with oral health, especially chronic and acute medical conditions. A lot of studies have been conducted regarding scariest medical conditions related to poor oral habits. The dentists can focus mainly on preventive measures in different ways. The dentists are now dealing with some of the scariest medical conditions including stroke, chronic kidney disease, lung cancer, respiratory infections, Alzheimer’s, breast cancer, oesophageal cancer.


Stroke is an obstruction of total blood flow to the brain and may be acute. Oral bacteria may cause diseases which affect the brain.

Types and symptoms

  • Haemorrhagic stroke
  • Transient ischemic attack
  • Ischemic stroke

Symptoms of stroke

Nausea, vomiting, numbness of face, unstable mind, headache, loss of balance, paralysis on one side of the body, blurred vision, drooping face and dizziness.

Effects on oral health

The effects on oral health include inability to brush teeth, slurred speech, inability to rinse mouth, dry mouth, inability to swallow, loss of teeth and abscess formation.

If it is untreated, the adverse effects are gingivitis, dental caries and periodontal disease. If patients do not take proper care of their oral health, it leads to denture stomatitis, inflammation of the mouth and ulcers.

Chronic kidney disease

The individuals with kidney disease have other health-related issues since their immune systems are compromised, so they are more affected by various infections.


Vomiting, sleep disturbances, swelling of ankles and feet, feeling of itching, weakness, cramps and loss of appetite.

Effects on oral health

The oral health is affected since the kidneys are unable to remove urea from blood and the urea breaks down in order to form ammonia. The changes in the bone density also occur since calcium is not absorbed by body properly. Therefore, people with kidney problems are high-risk. Bleeding gums, halitosis (bad breath), xerostomia, sensitive teeth, salivary gland infection, inflammation of the mouth, tooth loss are the symptoms of gum disease. If it is not monitored periodically, the adverse effects lead to dental caries, abscess formation and periodontal diseases. The other symptoms affecting general health are heart disease, anaemia and eating disorder known as anorexia blood disorder.

Lung cancer

It is the growth of abnormal cells in an uncontrolled way that may happen in the lungs and lead to tumours.


Fatigue, loss of appetite, difficulty in breathing, recurring infections, coughing are the symptoms of lung cancer. Some other symptoms are jaundice, lumps in collarbone or neck region, swelling of the face neck and arms, pain in the bone, limbs become numb or weak. In advance stage of lung cancer, the effects spread to the body mainly affects the brain, liver and bones.

Effects of oral health

It plays an important role in affecting oral health.  Chemotherapy affects the white blood cells, red blood cells and platelets which affects the lining of gums and mouth. The radiation therapy causes stiffness. It would result in dry mouth, gum diseases like gingivitis, sore mouth and more sensitivity. The taste of the food changes.

Respiratory infections

The reservoir has potentially been considered in the oral cavity which is specifically respiratory pathogens. The mechanism of infection of the lungs such as pneumonia, dental plaque colonization by pathogens of the respiratory tract is through aspiration. Along with pathogens of the periodontal region, facilitating dental plaque colonization in the pulmonary tract is also seen.

In the elderly people, the dental plaque colonization due to pulmonary pathogens is more frequent. The reaction leads to variable inflammatory process and connective tissue destruction which is present in emphysema and periodontal disease. There is also strong relation and association between COPD (chronic obstructive pulmonary disease) and periodontal disease. The acute condition such as pneumonia is a gradual onset with little or no fever with a cough.

Symptoms of acute respiratory infection

Runny nose, sore throat, fatigue, cough, loss of consciousness, dizziness and congestion.

Effects on oral health

Oral health is impaired in a great way and it leads to periodontal disease, poor oral hygiene, difficulty in swallowing, problems in feeding, poor functional status and dental caries.


Is a mental deterioration occurring progressively in middle and old aged people due to degeneration of brain.


  • Difficulty in remembering things due memory loss
  • Unable to cope with challenges of life
  • Difficulty in completing a task
  • Confused state of mind  with time and place
  • Vision problems especially in identifying visual images
  • Mood and personality change
  • Poor judgement capability
  • Avoid associating in social environment

Effects on oral health

Alzheimer leads to tooth decay and gum diseases like gingivitis, gum bleeding, halitosis, periodontal diseases in old aged people. Denture wearing results in denture stomatitis, sore mouth and chronic atrophic candidiasis.

Breast cancer

Is when cells in the breast begin to grow out of control. The cells ultimately form a tumour which may turn out to be malignant and spreads to surrounding tissues and distant areas of the body and often felt as a lump.


  • Pain in the breast and nipple
  • A discharge from the nipple other than breast milk
  • Irritation in breast skin
  • Thickening of the nipple
  • Redness and scaliness

Effects on oral health

The effects on oral health are inflammation of mouth, difficulty in swallowing, tastelessness, dry mouth, burning sensation in the mouth and dental infections.

Esophageal cancer

The growth of abnormal cells in the food pipe in an uncontrolled manner is also known as cancer of gullet. There is a strong association between poor oral hygiene and esophageal cancer.


  • Weight loss
  • Difficulty in swallowing
  • A persistent cough and indigestion
  • Throat pain
  • Heartburn

Effects on oral health

The association of oral hygiene with oesophageal cancer results in gum disease like gingivitis, halitosis, gum bleeding, periodontal disease, tooth erosion, sensitive teeth, dry mouth and dental caries.


The awareness of symptoms and regular check-ups by medical practitioners can bring a change in the society. If the symptoms are diagnosed in the initial stage, doctors can help the patients to cure. Otherwise, they won’t be able to help them and their life may come under risk. There are different educative programmes and campaigns to aware individuals about different scariest medical conditions.


  1. Gopal1Strokeand oral health, Vital 5, 40 – 42 (2008)
  1. Amir Azarpazhooh* and James L. Leake*  Systematic Review of the Association Between Respiratory Diseases and Oral Health DOI:10.1902/jop.2006.060010
  2. N A Dar,1,2,* F Islami,2,3 G A Bhat,1 I A Shah,1 M A Makhdoomi,1 B Iqbal,1 R Rafiq,1 M M Lone,4 C C Abnet,5 and P Boffetta2,6Poor oral hygiene and risk of esophageal squamous cell carcinoma in Kashmir Br J Cancer. 2013 Sep 3; 109(5): 1367–1372.


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DISCLAIMER : “Views expressed above are the author’s.”

Here’s what Orthodontists have to say on World Orthodontic Health Day

Here's what Orthodontists have to say on World Orthodontic Health DayHere's what Orthodontists have to say on World Orthodontic Health Day

May 15, 2017 was the first World Orthodontic Health Day, and the WFO created a special logo and posters that established the brand identity of this annual celebration. The logo, available in a variety of formats, is available for download (see below). WFO members should use this logo in all promotional materials for this celebration going forward. Read more.


Malocclusion which means teeth which are out of their normal positions in both upper and lowers jaws of an individual.  Malocclusion is associated with adverse Psychological & social effects including the longevity of the dentition & oral health overall & therefore adversely affecting the quality of life.

Malocclusion can manifest in a wide range & variations of malpositioning of teeth in the dental arch like – spacing/crowding/protrusion/retrusion /rotation and so forth.

Adverse consequences of Malocclusion

A person’s malocclusion can have a direct effect on his/her dental & facial aesthetics leading to poor social image & psychological disturbances. A person’s quality of life can be affected due to compromised functions of the oral cavity: chewing, breathing & speech.

Consequences of Malocclusion:

  1. Poor facial aesthetics

Negative body image

Psychological disturbances

  1. Compromised function of the oral cavity

Poor masticatory performance

Difficulty in articulation & lack of clarity of certain words

  1. Loss of tooth substance & attrition

Hypersensitivity of teeth

  1. Increased susceptibility to trauma
  2. More prone to dental diseases
  3. Obstructive sleep apnea

Benefits of Orthodontic Treatment:

  1. Improved smile/facial aesthetics
  2. Improved oral functions
  3. Positive psychological outlook
  4. Improved body image
  5. Reduction of Obstructive sleep apnea

The WFO Executive Committee chose May 15 for World Orthodontic Health Day as it marks the signing of the WFO’s charter in 1995 during the 4th International Orthodontic Congress in San Francisco. The main aim of celebrating this day – May 15th every year as the “World Orthodontist Day” is to promote the awareness of ill effects of malocclusion and promoting the science of Orthodontics to solve this problem.

  • The various treatment options available to the patients are:
  • Removable corrective appliances/plates
  • Preventive removable trainers
  • Functional jaw orthopaedic appliances

Fixed braces

Usually fixed orthodontic treatment commences at the age of 12-13yrs , i.e when all the permanent teeth have emerged in the mouth. But there are instances when the preliminary treatment has commenced as early as 8-9yrs due to the severity of the problem like severely displaced upper anterior teeth or any other jaw deformity or even a thumb sucking habit.

Habits such as thumb sucking have to be curtailed as early as possible. It is considered normal if a child sucks his/her thumb until the age of 4 yrs. But thereafter it poses a threat of deforming the dental arches by flaring up the upper front teeth and pushing back the lower front teeth.

To control this habit a Tongue crib is advised which has to be worn by the child for at least 6-8months depending on the severity of the problem.

Fixed braces treatment can commence after the full set of permanent teeth have emerged into the mouth.

The types of fixed braces are

  • Metal braces
  • Ceramic braces- Usually for adults who are more conscious about their appearance.
  • Lingual braces- which are invisible as they are placed on the inner aspect of the teeth
  • Invisalign/ Aligners – which involves a series of removable soft trays which the patient has to wear sequentially.

Usual duration of fixed braces lasts around one & half yr to two years depending upon the severity of the condition.




What are the first three most important patient factors for the
successful outcome of Orthodontic Result ?

Humans are complex and multiple patient, doctor, and appliance factors
are in play to give the resultant smile.

Three important patient factors which are mandatory to give best results

1. Maintenance of good oral hygiene.

2. Observing the appointment schedule.

3. Following dietary instructions to reduce appliance breakages.







Braces . . . a road map for a healthy lifestyle !

“What’s dental braces got to do with health ?!”

A lot ! Trust you are aware that your mouth is the gateway to your health. i.e. Whatever you put in your mouth has a big role to play in your overall health. Things put in the mouth, unless liquid, cannot be gulped down. It needs to be broken down in small pieces, so that the juices in the stomach may easily digest it. That job is delegated to your teeth, jaws and the muscles around your mouth.

“What difference does it make, if teeth are not ‘straight’ ?!”

If the teeth are not in the correct place, you think breaking down of food will happen evenly. In an attempt to break it down evenly, individual teeth undergo more than necessary strain. In the long run, teeth end up wobbly. One dial, of the many in a watch, if out of place, the time is never set right. Same with the teeth set.


If the upper and lower teeth are not in the correct place, the muscles around the mouth and jaws may shift the lower jaw such that it gets the teeth, as nearly in the correct place, as possible, to break down the food evenly. This shift can cause uneven wear of one or many teeth. It may weaken the teeth, cause pain in the gums around the teeth, pain in the jaw, pain in the jaw joint, pain in the head and neck, or, a combination of these.

“It’s alright doc. I brush my teeth twice a day. I wont have any such issues!”

If the teeth are not in the correct place, it becomes difficult to clean the teeth and gums thoroughly. Teeth and gums, dirty in some nook and corner of the mouth, not only gives a bad smell to those around you, but you end up having cavities on your teeth and gum infection around it. In the long run, you may end up losing few, or, many of your teeth.

“What, doc !! I have crooked teeth, but I have nothing, what you mentioned!”

If you don’t, thank your genes, and/or, your body’s capacity to deal with the situation. However, be aware, things will surface, given time. Meanwhile, in your best interests, do let a qualified orthodontist examine your pearly whites.

Orthodontic associations around the world, celebrate May 15, as WORLD ORTHODONTIC HEALTH DAY, to create awareness about the various possibilities with orthodontic treatment.


BDS,MScD (Phil.), MDS


As braces is not just for good looks

Let us raise awareness on this World orthodontist Day about the
increasing importance of teeth that are in line and bite properly.

Studies suggest. A single teeth that is not in its correct position can
cause interference in biting which can lead to temporomandibular joint
disorders and frequent headaches. Such cases are most commonly left
undiagnosed leading to patients taking painkillers for prolonged
periods.  These pain can be similar to migraines. Severe patients with
Migraine should go for a dental evaluation by an Orthodontist!!!

Maybe it was never a Migraine!!


An Orthodontist’s Message for World Orthodontic Day- 15th May 2018

 A confident smile can work wonders; it can inspire, motivate, exude charm and even give comfort and assurance.  It has the power of a thousand unspoken words. Such an uninhibited and radiant smile generally stems from good oral health.  Healthy teeth are often referred to as our “32 pearls” because of the immense esthetic value they add to the face when they are well aligned, correctly positioned in the jaws and disease free. The importance of celebrating 15th May as the “World Orthodontic Day” is aimed at creating awareness that orthodontic checkups beginning as early as 7 years of age can help create healthy, beautiful smiles with improved self esteem enhancing the psychosocial component of an improved quality of life.




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DISCLAIMER : “Views expressed above are the author’s.”

World Day for Safety and Health at Work – Infection control and safety in the dental practice

World Day for Safety and Health at Work - Infection control and safety in the dental practiceWorld Day for Safety and Health at Work - Infection control and safety in the dental practice

World Day for Safety and Health at Work is a campaign held on 28 April internationally and annually to promote healthy, safe and decent workplace. It has been observed since 2003 by an International Labour Organisation (ILO). This campaign is for the benefit of workers like trade unions, representatives of government, organization employer’s as well as for the next generation. Its main aim is to achieve and accelerate action for sustainable development and make workers feel secure in their working environments. It also highlights the importance of focussing on challenges related to work aspects, thereby improving the safety and health of workers, and also combats the efforts through awareness.

About International Labour Organization (ILO):

ILO is a United Nations (UN) agency brings together workers, employers and governments of near state of members of 187 countries to develop policies and set standards of labour, promote and programmes devices to work decently for all men and women worldwide. The ILO, with the celebration of World Day for Safety and Health at Work, promotes globally the creation of preventative health and safety culture involving its constituents and its key stakeholders.

History Of ILO

The ILO began with the United States in the year 1919, as part of the treaty of Versailles that reflected on the universal way and based on social justice with the belief of lasting peace. The labour commission by the constitution was set up by peace conference, it was held primarily in Paris and later in Versailles. The head of an American Federation labour, commission chaired by Samuel Gompers of United States was together held with many representatives from nine countries; namely Italy, Belgium, Japan, Cuba, France, Poland, Czechoslovakia, United States and the United Kingdom. The outcome resulted in an organisation of Tripartite, with including executive bodies, representatives of government and employees. The constitution of the ILO permeable speaks the parties of high contracting were moved by the desire of justice and also to secure the peace permanently in the world. Due to increasing understanding aspects of the world’s economic interdependence and also to obtain the cooperation of working conditions in competing countries, reflecting on these aspects it states as

  1. Based upon the social justice lasting peace can be established universally.
  2. Improvement on working conditions is essentially required for labour where harmony and peace never waver.
  3. If in case of adopting conditions of human labour since obstacle was on the way of other nations the desire to improve the conditions exist for their own countries.

Goals Of ILO

Aim for living conditions and labour alleviating

  1. Conditions of labour and living of people must be improved
  2. Unemployment must be prevented
  3. Duration of hours of working on any day of youth, women and children all must be protected, and also care for disabled and elderly provision must be created

The overall purpose of these aspects is to be accepted globally with social standards and also in international trade in divided participants will be prevented from creating advantages over by decreasing the rights of employees.

Functions Of ILO

  1. International labour standards to be established
  2. Information on labour and conditions of industrial related is distributed and also collected
  3. Assistance of technology to be provided

Infection control and safety in the dental practice

In the life of a person, most people will visit a dentist in order to get to know about their oral health; therefore, dental professionals are held responsible for ensuring a safe and infection control environment practice.

Infection control

Asepsis concept and its primary role in the infection control was put forward two centuries ago, by Ignaz Semmelweis in Europe and Olive Holmes in USA. After the Joseph Lister’s studies, the principles were accepted on prevention of wound infection. Though it is very much well known in surgery and general medicine it has been considered as late coming to dentistry.

In the field of dentistry, there are 4 possible routes where the disease may be transmitted.

  1. Direct Contact
  2. Indirect Contact
  3. Airborne route
  4. Droplet Transmission

Planning for Infection Control

  1. Always assess upon return and prepare before

It is the basis for assessing the effectiveness at the end, there follows to improve the process as future aids.

  1. Basic Setup

Choosing a best operating area where exactly the position of patient’s heads placed with regard to artificial or natural light.

  1. Site Setting

The positioning of a patient, access to supplies, adequate lighting, excessive noise and dirt. There are factors must be considered in selecting a setup for treatment of patients.

Principles of Infection Control for Safety practice

  1. Take appropriate action to stay healthy
  2. The spread of contamination has to be limited
  3. Always avoid contacting body fluids or blood
  4. Make objects safe for use

Safety Measures for dental care delivery

Hand Hygiene

Always wash hands before gloving and after removing the gloves. Use alcohol-based sanitizer on hands.

Personal barriers

Using gloves, gowns, masks and eye protection is the safest measure during dental care delivery.

Other Safety Measures

  1. Instead of using fingers to retract tissue use retractor or mirror
  2. Maintaining a container for sharp used instruments in order to allow disposal of blades or needles after using immediately
  3. While processing dental procedures carefully handling instruments
  4. While transferring instruments between operator and assistant have to be done carefully.

It is always safe and best to treat everyone as if they are infected with pathogenic microorganisms and also it is safe to handle every contaminated item as if carrying an infectious blood-borne agent. The effort and focus are to eliminate or decrease in the spread of infection from all types of microorganisms. Eliminating and breaking the cycle of infection is the core objective of a dental professional. The clinician holds a responsibility for implementing effective infection control and also for safe practice.

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DISCLAIMER : “Views expressed above are the author’s.”

Antibiotic Prophylaxis prior to dental treatment in cardiovascular patients.

Antibiotic Prophylaxis prior to dental treatment in cardiovascular patients.Antibiotic Prophylaxis prior to dental treatment in cardiovascular patients.

The American Heart Association (AHA) for prevention of Infective Endocarditis (IE) was updated in 2007. The guidelines were approved by Council on Scientific Affairs of the American Dental Association (AFDA) as it relates to dentistry.

Major changes in updated AHA include

  1. Only in extremely small cases might IE be prevented by antibiotic prophylaxis for dental procedures, even if such prophylactic therapy were 100% effective.
  2. IE prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE. For these patients. the prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue (or) periapical region of teeth or preparation of oral mucosa.
  3. Prophylaxis is not recommended on basis of increased lifetime risk of acquisition of IE.

High risk cardiac conditions where antibiotic prophylactic regimen recommended by AHA.

  1. Prosthetic cardiac valve
  2. H/O IE
  3. CHD except for conditions listed below, antibiotic prophylaxis is no longer recommended for any other form of CHD.
    • Unrepaired cyanotic CHD including palliative shunts and conduits.
    • Completely prepared heart defect with prosthetic material (or) device whether placed by surgery or by catheter intervention, during the first six months after the procedure
    • Repaired CHD with residual defects at the site (or) adjacent site of prosthetic patch (or) prosthetic device.
    • Cardiac transplantation recipients with cardiac vascular disease.

The following Dental procedures do not require Endocarditis Prophylaxis

  1. Routine anesthetic injection through non-infected tissue
  2. Taking dental radiograph
  3. Placement of removable prosthodontic (or) orthodontic appliances and their adjustments
  4. Shedding of deciduous teeth
  5. Bleeding from trauma to lips (or) oral mucosa.

Antibiotic Prophylaxis

The most common cause of Endocarditis for dental, oral, respiratory tract or esophageal procedures is viridans streptococci (VSG) hence an antibiotic regimen for endocarditis prophylaxis is directed towards VSG.

All doses shown are administered once as a single dose 30-60 minutes before a procedure

Standard general prophylaxis


Adult dose:         2 g PO
Pediatric dose:  50 mg/kg PO
Not to exceed:   2 g/dose

Unable to take oral medication


Adult dose:          2 g IV/IM
Pediatric dose:   50 mg/kg/IV/IM
Not to exceed:    2 g/dose

Allergic Penicillin


Adult dose:         600 mg PO
Pediatric dose:  20 mg/kg PO
Not to exceed:   600 mg/dose


Adult dose:          2 g PO
Pediatric dose:   50 mg/kg PO

Azithromycin (or) Clarithromycin

Adult dose:        500 mg PO
Pediatric dose:  15 mg/kg PO
Not to exceed:  500 mg/dose

Unable to take oral medication

Adult dose:         600 mg IV
Pediatric dose:   20 mg/kg/IV
Not to exceed:   600 mg/dose

Cefazolin (or) Ceftriaxone

Adult dose:        1 g IV/IM
Pediatric dose:  500 mg/kg IV/IM
Not to exceed:  1 g/dose

Professor Dr. Prasad MGS

Clinical Director
Specialists Dental Clinic,
K.R Puram, Bangalore

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DISCLAIMER : “Views expressed above are the author’s.”

World Health Day

World Health DayWorld Health Day

World Health Day | Did you know what’s the World Oral Health Day 2018-2020 theme? SAY AHH!

Health is a condition which reactively results from the body’s adaptation to changes in the surrounding environment and also response to stresses in order to maintain an internal equilibrium of balance known as homeostasis. The imbalance in health occurs due to lack of nutrients, as it does not release the required chemicals and also if diet lacks crucial nutrients. The body will not be able to make the right amount of chemicals. Therefore it affects the chemistry of body and results in mood disorders, depression and anxiety. Even in the brain, neurotransmitters release process takes action, lack of brain chemicals release affects the brain chemistry and leads to various disorders. The unhealthy mouth with improper oral hygiene affects the health of body. Good oral hygiene prevents gum disease, bad breath and tooth decay, keeping the teeth in a healthy status .

The World Health Organization (WHO) is a renowned agency and also member of development authority of United Nations, established in Geneva, Switzerland on 7th April 1948. WHO sponsors a global awareness of health which is celebrated as World Health Day every year on April 7th. Around the year 1948, the health assembly was held by WHO and decided to celebrate 7th April of each year, with effect from 1950, as World Health Day. According to the meeting discussion, outcome was to draw global attention toward health and it’s importance every year. WHO according to themes organizes campaigns and various activities related to health issues for public regionally, with local events. World Health Day is supported with media reports like such as global health council and acknowledged with various activities by both organisations of governmental and non-governmental bodies. The theme and slogan of World Health Day 2018 is universal health coverage, “Health for all”. Even oral health is considered one of the important aspect, since oral disease and infection caused by oral bacteria progressively leads to systemic diseases. The systemic effects the heart, lungs, bones, etc. like cardiovascular disease, pneumonia, diabetes complications, osteoporosis. World Oral Health Day is a global awareness campaign of oral health and its importance in our daily lives. The awareness about oral hygiene and the issues around healthy oral cavity, by government, health community as well as non governmental organisations  associate all together and contribute to achieve individuals mouth to be in a healthy state.

Is world oral health day is so important!!

Nearly 90 percent of population, suffer from oral disease and the reason for the
cause may be due to various factors. The role of dental health community, various
health organisations, and government is set to give a platform for action to contribute
to public awareness about the oral hygiene and it’s practises. Many campaigns are
conducted with various events.

History of world oral health day:

It was an year long campaign and also launched by FDI world dental federation. The
campaign was mainly focused with intent of raising awareness about oral health and
it’s importance, and also prevention of oral diseases.
These campaigns have always been featured with a specific theme.
World Oral Health Day is recognised on September 12th to commemorate the
birth date of Dr. Charles Godon, founder of FDI. The campaign was actively conducted since 2013, since it wasn’t fully activated and also in order to avoid the conflicts the date was moved to 20th March 2013.
Actually 20th March is expressed and translated as 3/20 based on numerical basis
and henceforth 20th March was taken into consideration, it reflected on the following

In the oral cavity:

  1. An total of 20 natural teeth at the end of the life of individual senior citizens considered to be healthy
  2. Total of 20 baby teeth for children’s
  3. Total of 32 teeth and nil dental caries.

Themes of World Oral Health Day:

Healthy teeth for a healthy life – 2013
Brush for a healthy mouth – 2014
Smiles for life – 2015
It all starts here, Healthy mouth healthy body – 2016
Live mouth smart – 2017
Say Ahh: Think mouth, Think health – 2018

World oral health day 2018-2020 theme? Say Ahh:

The ‘say Ahh theme’ is a three year campaign launched in 2018 beginning with subtheme “Think mouth, Think health”. The most common phrase used by general health doctors and dentists during check-up is “Say Ahh”. The most important significance of year 2018 theme is that our mouth is the reflection for overall health. The awareness of oral health and body health is very important since there is a strong relation between the both.The maintenance of oral health by keeping our mouth healthy empowers to keep the body in a healthy state and also enhances the quality of life.

The theme is based on 4 important messages:

  • Oral health is more important than a happy smile.
  • There is a hand in hand two way relationship for oral health and body health.
  • The oral health of mouth cannot be detached from the body.
  • The oral diseases contribute risk factors with body diseases also.

Celebration of World Oral Health Day | with ideas and various activities

World Oral Health Day focussed with the intent of spreading awareness by students, dental community, general health expert doctors to the public. Nearly 130 countries schedules and organise various campaigns with activities to promote the events.

  • Public awareness through workshops and seminars:

Students of dental community organises various seminars and workshops in order to educate about oral health and it’s practises by spreading knowledge about it to the general public.

  • Making creative banners and posters:

Students make creative and informative posters to contribute the benefits of oral health and how to practise it, showcasing them in offices, public places, schools, colleges, etc. The concerned institution of health community organises poster, banner creative contests about oral health and render by giving prizes to the top best posters or banners.

  • Activities which creates fun for children:

Schools organises various activities for the wings of students by which through fun they learn and get educated about the teeth brushing and also ways of maintaining oral health like a skit about oral hygiene, enacting and reciting songs of tooth brushing, making creative clay stands for keeping toothbrushes.

  • Demonstration of tooth brushing:

Local dentists is invited to demonstrate techniques of brushing teeth and its importance to children and families.

  • Competition by slogan and speech:

Colleges and schools organise debates, speech and also slogans creating in order to spread the awareness and message of oral health and its importance.

World oral health day campaign ultimately focusses and aims to educate people for keeping a healthy mouth. Diseases with non communicable diseases and its risk factors to promote awareness of good oral hygiene and improve the quality of overall health. This indeed makes the individual to lead a life of healthy mouth healthy life. An overall campaign outcome by government, health community, Various non- governmental organisations etc. is dedicated with great effort for the healthier mouth for all and make the individuals free from diseases and succeed with overall wellbeing for better life.

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DISCLAIMER : “Views expressed above are the author’s.”

Common Dental Misconceptions

Common Dental MisconceptionsCommon Dental Misconceptions

Common Dental Misconceptions

In the 16th century of France a story traced back according to Georgian calendar lead to the change in dates of celebration, since proposed date was unaccepted by all, although officially declared. Old Julian calendar was followed by many people, known as fools. The per-Christian group was celebrating in april1st, instead of May was also considered as fools. On this particular day, people played pranks and jokes, that resulted in misconceptions. These misconceptions related to dental tale lead to anxiety, doubts and suffer from dental disease. In the era of modern and advance dentistry, the misconceptions of dental treatment procedure are still prevailing in common public. The misconception is sometimes baseless, may be from someone else beliefs, or experiences, at times perception and interpretation by analytical thinking of experiences undergone, so various factors involve in forming a belief of individual. Here are some of the common misconception and facts of dental and its treatment procedures.

  1. Oral cleaning by scaling of teeth loosens, abrades the teeth and widens between the teeth

Fact: Scaling is a procedure of removal of calculus (tartar) and plaque surrounded around the teeth and gum line, and it relieves from eating bone around the tooth gums by bacterial flora. During scaling, when calculus is removed from the attachment of calculus to the teeth, in case if the tooth is already shaky then as soon as it is removed feels loosened and also feels the gap between the teeth, after some days it heals to certain extent based on severity. The other aspect of false belief is abrading the teeth because everything within limit sounds always good, since the scaling procedure has to be done 6 months once rather than at regular intervals. Incase of severe gum disease scaling has to be undergone 3 to 4 months interval.

  1. Extraction of teeth affects the eyes

Fact: The eyes are not affected by extraction of teeth since there is no direct connection between the eyes and tooth.If the upper teeth are decayed and infected, only if it is spreads beyond the space of sinus cavity, then the swelling of eyes is seen since there is connection between infection and eye, but not to extracted teeth.

  1. I, always brush my teeth 2- 3 times a day still cavities has occurred

Fact: The teeth brushing 2-3 times day doesn’t prevent caries since caries occurrence in the tooth depends on many factors like genetics, diet like sugary candies, pastries, cookies, saliva, medications(antidepressants, antipsychotics, Bp control drugs).

Genes play as a primary determinant role for development of tooth, the structure of Enamel varies among individuals, the softer the enamel causes the tooth to decay. Sugary diet like pastries, candy, cookies etc causes acids and attack the teeth results into tooth decay.

Saliva play a role in causation of caries, when the pH of saliva in the oral cavity becomes neutral at 6.5 to 7.5, and caries formation occurs when the pH becomes at 5.5 and the root at 6.0.

The medications of antidepressants, anti-psychotics, and BP controller drugs causes tooth decay due to dryness of mouth called as xerostomia where the saliva is reduced henceforth bacterial count is increased results to decay of tooth

  1. Hard method of brushing teeth whitens in colour.

Fact: The tooth is generally white in colour, as the age progresses, certain medications, eating, drinking like tea ,coffee,beverages etc causes the  tooth yellow in colour .Brushing hard , wears of the enamel and causes tiny cracks and crevices by that debris and plaque gets deposited and the dentin is exposed so hard brushing never causes the tooth to be whitened in colour.

  1. As soon as cavitated tooth is treated, thereafter no decay occurs for life time.

Fact: The restored tooth after some years forms a secondary caries due to microleakage and cracks in the restoration, poor oral hygiene also results into secondary caries so restored tooth has to be again consulted during regular visits by dentist.

  1. Bad odour occurs even after brushing teeth properly.

Fact: Bad odour in the mouth is known as halitosis. The causes of halitosis is due to diabetes,lung disease, respiratory tract infection, Kidney disease, cancer etc, diet like onion ,garlic,poor oral hygiene due to gum diseases causes tartar and debris deposition, Beverages like tea, coffee, etc causes stains .

Dry mouth due to reduced saliva, snoring, long period of time, speaking etc. So, consulting dentist would definitely diagnose the cause and treats the underlying cause and henceforth relieves from bad odour.

  1. Eating chocolates and sugary sweets decays the teeth

Fact: The decays of tooth occurs when the sugar turns into acid, on the surface of enamel becomes weak and results into cavities Chocolates and sweets contain high amount of sugar so after eating swishing the mouth would be of great help

  1. Drinking hot tea or coffee harms the teeth.

Fact: Depending on the amount of intake and also quantity of sugar consumed by the drink results into stains so after consuming it is an good advice to drink water or rinse with water for better results

  1. Eating hot or cold meals affects the teeth.

Fact: Generally eating hot or cold meals doesn’t harm. Only in case of enamel wear off then the sensitivity of tooth is experienced otherwise not.

  1. Whitening of teeth doesn’t remain whiten in appearance for longer period of time

Fact: Whitening of teeth remains for a longer period of time only when the intake of beverages like tea coffee, wine etc is less .If the intake of bevarages are consumed more number of times in a day then it causes stains and longevity of whitening reduces certainly.

  1. Avoiding visiting dentist during pregnancy.

Fact: During pregnancy regular dental visits is always good but undergoing x rays, surgical procedures, Elective surgeries and cosmetic procedures are restricted. Usually second trimester holds good for undergoing cavity fillings and crowns.

  1. It is unnecessary to visit dentist for decayed baby teeth, since in few years it falls out.

Fact: Baby teeth are important since they provide a pathway for the permanent to erupt. In case of decayed baby teeth if it left untreated the cavities will lead to abscess and causes pain and discomfort, affects the permanent teeth .As soon as the baby teeth emerges visiting dentist at regular intervals is ideal for healthy teeth.

  1. Dental procedural treatments are painful.

Fact: It’s a myth that all dental procedures are painful if in case of severity, the dental procedures are done under local anaesthesia, so that the procedures are pain free

  1. Wearing dentures all the time.

Fact: Wearing dentures is not recommended during sleep hours. It is always good to remove the dentures and soak in the denture solution and also by removing in the night, Gums and bones relaxes and avoids the bacteria affecting it.

  1. Braces are not for adults.

Fact: Many people are in a myth that braces are only for kids and teenagers, but it is also placed for adults if the bone around the tooth is strong and healthy

  1. Only when there is pain visit dentist.

Fact: Many people avoid dentist unless the severity in the pain increases they never visit dentist. Every 6 months regular visits to dentists are practiced then the oral health will be in healthy status. The pain in the oral cavity depends on various factors and also for like gum abscess, tooth abscess. It can be assessed only when thorough check up is done

  1. Eating sugarless chewing gum whitens teeth.

Fact: Sugarless chewing gum never whitens the teeth but to certain extent it prevents the tooth decay, since it increases the saliva , and reduces the acid attack on the teeth.

  1. After every meal usage of tooth pick widens the gap between the teeth.

Fact: The widening between the teeth depends on conditions prevailing in the oral cavity like it may be due to gum disease or caries in between the tooth etc. Usage of tooth pick is not recommended by dentist since it may injure the gums and soft tissue. It is always good to use dental floss for cleaning between the teeth and henceforth it doesn’t widen the tooth.

  1. Gum Bleeding is common for everybody after brushing.

Fact: It is uncommon for everybody only if the individual is suffering from gum disease then bleeding in the gums after brushing is seen, and by undergoing Oral cleaning by scaling is an effective method for gum disease

  1. Root canal is painful treatment.

Fact: Root canal treatment is a pain free procedure, since it is done under local anaesthesia, and the tooth is anaesthetised and helps to undergo the treatment with ease. It is always better to have the right beliefs rather than being in misconceptions. Never allow these misconceptions to affect like fools since it prevents from having a healthy dental status. Before accepting any dental misconception better to consult a dentist and properly follow instructions recommended by them, so that it helps to relieve from doubts and fears about dental health.

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DISCLAIMER : “Views expressed above are the author’s.”

How to brush your teeth

Dental hygiene for seniorsDental hygiene for seniors

Brush your teeth two to three times a day with a soft-bristled toothbrush for three minutes.

You can divide your mouth into four quadrants: upper right quadrant, upper left quadrant, lower right quadrant, and lower left quadrant.

Each quadrant must be brushed for 45 seconds. It is advisable to have a watch or hourglass on hand.

The positioning of the brush depends on the area you are going to brush:

  1. Start with the inner and outer surfaces: Position the toothbrush 45 degrees at the level of the gum and make small movements from the gum to the tooth, as if you were painting a wall. Also remember to clean the back of the last tooth
  2. Go to the chewing surfaces: Hold the brush flat and rub these surfaces.
  3. Once you reach the inner surfaces of your anterior teeth, tilt the brush vertically and clean these surfaces with the tip of the brush.
  4. Brush your tongue back and forth to eliminate food residue and odor-causing bacteria and freshen your breath.

What type of toothbrush to choose

Manual toothbrush or electric toothbrush?

The manual brush may be sufficient if you know how to brush your teeth by making roller movements while brushing “red to white” during the recommended three minutes. The main advantage is its low price. In addition, she is never short of battery and can easily be carried on a trip. However, its effectiveness is less good.

Which types of bristle do you prefer?

For people with no particular pathology, it is recommended to use toothbrushes with soft bristles, with a diameter of very fine filaments, of the order of 20 hundredths of a millimeter. Hard brushes cause tooth abrasion and gum retraction that can lead to dental and cosmetic problems.

What are the benefits of an electric toothbrush?

For the same brushing time, the electric brush removes more dental plaque than the manual toothbrush. It works alone and therefore requires less effort. It is important to “let work” the electric brush and not to do more wrist movements. Some brushes are also equipped with a timer that allows to better respect the three minutes of brushing. For children aged 7-8, it may be easier to use because their manual dexterity is worse than that of adults.

What are the disadvantages of an electric toothbrush?

The electric toothbrush is more expensive to buy. Vibration can also put some people off and the need to recharge can be a problem when traveling. In addition, an electric brush is often a little heavier than a manual brush because of its battery, which can be annoying for some elderly people. Nevertheless, the larger size of the handle generally allows a better grip.

What are the differences between electric brushes?

The former made a vertical back-and-forth movement. With their tilt-and-turn movement, the news is more powerful: the round brush head rotates on its axis, while adding a three-dimensional back-and-forth movement, which eliminates more plaque. There are also “sonic” brushes, which create vibrations.

We do not recommend “low end” brushes, battery operated, less efficient.

Which models of toothbrush to choose for children?

Better to choose a manual brush with soft bristles that can be used from 12 months, once a day. “Junior” brushes, manual or electric, have a small head, adapted to the size of the mouth of the child. From 7 to 8 years old, the “playful” side of the electric brushes can help the child find the brushing less time consuming, for example by playing a small music.

Are there toothbrushes for certain situations?

During pregnancy, the risk of gingival inflammation is higher due to hormonal changes.

A thinner toothbrush with bristles of 15 hundredths of a millimeter can be used if the gums bleed or are swollen and painful.

After dental surgery, dentists prescribe brushes with even finer hairs (7 hundredths of a millimeter). Very gentle, they can brush your teeth without pain. Then, a brush of 15 hundredths can be used on the painful gums then one returns to the normal toothbrush.

In the case of dental hypersensitivity, an electric brush with a sensitive brush head or a manual brush with very fine filaments is recommended. But they should only be used for a limited time because they are insufficient for good brushing.

For wearers of orthodontic appliances , the same as above or special brushes can be used, with specific bristle implantations to pass between the rings.

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DISCLAIMER : “Views expressed above are the author’s.”

Dental hygiene for seniors

Mar 6, 2018
Dental hygiene for seniorsDental hygiene for seniors

Although tooth loss increases with age, the main cause is not age-related. Periodontal diseases and root caries are the main culprits. Fortunately, with improved oral hygiene and regular visits, seniors now have the opportunity to keep their natural teeth healthy throughout their lives.


As with any age, it is appropriate for seniors to consume enough dairy products and each of the food groups.

Oral hygiene

It is important to maintain good daily oral hygiene by brushing with a soft bristle brush and a fluoride toothpaste. When motor skills are reduced, the toothbrush can be adapted to ensure better grip and the use of an electric toothbrush can sometimes help.

No brush can reach the contacts between the teeth and the space between the gum and the tooth. Because cavities and gum disease can develop, only dental floss can complete the cleaning of these surfaces. The market offers a wide variety of wire carriers that simplify this task. The cracks in the tongue contain dead cells, biofilm (dental plaque) and food debris that can only be removed with a toothbrush or tongue cleaner.

Visit to the dental hygienist

Visits every six or twelve months, to the dental hygienist, can detect beginner caries, gum disease and other oral diseases (defective fillings, oral lesions, etc.). It is important for you to mention all your health problems, medications used, diseases diagnosed, symptoms, etc. The advice, the preventive methods, the proposed treatments and the frequency of the visits will thus be personalized according to each one.

Periodontal diseases (gums and bones of the tooth support)

In the beginning phase, gum disease is often painless and not easily detectable by yourself. Early detection and management can prevent the progression of inflammation of the gums (gingivitis) to the tooth support (periodontitis). The loss of estrogen from the post-menopause causes a loss of bone density that can accentuate the predisposition to periodontitis. Untreated periodontitis results in bone resorption and may worsen until tooth loss. The control of periodontal diseases preserves the dentition and also helps prevent the progression or complications of other diseases (eg diabetes).

Many studies show that microorganisms in periodontal disease can migrate into the bloodstream and be involved in heart disease, stroke and lung disease.

Dental hypersensitivity

Gingival recessions and tooth wear (attrition, abrasion or erosion) cause exposure of tooth surfaces with narrower nerve endings (cementum and dentin). This often causes the hypersensitivity of the teeth to hot, cold, sweet, citrus acidity, brushing, pressure and touch. The dental hygienist can help you identify the cause and advise you on excellent solutions.

Removable dentures

Removable dentures (partial or complete) should be brushed after each meal with a soft brush. It is advisable to remove them at least four hours a day, massage the gums with a soft toothbrush and clean the tongue. Poor hygiene and the presence of microscopic fungi, such as Candida albicans, can cause inflammation of the tissues under the prosthesis (prosthetic stomatitis). The continuous wearing of the prosthesis aggravates this type of inflammation.

There are several factors that can affect mouth retention of prostheses (dry mouth, osteoporosis of the jaw bone, weight loss, etc.). Poor retention leads to premature resorption of the bone, and difficulty chewing can lead to digestive disorders. The annual office visit is desirable in order, among other things, to check and correct the fit of the prostheses. Nonprescription adhesive products in pharmacy are only a temporary solution.

During an extended stay in an establishment, it may be appropriate to engrave on the prostheses the name and first name of the wearer.

Halitosis (bad breath)

Halitosis can be occasional or chronic, that is, it persists despite good oral hygiene. Hormonal changes, medical problems or medications can alter your breath. However, the most common causes come from the oral cavity: poor hygiene, dental problems (eg tooth decay, abscess, gum disease, etc.), dry mouth, certain foods, alcohol, tobacco, etc. Good daily oral hygiene, healthy lifestyle habits and professional cleaning and care in the office eliminate many of the causes of halitosis.

Xerostomia (dry mouth)

With its antibacterial and antifungal properties, saliva also regulates oral pH. The decrease in saliva therefore creates discomfort and deprives precious natural protection against oral diseases. In some cases, the use of saliva substitute or fluoride may be beneficial. Xerostomia is caused by a variety of factors: medical conditions, medication, hormonal changes, radiotherapy, etc.


You may be part of the 75% of smokers who want to quit this habit but need help. Like all health professionals, the dental hygienist has information on this subject (documentation, help centers, etc.). And, as the very first signs of the harmful effects of tobacco are manifested at the level of the mouth, the smoker will be informed of its oral state.

Oral cancer

The predisposition to oral cancer is more pronounced from the age of 45 and the main risk factors are smoking, alcohol, sun, a poor diet, heredity, etc. Cancers of the mouth and throat have the particularity to evolve quickly and be fatal if they are not detected early. Regularly check the inside of your mouth and consult your professionals every year.

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DISCLAIMER : “Views expressed above are the author’s.”