BAD BREATH

Bad breath can be observed early mornings, late afternoons/evenings or after you eat some specific food items.
Garlic, onions, coffee, etc. can cause bad smell from your mouth. They cause instant bad odour from the mouth just after eating. Drinking water, brushing or having a mint will make the mouth fresh again.
Early morning, the bad breath which is observed is caused by the bacteria which have been in your mouth for the entire night. The bad breath is more if you don’t brush at night. The bacteria digest the food and release chemicals which cause this bad smell.

Bad oral hygiene results in bad smell from your mouth. Improper and incorrect methods of brushing or skipping brushing or brushing only once a day, will result in accumulation of food particles between teeth where brush is unable to reach on a daily basis. This harbours millions of bacteria. These bacteria start to break down the food and release substances which result in bad breath from the mouth.
A round of cleaning should be done. Once supra-gingival deposits are removed, the sub-gingival deposits should be evaluated and if required deep cleaning should be done. Once your oral hygiene is restored, you will experience fresh breath.
Another cause of bad breath could be increased acidity in the stomach. People who complain of acidic burps, heart burns, regular vomiting episodes etc and suffer from bad breath, should get a consult with a gastroenterologist after ruling out any dental cause.

If your bad breath is only after eating some specific foods then you should brush your teeth after your meal (ie after eating onions / garlic / egg / coffee, etc.)
If you are suffering from bad breath which increases by the end of the day irrespective of the food you eat, then you should visit your dentist and rule out any dental deposits / problems. The dentist may advice a round of cleaning and evaluate your gums to check for any deep seated infection. Depending on the extent of infection, there may be associated pus formation and bone loss which might require a round of sub-gingival cleaning to make sure all such deposits are removed. Another dental reason for bad breath could be a decayed third molar which is attracting food lodgement and is infected. Accumulation of bacteria in the infected site could lead to pus formation which in turn can cause bad breath.
After ruling out all the dental issues, if the bad breath still persists, a consult with a gastroenterologist should be planned. Get a check-up for acidity issues and GERD, etc.

BLEEDING GUMS

Bleeding gums are a common finding in people with bad oral hygiene. The bleeding could occur while brushing / while eating / or could be spontaneous.

Why does bleeding occur?

Inefficient brushing results in accumulation of food on the teeth along the gum line. This food, forms a faint yellow layer on the tooth, called plaque. When this accumulation continues over some time, a thick hard band is formed at the neck of the tooth, called calculus (white-yellow) / tartar (brown-black). Since it is food it harbours lot of germs in it. These germs easily enter the neighbouring gums & cause infection. As a protective response the gums swell up & pool in a lot of blood in them to fight this infection. Since the gums becomes so delicate now, the moment your brush touches it or when you bite an apple, they start to bleed.
Spontaneous bleeding is a sign of more progressed infection.

Infection in my gums?! , but I don’t have any pain??

Most of the people don’t experience any pain in their gums. Pain arises when the pressure inside a tissue increases due to building infection. Unlike your teeth which is a hard tissue, gums due to their loose nature easily dissipate this pressure around & no pain is felt.
Until & unless the infection is very acute & a visible prominent swelling is seen, gums won’t pain. Even if they do, the pain will be mild & dull; hence people tend to ignore it.

What do I do for my bleeding gums??

If your gums have started bleeding, your first step should be to go to a dentist & get your teeth cleaned. A full mouth cleaning should be done. Make sure that once the cleaning is done you yourself evaluate it properly. Ask your dentist to show you your teeth after cleaning through a mirror. Learn the correct way of brushing & flossing and ask your dentist if he suggests any other aides that would help you keep your teeth & gums healthy.
Once the superficial cleaning is done, you may get a full mouth x-ray to check whether any deposits are present inside your gums. In case there are, a round of deeper form of cleaning (sub-gingival scaling & root planning) may be required. A gum specialist will be the ideal person for this procedure.

I brush my teeth twice a day, but I still have these deposits??

Since our teeth are not flat, food can easily get stuck in the grooves & depressions in our teeth, especially in the area between 2 teeth & along the gum line. Usually people brush once a day, on top of that it is difficult to efficiently clean the back teeth & the inner surface of each tooth. So, some bit of food always tends to stay back in our teeth. When this happens daily, over a period of time, plaque would accumulate on your teeth, leading to bacterial accumulation & hence infection.
The part where you can play a role is brush twice a day & efficiently. Use floss alternate day or thrice a week to clean from in-between your teeth. You may use mouthwashes, for extra assistance. This would make sure that 70-80% of your teeth are clean & minimum deposits have accumulated. For the remaining 20-30% deposits, which are still there, we dentists step in & perform professional cleaning for your teeth. This ensures minimal damage to your teeth & gums and earliest treatment for any infection present.
A simple superficial round of cleaning would take around half an hour. Try & take out an hour for your teeth once in 6 months & then chill for the remaining 6 months. Too much to ask??

LASER DENTISTRY

A dental laser is a type of laser designed specifically for use in dentistry. Advances in technology have evolved dentistry into a cutting edge experience for everyone. With the evolution of Dental Lasers one can be rest assured that your dental care will consist of shorter procedures, especially if no anaesthetic is needed. Dental lasers offer minimal or no intraoperative and post-operative discomfort. Dental Laser is used by a trained and certified gum specialist.

What is laser and how does it work?

A laser is an instrument that produces a very narrow, intense beam of light. It is a technology which delivers energy in the form of light. This form of energy can be used in various dental procedures. Depending on the wavelength of light used, laser can be of two types – soft tissue laser and hard tissue laser.
Soft tissue laser (diode laser) is the most commonly used laser as it is easy to use and completely safe. It is used to treat various gum related problems.

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What all procedures can be performed with the help of laser?

We offer a variety of procedures performed by our expert under laser =
• Laser bacterial reduction
• Periodontal pocket reduction
• De-pigmentation of the gums
• Crown lengthening / gum re-contouring
• Laser bleaching (laser assisted teeth whitening)
• Laser Assisted New Attachment Procedure (LANAP)

Along with the above mentioned, minor procedures like – biopsies, frenectomy (removal of excess muscle attachments), excess gum removal, hemostasis (control bleeding in surgical procedures), soft tissue curettage, operculectomy (removal of gum tissue on top of wisdom teeth), treatment of major mouth ulcers, etc are also performed.

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Laser bacterial reduction = removal of infected or swollen tissue from inside the gum lining along with removal of deep seated calculus and deposits which cannot be removed with simple cleaning. Removal of infected tissue assures minimal bacterial activity and quicker healing.

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Periodontal pocket reduction = use of laser for debridement and disinfection of periodontal pockets (periodontal pockets are formed due to weak and infected gums and if untreated result in a loose mobile tooth). Their ability to form fibrin (important for healing) allows them to seal treated pockets.

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De-pigmentation = lasers are well absorbed by melanin pigment in tissues (which are responsible for the colour of the gums). Hence, these lasers can be used for cosmetic depigmentation of gums (making your gums more pink).

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Crown lengthening / Gum re-contouring = laser acts like a cutting instrument for tissue. It is increasingly being used in place of electro-surgery and standard surgery for gum contouring and gum size reduction. It is completely safe, easy to use, does not involver bleeding or pain and results in quicker healing.

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Laser bleaching = since laser is a source of heat, it enhances the effects of in-office bleaching / tooth whitening. In this a peroxide bleaching solution is applied on the tooth surface and activated by laser energy. This speeds up the whitening process.

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Laser assisted new attachment procedure (LANAP) = LANAP is a surgical therapy designed for treatment of gums (periodontal pockets – formed in infected gums and if left untreated lead to tooth loss) through regeneration rather than resection. Since laser energy is selective for diseased tissue, the infected part of the gums is removed and the underlying healthy tissue is spared. This permits healthier healing and regeneration as compared to other
standard procedures.
Advantages are minimal post-operative pain, bleeding, swelling, gum recession and root sensitivity. Healthier post operative status with use of laser, results in reduced risk of dental decay in future.

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What are the benefits of using laser in dentistry?

Treatment with laser involves no or minimal pain, allowing the patient to enjoy a more relaxed dental experience. Treatments are more precise and healing is faster. It reduces the amount of bacteria and infection considerably. There is minimal and controlled bleeding during and after the procedure and minimal post-operative swelling.

Are dental lasers safe?

Yes. If the correct wavelength of light is used, it is as safe as other dental instruments. However, when your dentist performs a laser procedure, you will be asked to wear special eyeglasses to protect your eyes from the laser.

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How much will it cost me?

Depending on procedure to procedure the cost is determined. Laser charges are 25% – 30% higher that their counterpart standard procedures.

SCALING

Preventive healthcare (alternately prophylaxis) consists of measures taken for
disease prevention, as opposed to disease treatment.

Oral Prophylaxis (Teeth Cleaning / Scaling)
A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.
Oral prophylaxis is a dental procedure that removes tartar and plaque build-up from the teeth through scaling and polishing. It is different from teeth bleaching procedures because its purpose is to keep your gums healthy, stop tooth decay or other dental issues. Through the process, the dentist normally cleans the surfaces of the teeth. It is not considered to be an aesthetic procedure.

How is it done?

Special equipment called automatic scalers are often used to perform oral prophylaxis. Sonic scalers deliver water and compressed air through a hose into a handheld unit. The air pushes the water out in rapid cycle to clean the teeth and area below the gums. Ultrasonic scalers use energy waves to clean the build-up. It is an easy procedure which is completely painless and safe.

When is it required?

Ideally cleaning is advised every 6 months. Some people choose to undergo this process every 3-4 months because they are trying to fight tooth decay, gum disease, or staining. The procedure is also recommended every 4-5 months for someone getting braces or other orthodontic work.

Why is it required?

Periodontal disease and gingivitis occur when bacteria from plaque colonise on the gingival (gum) tissue, either above or below the gum line. These bacteria colonies cause serious swelling and irritation which in turn produce an infectious response in the body. As a result, in order to protect itself, the body begins to destroy the infected gum and bone tissue, making the teeth loose, becoming unstable, or completely falling out. The pockets between the gums and teeth become deeper and may house more bacteria.

Benefits of prophylaxis/teeth cleaning 

Prophylaxis is an excellent procedure to help keep the oral cavity in good health and also halt the progression of gum disease.

Here are some of the benefits of prophylaxis:
• Tartar removal – Tartar (calculus) and plaque build-up, both above and below the gum line, can cause serious periodontal problems if left untreated. Even using the best brushing and flossing home care techniques, it can be impossible to remove debris, bacteria and deposits from gum pockets. The experienced eye of a dentist using specialised dental equipment is needed in order to spot and treat problems such as tartar and plaque buildup.
Aesthetics – It’s hard to feel confident about a smile marred by yellowing, stained teeth. Prophylaxis can rid the teeth of unsightly stains and return the smile to its former glory.
Fresher breath – Periodontal (gum) disease is often signified by persistent bad breath (halitosis). Bad breath is generally caused by a combination of rotting food particles below the gum line and periodontal problems. The removal of plaque, calculus and bacteria noticeably improves breath and alleviates irritation.

Identification of health issues – Many health problems first present themselves to the dentist. Since prophylaxis involves a thorough examination of the entire oral cavity, the dentist is able to screen for oral cancer, evaluate the risk of periodontitis and often spot signs of medical problems like diabetes and kidney problems.

Types of scalings performed:

Prophylaxis is generally performed in several stages:
1. Supragingival cleaning – The dentist will thoroughly clean the area above the gum line with scaling tools to rid them of plaque and calculus.
2. Subgingival cleaning – This is the most important step for patients with periodontal disease because the dentist is able to remove calculus from the gum pockets and beneath the gum line.
3. Root planing – This is the smoothing of the tooth root by the dentist to eliminate any remaining bacteria. These bacteria are dangerous to periodontitis sufferers, so eliminating them is one of the top priorities of the
dentist.
4. X-ray and examination – Routine X-rays can be extremely revealing when it comes to periodontal disease. X-rays show the extent of bone and gum recession, and also aid the dentist in identifying areas which may need future attention.

Prophylaxis is recommended twice annually as a preventative measure, but can also be performed every 3-4 months on periodontitis sufferers. Though gum disease cannot be completely reversed, prophylaxis is one of the tools the dentist can use to effectively halt its destructive progress.

SMOKING

Does smoking affect my teeth??

Smoking harms your teeth and gums. It makes your mouth dry, you experience bad breath, lowers the capacity of your gums to fight infection and increases chances of cavity formation. Prolonged smoking may cause mouth cancer and various other diseases.

How will smoking harm my gums??

The nicotine in the cigarette causes constriction (shrinkage) of the blood vessels present in your gums.
The blood vessels present in the gums supply blood to the gums and help them stay healthy and fight any kind of external bacterial infection. Blood contains lot of enzymes and fighting cells which are required to maintain a healthy state of the gums.
Nicotine shrinks the blood vessels such that the vessels are not able to supply the normal quantity of blood to your bone and gums.This means the gums are not able to fight this infection and the bacteria will in turn keep damaging your gums. Thus silently the gums will get destroyed without the knowledge of the patient. It can continue to the extent that the tooth loses total support and ultimately starts shaking.

Can smoking cause cancer??

Smoking primarily causes cancer of the lungs, respiratory tract, throat and mouth. The nicotine causes changes in the cells of these areas which leads to cancerous growths.
Mouth cancer spreads faster and is difficult to control. Not only smoking, but use of other tobacco products like tambaku, gutka, masala, etc. will result in similar cancerous results.

I have quit smoking, can the effects of smoking be reversed?

Once you completely quit smoking the effects of smoking may get reversed. It will not happen overnight but slowly the tissues of cheeks and gums will try and repair themselves.