Tooth Attrition

Tooth attrition is a type of tooth wear due to grinding between the opposing tooth. It results in loss of tooth structure specially in the occlussal surfaces. Tooth wear is considered as the common characteristic of ageing process . Pathological tooth wear occurs due to dental or some skeletal defect at very young age. And it requires treatment. Tooth wear is a dental condition where the surface and structure of teeth are progressively reduced as a result of internal and/or external forces placed upon them.

Excessive tooth wear causes many oral health complications, including unattractive and irregular tooth levels, jagged and sharp tooth edges, tooth pain and eventual loss of the teeth altogether. As the harder, outer surface of the tooth is worn away, the softer dentin will be exposed, speeding up the process.

There are preventative and corrective treatment options for patients experiencing tooth wear
issues. Treatment will vary based on the cause of wear and when it is detected, making it
critical to work closely with your doctor to proactively treat the issue before more
damage is sustained.

Symptoms of Tooth Attrition

  • Pain and sensitivity to hot and cold.
  • Loss of occlusal surfaces are seen.
  • Yellow shiny surface appears on the tooth surface due to exposed layer of dentin.
  • Wear facets are seen on posterior teeth.
  • Deep bite is common.
  • Altered occlusion due to decreased occlusal vertical dimenjsion.
  • Pain in the temporo mandibular joint due to clenching habit or traumatic bite forces.
  • Effect on the periodontal health.

Causes of Tooth Attrition

  • Grinding habits like bruxism.
  • Deep bite.
  • Reduced overjet or reduced overlap between the teeth.
  • It could be physiologic reduction that is related with ageing process.
  • Tooth wear due to excess acid reflux.
  • If an individual continuously clenches the teeth.
  • Temporomandibular joint problem.

Treatment for Tooth Attrition

  • The habit breaking appliance is used to break the habit.
  • If patient clenches the teeth unconsciously in night its advised to wear the night guard.
  • The wear facets are refilled back to get the normal tooth structure.
  • If sensitivity is there the patient is advised to use the desensitivity tooth paste.
  • Use of fluoride varnish or adhesive agents.
  • Root canal treatment is the other alternative to treat the sensitivity.
  • Correct the etiology like deepbite or some skeletal discrepancy if there by orthodontic treatment

Tooth Fracture

Tooth fracture is considered as a dental emergency if it involves the pulp. It causes severe pain to the patient. It is also known as cracked tooth syndrome. The fracture can be involving only the crown portion of the tooth or could extend to the roots.

Classification of Tooth Fracture

Tooth fracture is classified as crown fracture and root fracture.

Crown fracture is further classified as:

  • Ellis class 1- it involves only the enamel portion of the tooth.
  • Ellis class 2- it involves both enamel and dentin.
  • Ellis class 3- it involves pulp .

Causes of Tooth Fracture

  • Accidental injury.
  • Trauma due to occlusion.
  • Dental decay.
  • Biting something hard.
  • Traumatic bite.

Symptoms of Tooth Fracture

  • Sharp and shooting pain.
  • The pain arises on releasing the biting pressure.
  • Severe pain and sensitivity to cold stimulus is evident.
  • The fractured segments can be visible sometimes.
  • If pulpal involvement is there then bleeding is also seen.
  • The tooth can become mobile.
  • Pain on chewing food.

Diagnosis of Tooth Fracture

The tooth fracture is diagnosed by its nature of pain.The fracture line can be seen through radiographs. It is seen as the radiolucency.Another diagnostic instrument used is tooth sloth.

Treatment of Tooth Fracture

  • The fracture involving enamel or dentin are treated by filling and building the tooth structure.
  • The fracture involving the pulp is has to be treated by root canal treatment.
  • The mobile structures of tooth are stabilized.
  • Prognosis of root fractures are not so good and tooth has to be extracted if can’t be saved.

Tooth Decay

We have different kinds of bacteria that live in our mouths. These bacteria build a sticky film called dental plaque on the teeth. Tooth decay is the damage that occurs when these bacteria , that breed in the mouth produce acids, which can dissolve the layer under the plaque that protects the teeth. This production of acids takes place when we eat and drink. It removes the minerals from the enamel which if left without being treated and can lead to a hole in the tooth, which is commonly known as a cavity when left unnoticed for a long time. Decay begins in the central area of the tooth that is the enamel, and when the enamel breaks down, the decay goes deeper into the dentin and ultimately reaches the nerve or the pulp of the tooth.

Signs & Symptoms of Tooth Decay

  • Earliest sign is white chalky appearance on tooth surface .this is due to demineralization.
  • With further demineralization the tooth shows brownish black discoloration.
  • Loss of tooth structure or cavity formation.
  • Food enlodgement.
  • Sensitivity to hot, cold or sweets.
  • Pain occurs if pulpal infection is there.
  • Pain is throbbing and excruciating if pulpal exposure is there.
  • Tooth can fracture due to demineralization.
  • Bad breadth

Causes of Tooth Decay

  • Caries causing bacteria that are already present in the saliva.
  • Food resources that are rich in carbohydrates. The bacteria act on the fermentable carbohydrates and releases acid that demineralizes the tooth enamel.
  • Faulty eating habits like eating sugary or sticky food in between the meals.
  • Inefficient cleaning of teeth
  • Plaque deposits that are adhered to the surface of teeth
  • Malalligned teeth: angulated or crowded teeth does not allow proper cleaning and hence there are greater chances for caries to occur.
  • Dryness of mouth: reduced salivary flow

Classification of Tooth Decay

  • Class I – it involves occlusal surfaces of posterior teeth, buccal or lingual pits on molars, lingual pit near cingulum of upper incisors
  • Class II – it involves proximal surfaces of posterior teeth
  • Class III – proximal surfaces of anterior teeth excluding incisal edge .
  • Class IV – it involves interproximal surfaces of anterior teeth including incisal edge
  • Class V – it involves cervical third of tooth
  • Class VI – incisal edge or occlusal edge is worn away due to attrition

Prevention & Treatment of Tooth Decay

  • The tooth decay incidence can be decreased by maintaining the oral hygiene.
  • Restricting the sugary and sticky food intake in the diet.
  • Twice brushing your teeth with fluoridated tooth paste.
  • Fluoride application to the deep pit and fissures.
  • If cavity formation is there then it has to be treated by dentist , the decay is cleaned up and filled with a filing material.
  • The decay involving the pulp of tooth has to be treated by root canal treatment.

Tooth Pain

Tooth pain is the commonest orofacial pain. The pain in teeth can be very disturbing and requires treatment from dentist. It is regarded as a dental emergency. Tooth pain arises due to pulpal inflammation out of decay in the tooth, tooth fracture, hypersensitivity or any periodontal problems. The pain can be mild and moderate, extending to sharp shooting pain depending on the inflammation. The decay should be treated before it progresses even further causing inflammation to the pulp which could be reversible or irreversible pulpitis.

Causes of Tooth Pain

  • Dental decay or cavity.
  • Pulpal inflammation.
  • Dentin hyper sensitivity.
  • Tooth fracture or any injury.
  • Traumatic bite or chewing forces.
  • Periodontal problem.
  • Wisdom tooth eruption
  • Pericoronitis
  • Food enlodgement or impaction .
  • Dry socket formation after extraction of tooth.

Symptoms of Tooth Pain

  • The pain arising due to reversible pulpal inflammation is dull and triggered by stimulus.
  • The pain due to irreversible pulpitis is sharp and spontaneous.
  • The pain can be increased while sleeping.
  • Tooth abscess is often accompanied with swelling , fever.
  • Pain due to sensitivity arises on hot or cold stimulus which discontinues on the removal of stimulus.
  • Tooth having periodontal problem is tender on percussion .
  • Pain on biting is present

Diagnosis of Tooth Pain

The tooth pain can be diagnosed by using thermal tests like hot and cold. Otherways are taking radiographs that could be either single tooth or full mouth radiographs depending upon requirement.
Dental instruments can also be used to detect the cavity or perio problems.
Treatment and Prevention of Tooth Pain

  • The tooth pain arising due to reversible pulpal inflammation are treated by removing the cause or any decay and filling the tooth.
  • Root canal treatment has to be done for irreversible pulpitis .
  • Using fluorides and sensitivity tooth pastes to relieve sensitivity.
  • Treating the abscess by draining the pus.
  • Gum treatments if required.
  • Analgesics.

Gum Infection

Gum abscess is a localized collection of pus within the tissues of the periodontium. Gum abscess can be seen along or periapical to the tooth. Pus can either be diffuse to cause a gum infection. The abscess periapical to the tooth indicates the cause related with dental pulp necrosis. When the decay involves the pulp and the infection spread to periodontal ligament it causes abscess formation.

The gum infections are classified according to the involved state.

  • Gingival abscess—involves only the soft gum tissue near the gum line or the interdental area.
  • Periodontal abscess—involves area along periodontal ligament.
  • Pericoronal abscess- it involves the area along the impacted wisdom tooth.

Causes of Gum Infection

  • Dental cavity involving the pulp.
  • Gum infection like gingivitis.
  • Periodontitis
  • Injury to the gingiva by forceful food enlodgement or some hard objects like toothpicks ,bristles of toothbrush.
  • Impacted tooth can cause the formation of infection or abscess.
  • Trauma to the tooth by traumatic occlusion or accidental exposure.
  • Perforation to the periodontal ligament either accidental during root canal treatment or due to extended decay.
  • Bruxism habit
  • Systemic conditions like diabetes
  • If an individual has compromised immunity.

Signs and Symptoms of Gum Infection

  • Pain in the involved area.
  • The pain is excruciating and throbbing.
  • The tissue covering the abscess appears red and shiny.
  • The swelling is obvious intraorally orcan either be extraorally effecting the facial symmetry.
  • It can also cause mobility of the tooth.
  • An individual can often have high temperature.
  • The abscess swelling can be fluctuant .
  • The pus may sometimes drain and it gives foul smell and taste in the mouth.
  • The drained pus may spread to cause space infections and lymphadenitis.

Treatment for Gum Infection

  • The first line of treatment to manage gum abscess is to do the oral prophylaxis i.e scaling or deep cleaning.
  • If dental cavity is the cause of abscess it has to be treated by root canal treatment and proper debridement.
  • Antiseptic irrigation.
  • Drainage of the abscess is mandatory if it does not subsides.
  • Relieving the traumatic bite.
  • Use of antibiotics is secondary treatment; is opted if the abscess is accompanied with fever or some space infections.
  • And if prognosis is not good the tooth has to be extracted to drain the pus.

Tooth Mobility – Loose Teeth

Tooth mobility is the term used to describe loose teeth in the jaws or the alveolar bone. Tooth mobility of about 0.25 mm is present normally in all the individuals and is considered healthy . This mobility is termed as physiologic mobility.The reason for this mobility is that the tooth is not fused to the alveolar bone directly , but is attached to the sockets by the periodontal ligament. This slight mobility is to bear masticatory forces on the teeth while chewing without harming them.Milk (primary) teeth also become mobile. This is a natural process of exfoliation.This is caused due to resorption of the roots, stimulated by the developing permanent tooth underneath.

Causes of Loose Teeth

  • Trauma to the teeth caused by accidental injury.
  • Malocclusion : the trauma due to occlusion also results in tooth mobility. Conditions like deep bite or edge to edge relationship causes excess of chewing forces on the teeth.
  • Bruxism: is referred as the grinding habit of teeth either consciously or unconsciously.
  • Periodontitis: it is the gum disease
  • Gum recession
  • Gum abscess or periapical abscess
  • Cyst or tumour in the jaws.

Symptoms of Loose Teeth

Mobility is seen clinically by applying pressure with the ends of 2 metal instruments (e.g. dental mirrors or dental probe) and trying to move a tooth gently in front and back direction.

Grace & Smales Mobility Index

  • Grade 0: No mobility
  • Grade 1: mobility
  • Grade 2: 1mm but less than 2mm
  • Grade 3: 2mm or more or depressibility in the socket

Other Symptoms are :

  • Redness of the tissues around the tooth.
  • Pain or discomfort.
  • Difficulty in chewing food.
  • Tender gums.

Treatment for Loose Teeth

  • The mobile tooth can be treated by treating the cause first .
  • Relieve the traumatic occlusion and correct the bite.
  • Treat the tumour or cyst
  • Treat the gum infection by proper cleaning and curettage
  • Correction of the reduced bone level by adding the bone grafts.
  • The grade 2 or grade 3 mobility can be corrected by splinting the loose tooth and restricting any movement.
  • If prognosis is poor then the loose tooth has to be extracted and replaced by dental prosthesis.

Single Visit Root Canal

Single sitting root canal treatment is a new advance in dentistry, which has made root canal treatment absolutely painless.This Single visit Root Canal treatment is done to avoid multiple injections & visits, thus reducing the patient FEAR.This is extremely comfortable & less time consuming.

When is Single Visit Root Canal Required

  • Dental caries is moving towards the nerves of the mouth.
  • An injury has occurred in the teeth and it is at exposure to the nerve.
  • A severe sensitivity of the teeth is making it impossible for the patient to consume hot or cold liquid and even food items.
  • Acute infection with no pus accumulation in & around the tooth.
  • Non- Vital Tooth. Previous accidental traumatized history, particular front teeth .

Advantages of Single Visit Root Canal Treatment

  • Absolutely painless procedure.
  • Reducing the patient anxiety.
  • Less traumatic for the patient
  • Less time consuming.
  • Avoid multiple injections .
  • Avoid multiple visits.
  • Affordable and Cost.


Gum Plaque and Calculus

Plaque is the sticky, colorless film that continuously gets adhered to the teeth surface. Bacteria grows in plaque and secrete acids that cause dental decay and inflamed gum tissue. This plaque if not removed regularly by brushing and flossing, over time it hardens to form calculus .Now this Calculus cannot be removed with a toothbrush by your self ; it has to be removed by a dental professional via method called scaling .

This plaque usually accumulates along the gum line and in future results in supragingival calculus and extend below the gumline to form subgingival calculus. All individuals have plaque because bacteria are present in mouths ; you cannot see it but it is there.

Calculus, unlike plaque, is visible through naked eyes, particularly on the inner surface of lower front teeth. It looks like a hard yellow or brownish deposit. Calculus can only be removed by a professional cleaning by a dentist.

Causes of Dental Plaque and calculus

  • Inefficient brushing of teeth results in food deposits and plaque on your teeth surface.
  • Not flossing your teeth.
  • Using a weared toothbrush- one should switch to a new toothbrush if its weared off and its bristles become flared .
  • Eating lots of starchy food- it changes the pH level of the oral cavity and causes the bacteria to ferment those deposits and release acid.
  • Skipping proper rinsing of your mouth after having meals.
  • Deep groves and fissures in your teeth causes more food enlodgement.

Precautions taken at home to avoid plaque and calculus are:

  • Brush twice daily for a minimum of 2 to 3 minutes
  • Flossing the interdental spaces daily to remove plaque from in between teeth where your toothbrush is unreachable.
  • Smart munching –go for snacking which is sugarless and non starchy
  • Avoid sticky foods like chocklates and pastries
  • Using mouth washes to rinse your oral cavity

Symptoms of Dental Plaque and Calculus

  • Plaque is invisible to your naked eyes and generally is adhered along the gum line.
  • It feels like slimy layer on the teeth surface.
  • Plaque hardens to form calculus which can be seen .
  • Calculus is seen as hard chunks along the gum line ; and is yellow or brown in colour.
  • This is accompanied with redness of gums or bleeding.
  • It can often cause gum recession also.

Treatment for Dental Plaque

  • The first line of treatment is to get a thorough cleaning done by a dentist and then maintain the oral health by brushing twice daily at your home.
  • Cultivate the habit of flossing and rinsing your teeth.
  • Ask your dentist if some pit and fissure sealant is required to seal your deep groves on the teeth.
  • Switch to smart munching in between the meals.
  • Avoid excess of sugary and starchy food.
  • Once in a six months have a visit to your dentist.

Treatment for Bad Breath

Bad breath is medically called halitosis. It is a result of poor oral habits and could also be a sign of other health problems especially stomach related problems. Bad breath can also depends on the type of food you eat on a regular basis and other unhealthy habits. Persistent bad breath could also be a warning that it could lead to gum diseases. If you don’t brush and floss teeth daily, food particles can remain in the mouth, promoting bacterial growth between teeth, around the gums, and on the tongue causing bad breath .In most cases of persistent bad breath , the smell occurs from a growth of germs (bacteria) within the mouth. These are in food debris, in plaque and gum disease, or in a coating on the back of the tongue.

Causes of Bad Breath

  • Poor habits like skipping brushing or improper brushing.
  • Deposits like plaque , calculus or food left uncleaned on teeth.
  • Bacterial growth over these deposits.
  • Deposits over the tongue.
  • Gum infection or abscess
  • Periodontal problems
  • Poorly fitting dental appliances.
  • Dental caries with food enlodged.
  • Unclean dentures.
  • Dry mouth syndrome.
  • Some systemic diseases like diabetes , upper respiratory tract infections.
  • Acidity or gastric reflux.
  • Smoking
  • Certain food items like garlic, onion etc.

Symptoms of Bad Breath

Many a times a person is not aware of the bad breath coming from his mouth and some people have the misconception that they possess the bad breath. So to get a clear cut knowledge one has to get a dental visit.

Some people suggest a simple test which you can do yourself to detect bad breath. Lick the inside of your wrist. Wait a few seconds for the saliva to dry. Then smell the licked part of the wrist. If you detect an unpleasant smell, you are likely to have bad breath.

Morning Bad Breath

Most people have some degree of bad breath after a night’s sleep getting up in morning .This is not abnormal and occurs because the mouth tends to get dry and stagnate overnight. This usually clears when the flow of saliva increases soon after starting to eat breakfast.

Household Remedies for Bad Breath

  • Proper brushing twice daily ;morning and before going to bed.
  • Flossing interdental areas and rinsing with mouth wash after meals.
  • Drink lot of water : helps in proper salivary action thus keeping mouth moist and having self cleansing action.
  • Chewing sugarless chewing gum.
  • Avoiding smoking.
  • Avoiding food items that causes bad breath like garlic , onion etc.
  • Cleaning your tongue and dentures.

Treatment for Bad Breath

  • Bad breath can be treated by getting a professional cleaning done by dentist.
  • Treating the cause of bad breath like any systemic diseases.
  • Treating any dental cavities.
  • Treating gum diseases

If you are suffering from Bad breath our team of expert dentists would be happy to help. You can book an appointment online or call us.

Gum Recession

Gum recession is characterized as retraction of gum line from its position so that it leads to exposure of root portion of the teeth. Gum recession depends upon the bone level i.e., level of the alveolar bone and hence the attached gingiva. It can be affecting one tooth to multiple teeth in the mouth depending upon the severity.

Common Causes of Gum Recession

  • Poor oral hygiene practices
  • Improperly aligned teeth
  • Aggressive brushing
  • Flossing vigorously
  • Faulty habits like digging sharp objects
  • Alveolar bone loss
  • Loss of attachment of gums to the underlying bone
  • Trauma due to occlusion
  • Periodontitis
  • Piercings on the lip and tongue.
  • Grinding of teeth (bruxism)
  • Hormonal changes (especially during pregnancy)

Symptoms of Gum Recession

  • Gum recession can lead to sensitivity of the teeth, to hot or cold food due to exposed root surface.
  • Tooth loosening into its socket.
  • Caries into the cervical area of the teeth due to food or plaque getting enlodged in the gap between the tooth and the gums.
  • Teeth appear longer due to exposed root surface.
  • Gum bleeding while brushing or flossing.
  • Bad breath.
  • Abrasion of teeth.
  • Smoking and tobacco products.

Home Care for Gum Recession

  • If aggressive brushing is the cause, please follow a proper brushing technique.
  • Vigorous movements wile brushing should be avoided. Proper flossing and dental care must be followed.
  • Improving oral hygiene is a very important step in maintaining good gum health.
  • Following a strict maintenance program is advised.

Treatment for Gum Recession

Treatment of the gum recession depends upon the etiology and severity of the condition and it can be corrected various ways.

  • Regular dental visits are important. Teeth must be cleaned thoroughly by a dental professional.
  • Control accumulation of plaque and calculus.
  • Smoking and use of tobacco products must be stopped.
  • Correction of malocclusion by orthodontic treatment.
  • Correction of tooth brushing technique.
  • Dentinal sensitivity must be treated.
  • Treat occlusal trauma
  • Restorations of teeth.
  • Prosthesis, if needed.
  • Prevent further progression of recession.
  • Surgical procedures are initiated by placement of graft over the exposed surfaces of the root.