Oral Care

Geographic Tongue

August 19, 2013 by Dr.Deepak 1 Comment

Geographic tongue, also known as benign migratory glossitis or oral erythema migrans is a harmless condition that affects the surface of your tongue. Although geographic tongue may look scary to you, it doesn’t cause any serious health issues and is not usually associated with any infections or cancer. But who wants that scary looking white patches and cracks no matter how harmless they are.

Who gets geographic tongue?

About 2-3% of the world population is affected by geographic tongue. It can affect any age groups but commonly seen in adults. Females are twice more likely to be affected than males.

What causes geographic tongue?

The exact cause of geographic tongue is not known, although vitamin B deficiency and infection (viral, bacterial or fungal) may be involved. It has also been associated with psoriasis and fissured tongue. Few cases tend to run in families too. Although not a definitive cause, hot and spicy foods tend to aggravate the condition. This condition is less commonly seen in smokers.

Signs and symptoms of geographic tongue

Although some patients may have no symptoms at all, burning sensation and irritation of the tongue are common, especially with hot or spicy foods. In women the discomfort may worsen during menstrual cycle and pregnancy. Although the lesions are localized to the tongue, they can also arise elsewhere in the mouth.

Some common signs and symptoms are listed below:

Irregular red patches surrounded by white line giving map-like appearance of the tongue.
Patches tends to move to different areas of the tongue at different times.
Burning sensation and irritation of the tongue

There are several other conditions that can have similar signs and symptoms, so it is very necessary to visit the dermatologist or oral specialist and confirm the case. Some other conditions that may resemble geographic tongue are listed below:

Oral candidiasis
Stomatitis
Lichen planus
Fissured tongue
Tongue cancer
Chemical burn
Plague psoriasis

Geographic tongue treatment

Geographic tongue will get better after few weeks or months. If you have irritation or burning sensation you may take over the counter painkillers and topical mouth paint that can ease the pain and discomfort. Avoid foods and drinks that make your symptoms worse like acidic, hot and spicy foods and drinks. Visiting a doctor or oral specialist is the best way to rule out other serious conditions. Your doctor will diagnose the condition and prescribe medications accordingly.

Common medications used in symptomatic geographic tongue

Over the counter painkillers
Anti-inflammatories
Corticosteroids paint applied directly on the lesion
Zinc supplements and vitamin B complex
Mouth washes containing anesthetic agents

For symptoms to subside quickly you may need to limit acidic, hot and spicy foods or any other substances that irritates you. Some toothpaste contains additives, whitening agents that may irritate the lesion, if this is the case, avoid it.

Geographic tongue cure
There is no cure for geographic tongue, most tends to subside by themselves and never come or may come and go; medications are targeted in relieving the pain and discomfort.

Can geographic tongue turn into cancer?
There has been a major concern about the tongue cancer and geographic tongue but the good news is that geographic tongue usually don’t turn into cancer.

Cracked Tongue or Fissured Tongue – Should You be Worried?

August 18, 2013 by Dr.Deepak 2 Comments

Have you ever worried because you have cracked or fissured tongue? Don’t worry, you are not alone, millions of people around the world have it. The good news is that this condition is often harmless and is usually considered as variant of normal tongue architecture. Although tongue fissures are harmless it is wise to visit the doctor or oral specialist and confirm the case before making decision by yourself.

What is fissured tongue or cracked tongue?

Fissured or cracked on tongue simply denotes a harmless condition of the tongue where there are shallow or deep cracks, grooves or fissures on the surface the tongue. Fissured tongue is also called as scrotal tongue or lingua plicata. Although tongue fissures are often diagnosed in adulthood, it can also be seen during childhood. As we grow fissured tongue seems to be more prominent and severe (with increasing age). Men are more affected than females.

Fissured Tongue Causes

The exact cause of fissured tongue is unknown. Experts suspects it may be inherited or may be associated with certain conditions. It is sometime seen in Down syndrome, Melkersson-Rosenthal syndrome and oro-facial granulomatosis. It is also associated with pustular psoriasis and geographic tongue.

Signs and symptoms of fissured tongue

Most of the cases of fissured tongue may be asymptomatic unless derbis builds up in these fissures. Fissured tongue mostly affects top surface of the tongue that sometimes extends out to the edges of the tongue. The depth and size of the fissures varies, it may just be shallow or as deep as 6 mm in diameter. When large and prominent, the fissures or grooves may connect with each other separating the tongue into different sections or lobules.

Fissured Tongue Pictures

How is the diagnosis made?

Diagnosis is usually made with just direct visual examinations. Your dentist or healthcare provider may spot it initially. No other tests are required but your doctor may check for possible association if any.

Fissured Tongue Treatment

There is no specific therapy or medications for fissured tongue. As this condition is harmless, no treatment is required besides cosmetic concern. If bad breath, infection or any other symptoms are experienced due to debris collection on fissures, it is advised to brush the top surface of the tongue regularly. This will eliminate any derbis in the fissures and help prevent infection and bad breath. Make sure to hydrate yourself with plenty of water and avoid excessive spicy and hot food if it bothers you. If tongue fissuring was due to infection, your doctor will provide the medications accordingly.

If your tongue fissures are painful or if there is any bleeding and other associated signs and symptoms, visit the doctor immediately. He/she will evaluate the case and manage accordingly. Don’t try to diagnose or treat yourself just because you have seen some pictures or fissured tongue remedies on the net. Before treating it by yourself make sure you are doing it the right way so you don’t have to regret later.

In most of the cases fissured tongue or cracked tongue is nothing to worry about. Just make sure to confirm the case with the oral specialist and maintain good oral hygiene.

How Does Laser Teeth Whitening Work?

July 28, 2013 by Dr.Deepak Leave a Comment

For those looking for a quick solution for their teeth whitening problem; laser teeth whitening could be a very good option. Laser teeth whitening is new and fascinating procedure. It is considered as a much quicker procedure than other conventional methods and provides immediate. You will notice a change on the color of your teeth immediately after the procedure.

There are tons of teeth whitening products on market, not all gives the same results and almost every whitening product takes times. So to accelerate and enhance the whitening effect heat activation of the bleaching agents by lasers are being introduced. They works by providing heat in the process of whitening resulting in quick break up of the highly pigmented carbon areas.

On normal condition laser assisted teeth whitening procedure last around 45 minutes including general examination of the teeth for any problems like caries, periodontal problems, endodontic problems, enamel cracks and fractures, oral hygiene etc. After reviewing your oral status and if you are a candidate for tooth whitening, initial preparations are done which are listed as below.

Your doctor will place cheek and lips retractor to facilitate the process
Initial photographs are taken for before and after results
Teeth pre-treatment like removing stains, plaque and debris is done in order to increase the effectiveness of lasers, as they may interact with the bleaching agents and reduce the effectiveness of lasers.
After the pre-treatment procedure is complete saliva aspirators and bite block are placed
Gingival protectors are placed in order to protect teeth from unwanted bleaching agents and lasers to surrounding soft tissues.
The teeth and gums are dried and bleaching gel is applied to the area.
After application of bleaching gels, teeth are than irradiated with lasers light at 20 second interval for each tooth and is repeated 2-3 times for every tooth.
After the laser irradiation is complete, the bleaching gel is removed and the area is rinse with water spray thoroughly
The color is checked and compared with the previous photograph and if the results are not desirable procedure may be repeated again immediately.
After the desired results are achieved, teeth are gently dried and after procedure photograph are taken.
Now you are ready to go home.

Remember:

You may not drink or eat any colored drinks and foods for at least 72 hours after treatment. This may include smoking, coffee, tea, coke, red wine etc.
If the results are just satisfactory and not as you desired to be, the treatment can be repeated after 2 or more weeks.

Teeth Whitening Products

July 27, 2013 by Dr.Deepak 2 Comments

There are significant numbers of teeth whitening products available in the market. They are marketed in different forms including toothpaste, gels, paint-on-products, strips and mouth guards. These products generally improve your tooth color by two mechanism; tooth bleaching and removal and control of stains.

Tooth whitening products are primarily based on hydrogen peroxide or carbamide peroxide. These hydrogen peroxide teeth whitening or carbamide peroxide teeth whitening usually involves the application of the products in the form of toothpaste, gels, etc. once or twice daily for around 2 weeks, depending on dose and exposure time. Studies has demonstrated that this whitening effects may lasts up to 12 weeks or longer, depending on the product used and personal hygiene.

It is believed that these products diffuse into the enamel and dentin and oxidize a variety of organic and inorganic colored compound leading to reduction in tooth color and giving rise to whiter teeth. To maximize the result and a give better white teeth these products especially toothpaste, also contains optimized abrasive ingredients for cleaning.

These cosmetic dentistry treatments were previously administrated by professionals but are now increasingly available for in-home use. Some of the common ingredients used on these teeth whitening products are listed below.

Abrasives Agents

Hydrated silica
Calcium carbonate
Sodium bicarbonate
Calcium pyrophosphate
Alumina
Perlite

Chemical Agents

Hydrogen peroxide
Carbamide peroxide
Calcium peroxide
Sodium citrate
Sodium pyrophosphate
Sodium tripolyphosphate
Sodium hexametaphosphate
Papain

Optical agents

Blue covarine

In order to deliver a quick whitening effect, silica whitening toothpaste containing blue covarine are developed. Research shows that toothpaste containing blue covarine may reduce tooth yellowness and whitens the tooth immediately after a single brushing. Blue covarine alters the optical properties of the tooth by primarily giving a yellow to blue color shift which has been shown to aid whiteness perception.

Teeth Whitening Side Effects

Teeth whitening products are generally regarded as safe, but some temporary teeth whitening side effects like tooth sensitivity and gingival irritation may occur from these procedure which may last for few days before they disappear. Research has shown that application of fluoride in conjunction with whitening products could effectively reduce tooth sensitivity. No long lasting side effects has been reported in clinical studies.

Laser Assisted Teeth Whitening

For those looking for quicker solution to teeth whitening, laser assisted teeth whitening may be a good option.

Tips to Avoid Tooth Decay in Children

June 1, 2012 by Avinav Leave a Comment

Cavities are one of the worst things that could happen to your teeth. If you don’t take good care of your teeth from an early age; it could cause some very harmful effects. You’ll have to deal with the pain that tooth decay give you, treatment, the costs involved and all those days off work. For kids, cavities are more commonly noticed before they enter their teenage years. In terms of keeping your teeth in good dental health, you need to follow some of the tips we are going to be talking about in order to avoid tooth decay in children. As parents, you might also want to make sure that your kids are following these tips.

Tip #1 – Just like you maintain your hair and skin, your teeth need to be taken care of as well. Follow a good dental hygiene routine, where you brush a minimum of two times a day. It is actually recommended by dentists to brush and floss in-between meals as well. When you are able to take good care of your teeth, you will be able to avoid tooth cavities and tooth decay, which all arise from the creation of plaque. Additionally, you should be using a proper toothbrush and toothpaste. The toothpaste should have fluoride, which is the single most effective ingredient that helps remove plaque from your teeth.

Tip #2 – There are dental shields that you can use on your teeth, so that you can avoid the formation of plaque. The bacteria in your mouth will always be interactive with food particles, so you could use dental sealants on the biting surface of each tooth. If you are interested in getting sealants for your teeth, you should talk to your dentist, as there is a small treatment that goes along with it.

Tip #3 – The types of food you eat makes a huge difference on the health of your teeth, so always eat nutritious foods. Fruits and vegetables have a considerable level of natural ingredients, so it not only is beneficial for your health but for your dental health as well. Calcium is a well known addition for the growth of strong teeth, so make sure to have enough milk each and every day. You could also eat other calcium rich foods such as cheese, which is also made from milk.

Tip #4 – One of the reasons why tooth decay and cavities come about is because of the formation of plaque. If you can fully avoid the creation of plaque; you would be able to prevent cavities. When your mouth is dry, plaque formation is expected to take affect at a much faster rate. To ensure that plaque does not start to form, you should always keep your mouth fresh with liquids such as water. If you don’t want to be drinking water every few hours, you should think about chewing sugarless gum.

Lastly, you should take some time out of your day to visit the dentist every six months. I know you may be thinking that there is nothing wrong with your teeth, but not all dental changes are visible. Going through routine checkups is beneficial for your own health, so try to be on the safe side.

How to Whiten Teeth at Home

May 12, 2012 by Zenisha Leave a Comment

Ever wondered, how to whiten teeth at home? Well, there are tons of teeth whitening products in the market today, but knowing which one would work for you is the real question. To be honest, it is actually beneficial to read reviews on the various teeth whitening products which can be used at home, because only then would it be easy for you to know which whitening product would work best. For some people who have sensitive gums, it is important that you read the ingr

edient that goes into the whitening solution. Some gels may be a little hard on the gums, so it is important that you test out any product that you are going to be using. Now, it is important that you consider all the best teeth whitening products before you actually choose one.

Paint-on Teeth Whitening – This is one form of teeth whitening solution that many people have tried and prefer over others, because it is quite simple to use. The Colgate paint-on teeth whitener is known as Simply White. The whitening agent that helps clean your teeth is known as peroxide solution, which is what the paint-on product is added with. The peroxide based paint on solution should be kept on your teeth for a minimum of thirty minutes, and you will begin to see color changes within the first six weeks of continuous use. If you skip days in between, it will not have the best effect on your teeth.

Teeth Whitening Strips – One of the very popular whitening strips known as Crest White strips has been around for several years now, and they do seem to work quite well. The white strips are coated with peroxide solution on one side. This side is to be placed against your teeth, on both the bottom and top. You should leave the strips on your teeth for at least thirty minutes, and within this time; it will automatically dissolve with your saliva. Before applying the teeth whitening strip, you should first brush and floss your teeth thoroughly. This would ensure the best results in the end.

Teeth Whitening Trays – A good solution for some people, but could get a little messy at times. When home teeth whitening solutions were brought to the market, the teeth whitening tray was the first one. The tray has a peroxide whitening system which whitens your teeth, within six to eight weeks. Some people dislike using teeth whitening trays, because it really is a lot more work. If you are looking for a simple solution for whitening and cleaning your teeth; you might want to consider teeth whitening gels, pens and strips.

A newly launched teeth whitening pen is the Idol White system, introduced by the Kardashian sisters. The Idol White teeth whitening pen has been proven to be both safe and effective for people who have yellow teeth. The pen uses a peroxide cleaning agent mixed with several harmless chemicals to give you that dazzling bright smile. In essence, there’s tons of tooth whitening options available in the market to whiten teeth at home, so you should do some research before buying into any one of them.

How to Cure Receding Gums

May 10, 2012 by Zenisha 1 Comment

Do you have receding gums? If you do; you would have to meet with a periodontist, who studies teeth structures and any form of disease that affects it. Receding gums are easy to spot, especially when you are brushing your teeth. Receding gums are those in which the margin of the tissue that covers the teeth wears away towards the base of the tooth root resulting in more exposure of your tooth. If your gums have receded quite far; you would feel a great amount of pain. If you leave the problem to stay as is, it would lead to many other complications related to dental health. There primary reason as to why you would have receding gums is due to gum disease. Periodontal gum disease causes receding gums, so it is important that you get it checked out as soon as you notice it.

What Causes Receding Gums?
There are several factors that causes receding gums, some of the factors are given below:
Periodontal diseases
Genetic history of similar disease in the family
Aggressive tooth brushing
Inadequate oral care
Hormonal changes
Tobacco products
Clenching and grinding the teeth
Crooked teeth or a misaligned bite

Receding gum line is where it all starts to recede from. There are a few receding gums treatment options available, but before you can choose one that will work; it is important that you know the root cause for the disease. In many cases, bacteria are the primary reason as to why gum disease would develop. Having bacteria in your mouth is common, as everyone has bacteria in their mouth, no matter how well they brush and floss. For some people, these bacteria particles interact with food particles and cause gum disease complications. In the long run, the bacteria begin to eat up the gum tissue, leaving you with no gums to keep your teeth structure intact.

Receding Gums Treatment – Fortunately, there is a treatment option available for those who have receding gums. With a proper receding gums treatment, you would be able to get back your gum tissue through a method called gum tissue graft. Other surgical procedure involves Pocket depth reduction and Regeneration. However, just because these treatments works for you this time, it does not mean you should be hoping to use it again. Once you go through receding gum treatment, it should be enough to keep your gum tissue as is forever. While performing the treatment, it is crucial that the doctors keep away all forms of bacteria away from the inner linings of your gum tissue. As you know, once bacteria comes in contact with inner crevices of the gum, it would lead to the same situation again.

In order to avoid all forms of dental health complications, you should be very careful in keeping your teeth clean and plaque free. Once any form of plaque forms on your teeth; it would be too late to even consider the fact that you have healthy teeth. Bacteria, food particles and saliva are three things that you cannot stop from interacting, so it very important that you brush your teeth thoroughly every day. Always use a soft-bristled toothbrush. You should be flossing and brushing your teeth a minimum of two times a day because only then will you have perfectly healthy teeth. Don’t forget to visit your periodontist or dentist at least twice a year, or as recommended. People who take very good care of their teeth will rarely come across gingivitis, cavities or receding gums. Doctors can cure receding gums once, but it is your duty to make sure it does not come back.

Home Remedies for Canker Sores

March 11, 2012 by Dr.Deepak Leave a Comment

Canker sores, also called as aphthous stomatitis or recurrent aphthous ulcers are very common and painful recurrent lesions of the oral mucous membrane. They are usually seen on the inner lining of the cheeks, tongue, lips and the base of the gums. Don’t get confused with cold sores. Here are some home remedies for your canker sore that you may wish to try.

Home remedies for canker sores

Rinse your mouth with normal salt water or baking soda.

Use mouth wash containing Chlorhexidine gluconate, they are effective and safe.

Mix equal parts of Milk of Magnesia and Benadryl and hold the mixture in your mouth for 5 minutes and split it out, it will soothe your pain.

Mix equal part of hydrogen peroxide and water. Apply the mixture directly to the canker sore using cotton swap.

Apply small amount of Milk of Magnesia on the canker sore for 3 to 4 times a day. This will help soothe the pain and quicker healing.

Applying ice to your canker sores may also help soothing the pain.

If pain is severe one teaspoonful of Lidocaine 2% solution can be kept in the mouth for several minutes. Other topical anesthetics like dyclonine hydrochloride 0.5% can also be applied to the lesion.

Several numbing ointments and liquids are available over the counter containing benzocaine (Tanac, oragen, orabase, anbesol) which will help relieve the pain of canker sores. Remember not to overuse the products, follow the leaflet to avoid toxicity.

Taking multivitamins with iron may help if your canker sores are due to vitamins or iron deficiency.

Avoid hot and spicy foods that may irritate your lesion further.

Avoid hard and sharp foods that may further irritate the existing ulcers.

Avoid tobacco and alcohol

If your condition is severe, you may consult your doctor. He may prescribe you some anti-inflammatory medicines like mild to moderate topical corticosteroid accordingly.

Distinguishing Cold Sores and Canker Sores

March 8, 2012 by Dr.Deepak 1 Comment

Cold sores and canker sores share some physical characteristics so many of you might be confused resulting you to use inappropriate treatments or remedies which may reflect on its outcome. So it is necessary to differentiate between these two conditions. In this article we have tried to summarize some features of each so you can distinguish between these two conditions.

Distinguishing Cold Sores and Canker Sores

Location: Cold sores are primarily located outside the mouth (may also be seen inside mouth in immuno-compromised people), while canker sores are usually located inside the mouth, usually inner lining of the cheeks, tongue, lips and the base of the gums.

Frequency: Cold sores occur as multiple blisters, while canker sores may occur as a single or in small groups. Both have tendency to recur.

Appearance: Cold sores have fluid filled blisters surrounded by a red halo, while canker sore have large sallow round ulcer without blistering and surrounded by erythematosus halos.

Halitosis: Cold sores are associated with bad breath, while canker sores are not usually associated with bad breath (in case of canker sores due to bacterial or fungal infection, bad breath may be present).

Fever: Cold sores may be associated with fever, while canker sores are not generally associated with fever until it’s due to some systemic infection.

Association: Cold sores may be associated with swollen neck glands, while canker sores are generally not associated with swollen neck glands.

Note: The symptoms like fever and swollen glands are less likely to present in every individuals. However absence of these symptoms doesn’t exclude the disease.

Contagious: Cold sores are exclusively caused by herpes simplex virus type-1 and 2 and are highly contagious, while canker sore may be caused by either bacterial or may be due to the result of underlying hematological abnormalities or gastrointestinal disorders. Canker sores are not contagious.

Pain: In both of the cases of cold sores and canker sore, lesions may be painful.

Here are few home remedies for cold sores and canker sores

Home Remedies for Cold Sores

Home Remedies for Canker Sores

Home Remedies for Cold Sores

March 6, 2012 by Dr.Deepak 2 Comments

Cold sores, also called as fever blisters are small painful fluid-filled blisters that appear most frequently on the lips mouth or inside the nose. In rare circumstances like in case of immuno-compromised patients they may also occur inside the mouth. Cold sores are not same as canker sores.

What causes cold sores?
Cold sores are caused by herpes simplex virus (HSV). Two types of herpes simplex virus causes cold sores namely HSV-1 and HSV-2. Although in most cases HSV-1 is responsible for cold sore and HSV-2 is responsible for genital herpes, they may both cause cold sore on the lips or mouth.

Once herpes simplex attacks you there is no cure, it stays in your body throughout your life. But the good thing is that after primary infection herpes simplex stays inactive without causing any symptoms or any serious complications and you may live a normal healthy life. It may later reactivate to certain triggering factors like excessive stress or other factors that decrease your immune system. If you are struggling with recurrent herpes and looking for some cold sore home remedies, here we go:

Some home remedies for cold sores

Do not pick, pinch, squeeze or bite the blisters.
Avoid licking the lips area.
Avoid acidic foods or other salty foods if they irritate your skin.
Rinse your mouth with available mouthwash or mix one teaspoonful of salt in 500 ml water and rinse, it will help soother cold sore and reduce irritation.
If you see yellow pus around the cold sore, it may be due to bacterial infection. Coat the lesion with some antibacterial ointment. If infection persists see your doctor.
Wash the lesion area gently with mild soap free liquid cleansers and pat dry with paper towel, but remember to keep the lesion moist afterwards to prevent further drying and fissuring.
Avoid sharing day to day applications like razors, toothbrush, and towels.
Clean your hands after touching the lesion. Try not to touch your eyes or genitals before washing the hands.
Don’t apply reusable applications like lip balms, lipsticks etc directly to the cold sore lesion. Apply with hands or cotton swabs and wash hands after application.
If you have pain you may take some analgesics to relive the pain. Do not take analgesics like aspirin or ibuprofen if you have peptic ulcers, gastritis. Aspirin is contraindicated in blood disorder and child below 12 years.
Over the counter topical medications like topical analgesics and skin protectants are available which will soothe the skin and relief pain. Apply the products directly to the lesion; do not spread to adjacent skin or non involved areas.
If you have difficulty in eating due to cold sores apply above mentioned products before eating. This will ease the pain and facilitate eating.
As cold sore are very contagious. Strictly avoid contact with other person during the blister formation periods. If you practice oral sex avoid it during this period.
Avoid excessive sunlight to your lips. Always apply broad spectrum sunscreen on your lips and over the area of your face where cold sore develops. Ultra violet radiation also is thought as one of the aggravating factor for cold sore.
Cold sore may persist for 10-14 days there is no cure for it, all available topical or medications will not help cure lesion but may shorten the duration of lesion if used early.
It is estimated that almost 80%-90% of the world population will have cold core at any time during their lifetime. Remember, herpes virus can be transmitted to another person even when a person is asymptomatic and no blisters are present.
If you have diabetes or recurrent herpes infection, above mentioned home remedies for cold sore treatment may not work for you all the time, you may need oral prescription drugs. Talk to your dermatologist for prescription products.
Avoid stress and other factors that you think has link to your recurrent cold sores.

References:
1.Paterson J, Kwong M: Recurrent herpes labialis. Assessment and non-prescription treatment. GlaxoSmithKline Continuing Education in Pharmacy CCCEP#268-0405 1-21, 2005