Often patients feel disappointed when they find out that they have a cavity during their periodic dental visit. This occurs despite what they claim as good oral hygiene practice.
So is it possible to get a cavity even if someone practices excellent oral hygiene?
The answer is yes and no. Let’s go over some basics before we explore the answers.
A cavity forms when bacteria present on the surface of a tooth consumes sugar and produces acid as a byproduct. The acid erodes the tooth surface creating a cavitation. This in turn allows more colonization and more acid production and eventual growth of the cavity. Let’s examine in more detail why a cavity develops.
For a cavity to develop we need three things. The host site which in this case would be a tooth, bacteria, and sugar. If we eliminate one of these a cavity will not develop. Realistically, it is impossible to eliminate even a single one of these. We would like to keep our teeth for life which provides a host site for the bacteria. Our mouth cannot be sterilized, and even if you could sterilize them, constant consumption of food and exposure to the environment will reintroduce microorganisms. The third factor is the presence of sugar. In this case, sugar means any form of simple carbohydrate that are easily digested by bacteria. This includes a wide range of products available at the supermarket today. Bacteria like simple sugars because they are easier to digest. These are commonly found in soda drinks, cereal, baked goods, and anything else we to which we add sugar.
To reduce the number of cavities that we get we need to reduce one or more of the three factors needed for a cavitation to develop. This translates to good oral hygiene (to reduce the number of bacteria present), and reduced sugar intake. My Mount Pleasant dentist and dental office mentions this every time I visit. I wonder why. Do your dentists get on your case too? Consumption of less processed foods can also be of benefit. Complex carbohydrates take more energy and time to digest, which means less exposure to simple sugars in the oral cavity.
Sometimes even with excellent oral hygiene we can still get cavities. This can be due to the anatomy of teeth. Deep grooves, irregularities in the structure of teeth, large gaps between teeth that collect food, and microscopic cracks in the surface of a tooth can lead to collection of bacteria and formation of a cavitation. This is why regular dental visits are very important. Usually these small cavities can be monitored for further growth and dealt with when necessary.
To summarize, cavities can occur in different situations. There are certain steps we can take to reduce the chances of getting cavitations. These include regular dental prophylaxis (cleaning), regular checkups, good oral hygiene, reduced sugar intake and any other aids that will protect teeth.
As electric toothbrushes have become more popular among adults, it was just a matter of time before electric toothbrush specifically designed for kids would appear on the market. Kids usually love them. They make noise, they vibrate, and best of all they are brushing their teeth in a similar fashion as their parents. Kids electric toothbrushes on average cost anywhere between 6 and 30 dollars and are usually disposable. They are made by different companies, some well known in the dental market such as Crest or Oral B and others that I have never heard of. They are usually covered with graphics that are appealing to children. Whether it be a cartoon character or a superhero.
With all the hype about electric toothbrushes for kids, how do they perform during brushing? With my own kids (ages 3-6) recently started using electric toothbrushes I was curious to see the result. I have found that kids get distracted by the noise and vibrations and get a false sense of belief that they are efficiently brushing their teeth. On several occasions my 5 year old daughter would literally move the toothbrush to three different spots and claim that she was done brushing her teeth. She brushed very well with a manual toothbrush before the change to electric. Because of all the movement and noise produced by the brush kids feel that things are getting done. Many times I have to go back and brush their teeth manually to take care of what the electric toothbrush missed.
Another issue I have with an electric toothbrush is that kids at a young age should be practicing their brushing technique so that they understand when teeth are properly brushed. They can judge their own performance. This would be difficult with the use of an electric toothbrush.
As for cleaning efficiency, bristle head design appear cheap as compared to an adult electric toothbrush. The bristles are also much less efficient than the more expensive counterparts. Taking into account the design and the poor brushing technique when kids use the electric toothbrush, an electric toothbrush is not a good investment.
I do understand that kids like toys and brushing with an electric toothbrush make it fun for them. However, they should have a good understanding as to what the goal of brushing is and have developed good brushing habits before we introduce them to a new toy. Good habits developed early in life will stick with us for a lifetime.
More and more patients today ask about electric toothbrushes. Many dental professionals also recommend electric toothbrushes for their patients. One of the main reasons is to reduce damage to the teeth caused by brushing with excessive pressure. Toothbrush abrasion as it is commonly known is trauma induced recession of the gums that leads to exposure of the root surface of the tooth. This can lead to severe sensitivity. An electric toothbrush can help prevent toothbrush abrasion by eliminating the poor brushing technique. An electric toothbrush is also recommended for patients with poor manual dexterity.
As we mentioned before the two most popular brands of electric toothbrushes are Oral B and Sonicare. Having tried them both I would like to discuss the major things I like and dislike about each. This will strictly be a comparison between the two brands.
Oral B Electric Toothbrush:
The head of an Oral B toothbrush is round and rotates in a circular motion clockwise and counterclockwise. Dental plaque is removed mechanically just like a manual toothbrush. They are well designed, looks sharp, have a good battery life, and if used properly, do a great job eliminating plaque. The only disadvantage is that they are a bit noisy. Overall it is a quality product that I would recommend to everyone.
Sonicare Electric Toothbrush:
The head of a Sonicare toothbrush is rectangular and oscillates at a very fast rate back and forth. Plaque is removed through the motion of the brush as well as the sonic wave created by the brush. These toothbrushes are also well made. They function just as well as the Oral B and if used properly do a great job with plaque removal. The only disadvantage I encountered was that after using it for about two years, the battery failed. There is no way to replace the battery, which means that a new unit has to be purchased. I am trying out the new ones to see if there is improvement in that category.
Philips Sonicare Toothbrush
No review on this other than to mention it as an option for you to do your own research on.
In summary, no matter which brand you choose you will be happy with the result. If you were never educated on proper technique of brushing, the electric toothbrush will help you keep things simple and eliminate plaque in the process.
In pregnancy induced hypertension signs precedes symptoms and the disease can be diagnosed easily if the pregnant female is examined regularly before the condition becomes severe enough to give rise to symptoms.
Edema is the first sign to appear and dependent edema of mild to moderate degree is so common and can be disregarded unless the face and fingers are involved which is more significant. In severe hypertension there is edema of the vulva and the anterior abdominal wall.
Hypertension is diagnosed if there is a sustain rise of blood pressure more than 140/90 mmHg or diastolic pressure more than 90mmHg on at least 2 occasions 4 or more hours apart.
In practice diastolic blood pressure more than 90mmHg is considered as abnormal. But if previous blood pressure is known increase of systolic pressure by 30mmHg or increase of diastolic pressure by 15mmHg or increase of mean arterial blood pressure by 20mmHg also could be considered.
It is obvious that important clinical decisions depend on the accurate measurement of blood pressure. Therefore all health care persons must have good training in accurate measurement of blood pressure. It should be measured when the patient is resting in seated or if lying, in left lateral position; the arm should not be hanging and cuff should be large enough for the subjectâ??s are.(Ideally it should cover 2/3 of the arm). The manometer should be kept at the level of the heart. The health care person should be trained to identify korotkoff sounds on auscultation and to get the correct systolic and diastolic blood pressure.
Proteinuria is an important finding in assessing the severity of hypertension. It is defined as protein concentration of 300mg/l or more in atleast two random urine specimens collected 6hours or more apart.
Vaginal secretions and discharges are common in pregnancy and when mixed with urine give a positive result for urine test. The patient should be advised to clean the vulva with water and separate the labia minor with her fingers when collecting urine in order to prevent contamination. A catheter sample can also be obtained. Exclusion of urinary tract infection and renal diseases is important before diagnosing proteinuria with hypertension.
Differential diagnosis of hypertension
1. Chronic essential hypertension
2. Chronic hypertension due to renal disease
- Diabetes glomerularsclerosis
- Chronic renal failure
- SLE (Systemic Lupus Erythematosus )
- Acute and chronic glomerulonephritis
3. Chronic hypertension due to endocrine diseases
- Cushing’s disease
- Primary hyperaldosteronism
- Conn’s syndrome
4. Vascular causes
- Coactation of aorta
- Renal artery stenosis
- Fibromuscular hypertrophy of renal arteries