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Lok Sewa Aayog – Important Notes

Table of Contents

Lok Sewa Aayog

Oral Health Mental Health

Dental plaques and calculus, Dental Carries, Periodontitis, Peridonal pockets and Abscess, Importance and Maintenance of Oral Hygiene

Dental Plaque

  • Dental Plaque is a bio-film usually a pale yellow which develops naturally, on teeth
  • Substrate for dental plaque: sucrose
  • Composition of plaque: (mainly consist of micro organisms and extra celluar matrix):
  1. Micro organisms: 70-90% (mainly streptococcus mutans)
  2. Extra cellular matrix: 10-30% (organic and inorganic substances)
  • Composition of plaque buildup:
    • Formation of calculus (tartar)
    • Cause plaque associated gum disease
  • Prevention
  1. Mechanical – brushing, flush, floss
  2. Chemical – dentifrices, mouth wash
  3. Food intake – coarse, dry (avoid 3″S”: sweet, sticky, soft food)
  4. Gingival massage

Dental Calculus

  • Hard deposits formed on the tooth surface due to mineralization of dental plaque are called dental calculus.
  • 2 types according to it’s position
  1. Supra gingival – crown to gingival margin
  2. Subgingival – below the crest of marginal gingival
  • Supragingival calculus
    • Yellowish white if stained by tea/ coffee tobacco
    • Dental scar easily removed
    • Maximum occurs in upper buccal region of molar teeth
  • Subgingival calculus:
    • Dense, brown to grayish black in colour

Composition of dental calculus

  • 70-90% – inorganic (calcium/ magnesium, sulphate carbonate)
  • 10-30% – organic
  • Different bacteria: staph/ streptocococcus, bodetella
  • Desquamated epithelial cells, leukocytes
  • Plaques are converted to calculus in 50-60 days

Dental Caries

  • Progressive irreversible bacterial damage of teeth exposed to oral environment
  • Aetiology: decalcification by bacterial acid
  • 3 theories of dental carries:
  1. Protecteolysis – cehhlation theory ( recent theory)
  2. Proteolytic theory
  3. Acidogenic theory (oldest and widely accepted)
  • Acidogenic theory
    • Dental decay is a chemico- parasitic process with 2 stages
  1. Decalcification of enamel and it’s destruction
  2. Decalcification of dentine with dissolution of softened residue
  • Acid for destruction are obtained from starch and sugar fermentation by micro organism
    • Factors responsible for dental caries
    • Bacterial plaques with cario-genic bacteria
    • Bacterial substrate i.e. sugar
    • Susceptible tooth surfaces
  • Organisms: streptococcus mutans, S. viridians, S.saliarius, lactobacilli
  • Key principle of treatment- RESTORATION OF TEETH

Periodontitis

  • Inflammation of periodontal ligament of membrane
  • Periodontal membrane is connective tissue which connects tooth on sockets
  • Function of periodontal membrane:
    • Formative: contains cementoblasts, fibroblast and osteoblast
    • Supportive: supports or holds the tooth firmly
    • Protective: protects apical blood vessels from being compressed
    • Nutritive sensory: cementum surrounding bone get nutrition from periodontal membrane
  • Classification of periodontitis (acute and chronic)

Acute Periodontitis

  • Causes (41s)
    • Injuries: blow, trauma, fall bite on hard objects
    • Infection: pulpitis, caries
    • Irritation: over filled root canal
    • Impaction foreign body, meat
  • Clinical features
    • Pain
    • Fever
    • Malaise
    • Enlargement of lymph nodes

Treatment

  • Remove underlying cause
  • No chewing from affected sites
  • Hot/ salt water mouth wash
  • Soft comfortable food
  • Pus formation: drainage of us
  • Complication: periodontal abscess (treatment-drain)

Chronic Periodontitis

  • Common cause adult tooth lost
  • Causes- untreated chronic gingivitis applied during orthodontic procedure
  • Occlusal trauma
  • Excessive force

Clinical features

  1. Control of gingival infection
  • Removal of hard soft deposits
  • Removal of false pockets
  • Oral hygiene
  1. Eliminate or removal of periodontal pockets
  2. Micro gingival flap operation

Complication of periodontitis

  1. Accute lymphadenitis
  2. Osteomyelitis of jaw
  3. Intra or extra oral abscess
  4. Facial cellulitis
  5. Maxillary sinusitis
  6. Bacteraemia or septicaemia

Periodontal Abscess

  • Collection of pus in the peridentium
  • Causes: infection of periodontal tissue from gingival sulcus
  • Clinical features
  • Throbbing pain
  • Elongated tooth filling
  • No closure of tooth surface together
  • Fluctant swelling on buccal.lingual or palatal region
  • Dental caries

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Treatment: (I/D, open dranage, antibiotics and analgesic)

Commonest cause of toothache: pulpitis

Oral Hygiene

  • Practice of keeping the mouth and teeth clean to prevent dental problems, especially the common dental caries and gingivitis, and bad breath
  • Oral hygiene is maintained by mechanical cleaning (brushing) and chemical cleaning
  • Requirement of toothbrush
  • Bristles of even length, o concave, convex, 1 cm length
  • Small size for easy manipulation
  • Head length: Adult=2.5 cm, children=1.5 cm
  • Texture = medium (not hard or soft)
  • Easy to clean – bristles tuff should not be too many, to close

Brushing techniques

  1. Roll technique (common)
  2. Bass technique
  3. Combined roll and bass
  • Frequency of brushing: ( twice daily, after breakfast and at bed time in evening, after every meal)
  • Chemical cleaning of teeth
  1. Mouth rinse (Chlorhexidine 0.1-0.2 percent)
  2. Only works as long as used
  3. It decreases salivary bacterial count by 20-50 percent and decreases plaque formation

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