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What is a dental abscess?

An abscess is a collection of pus. Pus is a thick fluid that usually contains white blood cells, dead tissue and bacteria (germs). The usual cause of an abscess is an infection with bacteria. A dental abscess is a localised collection of pus in a tooth, or in nearby structures. They are classified into two main types:

Periapical abscess
This type of abscess starts in the dental pulp (centre of the tooth). This is the most common type. This type of abscess usually develops as a complication of tooth decay (caries). Dental decay is very common and erodes (damages and breaks down) the protective layers of the tooth (the enamel and dentine). The damage to the tooth allows bacteria to invade the pulp to cause an infection. An infection in the pulp can progress to form an abscess. Sometimes a periapical abscess develops if the nerve to the tooth dies for any reason. For example, from injury. The dead tissue inside a tooth is more prone to infection.

Periodontal abscess
This type of abscess starts in the supporting structures of the teeth, such as the periodontium which is between the tooth and the gum. It most commonly develops as a complication of gum disease (periodontal disease), which is infection or inflammation of the tissues that surround the teeth. Gum disease often causes the gum to become slightly detached from the tooth. This causes pockets to form which may get filled with bacteria and progress to form an abscess. A periodontal abscess may also develop as a complication of injury to the gums or periodontium. A periodontal abscess is sometimes called a gum boil as the abscess causes a swelling to develop next to a tooth.

What are the symptoms of a dental abscess?


Symptoms typically include one or more of the following:

Pain (toothache) which can quickly become worse. It can be severe and throbbing. Swelling of the gum which can be tender. Swelling of the face. The skin over an abscess may become red and inflamed. The affected tooth may become tender to touch, and may even become loose. High temperature (fever) and feeling generally unwell. In severe cases, there may be spasm of the jaw muscles.

What is the treatment of a dental abscess?


Initial treatment
See a dentist as soon as possible. A dentist will normally drain the pus and this often gives great relief of symptoms. This is done either by lancing the abscess or by drilling a small hole

in the tooth to let the pus escape. Sometimes, if the infection is not contained, an antibiotic is prescribed for a few days after draining the pus to clear any remaining infection. However, in most cases an antibiotic is probably not needed once the pus is drained. If there is a delay in seeing a dentist, a doctor or nurse may prescribe an antibiotic to help prevent the abscess from getting worse or spreading. However, an antibiotic will not clear the pus and cure the abscess. You still need to see a dentist soon. You may also need painkillers such as paracetamol or ibuprofen until the abscess is drained and treated. Note: paracetamol and ibuprofen can be taken together if pain relief with either alone is not enough. Some people require stronger painkillers prescribed by a doctor. Further treatment may include the following:

For a periapical abscess


The treatment for this type of abscess is normally root canal treatment. This treatment aims to save and restore the damaged or dead inner part of a tooth (the pulp). Briefly - a dentist will drill into the dead tooth and allow pus to escape through the tooth, and then remove the dead pulpal tissue. A root filling is then placed into the tooth to fill the space and prevent further infection. (Note: even if pain has gone with an initial emergency drainage of the pus, you are still likely to need root canal treatment. This is because the infection and abscess will almost certainly return unless the dead pulp tissue is dealt with.) If the infection persists despite root canal treatment, the dentist may have to extract (remove) the tooth.

For a periodontal abscess


Once the pus is drained, a dentist may clean the pocket where the abscess had formed. Following this a dentist may smooth out the root surfaces of the tooth to encourage the gum to close back on to the tooth, and for any pocket to disappear. This helps to prevent a recurrence of infection. If you develop repeated periodontal abscesses you may be referred to an oral surgeon who may carry out a procedure to reshape the gum tissue.

What is the outlook (prognosis)?


If treated, the outlook is good. The pus can usually be drained and the tooth can be saved if it is not badly broken down. If left untreated, the abscess may burst on to the skin of the face, or into the mouth. This may leave a sinus tract (a channel) between a persistent focus of infection and the skin or mouth, which can discharge pus from time to time.

Abscess
What You Can Do What Your Dentist Will Do When the inside of your mouth gets hurt or irritated, bacteria may enter and cause an infection. Sometimes you will see a painful swelling filled with pus (a thick, yellowish fluid). If the pus can't drain out, the area will get more swollen and painful. This is known as an abscess. The abscess forms a barrier around the infection. This is one way that your body tries to keep a bacterial infection from spreading. Abscesses can form very quickly. Sometimes they form only one or two days after the infection starts. There are two types of abscesses:

A gum abscess (also called a periodontal abscess) usually is caused by an infection in the space between the tooth and gum. The infection may occur after food gets trapped between the gum and tooth. In people with severe periodontal disease, bacteria can build up under the gum and in the bone. A tooth-related abscess (also called a periapical abscess) occurs inside the tooth. This happens when the tooth's nerve is dead or dying. This type of abscess shows up at the tip of the tooth's root. Then it spreads to the surrounding bone.

Most abscesses are painful, so people usually seek treatment right away. Sometimes, the infection causes little or no pain. If an abscess is not treated, the infection can last for months or even years. It will not go away on its own, so it's important not to ignore the symptoms. If the infection is not treated, it can damage the surrounding bone and teeth. A hollow tunnel sometimes forms through the bone and skin to allow pus to drain. This tunnel is called a fistula or "sinus tract." You might see or feel this opening inside your mouth. It looks like a pimple. If you have pus draining through a fistula, you might notice a strange taste in your mouth. The buildup of pressure causes the pain of an abscess. Draining the abscess through a fistula reduces the pressure. The pain will disappear. However, the infection still needs to be treated. Sometimes, an abscess that isn't treated can form a fluid-filled bubble (cyst) in the jaw bone. If the tooth is severely broken down and can't be saved, the cyst may come out when the tooth is extracted. If the tooth can be saved, you will need a root canal to remove the infected nerve. If this treatment does not heal the cyst, you may need surgery to remove it. In rare cases, the infection that causes an abscess may spread and lead to serious health problems. What You Can Do Abscesses are always serious because the infection may spread to other parts of the body. Call

your dentist for an appointment. If you can see or feel a pimple-like swelling on your gum, rinse your mouth several times a day with a mild salt-water solution. Use 1/2 teaspoon of salt in 8 ounces of water. This may help draw the pus out and relieve pressure. Even if the rinse seems to help, you still need to see your dentist as soon as possible. What Your Dentist Will Do Most gum abscesses will heal quickly after three things happen:

The area is cleaned thoroughly. The trapped pus is allowed to escape. The infection is treated.

If a fistula has formed, your dentist will trace it back to the source of the infection. Your dentist will insert a flexible, thin piece of material into the fistula. This will appear on an Xray and show the dentist where the fistula leads. Once your dentist cleans out the infection, the fistula usually will close on its own. If the infection started inside a tooth, your dentist will make a small hole in the tooth. This allows the abscess to drain. The tooth will need root canal treatment, followed by a filling or a crown. If an abscess is very large or the tooth is badly damaged, you may need to have the tooth removed. A large abscess often will need to be drained. The dentist makes a hole in the gum through the bone that provides an exit path for any fluid or pus. This will reduce the risk of further spread of the infection. People with severe periodontal disease may have abscesses. Draining them helps the immediate problem. However, the periodontal disease needs to be treated to prevent another infection. Your dentist may give you a prescription for antibiotics and painkillers. These drugs will help the abscess heal and keep the infection from spreading.

Kawasan karis berwarna coklat pucat menandakan karis aktif dan telah melibatkan dentin. Lubang telah terbentuk dan struktur yang rosak tidak akan pulih.

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What is Initial Caries?


Watch Dental Video about Initial Caries Initial caries is a carious lesion that is still limited to the dental enamel.
As long as caries are only located in the dental enamel, they can still be treated without any drilling. But how do caries develop to begin with? Plaque is the trigger of caries, because plaque contains bacteria and their products, which attack the tooth more on that in the video "Initial Caries". The bacteria in the plaque need feed to live off of, and they get it from food scraps, as long as these are located in the enamel. As soon as the caries have reached the dentin, the bacteria can feed themselves from the proteins contained in the dentin the disease thus develops its own momentum. From that moment on, the dentist must remove the caries with the drill. So if the caries are still limited to the dental enamel so-called initial caries and if one cuts them off from their nutrients, the bacteria and the plaque die off, provided that you optimize your brushing technique. This process is called caries sealing. As soon as the caries have reached the dentin, sealing it from the outside is simply not sufficient anymore. Here you see an X-ray of initial caries, i.e., the dark spot in the dental enamel (marked with the green circle).
Caries is the Latin word for corruption or decay. Caries or Cavities are caused by bacteria that demineralise hard tooth structure, like enamel or dentin. Our body is full of different types of bacteria, but gladly not all are harmful. A patient experiencing dental cavities may not be aware of it at first, since pain only appears when the infection gets to the dental root. The earliest sign of caries is the presence of a chalky white spot on the surface of the tooth. An efficient oral hygiene has proven to have a preventive effect on dental cavities. Make sure to brush your teeth thoroughly! Do you need more Information on how to prevent caries? Watch this video to find out.

Tooth Decay

or Cavities or Dental Caries is one of the most common human diseases. Main cause of dental caries is the loss of minerals from the tooth enamel due to the action of acids produced by dental plaque. Cavities are most likely to develop in pits on the chewing surfaces of the back teeth, in between teeth, and near the gumline or at the unprotected root if it is exposed by gum recession. If left untreated the tooth decay can destroy the tooth through the enamel, to the dentin and down to the pulp of the tooth. Factors as nutrition habits, quality of oral hygiene, dry mouth problems, presence of fluoride in water or toothpaste and heredity play a significant role in how susceptible your teeth may be to tooth decay.

Causes of Tooth Decay


Dentists use the term 'acid attack' to summarize the causes of tooth decay. After having a meal, snack or drink, the bacteria of the dental plaque start to convert sugar and carbohydrates of foods into acids. The normal mouth pH of 6.2 to 7.0 starts to drop to acidic values. If the mouth environment becomes too acidic (pH below 5,5-6,0), the acids start to dissolve the minerals (calcium and phosphate) of the tooth's surface creating microscopic lesions on tooth enamel (demineralisation), weakening its structure. Streptococcus mutans is the most destructive bacterial strain in the mouth as it attaches easily to teeth and produces a lot of acid. Other common but less destructive acid-producing bacteria are lactobacillus and actinomyces. After all the sugars are consumed by the bacteria, acid production eventually stops and the tooth has a chance to repair itself (remineralisation) helped by the minerals of saliva and toothpastes fluoride. If dental plaque is not removed regularly, or if sugar is consumed too often, then the remineralisation periods are not enough to repair the damage. Eventually a small cavity appears on the tooth enamel. The continuous exposure of the tooth to acids is what causes tooth decay. Tooth decay can then penetrate through the protective enamel down to the softer, vulnerable dentine and continue to the soft tooth pulp and the sensitive nerves within it. Although the metabolic activity of plaque bacteria in our mouth is what actually causes dental caries, the underlying causes of tooth decay are in most cases the poor oral hygiene and high sugar consumption.

Symptoms - How to check for Dental Caries - Diagnosis


Early caries may have no symptoms. Tooth decay begins with a small patch of demineralised enamel at the tooth surface, often hidden from sight in the fissures or in between the teeth. At this phase tooth decay can be identified visually only by your dentist. When the decay has progressed deeper in the enamel, the teeth may be sensitive to sweet foods or to hot and cold temperatures. The dentist will examine the teeth for damaged areas by probing teeth with a special instrument called explorer. Later, when the cavity has reached the pulp, the acute pain or swelling will be a clear sign of dental caries. The best way to spot dental caries and treat them before they become serious cavities is by visiting your dentist regularly for checkups.

THE STAGES OF TOOTH DECAY


The pictures of tooth decay below, provide an explanation of the destructive process of teeth decay, from the initial stages acid attack up to the total decay of tooth tissues.

The first indication of tooth decay are white spots on the enamel caused by the loss of calcium. Acids have started to dissolve and weaken the tooth enamel (demineralization). At this stage the tooth can remineralize and fix the weakened area itself with the help of minerals in saliva and fluoride.

If the demineralisation process outruns the natural remineralisation process, the lesion grows. Over time, the tooth enamel begins to break down beneath the surface while the surface remains intact. Once the decay continues and breaks through the surface of the enamel, the damage is permanent.

Left untreated, the decay will continue to dentine. When enough of the subsurface enamel is eaten away, the surface collapses, forming a cavity. The decay must be cleaned out and the cavity filled by a dentist.

The living part of the tooth, the pulp, becomes damaged. The bacteria invade and infect the pulp of the tooth. The blood vessels and nerves may die due to the infection. Root canal therapy is required to repair the tooth.

The infection can then spread to form a tooth abscess (collection of pus) around the root tip. As the infection inside the tooth's root canal builds up, the bone around it gets infected. The tooth pain is consistent, especially during the night.

If the infection is not stopped ontime and a root canal therapy is not carried out by the dentist, the tooth might be lost or need to be extracted.

Types of Tooth Decay


Coronal cavities is the most common form in all ages. Coronal cavities are cavities of the visible part of the tooth (crown), usually on chewing surfaces or between teeth. Root caries is more common in older adults as they are more likely to have receding gums that leave part of the tooth root exposed. Recurrent caries is decay that forms beneath or around existing dental fillings or crowns. Bacteria and food particles can get betwen the tooth and the dental fillings if a filling hasn't been placed properly or if the filling is cracked. Baby bottle tooth decay, a very destructive form of dental caries is common in children who use to fall asleep with a bottle of milk or other sweet liquid in the mouth. Caries may be acute or chronic, depending on how fast they progress in destroying the enamel. In children and young adults acute decay can create a cavity in a few months while in older adults with chronic caries the process of tooth decay can last for years

People suffer from caries when certain factors come together. The most important aspects are: certain host factors, plaque, time. Host factors encompass all the factors relating to the host, such as tooth anatomy, saliva composition and cleaning habits.
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Plaque is a layer on the teeth consisting of saliva parts, germs and carbohydrates, and it forms when the teeth are not cleaned properly. When all these factors come together bad cleaning habits, plaque and time they lead to the formation of caries. We will now use the animation to take a little tour into the plaque.
Therefore, it is very important to remove plaque efficiently with the help of a toothbrush, dental water jets and dental floss. By doing so, these germs are deprived of their habitat. Without a habitat, they cannot cause any more harm. Within the plaque, the bacterial products disintegrate the enamel of your teeth. However, as soon as caries reach the dentin depicted in yellow the dentin is

occupied by the bacterial infestation. This is because the dentin contains proteins that supply the germs with a food source. Even when plaque is removed thoroughly, the decay process cannot be stopped. They develop their own dynamic. There will be more about this in the video entitled "Initial Caries"

Dental caries is an infectious, communicable disease resulting in demineralisation and destruction of tooth structure by acid-forming bacteria found in dental plaque, an intraoral biofilm, in the presence of sugar1. Far from being static, dental enamel is in a constant state of change in that it undergoes cycles of demineralisation and remineralisation. Acid produced by oral bacteria in the glycolysis of carbohydrates is the driving force towards enamel demineralisation and caries progression. Saliva on the other hand is the driver of repair and remineralisation. In the absence of the protective properties of saliva, acid dissolution of the teeth would progress unchecked in susceptible individuals with cariogenic bacteria and unfavourable diets. The fundamental aims of strategies for caries prevention are to reduce demineralisation and/or to increase remineralisation. There are four factors of dental caries: bacteria, food, host (tooth) and time. 1, the bacteria: the Strep. Mutans Streptococcus mutans. 2 things: the sugary type, quantity and viscosity to determine the amount of acid produced. 3, tooth shape and arrangement affect food viscous time. 4, between: the number of feeding, the length of each feeding. Human dental plaque or saliva in the mouth of "bacteria", the use of sugar fermentation as "food", the resulting acid metabolism, long "time" and "teeth" contact, and thus undermine the tooth surface, so that the teeth have decalcified and caries. Seen after eating, brushing teeth as soon as possible, and use of dental floss, the complete removal of food residue, can get rid of "food" this factor! Reduce the formation of plaque Pulling a tooth "move" the body opportunities to maximize the "bacterial" and "food" do not meet! "teeth" is not a long "time" soaking in dirty environment, reduce the incidence of dental caries.

Sabtu, 31 Oktober 2009


Mengatasi fobia anak ke klinik gigi
Dari sudut perubatan psikologi mengatakan bahwa resah, bimbang dan takut adalah sesuatu yang biasa di kalangan kanak-kanak dan biasanya ia tidak akan berterusan untuk jangka masa yang panjang. Perasaan ini bermula apabila bertemu orang-orang asing dan bila berpisah dari penjaga adalah dua perasaan yang biasa di alami oleh kanak-kanak. Ini adalah satu perkembangan yang biasa. Keresahan terhadap orang-orang asing bermaksud bahawa kanak-kanak merasa takut bila berhadapan dengan orang yang tidak dikenali. Dalam konteks pergigian, doktor gigi dan kakitangan yang ada di klinik dianggap sebagai orang asing. Biasanya terjadi pada peringkat umur 4 - 5 bulan dan akan memuncak hingga ke usia 12 bulan. Kajian mendapati 80-85% pesakit yang datang ke klinik pergigian mengalami fobia rawatan pergigian. Ini bukan sahaja takut sakit tetapi takut dari segi psikologi terhadap doktor gigi tidak kecuali pada kanak-kanak kerana di awal usia ke klinik pergigian ini adalah pengalaman

pertama. Selain itu, kanak-kanak belajar dari pengalaman yang dialami ketika melihat ibubapa atau saudara terdekat menjalani rawatan yang menakutkan ketika di klinik pergigian. Pembelajaran ini akan membuatkan kanak-kanak takut untuk menjalani rawatan pergigian seterusnya tidak menghadiri temujanji pergigian

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Sabtu, 31 Oktober 2009


Mengatasi fobia anak ke klinik gigi
Dari sudut perubatan psikologi mengatakan bahwa resah, bimbang dan takut adalah sesuatu yang biasa di kalangan kanak-kanak dan biasanya ia tidak akan berterusan untuk jangka masa yang panjang. Perasaan ini bermula apabila bertemu orang-orang asing dan bila berpisah dari penjaga adalah dua perasaan yang biasa di alami oleh kanak-kanak. Ini adalah satu perkembangan yang biasa. Keresahan terhadap orang-orang asing bermaksud bahawa kanak-kanak merasa takut bila berhadapan dengan orang yang tidak dikenali. Dalam konteks pergigian, doktor gigi dan kakitangan yang ada di klinik dianggap sebagai orang asing. Biasanya terjadi pada peringkat umur 4 - 5 bulan dan akan memuncak hingga ke usia 12 bulan. Kajian mendapati 80-85% pesakit yang datang ke klinik pergigian mengalami fobia rawatan pergigian. Ini bukan sahaja takut sakit tetapi takut dari segi psikologi terhadap doktor gigi tidak kecuali pada kanak-kanak kerana di awal usia ke klinik pergigian ini adalah pengalaman pertama. Selain itu, kanak-kanak belajar dari pengalaman yang dialami ketika melihat ibubapa atau saudara terdekat menjalani rawatan yang menakutkan ketika di klinik pergigian. Pembelajaran ini akan membuatkan kanak-kanak takut untuk menjalani rawatan pergigian seterusnya tidak menghadiri temujanji pergigian http://www.ahu.on.ca/Default.aspx?l=,1,10,53,82 Langkah yang perlu dilakukan: 1. Mulakan dari awal dengan membawa anak anda bersama bila anda jumpa doktor gigi. Persatuan Pergigian Malaysia mengesyorkan supaya anda mula membawa anak berjumpa doktor gigi apabila dia sudah mencecah 1 tahun. 2. Ibubapa dan doktor gigi masing-masing memainkan peranan yang penting dalam menyediakan keadaan yang positif untuk perjumpaan pertama ini. 3. Pilihlah doktor yang mahir dalam mengendalikan kanak-kanak kecil. Tidak semestinya Pakar.

4. Tanyalah sesama rakan-rakan anda jika mereka dapat mengesyorkan doktor gigi yang prihatin dan simpati dengan ketakutan yang dialami kanak-kanak kecil. 5. Sesetengah doktor gigi mengadakan sesi untuk menyediakan kanak-kanak sebelum perjumpaan pertama. 6. Anda boleh temani anak anda untuk kali pertama sesi perjumpaan. 7. Kebanyakan kanak-kanak takutkan orang yang tidak dikenali termasuklah si doktor gigi. Tunjukkan kepadanya yang doktor itu adalah orang yang anda kenali dan percayai. Dengan memperlihatkan reaksi yang tenang, ia akan membantu anak anda menyesuaikan dirinya dengan lebih cepat. 8. Biasakan anak anda dengan doktor gigi dengan membawanya untuk pemeriksaan sahaja tanpa berbuat lebih dari itu. Janganlah tunggu sehingga sakit gigi baru hendak jumpa doktor kerana dia akan mengaitkan kesakitan dengan doktor gigi. 9. Dengar apa yang diperkatakan oleh kanak-kanak itu dan fahami tingkahlakunya. Dengar di mana kesakitan yang dialaminya. 10. Jangan sekali-kali memaksa atau mengugut anak anda. Ini akan menimbulkan rasa negatif setiap kali berjumpa doktor. 11. Yang paling penting pujilah anak anda setiap kali dia bekerjasama dan berjaya menjalani pemeriksaan di klinik gigi dengan baik. 12. Anda perlu faham bahawa peralatan yang digunakan oleh doktor gigi menakutkan bagi kanak-kanak. Cadangkan supaya doktor anda menunjukkan dan menerangkan kepada anak anda satu per satu peralatan yang akan digunakan 13. Sikap anda juga penting. Elakkan dari mengalihkan rasa takut anda sendiri kepada anak anda kerana dia akan merasainya. Jangan berbincang mengenai pengalaman silam yang menyakitkan dan elakkan dari menggunakan perkataan yang negatif. 14. Jangan pula menghadiahkannya dengan gula-gula selepas itu! Ini bertentangan pula dengan amalan penjagaan gigi yang baik. Kanak-kanak lazimnya mempelajari banyak tentang kehidupan melalui ibubapa mereka. Jadi, ibubapa mestilah peka tentang perkara ini untuk memastikan yang anda tidak memindahkan ketakutan anda sendiri kepada anak-anak. Dengan erti kata lain, anak takut akan sesuatu kerana melihat reaksi ibu bapa.