Greetings to all my readers,

a pleasure to talk to you again, for those who do not know me my name is Jennifer I am a dentist by profession, lover of animals and photography.

Today I decided to take a few hours to see what was new or relevant in steemit, and I have come across something really great and is the one that has created a wonderful group called @steemstem, basically responsible for promoting informative papers on Science , Technology, Engineering and Mathematics at Steemit.

If it catches your attention as much as me here I leave the link:

Steemstem

In a previous post I had commented on the malpractice of orthodontics, something that is very worrying in these times of high aesthetics today I come to talk about:

Many of you will have come to your dentist at some time due to tooth sensitivity when drinking cold or hot drinks, bleeding gums, discomfort or pain when chewing; or for a routine checkup. I can assure you that many times something as simple as having the dentist inform you that you have a caries generates a lot of stress and anxiety for the patient.

Before starting I would like to define what is the dental caries and that basically causes it, it is important to know that there are people with greater predisposition to suffer from this disease than others, not everyone who brushes 3 times a day or has an adequate hygiene is they save from these discomforts bacteria.

I am Jennifer Jiménez your online dentist and I come to teach you about:

The dental caries:

Dental caries is a multifactorial disease caused mainly by the bacterium Streptococcus mutans, which has the ability to demineralize the tooth surface and thus disintegrate the tooth. Once the enamel damage occurs, the bacteria continue to penetrate to the inner parts of the tooth, passing through the dentine to the dental pulp and getting to soft tissues outside the tooth.

• What happens if the process does not stop on time?

The tooth can be totally destroyed, remaining without any vitality and during the process causing much pain.

• What is the cause of dental pain?

When all these microorganisms penetrate the tooth and reach the root canals, they manage to cross beyond the roots, towards the soft tissue, where the whole inflammatory process is going to start which is very painful and its only repair is the dreaded "Treatment of conduit (Endodontics) "

The most appropriate way to understand this process is through this drawing, which shows when dental caries penetrates the tooth structure, reaching the pulp and affecting the entire dental structure both outside and inside, causing a process at the end infectious at the apex level of the tooth, this would be what happens inside the tooth.

• What happens outside?

Just as the abscess is seen in the root of the tooth, in the soft structures and clinically seen you will see inflammation and much pain, something like this poor girl in the picture.

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Dental caries is associated with the following causes:

The wrong oral hygiene techniques, sometimes something as simple as brushing your teeth can become a big problem if not done correctly; I can say that of every 10 patients who come to my office, only 1 can know the correct way to brush, others do it with great force, which causes something called "dental erosion"; Years later they become a real problem of dental sensitivity.

Sometimes you have to bear in mind that some teeth, due to their morphology or position, retain more or less dental plaque, it is something that is not 100% associated with the patient and for this reason must have a longer time to brush their teeth.

Another common problem is the intake of foods with high sugar content, a diet with a high presence of carbohydrates and, of course, carbonated drinks. Then imagine this, along with the very long lapses between meals and brushing, the bacteria do their thing and affect the tooth in a very fast way.

There are other problems, such as discussing the pH of saliva, this has a great influence on the appearance of dental caries, there are many other factors, age, medications, socioeconomic status and especially past experiences with dental caries.

Diagnosis

To make a correct diagnosis of the presence of dental caries, several common techniques are used and in case of uncertainty, it becomes a little less common, it is normal that caries is observed clinically, either by tooth loss or by presence of abscesses in the surrounding soft tissues.
Starting from the most basic to the most complex a clinical history is made and the nature of the pain is determined (in case you have it).

The most common questions we ask dentists are something like this:

• Does pain hurt you? In the positive case
• Does the masticatory act hurt? Or under some determined stimulus? (cold water, hot, sweet foods)
• Does it hurt to be in a resting state? (watching tv, reading, without the presence of any stimulus that activates the pain)
• How is the pain? (described in the most detailed way possible)
• Frequency? Intensity?
• How do you calm it, analgesics, antibiotics?

After making a correct history, I continue with other questions that may arise depending on the patient's response. In particular, I proceed to the percussion in the affected tooth. A positive reaction to the percussion indicates that there is inflammation of the apical periodontal tissue (supporting tissue around the end of the root of a particular tooth), which could mean the presence of an abscess, I can continue taking a periapical Rx and that this can corroborate the extension of the caries and therefore, the presence or absence of the abscess.

There are other techniques as a reaction to thermal changes (I have not used it in particular) the reason is very simple, if I have a patient who already doing a correct anamnesis tells me that when drinking cold water the pain is unbearable, I think that it is necessary to place a cold object on the tooth and relive the pain, just as with hot objects, if the patient knows how to explain his problem well it is not necessary to go through this discomfort, much less on the first date that the anxiety is very high.

Finally, clinical exploration is very important: nothing like observing oneself the extension and location of the lesion, it is important in spite of having taken the Rx palpation of the surrounding area, why? Because it is a second PLUS (as I call it, reconfirming what has already been seen radiographically) if it produces pain we know that the inflammation has reached the tissue surrounding the apex of the tooth sometimes does not produce pain but when palpating feels the tissue bulky.

Now the most important question

• How to solve the problem?

It would be difficult to say that things are going to work out the way we want, I consider myself a conservative dentist, I try to save as much as possible the dental structure and as much as possible to make the dental pieces stay vital in their place.

In cases of loss of considerable tooth structure, inflammation, abscesses, it is pitiful to proceed with endodontics (root canal treatment), although many are afraid of it, because of lived experiences or stories of other people it is preferable to do so before extracting the tooth.

I have had patients who prefer to remove a tooth before saving it, based on the argument that it will be less painful and will not bother again, I sometimes wonder if they will do the same with other parts of their body, if a finger hurts. amputate it? I really do not believe it, the teeth are the most wonderful that the human being has and we must take care of them and love them in the same way that we want other parts of our body.

Refletion

Returning to the subject the tooth must be repaired, the treatment of the canal is based on penetrating to the pulp chamber, extracting all the nerves (pulp tissue) and then with limes to do the same procedure in the roots , this in order to eliminate all the necrotic tissue, achieving a good cleaning and leaving the tooth totally lifeless. Although this sounds hard, the tooth will not be vital, but you will have your piece in your mouth in its position fulfilling its function during the masticatory process. The process of endodontics is very meticulous, but it guarantees a better quality of life for years to come.

In less severe cases, caries has not reached the pulp chamber, there is no involvement of the tooth, it is simply removed, a base is placed and its final filling in this case light-cured resin.

The best way and what I can advise you is not to wait for the time of extreme pain to go to the dentist, you can have your check-up every 6 months, as well as going to the doctor for your routine exams.
In the following post I will be talking about other common affections of the mouth.

Any suggestion or doubt can comment on it.

• I hope you have helped them.

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