Bruxism (teeth grinding)

Dr. Tejaswini Malasane, Smile Care, Nasik What is it ?
Bruxism is clinching or grinding your teeth. Some people grind their teeth only during their sleep“sleep related bruxism” or” nocturnal bruxism”. Bruxism is often related with anxiety and stress. Causes of bruxism :

• Stress.
• Natural response due to misalignment of teeth.
• After effect of certain medicines used for treating depression.
• Some neuron-muscular disease.

Symptoms :

• Check if you have been experienced in any of the symptoms.
• Tightening of jaw muscles.
• Grinding sound at night while sleeping.
• Dull morning headache.
• Tightening or pain of jaw muscles during the morning.
• Long lasting pain in the face.
• Pain of jaw joints.
• Damaged teeth, broken dental fillings and injured gums.

Diagnosis :

• Dentist can determine if you are a bruxer and will be in the best position to treat it.
• The dentist will ask about your sleep habits, unusual grinding sounds while sleeping.
• The dentist will examine your mouth and jaw regions.
• He/she will check for the tenderness of your jaw muscles and jaw joint.
• He / she will check for dental abnormalities such as broken teeth, missing teeth, poor teeth alignment, broken dental fillings, and injured gums.
• In addition he/ she will check your bite and many also suggest for series of x-rays of mouth.

Expected Duration :
Children may brux between the ages 3 to 10. More of half of them will stop it of their own by the age of 13. In teenager and adults, how long the bruxism last depends on the cause. Prevention :

• Cutting down on certain stimulants like caffeine and tobacco may help.
• In bruxism related to stress, the professional counseling may help.
• Usual method is to wear the night bite plate (a dental appliance worn at night). This helps in relieving the pressure on facial muscle and jaw joint.
• Hot compresses on facial muscles may help to relieve some of the muscle pain and tightness that bruxism cause.

Treatment :

1. Stress related bruxism :
   A professional counseling, psychotherapy, bio-feedback exercises may help you to relax. You may also receive a prescription of muscle relaxant to temporarily ease the spasm of the jaw.
2. Dental Problem related bruxism :
   The dentist will do the teeth alignment and may ask to you wear a bite splint or mouth guard that specifically fits your mouth and teeth. This will help in preventing further damage and help in realigning of teeth and jaw muscles.
3. Medicines :
   If the bruxism is caused due to the after effect of some medicines such as anti depressant , then your doctor should advice you to change the medicine and might also give your some other medicine to counteract the bruxism.

Causes of Bad Breath

Why do I have Bad Breath ?

Dr. Kripa Shetty, Smile Care, Bandra 1.

Bad breath is breath that has an unpleasant odor. It's also known as halitosis. This odor can strike from time to time, or it can be long-lasting, depending on the cause.

Millions of bacteria live in the mouth, particularly on the back of the tongue. In many people, they are the primary causes of bad breath. The mouth's warm, moist conditions are ideal for the growth of these bacteria. Most bad breath is caused by something in the mouth.

Some types of bad breath are considered to be fairly normal. They usually are not health concerns. One example is "morning mouth." This occurs because of changes in your mouth while you sleep. During the day, saliva washes away decaying food and odors. The body makes less saliva at night. Your mouth becomes dry, and dead cells stick to your tongue and to the inside of your cheeks. When bacteria use these cells for food, they produce a foul odor.

Causes of Bad Breath

• Poor dental hygiene — Infrequent or improper brushing and flossing, which allows bits of food to decay inside the mouth
• Infections in the mouth — Periodontal (gum) disease
• Respiratory tract infections — Throat, sinus or lung infections
• External agents — Garlic, onions, coffee, cigarette smoking, chewing tobacco
• Dry mouth (xerostomia) — Caused by salivary gland problems, medicines or "mouth breathing"
• Systemic (body wide) illnesses — Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
• Psychiatric illness — Some people may believe they have bad breath, but others do not notice it. This is referred to as "pseudo halitosis."

Symptoms

You may not always know that you have bad breath. That's because odor-detecting cells in the nose eventually get used to the smell. Other people may notice and react by recoiling as you speak.

Other symptoms depend on the underlying cause of bad breath :

• Poor dental hygiene — Teeth are coated with film or plaque. You may have food trapped between the teeth and pale or swollen gums.
• Infections in the mouth — Symptoms depend on the type of infection. They can include :
  • Red or swollen gums that may bleed easily, especially after brushing or flossing
  • Pus between teeth or a pocket of pus (abscess) at the base of a tooth
  • Loose teeth or a change in how a denture fits
  • Painful, open sores on the tongue or gums
• Respiratory tract infections — Sore throat, swollen lymph nodes ("swollen glands") in the neck, fever, stuffy nose, a greenish or yellowish nasal discharge, a mucus-producing cough
• External agents — Cigarette stains on fingers and teeth, a uniform yellow "coffee stain" on teeth
• Dry mouth — Symptoms may include:
  • Difficulty swallowing dry foods
  • Difficulty speaking for a long time because of mouth dryness
  • Burning in the mouth
  • An unusually high number of cavities
  • Dry eyes (in Sjögren's syndrome)
• Systemic (body wide) illnesses — Symptoms of diabetes, lung disease, kidney failure or liver disease

Dental Plaque

Dr. Rupali Jakhadi, Smile Care, Nashik

Dental plaque is a biofilm which builds up on and surrounding the teeth. Plaque is Sticky and usually colorless. It forms every day on teeth.

Content of plaque :

Plaque is formed by microorganisms embedded in the matrix made up of saliva. Most of the microorganisms are bacteria (mainly Steptococcus mutans and anaerobes). The anaerobes include Fusobacterium and Actinobacteria. The composition varies by the location of plaque.

How the plaque causes harm :

The microorganisms found in plaque are usually seen in mouth at all times and are harmless. They feed on many of the foods we eat. Carbohydrates and sugars are their favorite. Plaque sticks to the teeth. If not removed properly by tooth brushing it will build up in thick layers. Those Microorganisms which are nearest to the tooth convert to anaerobic respiration. In this stage they produce acids.

Being the thick film saliva can not penetrate and cannot neutralize the acid produced by bacteria. These acids demineralise the closest tooth surface. Thus it will lead to dental caries.

Plaque also causes irritation of gums and leads to gingivitis and if not removed, further will lead to priodontitis and tooth loss. Plaque can also mineralize and become hard called calculus (tartar) which invites more deposits causing more gum problems.

Testing of plaque :

Plaque is usually clear and can not be seen by necked eyes unless it is colored with a special dye. Dentist can identify plaque with dental instruments. Testing of plaque should be done after brushing and flossing to see if any residual plaque is remaining. It can be done by two ways.

• In this method, special tablets containing red dye is chewed thoroughly and mixture of saliva and dye is moved over teeth and gums for about 30sec.Mouth is then rinsed. The unremoved plaque gets stained pink which can be removed later on by brushing.
• In second method a special fluorescent solution is swirled around the mouth. Mouth is then rinsed with water and teeth and gums are examined while shining an ultraviolet plaque light in to the mouth. There are no pink stains in mouth with this method.

Control of plaque :

Some of the plaque is removed by saliva and by movement of cheeks and tongue over the teeth.

Regular brushing and flossing everyday (at least two times) is necessary to remove the plaque.

Regular professional cleaning by a dentist is the best way to get rid of the plaque and tartar.

Do You Have Tooth Abscess ?

Dr. Rachana Chindhade, Smile Care, Nashik

A dental abscess is a bacterial infection that originates from either a tooth or the gums that surround a tooth.

Causes, incidence and risk factors :

A tooth abscess is a complication of tooth decay .It may also result from trauma to the tooth ,such as when a tooth is broken or chipped. Openings in the tooth enamel allow bacteria to infect the centre of the tooth (pulp).Infection may spread out from the root of the tooth and to the bones supporting the tooth.

Infection results in a collection of pus and swelling of the tissues within the tooth. This causes a painful toothache .If the root of the tooth dies ,the toothache may stop ,unless an abscess develops. This is especially true if the infection remains active and continues to spread and destroy the tissue.

Symptoms :

Here are the main symptoms that can help you become aware of having tooth abscess :

• Your gums might become red and puffy with swelling around the infected tooth. Chewing on food can be hard task because the abscessed tooth becomes painful when it touches food or opposing teeth.
• An abscess, which is an infection ,can cause fever leading to general fatigue and even headaches.
• If swelling occurs, you may have a feeling of raised or loose tooth, this is due to the pus which might flow in the mouth.

How is an Abscessed Tooth Diagnosed :

Your dentist will tap your teeth with a dental instrument. If you have an abscessed tooth you will feel pain when the tooth is tapped. In addition your dentist may suspect an ab-scessed tooth because your gums may be swollen and red. Your dentist may also take X-rays to look for erosion of the bone around the abscess.

How is an Abscessed Tooth treated :

Strategies to eliminate the infection , preserve the tooth and prevent complications are the goals of the treatment.

• To eliminate the infection the abscess may need to be drained. Achieving drainage may be done through the tooth by procedure known as root canal. Root canal surgery may also be recommended to remove any diseased root tissue after the infection has subsided. Then a crown may be placed over the tooth.
• The tooth may also be extracted, allowing drainage through the socket.
• Finally, a third way to drain the abscess would be by incision into the gum tissue.

Antibiotics are prescribed to help fight the infection. To relieve the pain and discomfort associated with an abscessed tooth, warm salt water rinses and over the counter pain reducing medication like ibuprofen can be used.

Complications of Tooth Abscess :

Tooth abscess complications include :

• Loss of tooth.
• Spread of infection to soft tissue.
• Jawbone damage.
• Spread of infection to other areas of the body causing other disorders like endocarditis and pneumonia.
• Heart damage.

Can an Abscessed Tooth be prevented ?

Prevention plays a major role in maintaining good dental health.

• Daily brushing, flossing and regular dental check-ups can prevent tooth decay and dental abscess.
• If tooth decay is discovered early and treated promptly, cavities that could develop into abscess can usually be corrected.
• Avoidance of cigarette smoking and excess alcohol consumption can prevent the incidence of developing dental abscess.

Mouth Ulcers

Dr. Tanvee Singh, Smile Care, Bandra 2

A mouth ulcer is an open sore inside the oral cavity. Two common mouth ulcer types are aphthous ulcers (canker sores) and cold sores (caused by the herpes simplex virus).

The types of oral ulcers are diverse, with a multitude of associated causes including: physical or chemical trauma, infection from microorganisms or viruses, medical conditions or medications, cancerous and sometimes nonspecific processes. Once formed, the ulcer may be maintained by inflammation and/or secondary infection.

Symptoms :

The symptoms preceding the ulcer may vary according to the cause of the ulcerative process.

Some oral ulcers may begin with a sharp stinging or burning sensation at the site of the future mouth ulcer. In a few days, they often progress to form a red spot or bump, followed by an open ulcer. Sometimes this takes a little bit longer, depending on the cause of the ulcer.

The oral ulcer appears as a white or yellow oval with an inflamed red border. Sometimes a white circle or halo around the lesion can be observed. The grey, white, or yellow colored area within the red boundary is due to the formation of layers of fibrin, a protein involved in the clotting of blood. The ulcer, which itself is often extremely painful, especially when agitated, may be accompanied by a painful swelling of the lymph nodes below the jaw, which can be mistaken for toothache.

Causes :

There are many processes which can lead to ulceration of the oral tissues. In some cases they are caused by an overreaction by the body's own immune system. Factors that appear to provoke mouth ulcers include stress, fatigue, and illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies and deficiencies in vitamin B12, iron and folic acid.

Treatment :

Treatments based on antibiotics and steroids are reserved for severe cases, and should be used only under medical supervision.

Some doctors may also prescribe local anaesthetic, such as lidocaine, for cases of multiple or severe oral ulcers.

Oral Thrush

Dr. Rupali Jakhadi, Smile Care, Nashik Oral thrush is an infection of yeast fungus, Candida albicans in mucous membrane of mouth. Thrush is generally referred to the infection present in oral cavity of babies, while adult infection is known as candidiasis or moniliasis.

How do we get thrush ?

Candida is present in oral cavities of 50% of the population. Everyone who wear denture have Candida in their mouth without any noticeable side effects. Under normal circumstances growth of Candida albicans is kept under control by bacteria. When the growth becomes out of control the thrush develop. This may occur due to side effect of taking antibiotics or chemotherapy. Also may be due to diabetes, drug abuse, malnutrition and old age or infection such as AIDS. Also people with ill fitting dentures have cuts in their mouth which gives gateway to Candida. These people often shows moist, pale pink spots on lips called angular cheilitis which is an indication of Candida infection.

Who is at risk ?

• New born babies
• Denture users
• Adults with diabetes or metabolic disorders
• People undergoing antibiotics or chemotherapy treatment
• Drug users
• People with poor nutrition
• People with immune deficiency

Symptoms :

White creamy or yellow raised spots on the mucous membrane of mouth often described as curd like appearance.

Spots can be scraped off, leaving a red tender area beneath, which can bleed..

Spots are usually only in the mouth but may spread down in to the throat.

Uncomfortable but not usually painful. Oral thrush often causes burning or soreness in the mouth, the throat or at the corners of the lips.

Diagnosis :

Diagnosis is made through observation by the dentist or through laboratory samples.

Treatment :

If the underlying cause is treated the thrush will resolve itself.

• This may involve giving better fitting dentures, controlling diabetes
• The topical treatment is done with anti fungal medicines in form of oral suspensions that are held in mouth before swallowing (e.g. nystatin, miconazole, clotrimazole ) given for 5 to 10 days.

Pericoronitis

Dr. Tejaswini Malasane , Smile Care , Nasik

Wisdom tooth (third molars) starts erupting in late teens years. It would get stuck on its way if there is not enough room for them or if they are growing tilted. They may come in partially or not at all .An impacted tooth does not cause any pain, but when it tries to push inside the mouth, it creates a flap of gum above it to swell and it may become painful. The food is trapped in this flap and starts decaying thus converting the flap as a host for bacteria. Due to this the flap is inflamed and this is called pericoronitis. Pericoronotis also can occur around a wisdom tooth that is still completely under the gums.

Symptoms :

• Painful, swollen gum tissue in the area of affected tooth.
• Problems in jaw movements.
• Bad mouth odor.
• Pus discharge from gum near the tooth.
• Swelling on the affected side.

Diagnosis :

• Inflamed gum tissue in the area of unerupted or partly erupted tooth.
• Flap or gum tissue on the affected area may be swollen, red or may drain pus.
• Dentist may suggest a dental x-ray for unerupted or partially erupted tooth to confirm the path of eruption.

Expected duration :

• With proper antibiotics and warm saline rinses the condition would subside within a week.
• However if proper through cleaning is not taken care then the condition can return back.

Prevention :

• Brushing erupting wisdom tooth and flossing around the tooth is necessary this will ensure that food and bacteria do not build up under the gum.

Treatment :

• Through cleaning of the flap on the affected side to remove the debris or pus if any.
• If the area is infected you will be given antibiotics.
• If required the gum flap need to be removed.
• Dentist may suggest removing the partially erupted or unerupted wisdom tooth.

When to call a professional :

• If you have symptoms of pericoronitis as stated earlier.
• If your wisdom tooth are erupting.
• If there is any pus discharges from the flap near the erupting wisdom tooth.

Prognosis :

• Prognosis is generally good if the tooth erupts completely. If the tooth on the affected side is removed the condition does not return back.

Receding Gums

Dr. Sneha Lele, Smile Care, Nashik.

It is always said that ‘be in the pink of health’. In case of oral care, it literally means so. The pink tissue that surrounds your teeth is called ‘gums’ which plays an important role in holding the teeth in the jaws. The color of this tissue is usually pink but it maybe black in some people. It is very important that these tissues remain in good health and care should be taken to see that the gums don’t inflame and recede or shrink from their actual position.

Causes of Receding Gums :

There are various causes of receding gums; the most common are :
Accumulation of Dental Plaque

Dental Plaque is a sticky, soft, colorless film of bacteria that constantly builds up on the surface of teeth and gums. Failure to remove this film causes formation of a layer which accumulates many bacteria that produce acids. These start causing irritation to the gums and thus produce gum inflammation where the gums become red, swollen and bleed easily.

Tartar Formation

If oral hygiene is not maintained properly, the tooth plaque continues to build up and can become mineralized to form tartar or calculus. Thus, you can see it as a layer of yellow or brown hard mineral deposits on the teeth surface. It maybe present above and below the gums. It is full of bacteria and can cause severe irritation to the gums and in self defense, the gums become severely inflamed and start shrinking or ‘receding’ from their original position.

Other Causes

There can be some other causes like thin gums, prominent frenum pulling the gums, if a restoration is impinging on the gums, trauma due to biting forces and toothbrush trauma.

Effects of Receding Gums :

• Gums become inflamed, swollen and bleeding and pus discharge maybe seen.
• The root surface gets exposed which causes a lot of sensitivity, esp. while having food of extreme temperatures like cold water or hot tea.
• It causes bad breath and it definitely looks unesthetic in case of anterior teeth.
• In extreme cases, if the tartar is accumulated for a very long time, there is loss of bone around the tooth that is present below the gums, this causes loosening of the teeth.

Sometimes, due to neglect and lack of awareness, people think that tartar is a part of their tooth. In such cases, big tartar deposits remain, which cause gums to recede further. This is what we call ‘gum disease’ where pus discharge and loosening of teeth is prominently seen.

How to prevent Receding Gums ?

• Brush thoroughly at least twice a day, with a fluoride toothpaste to remove plaque from teeth
• Use dental floss daily to remove plaque from between your teeth and under your gums.
• Rinse your mouth properly after every meal esp. on having sticky food.
• Control your diet. Limit sugary or starch foods, esp. sticky snacks.
• Check your teeth in the mirror to look for any stains or yellow brown tartar deposits.
• Visit your dentist regularly for professional dental cleanings and dental examinations.

Treatment of Receding Gums :

Receding gums are treated by placing a ‘soft tissue graft’ over them and stitching or suturing it in place-this procedure is called Grafting. Placing a soft tissue graft involves taking a soft tissue from the donor site - e.g. the roof of mouth and moving it to the recipient site - e.g. where the gums have receded. Different types of soft tissue grafts are performed to treat or prevent further gum recession or bone loss and for cosmetic reasons like making the gum line more even. In case of severe bone loss, bone grafts maybe performed to help rebuild an area of bone. A dressing is placed on the graft area which is removed after a week and then gentle cleaning of the area is allowed. Gums begin to look normal in 1month and heal in 2-3months.

Temporomandibular Joint Disorder

Dr. Kripa Shetty, Smile Care, Bandra 1.

Temporomandibular joint disorder (TMD), or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the mandible to the skull. The disorder and resultant dysfunction can result in significant pain and impairment. Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry, neurology, physical therapy, and psychology — there are a variety of treatment approaches.

The temporomandibular joint is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, developmental anomalies, and neoplasia.

Predisposing Factors

• Modification of chewing surfaces of the teeth through dental neglect or accidental trauma
• Speech habits resulting in jaw thrusting
• Excessive gum chewing or nail biting
• Excessive jaw movements associated with exercise
• Repetitive subconscious jaw movements associated with bruxing or clenching
• Size of foods eaten

Signs and Sysmptoms

• Jaw pain and/or stiffness
• Headaches, usually at the temples and side of head Vague tooth soreness or toothache which often move around the mouth
• Sensitive teeth
• Painful or tender jaw joint
• Difficulty opening jaw
• Pain and fatigue when eating hard or chewy foods
• Clicks, pops, or grinding sound in jaw joint
• Ear pain
• Cervical neck tension and pain
• Tooth wear
• Awareness of grinding/clenching teeth while sleeping or awake (Bruxism)
• A pattern of breaking or cracking teeth with no other cause, i.e. tooth decay or trauma
• History of medically diagnosed migraine headaches (common  incidence of concurrent TMD

Treatment

The key words to keep in mind about TMD treatment are "conservative" and "reversible." Conservative treatments are as simple as possible and are used most often because most patients do not have severe, degenerative TMD. Conservative treatments do not invade the tissues of the face, jaw or joint. Reversible treatments do not cause permanent, or irreversible, changes in the structure or position of the jaw or teeth.

TMJ Symptom Relief

Many self-help remedies have been suggested to treat TMJ symptoms, but beware that these remedies do not treat the cause. In fact, TMJ treatment through the right dentist may be less costly, less time intensive and can produce a fully satisfactory result.

Although the following self-help remedies do not treat TMJ long-term, temporary relief may be found :

Heat and Cold Packs : Heat and cold packs applied to the side of the face and temple for 10 minute intervals may reduce the intensity of the pain affecting the muscles and surrounding area of the jaw.

Limit Jaw Movement : It is important to avoid large movement of the jaw such as singing and wide yawning. Also, do not apply pressure with your hand against your jaw for an extended time period during sleep. Limit the pressure you apply with a phone receiver.

Diet : Choose soft food and stay away from foods requiring repetitive chewing or the mouth to open wide. In particular, avoid chewing gum, taffy, pretzels and raw carrots.

Dental Treatment : Continue to receive dental treatment for any teeth requiring restoration. Tooth decay may affect the bite, a contributing factor to TMJ.

Physical Therapy, Biofeedback, and Massage : In some cases, physical therapy, biofeedback and massage provide temporary relief from TMJ.

Medications : Some doctors may prescribe non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen), muscle relaxants, anti-anxiety medications and in some cases anti-depressants. The choice of medication depends on the intensity of the disorder and your medical history. However, the need for medication is greatly reduced when treatment is received by an experienced TMJ dental professional.

Dental Appliances : Your dentist may prescribe a dental appliance such as a mouth guard or splint to reduce the effects of tooth grinding and clenching. Such appliances may also help improve your bite and the ability for the lower jaw to fall properly into the temporomandibular joint socket.

Thumbsucking : At what age should it stop ?

Dr. Tejaswini Malasane, Smile Care,Nasik

Thumbsucking in children is a pleasure giving activity or comfort giving activity. It can be attributed to the psychological needs of an individual child.

Many children tend to stop the habit by 1 year of age but few of them may carry this habit upto the age of 4 years of age. Carrying thumbsucking habit beyond this age could be detrimental. But it must be noted that pushing children to quit the habit by nagging from parents or shouting on them would make the child more adamant towards the habit.

Generally as the child gets to the age of 4-5 years he gets busy with the daily routine of the school, playing with other children and some other activities that he hardly thinks about thumsucking. But some children do not quit this habit and here parents need to adapt a careful approach in order to get their child to quit thumbsucking.

Thumbsucking has a major impact on oral health after the age of 5 years so it advisable to get the child rid of the habit by the age of 4-5 years .This is because the permanent teeth starts erupting from the age of 6-7 years.

Effects of thumbsucking :

• Narrow dental arches.
• Misaligned teeth.
• The roof of the mouth is pushed upward (deep palate) which would cause speech problems.
• Ugly callus on the thumb.
• Infection of thumbnail.
• Increased infections of oral cavity.
• Increased risk of pinworms.

Possible remedies :

• Admit the problem to the child in casual.
• Try to find out the cause of thumbsucking. Is it causal or due to stress ?
• Offer a reward for not sucking.
• A very effective method is asking the child to sit in front of the mirror and suck the thumb so that the child is embarrassed of the habit.
• Consult your dentist for an effective way to stop the habit.
• Coating thumb with a bitter medicine prescribed by your dentist may be an option.
• An orthodontist can place an orthodontic appliance which will deter the habit.
• Thumbguards are also known to deter the thumbsucking habit effectively.

Behavioral therapy :

Behavioral therapy helps a child avoid thumb-sucking through various techniques, such as substituting tapping fingers together quietly. Behavioral therapy works best if all people involved in the child's care follow the treatment plan.

Thumb devices :

Thumb devices, such as a thumb post, can be used for children with severe thumb-sucking problems. A thumb device is usually made of nontoxic plastic and is worn over the child's thumb. It is held in place with straps that go around the wrist. A thumb device prevents a child from being able to suck his or her thumb and is worn all day. It is removed after the child has gone 24 hours without trying to suck a thumb. The device is put back if the child starts to suck his or her thumb again. Thumb devices need to be fitted by a doctor.

Oral devices :

Oral devices (such as a palatal arch or crib that fits into the roof of the mouth) interfere with the pleasure a child gets from thumb-sucking. It may take several months for the child to stop sucking the thumb (or fingers) when these devices are used. When the child stops sucking, parents may choose to continue using the device for several months. This may prevent the child from starting the habit again. Oral devices need to be fitted by a dentist.

What is Leukoplakia

Dr. Rachana Chindhade, Smile Care, Nashik

Leukoplakia is a precancerous lesion ,with adherent white plaques or patches that develops on the tongue or the inside of the cheek as a response to chronic irritation.

Causes :

• Irritation from rough teeth or rough places on the dentures, fillings and crowns.
• Smoking,chewing tobacco or snuff in the mouth for a long period of time.
• Like other mouth ulcers, leukoplakia may become cancerous.

Symptoms :

Leukoplakia is a skin lesion with following characteristics :

1. LOCATION -
   • Usually on the tongue.
   • Maybe on the inside of the cheeks.
   • In females, occasionally on the genitals.
2. COLOUR -
   • Usually white or gray.
   • It could be red(erythroplakia).
3. TEXTURE -
   • Thick.
   • Slightly raised.
   • Hardened surface.

Possible Complications :

• The lesion causes chronic discomfort.
• Infection of the lesion is a possibility.
• Oral cancer.

Exams and tests :

• Typical leukoplakia develops slowly over weeks to months, it may become rough in texture, sensitive to touch, heat, spicy foods or other irritation.
• Biopsy of the lesion confirms the diagnosis.

Treatment :

• The goal of the treatment is to eliminate the lesion. Removal of the source of irritation is important and may lead to disappearance of the lesion.
• Dental causes such as rough teeth, irregular denture surface or fillings should be treated as soon as possible.
• Smoking or other tobacco use should be stopped.
• Surgical removal of the lesion under local anaesthesia.
• Vitamin A or vitamin E supplements may shrink lesions.

Prevention :

Minimize or stop smoking or other tobacco use. Have rough teeth treated and dental appliances repaired promptly.