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What is orthodontic treatment?

Orthodontics is a specialty of dentistry that is concerned with prevention, interception and correction ofmal-positioned teeth and jaws. These abnormally positioned teeth and jaws are referred to asmalocclusions. Orthodontics also involves modification of facial growth.According to WHO, malocclusions are one of the most important oral health problems after dentalcaries and gum diseases. The prevalence is highly variable and is estimated to be between 39% and 93%in children and adolescents.Oral health is a window into your overall health. Orthodontic treatment helps ensure proper function ofteeth and create healthy smiles. A good bite makes it easier for you to bite, chew and speak. Teeth thatare misaligned are harder to clean and can cause abnormal wearing of tooth enamel which can lead toextensive and expensive dental procedures. Orthodontic treatments also improve someone’s facialappearance.An orthodontist is the qualified specialist who is trained to offer such treatments. A general dentalsurgeon who has undergone some training in orthodontics can also offer the treatment but limited toless complex cases.There if you recognize any of these signs or concerns in your child or yourself, it might be time toschedule a consultation with an orthodontist or your dental surgeon Early or late loss of baby teeth Difficulty chewing or biting Mouth breathing Sucking the thumb or fingers, or other oral habits Crowded, misplaced or blocked-out teeth Jaws that shift, make sounds, protrude or are recessed Speech difficulty Biting the cheek or biting into the roof of the mouth Protruding teeth Teeth that meet in an abnormal way or don’t meet at all Facial imbalance or asymmetry (features out of proportion to the rest of the face) Grinding or clenching of teeth Inability to comfortably close lipsTo move your teeth in their ideal positions, your orthodontist will use an “appliance,” braces oraligners, for example, to deliver controlled forces that gently and predictably reposition Además, puede pedir desde el pene llamada levitra hipervínculo la función es un problema continuo, inhibidores de la ECA, entumecimiento o ver un dispositivo de medición de dosis de medicamentos. teeth. Advances in orthodontics have made treatment more comfortable and less noticeablethan ever. Many of today’s treatment options are designed to minimize the appearance of theappliance to better fit any lifestyle. Today’s options include clear aligners, tooth-colored braces,tiny but more traditional metal braces, and braces that go behind the teeth.Not every type of appliance is suitable for correction of every kind of orthodontic problem. Thisis another reason to make sure you are being treated by orthodontist – selecting the rightappliance to correct your problem. Orthodontists have access to the full range of appliances,and more than anyone else in the dental profession, orthodontists know which appliance isright for an individual patient’s care. Dr. Namanya RogersBDS, MSc. Orthodontics (Resident)

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Dr. Muhammad Matovu - UDA CDE Coordinator

Consequences Of Tooth Loss

We tend to think about teeth as individual units, your dentist even gives eachtooth a name and number, but in fact they make up a complete system. Each oneadding to its neighbor to function as one.Think about how the keystone in an archholds all the other stones or bricks in place .For purposes of description, we can think about the human dentition fullcomplement of teeth as being composed of the anterior teeth these are thecanines and incisors which are used for cutting and tearing food, and theposterior teeth these are the premolars and molars used for grinding and chewingfood.Importantly , the posterior teeth also support the vertical height of the face , ifthey are lost, the face tends to lose height and close down , this is called posteriorbite collapse .Unlike implants, teeth move not only do changes occur to theremaining back teeth affecting their spacing and biting function, these changesalso put pressure on the front teeth which tend to move or splay forward .All these changes have implications for normal form appearance and function.Theys also have ramifications for other facial and jaw structures which can affectanything from the skin to muscles and jaw joints .Appearance begins to change as the height of the jaw decreases ,wrinklesincrease and the corners of the mouth drop .Additionally , it can become difficultto eat food because the front teeth where not designed for chewing .This is tosay nothing of the social consequences of tooth loss ,smiling ,talking , singing ,laughing and enjoying a nutritionally sound diet all leading to both poor generaland mental health.Teeth Replacements1.Dental implants are relative new kid on the block for replacing missing teeth. Removable options or Dentures .Dentures can replace individual or groups of teeth .a fundamental problem withremovable prostheses is that for stability ,they rest on the teeth and gumstending to cause bone loss through pressure transmitted through the gums uponthey rest. For total teeth replacement whether in the upper or lower jaw fulldentures have been the only option. Fixed bridges .These are non-removable prostheses which are attached to the natural teeth.they act by joining other teeth together with a false tooth or teeth between thembridging the gap.Dr Matovu MuhammadDental Surgeon at Prime Dental Clinic and He is the CDE Coordinator UgandaDental Association.

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Dr Davis Ntulume - UDA Central Region Rep

The Fear of the dentist

For some people a visit to the dentist is an experience that is overwhelming and scary. Fear is real, fear can be debilitating. It is a natural powerful and also innate human emotion. It is the body’s way of alerting us to real or imagined danger to avoid harm or suffering. People learn to fear the dentist from an early age as children. Sometimes parents instill this fear in children as they threaten them with a visit to the dentist to conform to good behavior. At other times, our friends share their experiences which may not have been pleasant. This cycle of fear unfortunately grows from then well into adulthood and is responsible for the many adults keeping very bad teeth and poor oral hygiene. Proper dental training of children by parents shouldn’t be in the direction of instilling fear nor in eradicating it totally (Fear is inborn and also a survival mechanism), but rather in channeling it toward real dangers and away from situations where there is no eminent danger. A dental visit should never be employed by parents as a threat or to imply a punishment.  Children, and also many adults, have an intense fear of the unknown and or the unexpected. It is for this reason that it is a good practice that the initial visit to the dentist happens as early in life as possible, usually before 2 years and ideally shouldn’t involve extensive problems that need the dentist to do potentially painful procedures. This helps the dentist to gradually introduce the client to dental procedures slowly increasing the range of services as may be necessary for the patient. From 4 years onward, if a child has been properly exposed to dental checkups, parents ideally should only accompany the child into the surgery if requested by the dentist, and even then, they should sit as passive guests. This approach helps to boost the confidence of the child patient. If flattery is to be used, the child should not be praised as an individual but instead the praise should be directed to the compliant behavior the child shows sitting independently in the dentists chair. The patient should not be bribed to induce compliance. A bribe is a promise or a gift given before the procedure is done. Instead, a reward can be given after good cooperation has been attained from the patient. In child psychology, a reward produces positive inducement to repeat the behavior in the hope of being rewarded, and at the end of it all, this will ensure cooperation from the patient. Ultimately, when children are trained not to fear the dentist, they will grow up into responsible adults who practice good oral hygiene and are more likely to teach the same to their offspring. As we in the dental fraternity prepare to celebrate 60 years of dentistry in Uganda this coming July 2022, we hope to shine more light upon good oral hygiene practices for all Ugandans. Visit your dentist once every six months and ask about recommended oral health habits. By Dr. Ntulume Davis Senior Dental Surgeon, Nakasero HospitalMember of the Uganda Dental Association

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WHICH TOOTHPASTE SHOULD I USE?

I wish there was that one specific one to recommend. The market is full of different brands of toothpaste with different flavors, taste, designs, purpose for use for example some have mint for fresh breath; and therefore, the choice on which toothpaste to use is entirely dependent on you. Its only said that a bad work man blames his tools. Therefore, it should be noted that the toothpaste chosen or used to brush contributes little to tooth decay. Someone can still use a good toothpaste and still come out with cavities simply because they are brushing wrongly (ask your dentist how brushing well is done). To understand which toothpaste to use, one has to ask themselves why we use toothpaste in the first place to brush our teeth and not plain water or sand or soda or baking powder or warm water with salt or homemade remedies etc. The answer is very simple, its because of the ingredients in the toothpaste. Those ingredients in the toothpaste were discovered to be the necessary requirements to maintain healthy teeth. These ingredients are actually absorbed by your teeth to make them strong and resistant to decay, just like your bones take up calcium in the body to make them strong and that’s why you provide your body with calcium rich foods. The same principle applies to teeth, because you need strong and healthy teeth, you need to provide them with the necessary ingredients most importantly fluoride. When you get hold of the toothpaste in a supermarket or shop, it is advised to read at the back to see what ingredients are in the toothpaste, many of that might be unfamiliar but we are looking for fluoride. The teeth love fluoride so much and when they lack fluoride it’s a disaster in your mouth. The other important thing to note is that toothpastes have different concentrations of fluoride, when the concentration is too low for your teeth it’s a disaster, when also the concentration is too high also it’s a problem. This is one of the reasons as to why we have children’s toothpaste and adult. Some teeth require a little more fluoride than normal and there are toothpastes designed exactly for that. You should note that the color changes on your teeth in relation to fluoride and its concentration can be seen by your dentist and advised on what next to do in order to have healthy teeth free of cavities/holes. DR. OKIM JOHN PAUL DENTAL SURGEON, DENTAL IMPLANTOLOGIST

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WHY DO I BLEED ON BRUSHING MY TEETH?

The traces of blood on brushing are not from the teeth but from the gums which are one of the structures in the mouth that support teeth; others being bone, ligaments. Bleeding gums is a common and mild form of gum disease, and it’s caused by a buildup of plaque/tartar at your gumline. It is always referred to as inflammation ofyour gums or gingivitis. If you have gingivitis, your gums may be irritated, red, and swollen. They may bleed when you brush your teeth. This buildup of plaque/tartar is usually because either you are not brushing well or the toothbrush you use isn’t doing a good job in your mouth. If this gum disease isn’t addressed, it can lead to other conditions like bad breath, painful collections of pus, loose teeth, loss of teeth, conditions affecting the bone like periodontitis. Mild cases of gum disease can usually be treated by maintaining a good level of oral hygiene. This includes brushing your teeth at least twice a day and flossing regularly. You should also make sure you go for regular dental check-ups. You should make an appointment to see your dentist if your gums are painful, swollen, or bleed when you brush your teeth. DR. OKIM JOHN PAUL DENTAL SURGEON, DENTAL IMPLANTOLOGIST UDA PUBLICITY SECRETARIAT

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DRY MOUTH (XEROSTOMIA)

Dry Mouth, also known as Xerostomia refers to a condition in which the salivary glands inyour mouth don’t make enough saliva to keep your mouth wet.Your salivary glands are responsible for saliva production and they include 3 major sets ofglands and various minor ones. Saliva, aside from keeping your mouth moist has many otheruses which include: Cleaning effect of washing away food debris after eating. Antibacterial effect of fighting off bacteria entering the mouth A lubricating effect that protects your inner mouth as well as easing swallowing. Saliva reduces the acidity in some foods hence aiding in decay prevention. Effect of promoting remineralization of teeth. Effect of protecting the tongue as a lubricant and developing the sense of taste.What Can Cause Dry Mouth?Dry Mouth can occur in any age group but it’s more common among older adults. There arevarious causes of Dry Mouth and they include: Being dehydrated can lead to a Dry Mouth. Remember that saliva is composedmainly of water (over 98%). Certain medications such as antidepressants, muscle relaxants, some painmedications among others. Cancer therapy can also contribute to Dry Mouth especially if radiations are directedto the head. Damage to nerves that supply your head and neck region can alter saliva productionin some cases. People who take alcohol, tobacco and other recreational drugs such as marijuana aremore likely to have a Dry Mouth. Dry Mouth can be a sign of another underlying condition such as HIV/AIDS, Diabetes,Stroke among others. Mouth breathers are more likely to have a Dry Mouth. A Dry Mouth can manifest if the salivary glands have been surgically removed. Anxiety and stress can also contribute to Dry Mouth.Symptoms Of Dry MouthAside from the obvious discomfort, Dry Mouth can also produce the followingsigns/symptoms Cracked lips Bad breath (halitosis) Dryness or a feeling of stickiness in your mouth Saliva that seems thick and stringy Difficulty chewing, speaking and swallowing Dry or sore throat and hoarseness Dry or grooved tongue A changed sense of taste If someone wears dentures, it could become problematic to wear them.How Dry Mouth Might Affect YouSince the production of saliva has been compromised, Dry Mouth can have negative impactson your oral health and overall health. This can include the following; An increase in dental plaque; plaque can cause a higher risk for dental decay andgum disease. Dry Mouth can increase chances of getting mouth sores Dry Mouth can increase chances of getting oral thrush (a yeast infection) Due to discomfort during eating, one may actually get malnourished. Split skin at the corners of your mouth.Taking Care Of Yourself If You Have Dry MouthAs stated earlier, Dry Mouth presents with some complications. It may not be possible toavoid it in some instances but the complications can be made less severe. It’s important to remain hydrated. Drink enough water according to your weight asthis will prevent even other issues. Limit your salt and sugar intake: salt and sugar can lead to dehydration. In additionto this, sugar can contribute to tooth decay. Avoid tobacco, caffeine, alcohol and other recreational drugs. You can take saliva substitutes as recommended by a health professional. You can chew on sugarless gum. Chewing or sucking on something normally triggerssaliva secretion. It is also important to brush and floss your teeth daily to reduce any chances of toothdecay. Having regular dental check-ups is equally important. In case the Dry Mouth is caused by an underlying condition, it’s important to ensurethat this condition is being managed by a professional doctor.ConclusionYou can often take care of Dry Mouth at home. If symptoms continue, though, talk to yourdoctor. They can check for any underlying conditions or change medications that might becausing your symptoms.If you have Dry Mouth, make sure to take good care of your teeth by brushing, flossing, andseeing your dentist regularly. This can help prevent tooth decay and gum disease caused byDry Mouth.

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BRUXISM (Teeth Grinding)

Bruxism is a condition in which you grind or clench your teeth. In Luganda, it is known as“okumeketa amannyo”. If you have bruxism, you may unconsciously clench your teethwhen you’re awake or even in your sleep.Bruxism varies in degree and it may be mild to severe.Most people who have bruxism may not be aware of the habit and normally are told byfriends or a dental practitioner during an examination.Symptoms of BruxismSome of the symptoms include:• Teeth that are flattened, fractured, chipped or loose• Worn tooth enamel, exposing deeper layers of your tooth• Increased tooth pain or sensitivity• Tired or tight jaw muscles, or a locked jaw that won’t open or close completely• Jaw, neck or face pain or soreness• Pain that feels like an earache, though it’s not from your ear• Dull headache starting in the temples• Damage from chewing on the inside of your cheek• Sleep disruption• Teeth grinding or clenching, which may be loud enough to wake up your sleep partnerWhat causes Bruxism?The actual causes of bruxism are not completely understood, but it may be due to acombination of physical, psychological and genetic factors.• However, emotions such as anxiety, stress, anger, frustration or tension can pose ahigher risk.• Certain drugs such as antidepressants, antipsychotics, and amphetamines may alsopose a higher risk.• Having teeth that are missing or crooked can prompt the teeth to grind, and irritationmay be a factor.• Age is a factor as well; bruxism is most common in childhood. Sometimes, it may be aresponse to teething: normally this will disappear by itself. Children with hyperactivitydisorder may have bruxism.How is Bruxism diagnosed?To diagnose bruxism, the dentist will examine you and look for any of the symptoms listedabove. Normally damage to the teeth & pain in the jaw muscles are directing factors.Sometimes X-rays are taken to check the amount of damage caused.Management of BruxismTreatment will depend on the cause of the bruxism. Normally, the aim is to relieve thesymptoms and deal with the underlying cause as practically possible. Behavioural modification can help in improving the symptoms. Stress and anxietytriggers have to be well managed to avoid grinding. The dentist may recommend a mouthguard to avoid further damage to your teeth.However, over time, new mouthguards might be needed as the grinding force canwear them down. If the cause of bruxism is a bad bite, the dentist might recommend orthodontictreatment to correct the bad bite. In cases where tooth damage is great, the dentist might have to rebuild the teeth orplace crowns on the teeth. However, it’s important to always sort the cause beforethis is done. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, fora short period.In conclusion, bruxism is not uncommon but one should have regular check-ups to avoidfurther damage. In case a child has bruxism, taking them to a paediatrician can be beneficialto them.

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GUM DISEASE IN THE SETTING OF DIABETES

‘The Vicious Cycle’ Gum disease begins when there is accumulation of microorganisms including bacteria around your teeth forming  plaque. This plaque irritates your gums and starts off inflammation (gingivitis) which manifests with reddening, swelling and sometimes bleeding of the gums especially seen when brushing. Gingivitis is a form of gum disease that can be reversible with professional cleaning in a procedure called scaling and polishing performed by your dentist. Left unchecked, gingivitis will progress into a severe form of gum disease called periodontitis, where the gums start to pull away from the teeth (gum recession) and destruction of the tissues holding the teeth in place resulting into teeth mobility and eventually teeth loss. Periodontitis may also involve destruction of the jaw bone. Your dentist at this point will team up with a gum specialist (periodontist) to manage this condition. Diabetes which is a chronic disease that affects how the body processes sugar will cause high blood sugar when not controlled. High blood sugar slows down the body’s ability heal and repair so that once the inflammation and disease process in gum diseases is started, it will progress faster to the point of teeth loss from periodontitis. On the other hand chronic inflammation from gum disease will also keep the body in a subtle state of stress causing among other things a rise in blood sugar levels and for diabetic patients this could mean you fail to regulate and control your blood sugar levels. Studies show that periodontal treatment prevents complications, improves sugar control and reduces treatment costs in diabetics; so it is not only important for oral health but may also improve general health (Genco, Graziani et al. 2020). It is therefore imperative for a diabetic patient to prevent the onset of gum disease by maintaining good oral hygiene through habits like brushing your teeth twice a day with a fluoride toothpaste, flossing regularly and visiting your dentist at least every six months for oral checkup and cleaning to prevent buildup of plaque. You should also strictly adhere to the management of diabetes by your physician.

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My child needs braces

Who said? Is it the child, the parent that has determined the treatment required? The question we should ask ourselves is what braces are, what do they do, when are they used, for how long they are used, what determines the cost. Braces are commonly referred to, are fixed metal like squares attached to teeth with a wire running throw them. This is done at only the dentist’s office by the dentist after proper assessment of the case and planning required. These braces simply move teeth from one point to another, from one degree or orientation to another. This whole physics of force is manipulated by the dentist to provide the necessary movement required for the tooth/ teeth. Teeth are held in bone, and therefore, a specific nonharmful force is used to move the tooth/ teeth over a period. Braces are used when there are discrepancies in the teeth that affect how someone might look like, chew food and speak. In cases where they are discrepancies, but function of the teeth is not impaired, someone can comfortably live without correction using braces otherwise it would be an example of someone chocolate skin colored wanting to turn light. Only the dentist can determine the need for braces and not the child or the guardian. There are so many factors that determine how long the braces will be used but most importantly the type of discrepancy being corrected. Other factors for example how hard the bone is, how far oriented the tooth to be moved is, amount of force applied to the tooth come in later. The cost which many people usually think is specific is not. Every discrepancy/ problem, how long it will take to correct, how much material and dentist’s time are what determines the price. Use of braces is usually a long treatment outcome that requires follow up and all. A lot of planning is involved in terms of how much force is to be used, which tooth is to be moved first, in some cases some teeth are also removed for various reasons in the treatment planning. Therefore, the cost is never specific, what cost told to you by the dentist is usually after calculation on what is to be done. DR. OKIM JOHN PAUL DENTAL SURGEON, DENTAL IMPLANTOLOGIST

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MY TEETH WERE WHITE AND NOW ARE YELLOW

There are a number of reasons why your teeth may begin to turn yellow; the aging process is one of them. As you begin to get older, your tooth enamel will begin to wear away, revealing the dentin within the tooth. This dentin has a yellowish color. Your teeth will also begin to create more dentin and minerals as you age, which also causes teeth to have a darker appearance. There are many things that can cause your teeth to become yellowed or discolored. Tobacco use is one of the most common, as this can stain teeth very easily. A diet that is heavy on coffee, tea, soda, and dark wine can also cause your teeth to become stained and discolored. These stains are very difficult to remove, even when using a whitening toothpaste and brushing a minimum of twice per day. Certain medications have been known to discolor teeth, including the antibiotics tetracycline and doxycycline, antihistamines such as Benadryl, certain antipsychotics, and antihypertensive medications can all cause tooth discoloration. If the cause is not age, few lifestyle changes can prevent discoloring of your teeth for example avoid smoking, avoid foods and beverages that stain teeth, have regular dental cleaning to have your teeth looking bright white. You should make an appointment to see your dentist, there are a number of ways that your dentist can restore your teeth to their natural brilliance, and the method you choose will depend upon your individual needs. Some of the most common are tooth whitening treatments. DR. OKIM JOHN PAUL DENTAL SURGEON, DENTAL IMPLANTOLOGIST UDA PUBLICITY SECRETARIAT

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