Dentist

Teeth problems may be many and varied. Some of the teeth problems handled by dentists are:

• Removal of tooth decay
  
• Filling of teeth cavities with gold, silver, amalgam or cement with fused porcelain inlays
  
• Removal of teeth (extraction)
  
• Removing the nerves of teeth or root canal treatment
  
• Replacement of teeth with bridges and dentures or dental plates
  
• Examine x rays
  
• Place protective plastic sealants on kid's teeth
  
• Straighten teeth and repair fractured teeth
  
• Dentists also perform corrective surgery on gums and supporting bones to treat gum diseases.
  
• Dentures are constructed by dentists by making models and measurements of extracted teeth.
  
• Dentists render advice on dental care.
  

Most dentists handle general teeth and gum-related issues. Some dentists do specialty practice. Orthodontist is a specialist who straightens teeth by applying pressure to the teeth with braces and retainers. This is the largest practicing group in dentistry. Oral and Maxillofacial surgeons are the next largest group and they operate of the mouth and jaws. Periodontist treats gums and bones supporting the teeth, prosthodontist replaces missing teeth with permanent fixtures, endodontist performs root canal therapy, and public health dentist promotes good dental health and prevents dental diseases in the community level. An oral pathologist studies oral diseases and oral and maxillofacial radiologist diagnoses diseases in the head and neck through the technique of imaging.

Angular Cheilitis

Angular Cheilitis is a condition in which one or both corners of the mouth develop cracks and sensitive sores and eventually get infected. The ends of the lips become dry, scaly and painful. The infection is caused by continuous exposure to the bacteria present in the saliva. The bacteria get accumulated in the cracks of the lips giving rise to infection. The infection may be caused by various microbes like bacteria, virus or fungi leading to Oral Thrush or candidiasis.

Causes

• Vitamin deficiency, particularly of B12
  
• Exposure to irritants
  
• Drooling of saliva in children
  
• Poorly fitted dentures
  
• Weakened immune system
  
• Systemic disorders
  
• Dry weather
  
• Continuous licking of lips
  
• Loss of teeth in elders

Signs and Symptoms

Initially, angular cheilitis will show up with mild symptoms, and if left untreated, turns chronic and causes severe discomfort. At the initial stage, Angular Cheilitis presents itself with the following symptoms:

• Tight feeling near the angles of the mouth
  
• Dry and scaly lips
  
• Mild discomfort in opening the mouth.

As the condition worsens one may suffer from the following symptoms:

• Redness with pain
  
• Sores and bleeding fissures
  
• Pain and oozing
  
• Difficulty while talking and eating.

Angular Cheilitis causes

A single definitive cause is yet to be ascertained. Contributory factors are identified. Poor nutrition and infection score high as compared to other factors. One or combination of these factors is enough for bacteria or fungus in the mouth region to suddenly multiply and cause localized soreness.

• Nutritional deficiency of mineral and vitamin (folate, iron, B-vitamin deficiency)
  
  
• Deficient immune system
  
  
• Poor hygiene
  
  
• Diabetes, cancer, anemia, Celiac disease, HIV/AIDS, infection
  
  
• Ill fitting dentures , dry mouth, tobacco smoking, make-up, lip balm, high fever, cold weather, allergic reactions, overdose of vitamin A
  
  
• Facial disorders where the lips are enlarged, Down syndrome, Crohn's disease
  
  
• Medications to treat specific health issues such as lithium (for mania), ionized (TB), D-penicillamine (Wilson's disease), retinoids for acne, chemotherapy agents, phenothiazine (for headache, mental disorders).

Angular Cheilitis signs and symptoms

• Slight tightness in one or both corners of the mouth causing discomfort in opening mouth.
  
  
• Formation of small flaky skin in the corners of the mouth.
  
  
• Redness and swelling that tempt frequent licking of the mouth which aggravate the condition.
  
  
• Split corners at the edges of the mouth.
  
  
• Difficulty in eating and talking.

Treatment

Treatment for angular cheilitis involves applying topical anti bacterial and anti fungi creams or ointments along with oral medication. Ointment with emollient properties is usually prescribed and depending upon the microbial infection antibiotics, antifungal, anti-viral and topical steroids are prescribed.

Angular cheilitis can also be treated at home with the help of easily available natural products. Aloe Vera, honey or fresh neem leaves have anti bacterial and anti fungi properties. They can be gently rubbed on the wounded area at frequent intervals. Applying salt water on affected region works well as the saline water inhibits the growth of bacteria and kills the existing microbes.

Appearance of Angular Cheilitis is often misconstrued to be an outcome of cold sore throat. It is actually a form of dermatitis, a type of skin infection. Typically, one or both the corners of the mouth have lesions making opening of the mouth highly painful. If left untreated, the lips can chap and the areas around the lips may start to peel off thereby worsening the condition.

A culture test to establish the bacteria, fungus or virus is required. A swab from the affected corner is taken and tested. Nutritional supplements containing Vitamin B12, folate and iron are suggested. Maintain good oral hygiene and avoid lip makeup till the condition improves.

Cosmetic Dentist

A cosmetic dentist is a general dentist with an added dimension. Besides performing the functional requirements of a dentist, the cosmetic dentist pays close attention to the appearance of the dental work. Cosmetic dentistry is not generally taught in dental schools as part of the normal curriculum. A cosmetic dentist, in addition to qualifying as a dental graduate needs to pursue additional training after graduation and undergo specialist accredited training in the field. Cosmetic dentistry covers a multitude of procedures that improves the beauty and health of one's smile. Cosmetic dentistry can be as simple as re-contouring of one or more teeth or as comprehensive as an aesthetic and functional rehabilitation. Cosmetic dentistry can brighten a dull teeth, whiten stained teeth, close gaps between teeth, repair chipped teeth, mask metal fillings and straighten crooked teeth.

• When a person's teeth are short or long, stained or chipped, misaligned or over crowded, a cosmetic dentist renders multiple cosmetic dentistry treatments and transforms the unattractive smile of a patient.
  
• A cosmetic dentist places porcelain veneers over the teeth to mask virtually any cosmetic problem.
  
• A cosmetic dentist can remove the coffee, tea and cigarette stains from the teeth. These stubborn stains cannot be removed by brushing alone. Special teeth whitening procedures can help eliminate these superficial stains. Staining caused in teeth due to aging or medication usage can also be removed.
  
• A cosmetic dentist addresses minor cosmetic issues including jagged or chipped teeth and noticeable gaps between teeth. Dental bonding is an ideal solution for such minor imperfections. The cosmetic dentist uses a tooth bonding material and masks these imperfections.
  
• Tooth decay is one of the commonest of problems among all ages. A cosmetic dentist recommends filling the cavity with tooth colored white filling or reinforces the tooth with dental inlays or onlays.
  
• For a severely cracked and damaged or fractured tooth, when filling or dental inlays or onlays do not work, a cosmetic dentist uses 'dental crown' or caps.
  
• Old and unsightly crowns can also be replaced with ultimate all-ceramic crowns.
  
• A cosmetic dentist provides viable treatment options for patients with missing tooth or more teeth. 'Dental implants supported by dental bridges' are the most modern permanent solution to this problem. Sometimes patients can also opt for full and partial dentures.
  
• The modern alternatives of 'invisalign invisible braces' are used by cosmetic dentists in place of traditional metal braces to attend to crooked, misaligned or overlapping teeth.
  
• A cosmetic dentist renders gum disease treatment for painful, swollen or inflamed gums. A 'gummy smile' or excessive uneven gums are often helped with a 'gum life procedure'.
  
• Excessive tooth wear and grinding are often linked to jaw joint problems and headaches. A cosmetic dentist helps to alleviate these problems by using 'occlusal splint' or in severe cases treat with full oral rehabilitation.
  
• Depending upon the unique aesthetic needs and physical characteristics that change with age, the cosmetic dentist adopts useful procedures that are more suitable for achieving the look an individual desire.
  
• 'Combined techniques' are frequently used in smile design to create an ideal and natural looking smile. An example is 'bleaching' may be followed with 'minor orthodontics' and completed with porcelain veneers.

Techniques adopted by a cosmetic dentist

A cosmetic dentist adopts latest dental techniques to improve the treatment and reduce the 'chair time' of the patient. Some of the latest techniques are:

• Laser technology that adopt a 'no drill' technique
  
• Digital x ray technology
  
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• Computerized anesthetic delivery
  
• Diagnodent-laser cavity detection
  
• Tooth whitening