Teething Presentation for Dentistry.pptx.pptx

Presentation on teething by Dr.Sanjul kalra (B.D.S.).

1. TEETHING Sanjul Kalra B.D.S. 3 RD Year

2. Contents INTRODUCTION DEFINITION CLINICAL FEATURES MANAGEMENT STUDY REPORTS ASSOCIATION WITH HERPES SIMPLEX INFECTION CONCLUSION BIBLIOGRAPHY

3. INTRODUCTION 1 Teething - 'eruption of primary teeth’. Either Abnormal or difficult eruption Eruption happens in fifth or sixth month. Eagerly awaited and important milestone Sometimes local irritation - minor or severe enough to interfere with the child’s sleep Relatively large molars

4. DEFINITION Teething is the process by which an infant teeth erupt or break through the gums. It is also referred as cutting of the teeth. It is medically termed as odontiasis .

5. CLINICAL FEATURES LOCAL SYMPTOMS Hyperemia or swelling of the mucosa overlying the erupting teeth Patches of erythema on the cheeks Flushing of the skin of the adjacent cheek Frequent movement of Hand and fingers inside the mouth

6. SYSTEMIC SYMPTONS General irritability and crying Increased salivation and drooling Loss of appetite Sleeplessness and restlessness Increased thirst Cough

7. ASSOCIATED PROBLEMS SYSTEMIC Fever Convulsions Diarrhea Vomiting Rashes around mouth

8. ASSOCIATED PROBLEMS LOCAL Eruption haematoma Eruption sequestrum Ectopic eruption Transmigration Transposition

9. POSSIBLE EXPLANATION FOR THE SYMPTOMS There is an active diarrhea, nausea, vomiting, convulsions in Alimentary canal. Coincidental association with diarrhea, fever, convulsions. Mouthing of contaminated toys or teethers were used to rub the gums

10. MANAGEMENT Mention teething in prenatal counselling- the first postnatal oral issue confronted Educate members of the family about good oral and body hygiene to keep gums healthy and fresh Gums to be wiped after each meal with cotton soaked in weak antiseptic- 1:100 KMnO4 Adequate vitamins, minerals, proteins to be fed. PREVENTIVE MEASURES

11. LOCAL MANAGEMENT Gentle massage- clean finger or saline soaked gauze piece & increased fluid consumption TEETHING OBJECTS Satisfy the natural desire of the infant to chew on hard objects Stimulates the gumpads for the smooth and painless eruption

12. LOCAL MANAGEMENT Teething foods Hard non sweetened firm rusks Toasted bread Biscuit preparations Hard fruits and vegetables, apple, guava, carrot.

13. LOCAL MANAGEMENT Teething toys Specifically manufactured teething rings, keys, blowers, rattles to be used. A cold solid teething toy or ring are helpful Chewing on a teething toy soothes soar gums.(Preferred to buy a teething toy made of soft silicone or rubber)

14. LOCAL MANAGEMENT Topical Medicaments glycerin lignocaine hydrochloride ( tds / qid ) Caution : Rapid systemic absorption. Toxicity may occur if misused. benzyl alcohol mild purgatives (phenolphthalein, castor oil, calomel, milk of magnesia)

15. INGREDIENTS IN PREPARATIONS

16. SYSTEMIC TREATMENT Only if local treatment has been ineffective ANALGESICS Sugar free Paracetamol preparations(5ml=120mg) Dosage: upto l year- 5ml at bedtime 1-5 years - 10ml at bedtime Soluble acetyl salicylic acid tablets Chamomilla- homeopathic medicine

17. SYSTEMIC TREATMENT HYPNOTICS & SEDATIVES To restore normal sleep rhythm after a succession of sleepless nights Combined with analgesics Chloral Elixir Pediatric BPC(5ml=120mg of chloral hydrate). Dosage: Upto l year: 2.5ml bd; 1-5 years: 2.5-5ml tds Dichloralphenazone Elixir BPC ( Welldorm Elixir) (4ml= 150mg dichloralphenazone) Dosage: Upto 1 year: 2.5-5 m1 tds ; 1-5 years: 5-10ml tds

18. CAUTION If symptoms persist for more than 24 hours, physician should be consulted to rule out URTI and other diseases of infancy

19. SURGICAL TREATMENT Pain relief from an eruption cyst or hematoma TECHNIQUE: Two semilunar incisions are made over the crown of the tooth which meet at their extremities The intervening portion of the tissue which lies over the occlusal portion of the unerupted tooth , is then removed with a pair of tissue forceps

20. ASSOCIATION WITH HERPES SIMPLEX INFECTION Few scientific data to implicate teething as the etiology of fever, diarrhea Children with teething symptoms- culture positive for HSV Type-1 On examination: Generalized erythematous gingiva Several ulcerated areas in the mucosa Coated white tongue Several partially erupted teeth

21. ASSOCIATION WITH HERPES SIMPLEX INFECTION Diagnosis Subjective symptoms Prodrome of itchiness or mild tingling sensation before the development of the lesions Mild flu-like symptoms Objective symptoms It is 2-4 mm diameter and these are painful blisters and erosion of the gums and the skin around or lining of the mouth. Heals in 7 days

22. ASSOCIATION WITH HERPES SIMPLEX INFECTION Therapy Keep the lesions well lubricated with an emollient to promote healing Isolate the patient from persons at risk for primary herpes infection Prophylactic oral acyclovir reduce the frequency

23. Conclusion Since the time of Hippocrates (460-377BC) it has been observed that teething infants often suffer from several systemic conditions including fever, diarrhea, convulsions. This discussion concludes with the note that, from the review of the available literature on teething there is no conclusive evidence to attribute teething as the sole factor leading to the conditions associated with it. This is an area that requires still lot of investigation for explanation.

24. BIBLIOGRAPHY Dentistry for the Child and Adolescent- McDonald, Avery, Dean (8th edition) Pediatric Dentistry- Infancy through Adolescence- Pinkham (3rd edition) A manual of pediatric dentistry- R.J.Andlaw & W.P.Rock (4th edition) Textbook of Pedodontics- Shobha Tandon (2nd edition) Textbook of Pediatric Dentistry- S.G.Damle (3rd edition) Principles & Practice of Pedodontics- Arathi Rao (2nd edition) Jablonski’s Dictionary of Dentistry www.infantteethingtoys.com

25. THANK YOU! A HEALTHY MOUTH, IS A HAPPY MOUTH