IMPACTED बुद्धि बंगारा (Impacted third molar tooth) OR Impacted wisdom tooth

IMPACTED बुद्धि बंगारा भनेको त्यो दाँत हो जुन पूर्ण वा आंशिक रूपमा अव्यवस्थित हुन्छ र अर्को दाँत, हड्डी वा नरम टिश्युले ढाकेको हुन्छ। यस्तो दाँतको पूर्णरुपले उम्रने सम्भावना हुँदैन। यी दाँत सामान्यतया १७  देखि २५ बर्ष उमेरको बीचको उम्रने गर्दछन्। बुद्धि बंगारा आउँदा त्यस वरिपरिका गिंजामा खान अड्किएर वा सफाई नपुगेर संक्रमण हुन सक्छ। त्यस्तो अवस्थालाई PERICORONITIS भानिन्छ। अन्वेषकहरूले सुझाव दिएका छन् कि पुरुषको तुलनामा महिलाहरुमा बुद्धिबंगारा IMPACTION को प्रभाव बढी हुन्छ।

दाँतको चोटपटक र तिनको व्यवस्थापन (Traumatic Injuries of Tooth)

दाँत भाँचिनु 

मुखमा कुनै दुर्घटनाबाट दाँत भाँचिन सक्छ । दाँत भाँचिदा दाँतको विभिन्न सतह मा भाँचिन सक्छ। 

• Enamel मात्र 
• Enamel र Dentine 
• Enamel, Dentine र Pulp 

दाँतको जरै देखि भर्ने उपचार (Root Canal treatment-RCT) के हो?

दाँतको जरै देखि भर्ने उपचार (RCT ) के हो?

दाँतको देखिने भागलाई Crown भनिन्छ । Crown तिन पत्रले बनेको हुन्छ । Enamel, Dentin र Pulp। दाँतको बाहिरी पत्रलाई Enamel भनिन्छ ।  Enamel को मुनिको भागलाई Dentin भनिन्छ भने, Dentin मुनिको भागलाई Pulp भनिन्छ । Pulp मा नशा तथा रक्तनलि रहेको हुन्छ जसको माध्यमबाट दाँतले पोशकतत्व पाउँदछ । Pulp दाँतको जरा सम्मनै फैलिएको हुन्छ । संक्रमणको शुरुवाती चरणहरूमा तपाईलाई कुनै पीडा नहुन सक्छ। Pulp मा संक्रमण फैलिएको अवस्थामा PULP निकालेर जराको नहर भर्ने विधिलाई RCT वा Root Canal Treatment भानिन्छ।  

https://nhakhoaminhkhai.net/endodontic-treatment-minh-khai-dental-clinic/

दाँतको जरै देखि भर्ने उपचार (RCT ) 

को आवश्यकता किन ?

यदि पल्प संक्रमित भयो भने, संक्रमण दाँतको जरामा फैलिन सक्छ र गम्भीर पीडा हुन सक्छ। यो अन्ततः पिप जमेर सुनिन्न सक्छ। यसले  दाँत वरिपरिको भाग सुनिन्नका साथै अनुहारको infection पनि निम्त्याउँछ।  यदि RCT  गरिएन भने, संक्रमण फैलिनेछ र दाँत निकाल्न आवश्यक पर्दछ।

संवेदनशील दाँत (Tooth Sensitivity) के हो ?

संवेदनशील दाँतको कारण (Cause for tooth Sensitivity)

हामीले देख्न सक्ने दाँतको भागमा इनामेलको (Enamel )लेयर हुन्छ जसले  मुनिको नरम डेन्टिन (Dentine) सुरक्षित गर्दछ। यदि  डेन्टिन खोलियो भने, दाँत संवेदनशील हुन सक्छ।  

संवेदनशील दाँतको केहि कारणहरू यस प्रकार छन्:

• धेरै कडा ब्रश ('Tooth  brush Abrasion ') - कडा ब्रशले इनामेल खियाउछ र खुला डेन्टिन त्यसपछि संवेदनशील हुन सक्छ।
• दन्त क्षरण (Dental Erosion ): यो एसिडको खाना र पेय पदार्थहरूको एसिडको कारणले गर्दा हुने दाँतको इनेमेलको क्षति हो /
•  गिजाको रोग (Gum Disease) : plague  वा टार्टरको निर्माणले गर्दा गिजा तल खसाल्न सक्छ र दाँतको हड्डी समर्थन पनि नष्ट गर्न सक्छ। 

मुखको अल्सर (Mouth Ulcer)

मुखको अल्सर के हो?

मुखको अल्सर एकदम दुख्ने  पीडादायी घाउहरू हुन् जुन मुख भित्र देखिन्छ। तिनीहरू प्राय: रातो, सेतो वा पहेंलो हुन्छन्। तिनीहरू अन्य घाउहरू भन्दा फरक हुन्छन् , जुन बाहिरी ओठहरूमा देखा पर्दछ र भाइरसको कारणले हुन्छ।

मुख अल्सरको सामान्य कारणहरू-

सामान्यतया एकल मुखको अल्सर गाला  वा जिब्रोमा टोक्ने क्षतिको कारणले हुन्छ, वा तीखा दाँत, ब्रश वा खराब

सुख्खा मुख (Xerostomia or Dry Mouth) भनेको के हो?

सुख्खा मुख  (xerostomia or Dry Mouth) भनेको के हो?

राम्रोसँग काम गर्नका लागि तपाईको मुखलाई र्‍याल  चाहिन्छ। र्‍यालले तपाईंको मुख ओसिलो राख्छ, र यसले तपाईंको खाना मसिनो बनाउन मद्दत गर्दछ र तपाईंलाई निल्न सहयोग गर्दछ। यसले सफा पनि गर्ने काम गर्दछ।  सुख्खा मुख वा 'xerostomia' एक मुख सम्बन्धि समस्या हो जसले र्‍यालको प्रवाहलाई असर गर्छ र तपाईंको मुख सुक्खा महसुस गराउँछ।

मुख सुख्खा छ भनेर कसरी थाहा पाउने ?

मुख सुक्खा भएको धेरै लक्षणहरू छन्। सब भन्दा पहिले त सुख्खा मुख नै हो। केही व्यक्तिहरु लाई लाग्छ कि उनीहरुको र्‍याल बाक्लो र टाँसिएको छ, यसले बोल्न वा निल्न गाह्रो बनाएको छ। केही व्यक्तिको पनि मुखमा जल्दो उत्तेजना हुन्छ र केहि खानेकुरा प्रति संवेदनशील हुन्छन्। मुख दुख्न सक्छ र दाँत किरलाग्ने र गिज रोग को एक उच्च जोखिम हुन्छ। केहि केसहरूमा, मुख पनि रातो र चम्किलो हुन सक्छ। यदि तपाईंसँग यी कुनै लक्षणहरू छन् भने यसको मतलब यो हुनुहुदैन कि तपाईंसँग मुख सुख्खा छ। तर यसको बारेमा तपाइँको दन्त चिकित्सकसँग कुरा गर्नु उत्तम हुन्छ।

दूधे दाँत उम्रने क्रम (Eruption of Deciduous teeth)

दुधे दाँतहरु ६ महिनादेखि ३ बर्षको बीचमा उम्रन्छन / सामान्यतया पहिलो फाली दाँत , दोश्रो फाली दाँत। पहिलो बंगारा, कुकुर दाँत र दोश्रो बंगाराको क्रममा दाँत उम्रन्छन / प्राकृतिक रूपमै ६ देखि १३ बर्षको बिचमा यी दाँतका जराहरु आफै हराएर साट्ने गर्छन / साटिने क्रम यस प्रकारले हुन्छ- पहिलो फाली दाँत, दोश्रो फाली दाँत, पहिलो बंगारा, कुकुर दाँत र दोश्रो बंगारा।  

                                        दूधे दाँत  उम्रने क्रम                         दूधे दाँत साटिने क्रम 

दाँत	माथिल्लो र तल्लो बंगारा                  (महिना )	तल्लो बंगारा              (बर्ष )	माथिल्लो बंगारा                  (बर्ष )
बिचको फाली दाँत	६-७	५-७	६-७
छेउको फाली दाँत	७-९	७-८	७-८
कुकुर दाँत	१८-२०	९-१२	१०-१२
पहिलो बंगारा	१२-१५	९-११	९-११
दोश्रो बंगारा	२४-३०	१०-१२	१०-१२

School Based Integrated Community Health Program (BABU Project)

BABU Project (Bringing About Better Understanding ) is the integrated health program targeted to the rural community through schools. The program includes integrated approach to the school children, teachers,

BABU project ( School Based Integrated Health and leadership Development Program)

BABU Project (Bringing About Better Understanding ) is the integrated health program targeted to the rural community through schools. The program includes integrated approach to the school children,

दाँतका विभिन्न प्रकारहरु, बनावट र दाँतको कार्य |

दाँतका विभिन्न प्रकारहरु, बनावट र दाँतको कार्य |

दाँत हाम्रो शरिरको एक अभिन्न अंग हो | हाम्रो वयस्क शरिरमा ३२ वटा दाँत हुन्छ | तर आजभोली ३२ वटा दाँतको सट्टा प्राय मानिसमा २८ वटा मात्र दाँत रहेको भेटिन्छ | त्यसतै बालबालिकाको मुखमा भने २० वटा मात्र दाँत रहेको हुन्छ जुन उमेरसंगै फेरिदैँ जान्छ |बालबालिकाको दाँत अथवा दुधे दाँतलाई Primary/ Deciduous teeth भनिन्छ भने वयस्कको दाँतलाई Secondary/ Permanent teeth भनिन्छ ।

दाँत नम्न प्रकारका हुन्छन् :

फाली दाँत (Incisors) : अगाडीको दाँतलाई फाली दातँ भनिन्छ । फाली दाँत २ किसिमको हुन्छ। पहिलो फाली दातँ (Central Incisor) र दोस्रो फाली दातँ (Lateral Incisor) ।

कुकुर दाँत (Canine) : हाम्रो मुखको कुनाको दातँलाई कुकुर दातँ भनिन्छ । कुकुर दातँको जरा सबै भन्दा लामो हुन्छ र यो दातँले मुखको पिल्लरको काम गर्दछ ।

दाँत किराले खाने समस्या के हो ??

हाम्रो शरिर तथा मुखमा आँखाले नदेखिने थुप्रै किटाणुहरु हुन्छन् जसलाई हामी Normal Microbial Flora भन्दछोैँ । यि किटाणुको हाम्रो शरिरमा महत्वपुर्ण भुमिका हुन्छ । यि किटाणुले हामीलाई स्वस्थ्य राख्न हाम्रो शरिरमा हुने बाहिरी किटाणुको आक्रमण बिरुद्ध लड्दछन् । त्यस्तै यि किटाणुले खाना पचाउने र हाम्रो शरिरमा रोग प्रतिरोधात्मक शक्ति विकास समेत गर्दछन् ।

How to register dental clinic in Nepal

1.First you should find the good place for rent. Do an agreement/contract paper with the landlord for minimum mentioning the monthly rent and and tax.
2.  Collect all photocopied documents of a doctors, dental hygienist and staffs.  Make an Appointment paper (niyukti patra) of all those staffs. certificates of all those staffs and citizenship should be collected along with the CVs. Don’t forget nagariktako photocopy of all the staffs, house owner, agreement paper with the house owner, kar tireko bill or batti ko bill.
3. Go company registration or go to Gharelu Udhyog for the registration process. you need to fill the form which is available there with all the details and register the submission.you should mention the total investment and  also list of equipment.  Produce all those documents and pay money (charge) to register a business with name. Eg. Community Dental Clinic. Company registration office or Gharelu Udyog will give you a letter initially. That is not the company regisration.

What is Fluoride

What is Fluoride?

Fluoride is a mineral that occurs naturally in rocks, soils and in water. Small amounts are present in almost all foods. In humans, it is a natural constituent of tooth enamel.

Sources and Benefits of Fluoride

There are numerous studies concerning the relationship of fluoride intake and decreased caries. The beneficial effects of fluoride can be systemic or topical.

Dental Care for special children

Special Care dentistry

Research has shown that poor oral health is one of the most common secondary conditions affecting people with ID. This population group has a higher prevalence and greater severity of periodontal diseases such as gingivitis and periodontitis, compared to people without ID. Some people need special facilities or services to have this care provided. People with physical disabilities may have problems getting into the surgery or even into the dental chair. People living with intellectual disabilities may become overanxious at the thought of going to the dentist or may need extra reassurance. People suffering from severe medical problems may need extra precautions or care. 

Who can provide treatment?

Many dentists will happily treat people with special dental needs in their surgery. However, some people find it hard to get to the surgery and so other arrangements may be made by the practice: for example, home visits and special health centres. Some people need a specialist service. The local Community Dental Service or some health centres will also help people needing specialist care and may be able to offer possible treatment alternatives, such as sedation or general anaesthetic. The dental team need to know the patient's medical history and about any medicines they are taking. This includes any inhalers and regularly prescribed medicines from the doctor.

It is also helpful if the dental team know about any concerns or anxieties the patient has, so that they can help to make the patient feel at ease. This information can be given by the patient's parents or care giver. However, some patients do prefer to communicate directly with the dentist. Some patients may have other special needs: for example, the help of an interpreter or translator, or to have a guide dog. Dentists are prepared for working in these situations.

How accessible are treatment clinics?

Practices should offer facilities for wheelchair users, including access to the practice, and ground-floor surgeries. If wheelchair access is particularly important, contact the surgery and ask if this is something they are prepared for. Some clinics have specially adapted surgeries for patients with mobility problems.

Is there anything to make brushing easier?

For some people, moving their arms or hands can be a problem, which makes effective cleaning difficult. It is important to reach all the areas of the mouth to clean effectively. A toothbrush with a small to medium head size with soft to medium bristles is usually recommended. There are special handgrips and other adaptations which can be fitted to manual toothbrushes to make them easier to hold.

In some cases, electric or ‘power' toothbrushes are recommended for people with mobility problems. They are also helpful to people with learning difficulties as they can be a novelty and therefore encourage brushing. The dentist or dental team will be able to offer advice and practical help on brushing and general mouth care.

Is sedation available?

Intravenous sedation (an injection) is an effective way of treating most nervous patients. The drugs given can relax and calm the patient, so treatment can be carried out with the dental team and patient still able to talk to each other. There are certain things that affect a patient's suitability for this type of sedation. These include weight, age and medical condition. This would all be discussed during the consultation. Sometimes the patient would need to be referred to a specialist clinic for this treatment.

What other help is available?

Relative Analgesia (RA) can also help patients get through their treatment more easily. Here, nitrous oxide and oxygen are breathed in through a nosepiece. It is the safest and simplest form of sedation and is often the one most suitable for both children and people with special needs. However, this is not appropriate for everyone - especially people with limited understanding, cerebral palsy or multiple sclerosis.

In some cases, the dental team prefer to use other ways of calming the patient. These can include simply talking, visiting the practice to meet staff, or even hypnosis. These can all be effective in making the patient less anxious.

How often should I visit the dental team for care?

It is important to visit the dental team regularly. This would normally be every six months, but some people need to visit less often and others more often. The dental team will be able to tell you.

The dentist may also recommend appointments with a dental hygienist, who will remove plaque and tartar from the teeth and offer advice on how to brush effectively and keep your mouth clean and healthy. The dental team may also offer advice to care givers about the dental care of others. It is very important to build a relationship between the dental team, the patient and their care giver. This can help greatly with people who have severe learning difficulties. Short but regular appointments seem to work better at building trust between the patient and the dental team than long appointments at irregular intervals.

What toothpaste should be used?

It is recommended that children up to three years old use a toothpaste that contains at least 1000ppm (parts per million) of fluoride. Over the age of three, a toothpaste that contains 1350 to 1500ppm of fluoride is recommended. If the dentist thinks that the patient is particularly at risk of tooth decay, they may prescribe a toothpaste or fluoride varnish which contains a higher level of fluoride to offer more protection.

https://www.dentalhealth.org/dental-care-for-people-with-special-needs

Early Childhood Caries

Early childhood caries occurs in young children who frequently suck on bottles/dummies of fluid containing sugars. Frequent intake of biscuits is another cause. Some of the caries causing bacteria can even be transferred from the mother to the child through kissing and food tasting. Extended use of medicines with high sugar content, especially just before bedtime can also cause caries. The upper front teeth are most likely to decay, though other teeth may also be affected . 

Regressive alterations of teeth

Attrition

Includes variety of alteration that are not necessarily related either etiologically or pathogenetically

ATTRITION
- Physiological wearing away of tooth as a result of tooth to tooth contact, as in mastication
- Phenomenon is physiologic rather than pathologic
  Clinical feature
 Men> female
–masticatory force
–chewing tobacco habits
–bruxism

Post Extraction Instructions

bfFt lgsfln;s] kl5 la/fdLn] Wofg lbg'kg]{ s'/fx? M

Ø bfFt lgsfn] kl5 lbOPsf] skf;sf] 6's|f slDtdf cfwf 306f;Dd 6f]Sg'k5{ .

Ø y'Sg' x'Fb}g, y's cfPdf lgNg'k5{ .

Ø bfFt lgsfn]sf] lbg d'v s'Nnf ug{' x'Fb}g t/ ef]nL kN6af6 #–$ lbg ;Dd dg tftf] g"g kfgLn] ;fFem laxfg s'Nnf ug{'k5{ .

Ø bfFt lgsfn] kl5 cf}iflw lbPsf] eP 8fS6/sf] ;Nnfx cg';f/ lgoldt ?kdf vfg'k5{ .

Ø dfly pNn]lvt s'/fx? u/]/ klg ;d:of ePdf ;DalGwt 7fpFdf jf :jf:Yo rf}sLdf km]l/ ;Dks{ /fVg'k5{ .

Ø d'v :j:y /fVg x/]s lbg vfgf vfO;s] kl5 ˆnf]/fO8o'Qm d~hgn] lbgsf] b'O{ kN6 bfFt df‰g'k5{ .

Health and Development Society Nepal, Oral health program, Health camps,...

Basic First Aid Training- HDSN health and development society nepal

oral health program at OKhaldhunga HDSN health and development society n...

dental camp/ oral health program

health camps and Psychosocial trauma relief, we help nepal

oral health program, General Health camps and psychosocial Trauma relief

Health and development Society Nepal, First aid training

Integrated health camp organized by swasthya karyalaya lalitpur

Oral Cancer

 A new tissue growth on the lip, gum, tongue, floor of mouth and unspecified parts of the mouth, with uncontrolled growth of cells that have no physiological use.

 Incidence

·    40% of all cancers in South Asia, 10-15% of all cancers in Nepal (hospital-based finding)

·   Cancer of mouth and pharynx ranks as the 5th commonest site of cancer in developing countries and 8^th in developed countries. In Nepal, over 2000 new cases of cancer and 600 deaths reported annually, with a distribution of 5:1 for male: female.

Start From School Project

Dental caries is one of the most prevalent childhood diseases in Nepal, especially in the young children in the rural areas. Most of the dental caries are not treated due to the lack of knowledge, poor access to dental services, and the cost of dental treatment which leads to pain and eventually leads to tooth loss. A prevalence of 57.5% of 5–6 years old and 25.6% of children of 12–13 years old suffers from dental caries. The report of pain and discomfort due to toothache ranges from 18% in 5–6 years old to 64% in older adults. About 55% of 50+ year adults reported having trouble eating hard foods. This has hence got an indirect effect on the overall nutrition intake of the population resulting into other health problems.

Integrated Health camp and oral health program

Gum Diseases (Gingivitis and Periodontitis)

Gum disease (Gingivitis and Periodontitis)

Gum disease is described as swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.

Gingivitis-

Gingivitis refers to ‘inflammation of the gums'.Signs and Symptoms:

·       Colour- red

·       Contour- loss of stippling

·       Consistency- swollen (inflamed gums)

·       Pockets (gingival sulcus with a depth of more than 3mm)

Dental Caries (Decay)

What is dental caries?

The current concept considers caries as a dynamic and reversible process, characterized by demineralisation and remineralisation occuring over time. Cavitation will occur only if dimineralisation predominates. Under favourable conditions, with the help of the modifiers, even an incipient lesion can become inactive and arrested. Arrested caries has a dark appearance.

Oral Health program at Gorkha. (Tanglichowk and Ghairung-2, Bataase)

Oral Health program at Gorkha. (Tanglichowk and Ghairung-2, Bataase) Treatment of the patients were done in the school premises in the form of Extractions, Restoration, fluoride application, scaling and education about importance of oral health.

Health camp in Kagati gaun, Nuwakot

Free health camp organized by Hamri bahini-the green angels in Kagati gaun, Nuwakot. Kagati Village is located in Nuwakot district under OKharpauwa VDC in the North west. The program's concept and execution was done by Himalayan climate initiative in collaboration with Sahayata jeevan ka laagi along with the support from HDSN-Health and Development Society Nepal and npl. Local organization of camp was done by Rastriya Swayam sewak Nepal. Dr. Bijay Tamang