Diagnostic Studies And Procedures

Several approaches may be necessary to determine the cause of pain and the tooth responsible for the problem. These include tapping the teeth with a metal probe and observing your response, taking X-rays, applying a small amount of electrical stimulation to suspected teeth in a pulp vitality test, and exposing them to a jet of cold water or air. Drilling a small hole in a tooth can reveal infection under the enamel.

Medical Treatments

A toothache due to dental caries requires drilling out the decayed area and filling the cavity. If decay is deep, the dentist may apply medicine to the underlying tissue before inserting the filling to help prevent sensitivity. If an abscess is present, the dentist will drill a hole in the tooth to allow the pus to drain. Opening the tooth to relieve internal pressure usually provides immediate relief from pain. Depending on the extent of the infection, the tooth may be left open to drain for several days or it may be temporarily filled. The dentist will also prescribe antibiotics. When the abscess affects a primary, or baby, tooth, the dentist may extract it. If a permanent tooth is affected, he will likely try root canal treatment, which involves cleaning out the canals, removing the nerve, and then filling and sealing the tooth. If the nerve is dying, either extraction or root canal treatment will be recommended, depending on whether the tooth is primary or secondary.

Alternative Therapies

Dental care is essential for curing a toothache, but alternative therapies can help ease pain until you see the dentist.

Acupressure

Rubbing an ice cube over the web of the hand between the thumb and forefinger, or massaging this same area, may help short circuit dental pain.For toothache in the lower jaw, use the thumb of one hand to massage the jawbone vigorously where it angles toward the front of the head. To ease a toothache in the upper jaw, place your thumb over the middle of the ear and slide it forward until it reaches the indentation under the bone about an inch in front of the ear; then press hard for one minute .

Herbal Medicine

Traditional herbal remedies for toothaches call for applying full strength oil of cloves or cinnamon to the tooth. Dentists discourage this practice, however, because these oils can burn and irritate the gums and other oral tissue. Safer alternatives are oil of sassafras or fresh aloe vera gel, which can be applied around the tooth.

Self Treatment

Over the counter analgesics, such as aspirin or acetaminophen, can provide temporary relief of mild to moderate toothache. Don’t, however, resort to the old home remedy of pressing crushed aspirin against the tooth; this can burn gums and damage tooth enamel. Moist heat or a heating pad applied over the aching area may help ease the aching. However, for throbbing pain that indicates a possible infection, apply instead an ice compress to the side of the face for 5 to 10 minutes every half-hour to an hour. It should help alleviate both pain and swelling. If your teeth are sensitive, brush with baking soda or a toothpaste formulated for sensitive teeth. To protect your teeth from cold air in the winter, wear a ski mask or a scarf over your mouth.

Other Causes of Toothaches

Gingivitis can cause gums to recede, exposing parts of the tooth root and leading to dental pain. In addition, bruxism grinding of the teeth when awake or asleep-can cause tooth aches. An impacted molar or other tooth is another cause of dental pain.

Forty years ago coronary heart disease was essentially a disease of men belonging to the well-to-do classes, successful businessmen and professionals like doctors and so on. It was uncommon to find an affected woman. Since then, there has been a steady increase in the incidence of this disease affecting both the sexes’ of all classes.

Coronary heart disease is about ten times as common in men as in women up to the age of 45 years. After the age of 50 years, there is an increased incidence in women. By the age of 70 years, there is no difference between the sexes. Short and fat people are more susceptible. In certain cases the susceptibility is inherited. People who show an excessive sense of time urgency, a preoccupation with vocational deadlines and enhanced aggressiveness and competitive drive have increased chances of coronary heart diseases.

Over 20 studies have been done on thousands of people in 14 countries. All of them have found that the three biggest risk factors for coronary heart disease are high plasma total cholesterol, cigarette smoking and high blood pressure (hypertension). Cigarette smoking is injurious to health, a statutory warning on every cigarette pack means that it predisposes one to coronary heart disease. The mechanism behind it is not clear. What is clear, however, is that patients with coronary heart disease should give up smoking.

The other risk factors are diabetes, obesity and, in some cases, gout. In diet, an increased consumption of animal fats and sugar has been found to contribute to the rise of these diseases. An extraordinary finding, for which no explanation has yet been established, is that harder the drinking water, the lower is the death rate from coronary heart diseases.

Prosperity certainly leads to reduction in the amount of manual work done by a person. As the wealth of a country increases, the labour class declines and is replaced by those who flick switches and occupy office chairs. An increase in private cars and public transport reduces the number of those who rely on walking and cycling. There is certainly some evidence that physical activity protects against coronary heart diseases.

Diet

All cholesterol in blood plasma is carried on lipoproteins. Low-density lipoprotein (LDL) cholesterol, which normally carries about three-fourths of the total cholesterol, is the risk factor, as it carries cholesterol into the inner lining of the artery walls. High-density lipoprotein (HDL) cholesterol, on the contrary, tends to act as a protective factor, as it clears some of the cholesterol deposited in the periphery and carries it to the liver, where it can be excreted with the bile. Deposition of cholesterol on the inner aspect of the walls of the arteries is part of the process of formation of atherosclerosis, the pathological basis of coronary heart disease.

Plasma HDL cholesterol only makes up about one-quarter of normal total cholesterol concentration, and its level is higher in women than in men, but never very high. Total cholesterol that is high nearly always results from the elevation of LDL cholesterol. Plasma (total or LDL) cholesterol may be raised as the inherited condition of hypercholesterolemia, a condition with a tendency towards premature coronary heart disease. Plasma cholesterol is also raised secondary to certain diseases; e.g., hypothyroidism, some types of kidney disease, bile duct obstruction, and diabetes. Finally, it is moderately raised by a diet rich in saturated fat and cholesterol.

In order to lower the blood cholesterol level, the diet has to be slightly modified. Cholesterol is essentially present in all animal fats. It is not desirable to restrict all forms of fats, as severe restrictions may result in mental depression. The total intake of fat should not be more than 30 percent of the total calorie intake. It should be consumed partly as unsaturated vegetable oils, such as mustard oil, ti1oil, groundnut oil, olive oil, etc. Saturated fats, hydrogenated vegetable oil (vanaspati), coconut oil, margarine and animal fats like butter, cream and ghee should be taken in moderation. Mutton and organ meats should be replaced by fish and chicken. The use of egg should also be restricted to two to three eggs per week. Whole milk should be replaced by skimmed milk.

Vegetables, fruits, cereals, sabut dais, skimmed milk and lean meat should be the main items of diet. The fibre content of the diet should be increased as much as possible. Three or four smaller meals are preferable to two big meals. The evening meal should be taken about two hours before sleeping.

In the case of high blood pressure, which is mostly associated with coronary heart diseases, a low salt diet is advised. In such a diet, no table salt is permitted, and salt, used in cooking must be reduced to a minimum. All tinned and processed products containing preservatives (sauces, jams, pickles etc.) and confectionaries containing baking powder (cakes, biscuits etc.) should be avoided. The maximum number of slices of ordinary bread allowed per day is five thin slices only. Butter used should be salt free. Helpings of fresh meats, fish, potatoes and other root vegetables should be small.

Since obesity predisposes one to coronary heart diseases, it is advisable to restrict the total calorie intake to reduce weight to the expected normal for one’s height, age and sex. In normal individuals, the ideal body weight should be maintained by keeping a periodic check.

Obesity is also associated with elevated total cholesterol and triglyceride levels and lower HDL levels. Even gradual increases in body fat may produce unhealthy cholesterol levels. One study found that an average increase of one kilo of fat a year, as people aged, caused total cholesterol to rise and HDL levels to drop. The goal for a cholesterol-lowering diet then must also include attaining or maintaining a healthy weight.

A recent study reported that dietary changes improve cholesterol levels only when an aerobic exercise programme is also included. In addition to having a beneficial effect on cholesterol, exercise is critical to maintaining a healthy heart; it helps keep weight off and lowers the heart rate and blood pressure. People who maintain an active lifestyle have a 45% lower risk of developing coronary heart disease than do sedentary people. Regular aerobic exercises-brisk walking, jogging, swimming, cycling, aerobic dance, and racquet sports-are the best forms of exercise for lowering LDL and raising HDL levels.

It may take up to a year of sustained exercise for HDL levels to show significant improvement. Experts recommend that people aim for a routine of a 30-minute brisk walk most days of the week; an excellent goal is 20 to 25 miles a week, but in terms of raising HDL levels, more is better. Resistance (weight) training offers a complementary benefit by reducing LDL levels. After a high-fat meal, triglycerides can be lowered either with a single, prolonged (about 90 minutes) aerobic session or by several shorter sessions during the day.

One study indicated, however, that short bursts of exercise actually increase LDL oxidation-the process that makes LDL dangerous to the heart, so individuals should always aim for a consistent, regular programme. Before engaging in any strenuous exercise, it is advisable to consult a physician. Children should especially be encouraged to exercise every day.

After an adult has attained full growth, it is advantageous to maintain the body weight at about a certain norm for the height. Being overweight or underweight represent disadvantages which usually result in lesser efficiency or poorer health.

If the body weight is persistently, though slowly, increasing, there is certainty that the energy value of the food intake is greater than the energy needs of the body. Even a small excess such as 150-200 calories per day (equivalent to 2 teaspoons of butter or 300-400 ml of any aerated drink), if persistently indulged in, will mean the storage of 8-10 kg of body fat in a year’s time I Usually overeating of calories is the result of too great a fondness for high-calorie foods (fried foods, sweets and starchy foods). Decreased muscular activity is also often a contributing factor; for instance, the sedentary nature of office work, commuting by scooters and cars, etc. As one becomes older, there is a tendency for both the basal metabolism (energy for internal body functions) arid the physical activity to be lessened.

If one carries over into later life the food habits of younger years, the weight is almost certain to increase undesirably. Then it will be necessary to take either less food or more exercise, ‘or both, in order to bring the weight down to about the normal for age 30. A decrease in food intake of 500 calories daily below the amount that would presumably keep the body weight constant, will normally result in ‘burning’ or melting of fatty tissues of the body to an extent that will reduce the body weight by 1/2 kg per week. The maximum weight reduction considered safe is 1 kg per week, which is 1,000 calories per day.

Obesity is certainly not desirable, as it leads to inconvenience in moving about, embarrassment, inefficiency and lack of ambition. Obesity also results in diseases of the heart, circulatory system, kidneys and pancreas and lessened chances of long life. It is prone to develop at 34-45 years of age and is especially disadvantageous after 50 years of age. The dangers of over weight are naturally increased. with a larger excess of weight and advancing years. For instance, betwedn 40 and 44 years, a 20 percent excess over normal weight means 30-40 per cent mortality above the normal for that age bracket. A 40 percent excess of weight involves an 80-100 per cent increase in mortality rate. To put it more simply, a 50-year-old man, who is 25 kg overweight, has about half the life expectancy of one of the same age who is of normal weight. For younger adults, a moderate amount of extra weight may be acceptable but after 40, a moderate amount of leanness tends to promote longevity.

Diet

For the ordinary overweight individual, by far the most satisfactory way to effect weight reduction is simply to cut down sharply on concentrated energy foods (sugar, starch and fats), keeping on with an otherwise well balanced and adequate diet. Such a diet does not involve actually going hungry and it can be maintained over fairly long periods without causing any harm. By adding limited amounts of high-calorie foods, this diet can be continued into the post-reduction period in order to maintain the desired body weight. Such a reducing diet should be based on one’s food preferences so that it can be used indefinitely.

The reducing diet should be built around certain basic foods, which provide the nutritive essentials,.like the protein-rich foods (dals, meat, egg, milk) and fruits and vegetables to provide minerals and vitamins. Certain foods, like sugar and fats, chiefly provide calories and no other nutritive essentials. Varying the amount of these foods is the easiest way to alter the caloric intake without affecting the other nutritive values of the diet.

Other foods that are useful mainly for their energy value and carry only minor amounts of other nutrients are sweets Garn, jelly, desserts), starchy foods (bread, breakfast cereals, cereal puddings) and fatty foods (fatty meats, salad dressings, chocolates, cream). Another way to cut down on calories is to eat foods in their natural state, unadulterated by added calories in the form of sugar or fat. A medium-sized apple furnishes

70-80 calories, a baked apple 210 calories and a piece of apple pie about 370 calories. It should be emphasised that while it is entirely possible to get all the required nutrients in a well-planned reducing diet, supplementary vitamins and minerals may well be a safeguard

for persons on drastic or lengthy reducing regimens. This is especially true of the fat-soluble vitamins (A, D, E, K), since fats are sharply curtailed, and many people cannot take large amounts of leafy vegetables.