Wednesday, December 15, 2010

BLACK HAIRY TONGUE

   Hairy tongue is characterized by marked accumulation of keratin on the filliform papillae  of the dorsal tongue resulting in a hair like appearance.Many affected people are heavy smokers.
Other possible associated factors are

  • antibiotic therapy
  • poor oral hygiene
  • general debilitation
  • radiation therapy
  • use of oxidizing mouthwashes
  • overgrowth of fungal or bacterial organisms
The condition is usually asymptomatic.the elongated papillae are usually brown, yellow or black


TREATMENT :The condition is benign . Any predisposing factors should be eliminated.oral hygiene  maintenance has to be encouraged .Periodic scraping or brushing with a toothbrush or tongue scraper is recommended.

LINEA ALBA

      Linea alba  is a white line seen on the buccal mucosa usually associated with pressure , frictional irritation, or sucking trauma from the teeth.
linea alba  consists of a white line that is usually bilateral i.e on both sides .the line may be scalloped and is located  on the buccal mucosa at the level of the occlusal plane of the adjacent teeth. It is most pronounced  adjacent to the posterior teeth.
           No treatment is required for patients with linea alba .Spontaneous regression may occur

CLEFT LIP AND PALATE

                The formation of the face and oral cavity is of complex nature and involves development of multiple tissue processes  that must merge and fuse in a highly orchestrated fashion.Defective fusion of the medial nasal process with the maxillary process  causes cleft lip ; failure of the palatal shelves to fuse results in cleft palate.                                                                                                                                           The problems afflicted on a cleft lip   and palate patient are numerous.....

  • The dental problem  like missing teeth,presence of supernumerary teeth,anomalies of tooth morphology,smaller sized tooth,spacing or crowding of the teeth  .
  • esthetic problems - facial disfigurement can  vary from mild to severe.
  • hearing and speech difficulties.
  • psychological stress faced by the patient.
MANAGEMENT OF CLEFT LIP AND PALATE

            The cleft lip treatment is usually multi -professional.  It can be divided into the following stages:

STAGE 1     :  treatment done from birth to 18 months of age.   
        the treatment moalities carried out during this stage are

  • fabrication of a passive obturator  :it is an intra oral prosthetic device that provides a false roofing in the child`s mouth which facilitates in feeding and helps the baby to suckle. 
  • Presurgical orthopaedics : the aim is to achieve an upper arch form that conforms to the lower arch form.
  • surgical management of cleft lip: surgical lip closure is done
  • surgical management of cleft palate :   this has to be done between 12 to 24 months of age.this facilitates normal speech, hearing and  improves swallowing
STAGE 2 : this phase  is from 18th month to 5 th year of life .the procedure carried out during this phase are

  • adjustments  in the intra oral obturator to accommodate the erupting primary teeth
  • to maintain a check on the eruption pattern and timing 
  • restoration of the decayed tooth
STAGE 3 : it spans from 6 years to the 11 th year of life . Orthodontic corrections are done during this phase                                            

  • anterior crossbites and buccal crossbites are managed by using removable or fixed appliances
STAGE 4 : this phase is carried out during the 12th to 18the year of life.

  • fixed orthodontic appliances are provided during this phase to correct irregularities like crowding,spacing,overjet etc.
The key to the successful rehabilitation of a cleft lip and palate includes flexibility and a multidiscilinary approach.