Author Archives: phebe

Leukemia and oral health

What is leukemia?

Leukemia is a malignant cancer of the blood in which one’s bone marrow produces white blood cells in excess in association with gene mutations.

leukemia: white blood cells (dark purple) produced in excess

Causes of leukemia

Genetic predisposition (family history, people with Down syndrome have higher tendency to get leukemia)

Artificial ionizing radiation

Chemicals (eg benzene and other petrochemicals)

Viruses, e.g. HIV (Human Immunodeficiency virus  or HTLV-1 (human T-lymphotropic virus) Continue reading

Osteonecrosis of the Jaw Part 2

A brief introduction has been done in “Osteonecrosis of the jaw Part 1“. Here in this article we will be discussing briefly about the prevention and treatment of osteonecrosis of the jaw.

Osteonecrosis-exposed bone on the right edentulous region of the lower jaw

How is osteonecrosis of the jaw treated?

Osteonecrosis can either be treated conservatively, or surgically:

i) Conservative treatment

Conservative treatment basically means that no active treatment is done that is directly addressing the problem. Usually, patients who present with osteonecrosis of the jaw are started on antibacterial rinses (eg: Chlorhexidine gluconate mouthwash), antibiotics and oral analgesics. Continue reading

Osteonecrosis of the Jaw Part 1

In this article we will be discussing questions about osteonecrosis of the jaw such as :

What is it?

How does it happen?

What are the causes & risks for osteonecrosis of the jaw?

What are bisphosphonates?

Should I be concerned if I am on bisphosphonates?

Why is osteonecrosis of the jaw dangerous?

The treatment and prevention of osteonecrosis of the jaw will be further discussed in the article “Osteonecrosis of the Jaw Part 2”.

Osteonecrosis- exposed bone that does not heal in the right edentulous region of the lower jaw.

What is osteonecrosis of the jaw?

“Osteonecrosis” is made up of the words “osteo”, which means bone, and “necrosis” which means death of cells. Hence “osteonecrosis” of the jaw bone means death of cells in the jaw bones. It is diagnosed when an area of bone is exposed and shows no sign of healing or gum growing over it 8 weeks after an invasive dental procedure, such as tooth extraction or implant surgeries. Both the upper and lower jaw may be affected, and it may be associated with pain, numbness, swelling and infection of the affected site. The damage to the jaw bone is irreversible, and if left untreated, can spread and can cause devastating damages, even to the point of death. Continue reading

Fracture of the Lower Jaw-Part 2

We have discussed the principles of management of fractures in Fracture of the Lower Jaw-Part I. In this article we will be discussing a little in depth regarding the management of Lower jaw fractures, or mandibular fractures.


  • Reduction of the fracture-Reduction can be done in 2 days: Open Reduction or Closed Reduction, as will be discussed below
  • Fixation & stabilization of the fracture-Direct or Indirect
  • Immobilization of segments at fracture site
  • Occlusion restored-to allow the patient to bite in his original position
  • Infection eradicated/prevented-infection can prevent or delay healing, thus it is of essence that infection be avoided. Continue reading

Fracture of the Lower Jaw-Part I

Trauma exerted onto the head and neck region can cause a fracture to any of the bones. The lower jaw, or the mandible, is particularly prone to fracture. In this article we will discuss some of the aspects related to fracture of the lower jaw (mandibular fracture).

CAUSES OF JAW FRACTURE (upper or lower):

  • Accidents: Motor-vehicle accidents (MVA), sports injuries, occupational (accidents that occur during work)
  • Falls (eg, falling down the stairs, slipping on a slippery floor)
  • Assault and fights
  • Pathological– a pathology such as tumours or cysts in the jaw bone can cause thinning of the bone or decrease in density of the bone, ultimately leading to fracture of bone in that region, even when a light external force is applied to the bone. Continue reading

Thalassemia and oral healthcare

What is Thalassemia?

Hemoglobin is the protein found in red blood cells in our blood that is responsible for carrying oxygen to all the different parts of out body. Hemoglobin is made up of 4 protein chains, ie 2 beta globin and 2 alpha globin. Thalassemia occurs when there is decrease in production or absence of production of either of these chains, leading to malfunctioning hemoglobins that are unable to carry oxygen. This then leads to anemia.
Thalassemia is thus classified by the type of globin that is affected: either alpha thalassemia or beta thalassemia, and each is classified according to the severity of which one is affected, ie either thalassemia major or thalassemia minor. People with thalassemia minor, either alpha or beta, may not have any symptoms. Continue reading

Oral healthcare in stroke patients

What is a stroke?

A stroke, also called cerebrovascular accident (CVA), is a condition whereby the blood supply to the brain is blocked leading to lack of oxygen supply to the brain cells. Brain cells can die when the oxygen supply is cut off for even a few seconds. This leads to loss of function of parts of the body controlled by that region of the brain. If the right side of the brain is affected, the left part of the body will be affected and vice versa.


There are two types of stroke based on their etiology:

Hemorrhagic stroke

Continue reading

Gorlin-Goltz Syndrome

What is Gorlin-Goltz syndrome?

It is a multisystemic disease characterized by a predisposition to neoplasms and other developmental abnormalities as will be listed down later. It was 1st described by Robert James Gorlin and Robert William Goltz in 1960.


Other names:

– Gorlin Syndrome

-Naevoid basal cell carcinoma syndrome (NBCCS)

Continue reading

Pulp Therapy for kids

Carious tooth

When caries in your child’s teeth has gone so deep that it has reached, or is near the pulp, your child will need more than just a normal filling to restore the tooth. If the infection from caries has reached the pulp, yet left untreated, the infection may spread causing more harm to your child. The pulp therapy that can be done on your child’s teeth can be divided into vital and non-vital technique:

Vital techniques: Continue reading

Crowns for children

Intoduction to crowns for children

Just as we have crowns in adult dentition, so we have crowns for children. These crowns differ from those in adults in many ways, as will be discussed in the following sections. When your child has caries in his or her teeth, restorations with fillings such as composite or even amalgam is sufficient for small cavities, but if the cavity has become so large to an extent that normal restorations will be weak and easily fracture, a crown becomes the better option to protect the tooth from further damage. Continue reading