This document discusses topical treatment in dentistry. It defines topical treatment as medicine that has localized effects and is applied directly to oral tissues. Topical administration has advantages over oral administration like avoiding first-pass metabolism and having higher drug concentrations at the site of application. Common topical forms include creams, gels, and patches. The document focuses on topical antibiotics and antifungals used to treat oral conditions like ulcers, gingivitis, and denture stomatitis. It also discusses topical antiseptics like chlorhexidine that have substantivity and remain active in the mouth for hours.
The content narrates about commercially available disclosing agents for the detection of dental plaque. It holds its significance from both clinician and patient viewpoint, especially in reinforcing oral hygiene measures and early detection of inflammatory changes in the gums.
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
The content narrates about commercially available disclosing agents for the detection of dental plaque. It holds its significance from both clinician and patient viewpoint, especially in reinforcing oral hygiene measures and early detection of inflammatory changes in the gums.
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
One of the most painful but easy-to-treat dental emergencies is a dry socket.
• Dry socket symptoms are experienced after a tooth extraction.
• This condition requires follow-up care by the doctor who performed the surgery, an oral surgeon or a dentist who is familiar with how to treat it.
For more information, contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
#drysocket #management #thirdmolarextraction #extractioncomplications
self correcting anomalies in the development of occlusion. this ppt includes the anomalies of a child's developing occlusion which get corrected by itself in some time as the development continues. This includes Retrognathic mandible,infantile swallow,anterior open and deep bite,etc. these topics are important in BDS final examination
a detailed account of the principles of tooth preparation with main reference from Shillingburg
The presentation is available on request. Mail me at apurvathampi@gmail.com
The Gold Standard Antiseptic in Dentistry. Its composition, mechanism of action, available forms, uses, disadvantages. Its role in Periodontics. Done by : Ivan Obadiah (CRI) Guided by : Dr. Veejay Chandran (MDS).
This comprehensive lecture explain the basic antiviral, antifungal, and steroid medications used commonly to treat oral conditions. It is directed to the level of mind of undergraduate dentist
Drugs in endodontics /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
One of the most painful but easy-to-treat dental emergencies is a dry socket.
• Dry socket symptoms are experienced after a tooth extraction.
• This condition requires follow-up care by the doctor who performed the surgery, an oral surgeon or a dentist who is familiar with how to treat it.
For more information, contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
#drysocket #management #thirdmolarextraction #extractioncomplications
self correcting anomalies in the development of occlusion. this ppt includes the anomalies of a child's developing occlusion which get corrected by itself in some time as the development continues. This includes Retrognathic mandible,infantile swallow,anterior open and deep bite,etc. these topics are important in BDS final examination
a detailed account of the principles of tooth preparation with main reference from Shillingburg
The presentation is available on request. Mail me at apurvathampi@gmail.com
The Gold Standard Antiseptic in Dentistry. Its composition, mechanism of action, available forms, uses, disadvantages. Its role in Periodontics. Done by : Ivan Obadiah (CRI) Guided by : Dr. Veejay Chandran (MDS).
This comprehensive lecture explain the basic antiviral, antifungal, and steroid medications used commonly to treat oral conditions. It is directed to the level of mind of undergraduate dentist
Drugs in endodontics /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
This PowerPoint presentation demonstrate a useful review of Oral candidiosis, including its different types, clinical presentations, differential diagnosis, and treatment options.
Lingual orthodontics /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This presentation shows the common abbreviations, prefixes, suffixes, that can help dental practitioner identify the group that a certain drug belongs to.
This fresh lecture explain the basics of antibiotic prescription, and common interactions, clinical use, and dosages. It is written to level of undergraduate mind
This lecture explain the basic of root canal preparation in endodontic treatment. It is not meant to be a comprehensive lecture, rather an preliminary one
Most common Complications during Dental Extraction: ExplainedIraqi Dental Academy
this brief lecture will present to you the basic and most common complications that occur during dental extraction. It is presented to the level of mind for undergraduate students.
Etiology of malocclusion 1/certified fixed orthodontic courses by Indian dent...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Here I present to you the basic concept and definition of endodontic diagnosis and treatment planning. It is presented to the level of mind of undergraduate students.
This lecture present to you the very basics of dental management of asthmatic patient in dental clinics. I kept it short and comprehensive as I can, for more info please refer to the reference mentioned in the lecture
skeletal maturity indicators in orthodontics /certified fixed orthodontic cou...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
In this lecture I explain the basic concept of root canal filling or what called obturation. The lectures discuss different techniques used in that matter in step-by-step fashion and explanatory pictures.
It is directed to the level of undergraduate mind.
This short presentation discuss very important subject in endodontic field, which is the complications that most commonly occur during root canal treatment, like sodium hypochlorite accident and air emphysema and others. management of these complications is also discussed.
The rationale for using antibiotics and chemotherapeutics in the periodontal disease treatment is its polymicrobial nature of disease. Antibiotic use should be done cautiously in treating various periodontal infection as improper use of it can lead to its resistance by bacterial strains. Antibiotic in periodontics is a very helpful adjunct in controlling the bacteria in the oral cavity
Hello friends. In this PPT I am talking about anti-fungal drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. Topical Treatment in Dentistry
Iyad Abou Rabii DDS, OMFS, MRes, PhD
QASSIM UNIVERSITY
2. Topical Treatment in Dentistry
Iyad Abou Rabii DDS, OMFS, MRes, PhD
Topical Treatment
A term used to describe medicine that has effects only in a specific area, not
throughout the body, particularly medicine that is put directly on the mucosa,
dental, gingival, or pulpal tissues.
Advantage of Topical administration
1. Avoids the GI tract and hepatic first-pass metabolism
2. Reduces systemic side effects
3. Higher concentration of drug at site of application
4. Improves compliance
5. Allows ↑ concentration of Rx at site of application
6. Plasma concentrations of <10% compared to oral route.
Pharmaceutical Forms
Topical medications include
• balms,
• creams,
• gels,
• lotions,
• patches,
• ointments,
• Muscoadhesive tablettes
• and other products that you apply to the mucosa, pulp, and dental tissues.
Most are available over-the-counter..
Topical Antibiotics
Pharmaceutical Forms
Some topical antibiotics are available without a prescription and are sold in
many forms, including creams, ointments, powders, and sprays. Some widely
[ | ]اﺧﱰ اﻟﺘﺎرﻳﺦTopical Treatment in Dentistry
used topical antibiotics are bacitracin, neomycin, mupirocin, and polymyxin B.
Among the products that contain one or more of these ingredients are
Bactroban (a prescription item), Neosporin, Polysporin, and Triple Antibiotic
Ointment or Cream.
Antibiotic mouthwash can be prepared by the patient by dissolving the contents
of 250 mg tetracycline capsule in 10 ml of water to give a 2% solution. It may be
more effective to add glycerol to the solution as a demulcent, this must be done
by pharmacist.
Advantages
The value of topical antibiotics overweighs such risks in some cases. Tetracycline
is a useful topical antibiotics. As at 2% solution it’s often effective in reducing
1
3. secondary infection (and thus the discomfort) in cases of aphtous stomaitis,
primary herpetic stomaitis, and all oral ulcerative conditions.
Use of topical antibiotics is also seen to be helpful in acute chronic gingivitis
treatment.
Disadvantages
There are inherent disadvantages associated with the use of topical antibiotics
because of the possibilities of selection for resistant strains and inducing
hypersensitivity reaction at the patient.
Use of Topical Antibitics
Indication
Topical antibiotics help prevent infections caused by bacteria that get into minor
cuts, scrapes, and burns. Treating minor wounds with antibiotics allows quicker
healing.
They are always used to prevent secondary infection (ulcers)
Duration
The use of topical antibiotics cannot normally be practiced as long- term
treatment, it is better to be reserved for acute episodes. Otherwise, there will be
the risk of overgrowth of resistant organisms, although a candidal infection may
occur. However, in some rare cases a prolonged topical antibiotic treatment is
justified (Patients with severe and persistent oral lesions), in that case a
tetracycline with triamcinolone combination is preferred
Topical antifungal treatment
Antifungal drugs
The polyene antifungal agents, nystatin and amphotericin B, are well
established and relatively free from side-effects when used locally. They are
available in various forms, such as lozenges, pastilles, creams, and suspensions.
Unfortunately, patient compliance is often poor with these preparations, which
may take a while to dissolve in the mouth (for example, pastilles and lozenges)
and have a a distinctive taste.
The newer azoles have very useful properties, although resistance is rather more
commonly met and may be problematic in the future, particularly in the
[ | ]اﺧﱰ اﻟﺘﺎرﻳﺦTopical Treatment in Dentistry
immunocompromised patient. (C. krusei and and C. glabrata are usually resistant
to fluconazole.) The locally active agent, miconazole is available as an oral gel or
cream.
Pharmaceutical Forms
Conventional
In order to assure topic application of antifungal agents, conventional lozenge,
mouthwash, or gel would be the simplest dosage forms for the delivery of drugs
in the buccal cavity, but these conventional dosage forms had the disadvantage
of an initial burst of salivary concentration followed by a rapid decrease. A
lozenge produced effective salivary drug levels for more than one hour but
repeated administration was restricted due to systemic toxicity coming from the
2
4. large quantity of ingested drug. The action of mouthwashes was even more
transient than that of lozenges, and gels/pastes were difficult to retain in the
mouth .
Sustained Release forms
In case of oral fungal infections, a prolonged therapy with antifungal agent was
required, and some papers documented prolonged release of antifungal agent
from buccal devices in the form of an adhesive tablets.
I.Abou Rabii et al (2004, France) has developped a Miconazole musoadhesive
tablette which has been given higher concentration of Miconazole in Saliva
(Over the IMC for more than 9h).
Topical antifungal therapy
Pseudomembranous, erythematous hyperplastic candidosis
Amphotericin lozenges (10 mg)
Nystatin pastilles (100 000 units)
Dissolve slowly in mouth, after meals; use 4 times daily;
Candida-asso ciated denture stomatitis
Amphotericin or nystatin (as above) and remove dentures
Miconazole gel applied to palatal surface of denture 4 times daily for 1 to 4
weeks
Chlorhexidine 0.2% rinse, 4 times daily (do not use with nystatin)
Candida-asso ciated angular cheilitis
Nystatin cream; apply to corners of mouth 3 to 4 times daily, until resolution
Miconazole cream (or gel); apply 3 to 4 times daily to angles
Topical Antiseptics
First Generation
Many substances with some degree of antimicrobial efficacy have been tested,
especially in vitro, but it is totally impractical to ask everybody to rinse his or her
mouth ten times a day, because the solution is completely devoid of
substantivity, and rapidly diluted by and swallowed with saliva.
The agents that do not exhibit any significant substantivity (only minutes) were
categorized as first-generation antimicrobial agents and are composed of certain
[ | ]اﺧﱰ اﻟﺘﺎرﻳﺦTopical Treatment in Dentistry
antibiotics,
quaternary ammonium compounds (cetylpyridinium chloride),
essential oil phenolic compounds
fluorides including monofluorophosphate
and sodium fluoride,
oxidizing agents,
plant alkaloids and iodines including povidone
iodine
Second Generation
3
5. Second-generation antimicrobial agents are characterized by high substantivity,
that is, retention of 25-30% after each 1-minute mouthrinse. Such compounds
remain active in situ for hours and include
bisbiguanides (such as chlorhexidine),
amine fluoride and stannous fluoride mouthrinse,
triclosan when associated with a copolymer of polyvinyl methyl ether and
maleic acid copolymer.
Chlo rhexidine
The most tested and effective antiplaque agent known today is chlorhexidine,
which has been used for more than two decades. The mode of action of
chlorhexidine against bacteria is well understood and is concentration
dependent.
• Chlorhexidine has antibacterial and some anticandidal activity and currently
the most effective antiplaque agent.It can be used as a mouthwash, spray,
or gel to control secondary infections in mucosal ulcerations.
• Chlorhexidine acts on the cell wall of the microorganisms by changing their
surface structures. Osmotic equilibrium is lost and, as a consequence,
cytoplasmic membrane is extruded, vesicles are formed and the cytoplasm
precipitates.
• Because chlorhexidine has been shown to be able to break up existing
dental plaque, it can really be considered as a potent antibacterial agent,
bactericidal at high concentration and bacteriostatic at lower
concentration, such as when gradually diluted in saliva over time.
Local Side effects of Chlorhexidine
• Chlorhexidine has been reported to originate some reversible local side
effects:
• Taining on teeth and tongue appears largely dose dependent whereas
desquamation of the oral mucosa and perturbation of the taste appear to
be largely concentration dependent.
Topical Steroids
Indication
• Topical corticosteroids are frequently used in management of the oral
mucodermatoses and other conditions. Topical steroids are frequently
[ | ]اﺧﱰ اﻟﺘﺎرﻳﺦTopical Treatment in Dentistry
included in potential predisposing factors of oral candidiasis. Secondary oral
candidiasis is of particular importance in patients being treated for oral
mucosal disease. Candidiasis will aggravate the existing oral condition and
may prevent successful treatment unless it is recognized and managed.
Forms
• Hydrocortisone hemisuccinate (pellets)
• Triamcinolone acetonide (in adhesive paste)
• Fluocinonide (in adhesive paste)
• Betamethasone sodium phosphate (mouthwash)
• Triamcinolone mouthwash
• Beclomethasone dipropionate (spray)
4
6. • Budesonide (spray)
Topical Analgesics
Indication
• in all painful oral conditions (burns, inflammation, ulcers. etc)
• Before Syringe injection in children
• Topical anesthetic faces two main hurdles
1.Laryngeal reflexes : a further precaution to be taken includes the
avoidance of preparations of sufficient strength to affect the laryngeal
reflexes
2.The effectiveness of these Topical oral anesthetic drugs is typically
hampered by the rapid dissolution of the carrier matrix. In the Saliva
Forms
Benzydamine hydrochloride (mouthwash)
Lignocaine rinse
Ligocaine hydrochloride spray
Benzocaine Gel
Fluoride as Topical drug
The use of fluoride toothpastes, mouthrinses, gels or varnishes reduces tooth
decay in children and adolescents.
Fluoride is a mineral that prevents tooth decay.
Children aged 5 to 16 years are applied fluoride in the form of toothpastes,
mouthrinses, gels or varnishes ,
Fluoride varnishes may have a greater effect but more high quality research is
needed to be sure of how big a difference these treatments make, and whether
they have adverse effects.
[ | ]اﺧﱰ اﻟﺘﺎرﻳﺦTopical Treatment in Dentistry
5