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Family & Child dentistry

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Royal Dental Clinic

2020-05-14 01:48:30



What is Fluorosis?


Fluorosis is a chronic condition caused by excessive intake of fluorine compounds, marked by mottling of the teeth and, if severe, calcification of the ligaments.


Fluoride is good for teeth because it helps prevent tooth decay. However, applying and consuming too much fluoride while teeth are developing can cause dental fluorosis. Fluorosis affects the tooth’s enamel. Milder cases cause barely noticeable white flecks on the teeth, whereas more severe cases can include heavy staining or even very visible pitting and pocking.


Who is the most vulnerable to Fluorosis?


Children under eight years of age are the most susceptible to developing fluorosis because their developing permanent teeth are still under the gum line and dental fluorosis damages teeth that haven’t erupted yet. Once teeth have erupted, children are no longer at risk. Due to the risk of fluorosis, children under the age of three should use just a “smear” of fluoride toothpaste and children three to six should use a pea-sized amount of fluoride toothpaste.


Causes of fluorosis


A major cause of fluorosis is the inappropriate use of fluoride-containing dental products such as toothpaste and mouth rinses. Sometimes, children enjoy the taste of fluoridated toothpaste so much that they swallow it instead of spitting it out.


But there are other causes of fluorosis. For example, taking a higher-than-prescribed amount of a fluoride supplement during early childhood can cause it. So can taking a fluoride supplement when fluoridated drinking water or fluoride-fortified fruit juices and soft drinks already provide the right amount.


Fluorosis symptoms


In general teeth will be smooth, glossy and creamy white in appearance. The severity of fluorosis varies widely, from mild to severe, but common fluorosis symptoms include:


- White spots on teeth

- Black spots on teeth

- White streaks on teeth

- Discolored teeth

- Mottled teeth

- Pitted teeth


Fluorosis Treatment


Remember that fluorosis affects only the appearance of teeth. It does not result in cavities. As a result, most of the treatment consists of masking the stain.


Many cases are minor enough not to need treatment. Sometimes fluorosis occurs only on the back teeth, where it can't be seen. Severe cases or the ones involving the front teeth can be treated by removing the surface-stained areas through tooth whitening or similar procedures. Extreme cases of fluorosis can be covered with bonding, crowns or veneers.


How to Prevent Dental Fluorosis


Infants can contract dental fluorosis due to the fluoride that is found in water (usually ingested when mixed with infant formula) or due to ingesting fluoride toothpaste. For kids under 2, breast feeding is a great alternative to formula and brushing can be done with a small, soft-bristled brush and plain water to limit fluoride intake.


For older children, remember to only apply a pea-sized amount of toothpaste and monitor their brushing to help them remember to spit toothpaste out after use.


Most cases of fluorosis are cosmetic and need no form of treatment. If the appearance of the teeth is seen as a problem, teeth whitening treatments can help to resolve visibly white spots. For more severe cases, consult your child’s dentist for the best treatment options.


Family & Child dentistry

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Royal Dental Clinic

2020-04-17 14:53:42

Oral health is an integral part and essential to general health. Oral health means more than good teeth; it is critical to general health and essential for well-being. It implies being free of chronic oral pain or throat cancer, oral tissue lesions, birth defects such as cleft lip and palate, and other diseases and disorders that affect the oral, dental and craniofacial tissues, collectively known as the craniofacial complex.


The mouth is a window into the health of the body. The interrelationship between oral and general health is proven by evidence. The strong correlation between several oral diseases and non-communicable chronic diseases is primarily a result of the common risk factors. Many general disease conditions also have oral manifestations that increase the risk of oral disease which, in turn, is a risk factor for a number of general health concerns. One example of such risk factors include diet and other cultural variables.


Diet and oral health are related, and believe it or not cultural beliefs and lifestyles affect your chance at having a smile that shines. Cultures that  advise that you eat (or avoid) certain foods predispose  one to lower or higher  risks of developing cavities and gum disease, and some countries as a whole have better dental diets than others.


Understanding culture.


Culture plays an important role in human societies. It lays down norms of behavior and provides mechanisms which secure for an individual, his personal and social survival. Culture includes everything which one generation can tell, convey or hand down to the next.


Culture has three parts. It is an experience that is learned, shared and transmitted. Acculturation refers to culture contact. There are various ways by which the acculturation can occur, like in the way of trade and commerce, industrialization, propagation of religion, education and conquest to name some.


Every culture has its own customs which may have significant influence on health and oral health. The increased incidence of lung cancer because smoking, cirrhosis because of alcoholism in many developed countries, the surge in the incidence of oral cancer in Kenya  due to tobacco chewing  habits for example are some classical examples to demonstrate the influence of culture on health and oral health.


It is now fairly established that cultural factors are deeply involved in the whole way of life generally and specifically in matters of dental health.


However, it is worth pointing out that not all cultural practices are harmful. Every human has the culturally ingrained habit of cleaning or brushing the teeth early in the morning for instance. Such positive aspects of culture ought to be encouraged, but the inclination to get into the habits of smoking, alcoholism, drug addiction in the name of civilization among the younger generation needs to be countered at the earliest time, otherwise, it may have a huge deleterious impact on the health status of the generation to come.




There are several reasons some countries and cultures have higher rates of cavities and other oral health problems. The World Health Organization says cultural factors that increase the risk of poor dental health include inadequate fluoride exposure, living in a poor or disadvantaged country, insufficient access to proper dental care, unhealthy diets, poor oral hygiene, tobacco use and excessive smoking.


Indeed, cultural influences overlap with dental health literacy, socioeconomic status, and personal experience in complicated ways, but it is possible to identify some common beliefs and care-seeking practices around oral health that are culturally-based.


To mitigate the harmful effects of culture on dental health, the following interventions are proposed; one, help-seeking and preventive care, two, better oral hygiene practices, three, eradication of outdated  beliefs about teeth and the oral cavity, and four, the use of folk remedies to alleviate poor dental health.


In conclusion, it should be noted that health care is a cultural construct arising from beliefs about the nature of disease and the human body, and it follows that cultural issues are central to the delivery of effective preventive care and dental illness intervention.  As the link between primary care providers and oral health care becomes more and more important in reducing overall health disparities, it is important to consider the cultural aspects of oral health – treatment seeking-behaviors, hygiene practices, and beliefs about the relationship between teeth and the health of the entire body. 


Oral Health

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Royal Dental Clinic

2020-03-27 17:31:45

Many research studies have been conducted to understand the genetic aspects of disease and to generate novel approaches to prevent, diagnose, and manage diseases not only in diverse aspects of health, but also in dentistry. New knowledge has emerged in scientific understanding of the role of genetics for diagnosing diseases and for treatments and prevention.


The contribution of hereditary factors to caries, periodontal disease, oral cancer, absent or malformed teeth, and other common oral disorders is becoming increasingly evident in dentistry, as are the implications of systematic genetic disease on oral health care.


According to the American Dental Association, heritability of the genetic control of periodontal disease for example has been estimated at around 50%, although gene variants appear to vary according to population. It has been suggested that periodontal disease is a two-step process, requiring both genetic susceptibility followed by a “bacterial challenge".


It is without doubt that several genetic factors can influence your oral health. They can determine the alignment of your teeth and whether or not you get cavities, regardless of your dental care habits. The chemical composition of your saliva determines how well it can neutralize the acids that lead to plaque formation and subsequent decay.


Additionally, if your teeth have more grooves and crevices, it’s easy for acids to infiltrate these areas, and they will remain for longer periods of time and be harder to remove through routine at-home dental care.  Besides, a family history of gum disease predisposes you to the condition, and if you inherited a weak immune system, it’s harder for your gums to recover from infection.


Genetics and Behavior


Researchers posit that genes determine even our behaviors. Studies have proven that genetic factors influence which foods you choose and the way they are processed by your body. If you’re more likely to eat foods that are bad for your teeth, you’ll be more likely to develop dental problems. Although you can’t change your genes, you can be aware of your inherited weaknesses by paying close attention to your family history. Dentists want to know about problems that run in your family, so they can recommend the best and most affordable prevention options.


In view of the above, there's growing evidence of the dentist’s role in recognizing not only dental and oral disorders but also systemic indicators of genetic disorders, making the dentist integral to the overall health and well-being of patients.


Dentists should be prepared to discuss genetic factors as well as genetic tests for susceptibility to common oral health concerns and structural oral-facial anomalies and the impact of genetic disorders on oral health care. An improved understanding of genetic susceptibility, lifestyle, and oral health risk factors allows a family’s dentist to offer effective preventive and treatment strategies for oral diseases.


For continuous updates and additional information on research study outcomes in Dentistry, keep it here.


Family & Child dentistry

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Royal Dental Clinic

2020-03-19 02:03:07

Pregnancy and dental work questions are common for expecting moms. Preventive dental cleanings and annual exams during pregnancy are not only safe but are recommended. The rise in hormone levels during pregnancy causes the gums to swell, bleed, and trap food causing increased irritation to your gums.


Preventive dental work while pregnant is essential to avoid oral infections such as gum disease, which has been linked to preterm birth.


Below are some tips to help you maintain good oral health before, during, and after pregnancy.


Before pregnancy


Try to make a dental appointment shortly before pregnancy. That way, your teeth can be professionally cleaned, gum tissue can be carefully examined, and any oral health problems can be treated in advance of your pregnancy.


Dental Care during pregnancy


Tell your dentist (and doctor) if you are pregnant. Routine dental care can be done any time during pregnancy. Any urgent procedure can be done, as well. All elective dental procedures, however, should be postponed until after the delivery. Before you have your dental appointment, check with your obstetrician to see if she has any special precautions/instructions for you.


Tell your dentist the names and dosages of all drugs you are taking – including medications and prenatal vitamins prescribed by your doctor – as well as any specific medical advice your doctor has given you. Your dentist may need to alter your dental treatment plan based on this information.


Dental X-rays can be done during pregnancy. Your dentist will use extreme caution to safeguard you and your baby, such as shielding your abdomen and thyroid. Advances in technology have made X-rays much safer today than in past decades.


Don't skip your dental checkup appointment simply because you are pregnant. Now more than any other time, regular periodontal (gum) exams are very important, because pregnancy causes hormonal changes that put you at increased risk for periodontal disease and for tender gums that bleed easily – a condition called pregnancy gingivitis. Pay particular attention to any changes in your gums during pregnancy. If tenderness, bleeding or gum swelling occurs at any time during your pregnancy, talk with your dentist or periodontist as soon as possible.


Follow good oral hygiene practices to prevent and/or reduce oral health problems.


Avoid sugary snacks. Sweet cravings are common during pregnancy. However, keep in mind that the more frequently you snack, the greater the chance of developing tooth decay.


Eat a healthy, balanced diet. Your baby's first teeth begin to develop about three months into pregnancy. Healthy diets containing dairy products, cheese, and yogurt are a good source of these essential minerals and are good for baby's developing teeth, gums, and bones.


After pregnancy


If you experienced any gum problems during your pregnancy, see your dentist soon after delivery to have your entire mouth examined and periodontal health determined.


Immediately after delivery, more care should now be diverted to the baby.

As soon as the first baby teeth start to appear you should start to clean them.


At first you may find it easier to use a piece of clean gauze or cloth wrapped around your forefinger. As more teeth appear, you will need to use a baby toothbrush.


Use a pea-sized smear of fluoride toothpaste and gently massage it around the teeth and gums.


It can be easier to clean their teeth if you cradle your baby's head in your arms in front of you.


Don't forget to pay us a visit at the Royal Dental Clinic in case of any difficulties.



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Royal Dental Clinic

2020-03-16 03:05:57

• Collect lower respiratory tract specimens (sputum, endotracheal aspirate, bronchoalveolar lavage) where possible and depending upon the patient’s condition

• Upper respiratory tract specimens (nasopharyngeal aspirate or combined nasopharyngeal and

oropharyngeal swabs) may be used if lower respiratory tract specimens cannot be collected

• If initial testing is negative in a patient who is strongly suspected to have COVID-19, recollect specimens from multiple respiratory tract sites (nose, sputum, endotracheal aspirate) and retest

• Blood, urine, and stool specimens may also be used to monitor for the presence of the virus; however, sensitivity of diagnoses at these sites is uncertain.

Also rule out infection with other respiratory pathogens (e.g., influenza, atypical pathogens). Collect nasopharyngeal swabs for testing.

Serological testing is not available as yet, but assays are in development.




All imaging procedures should be performed according to local infection prevention and control procedures to prevent transmission.

Chest x-ray

• Order a chest x-ray in all patients with suspected pneumonia. Unilateral lung infiltrates are found in

25% of patients, and bilateral lung infiltrates are found in 75% of patients.

Computed tomography (CT) chest

• Consider ordering a CT scan of the chest. It is particularly helpful in patients with suspected pneumonia who have a normal chest x-ray in order to detect infiltrates with greater sensitivity. Evidence of viral pneumonia on CT may precede a positive RT-PCR result for SARSCoV-

2 in some patients. CT is the primary imaging modality in China.

• Nearly all patients in the initial cohort of 41 patients had bilateral multiple lobular and subsegmental areas of consolidation. However, multiple mottling and ground glass opacity was only identified in 14% of patients in another study. Small nodular ground glass opacities are the most common finding in children.


Step-by-step treatment approach


No specific treatments are known to be effective for COVID-19 yet; therefore, the mainstay of management is optimised supportive care to relieve symptoms and to support organ function in more severe illness. Patients should be managed in a hospital setting where possible; however, home care may be suitable for selected patients with mild illness. Much of the information in this section is based on early evidence, analysis of case series and reports, and data from previous betacoronavirus infections such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). You should consult local guidance for further detailed information as the situation is evolving rapidly.


Infection prevention and control

Immediately isolate all suspected or confirmed cases in an area separate from other patients. Implement appropriate infection prevention and control procedures. Report all suspected and confirmed cases to your local health authorities.


Management of patients with pneumonia or comorbidities


Promptly admit patients with pneumonia or respiratory distress to an appropriate healthcare facility and start supportive care depending on the clinical presentation. The median time from onset of symptoms to hospital admission is reported to be approximately 7 days. Patients with impending or established respiratory failure should be admitted to an intensive care unit. Between 23% to 32% of hospitalized patients require intensive care for respiratory support. However, this estimate may be lower based on current case counts. Symptomatic patients who no longer require hospitalisation may be considered for home care if suitable (see below).

Supportive therapies

• Oxygen: give supplemental oxygen at a rate of 5 L/minute to patients with severe acute respiratory infection and respiratory distress, hypoxaemia, or shock. Titrate flow rates to reach a target SpO₂ ≥90%.

• Fluids: manage fluids conservatively in patients with severe acute respiratory infection when there is no evidence of shock as aggressive fluid resuscitation may worsen oxygenation.

• Symptom relief: give an antipyretic/analgesic for the relief of fever and pain.

• Antimicrobials: consider starting empirical antimicrobials in patients with suspected infection to cover other potential bacterial pathogens that may cause respiratory infection according to local protocols. Give within 1 hour of initial patient assessment for patients with suspected sepsis. Choice of empirical antimicrobials should be based on the clinical diagnosis, and local epidemiology and susceptibility data. Consider treatment with a neuraminidase inhibitor until influenza is ruled out. De-escalate empirical therapy based on test results and clinical judgement. Some patients with severe illness may require continued antimicrobial therapy once

COVID-19 has been confirmed depending on the clinical circumstances.


• Monitor patients closely for signs of clinical deterioration, such as rapidly progressive respiratory failure and sepsis, and start general supportive care interventions as indicated (e.g., haemodialysis, vasopressor therapy, fluid resuscitation, ventilation, antimicrobials) as appropriate.


Mechanical ventilation

• It is important to follow local infection prevention and control procedures to prevent transmission to healthcare workers. Endotracheal intubation should be performed by an experienced provider using airborne precautions.

• Intubation and mechanical ventilation are recommended in patients who are deteriorating and cannot maintain an SpO₂ ≥90% with oxygen therapy. Some patients may develop severe hypoxic respiratory failure, requiring a high fraction of inspired oxygen, and high air flow rates to match inspiratory flow demand. Patients may also have increased work of breathing, demanding positive pressure breathing assistance.

• High-flow nasal oxygen and non-invasive ventilation are recommended in select patients.

Mechanically ventilated patients with acute respiratory distress syndrome should receive a lungprotective, low tidal volume/low inspiratory pressure ventilation strategy. Those with persistent severe hypoxic failure should be considered for prone ventilation.

• The risk of treatment failure is high in patients with non-acutely reversible conditions, and there is also concern about nosocomial transmission with open ventilation systems and suboptimal noninvasive face mask or nasal pillow seals. More research to define the balance of benefits and risks to patients and health workers is needed.

• Some patients may require extracorporeal membrane oxygenation (ECMO) according to availability and expertise.


Management of patients without pneumonia or comorbidities


Although treatment in a hospital setting is preferred, sometimes inpatient care may not be available or may be considered unsafe, or the patient refuses to be hospitalised. Home care may be considered on a case-by-case basis. The location of home care may depend on guidance from local health authorities as forced quarantine orders are being used in some countries.

Patients suitable for home care

• Mild symptoms only (e.g., low-grade fever, cough, fatigue, rhinorrhoea, sore throat).

• No warning signs (e.g., shortness of breath or difficulty breathing, haemoptysis, increased sputum production, gastrointestinal symptoms, mental status changes).

• No underlying health conditions.


Home infection prevention and control measures


ʉۢ Infection prevention and control procedures are still important during home care. Recommend patients use a single room and a single bathroom (if possible), minimise contact with other household members, and wear a surgical mask if contact is necessary.

Supportive therapies

• Recommend symptomatic therapies such as an antipyretic/analgesic, and advise patients to keep hydrated but not to take too much fluid as this can worsen oxygenation.


• Monitor patients closely and advise them to seek medical care if symptoms worsen as mild illness can rapidly progress to lower respiratory tract disease.


Special patient groups


Pregnant women


• Data on pregnant women are limited; however, they can generally be treated with the same supportive therapies detailed above, taking into account the physiological changes that occur with pregnancy.




• Data on children are limited; however, guidance for the treatment of children has been published.






Monitor vital signs (i.e., respiratory rate, heart rate, blood pressure, oxygen saturation) as well as renal function, liver function, and coagulation profile regularly.


Patient instructions


General prevention measures


• Wash hands often with soap and water or an alcohol-based hand sanitiser and avoid touching the eyes, nose, and mouth with unwashed hands.

• Avoid close contact with people (i.e., maintain a distance of at least 1 metre [3 feet]), particularly those who are sick.

• Stay at home if sick and isolate yourself from other people.

• Practice respiratory hygiene (i.e., cover mouth and nose when coughing or sneezing, discard tissue immediately in a closed bin, and wash hands).

• Regularly clean and disinfect frequently touched objects and surfaces.



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Royal Dental Clinic

2020-03-16 03:02:43



Coronavirus disease 2019 (COVID-19) is a potentially severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was identified as the cause of an outbreak of pneumonia of unknown cause in Wuhan City, Hubei Province, China, in December 2019. The clinical presentation is that of a respiratory infection with a symptom severity ranging from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal.



Primary prevention


General prevention measures


• The only way to prevent infection is to avoid exposure to the virus and people should be advised to:

• Wash hands often with soap and water or an alcohol-based hand sanitizer and avoid touching the eyes, nose, and mouth with unwashed hands

• Avoid close contact with people (i.e., maintain a distance of at least 1 meter [3 feet]), particularly those who have a fever or are coughing or sneezing

• Practice respiratory hygiene (i.e., cover mouth and nose when coughing or sneezing, discard tissue immediately in a closed bin, and wash hands)

• Seek medical care early if they have a fever, cough, and difficulty breathing, and share their previous travel and contact history with their healthcare provider

• Avoid direct unprotected contact with live animals and surfaces in contact with live animals when visiting live markets in affected areas

• Avoid the consumption of raw or undercooked animal products, and handle raw meat, milk, or animal organs with care as per usual good food safety practices.



Medical masks


• The World Health Organization (WHO) does not recommend that people wear a medical mask in community settings if they do not have respiratory symptoms as there is no evidence available on its usefulness to protect people who are not ill. However, masks may be worn in some countries according to local cultural habits. Individuals with fever and/or respiratory symptoms are advised to wear a mask, particularly in endemic areas.

• It is mandatory to wear a medical mask in public in certain areas of China, and local guidance should be consulted for more information.



Screening and quarantine


• People travelling from areas with a high risk of infection may be screened using questionnaires about their travel, contact with ill persons, symptoms of infection, and/or measurement of their temperature.

Combined screening of airline passengers on exit from an affected area and on arrival elsewhere has been relatively ineffective when used for other infections such as Ebola virus infection, and has been modelled to miss up to 50% of cases of COVID-19, particularly those with no symptoms during an incubation period, which may exceed 10 days. Symptom-based screening processes have been reported to be ineffective in detecting SARS-CoV-2 infection in a small number of patients who were later found to have evidence of SARS-CoV-2 in a throat swab.

• Enforced quarantine has been used in some countries to isolate easily identifiable cohorts of people at potential risk of recent exposure (e.g., groups evacuated by aeroplane from affected areas, or groups on cruise ships with infected people on board). The psychosocial effects of enforced quarantine may have long-lasting repercussions.





• There is currently no vaccine available. Vaccines are in development, but it may take up to 12 months before a vaccine is available. An mRNA vaccine (mRNA-1273) has been shipped to the National Institute of Allergy and Infectious Diseases for phase I clinical trials in the US, with an estimated start date of 6 March 2020.




Management of contacts


People who may have been exposed to individuals with suspected COVID-19 (including healthcare workers) should be advised to monitor their health for 14 days from the last day of possible contact, and seek immediate medical attention if they develop any symptoms, particularly fever, respiratory symptoms such as coughing or shortness of breath, or diarrhoea. Some people may be put into voluntary or compulsory quarantine depending on the guidance from local health authorities.


Screening of travelers


Exit and entry screening may be recommended in some countries, particulary when repatriating nationals from affected areas. Travellers returning from affected areas should self-monitor for symptoms for 14 days and follow local protocols of the receiving country. Some countries may require returning travellers to enter quarantine. Travellers who develop symptoms are advised to contact their local health care provider, preferably by phone.


Secondary prevention


Early recognition of new cases is the cornerstone of prevention of transmission. Immediately isolate all suspected and confirmed cases and implement recommended infection prevention and control procedures according to local protocols, including standard precautions at all times, and contact, droplet, and airborne precautions while the patient is symptomatic. Report all suspected and confirmed cases to your local health authorities.



Step-by-step diagnostic approach


Early recognition and rapid diagnosis are essential to prevent transmission and provide supportive care in a timely manner. Have a high index of clinical suspicion for COVID-19 in all patients who present with fever and/or respiratory symptoms and who report a travel history to an affected area or close contact with a suspected or confirmed case in the 14 days prior to symptom onset. Evaluation should be performed according to pneumonia severity indexes and sepsis guidelines (if sepsis is suspected) in all patients with severe illness.


Infection prevention and control


Triage all patients on admission and immediately isolate all suspected and confirmed cases in an area separate from other patients. Implement appropriate infection prevention and control procedures.

Screening questionnaires may be helpful. Report all suspected and confirmed cases to your local health authorities.


The World Health Organization (WHO) recommends the following basic principles:

• Immediately isolate all suspected cases in an area that is separate from other patients

• Implement standard precautions at all times:

• Practice hand and respiratory hygiene

• Offer a medical mask to patients who can tolerate one

• Wear personal protective equipment

• Prevent needlestick and sharps injury

• Practice safe waste management, environmental cleaning, and sterilisation of patient care equipment and linen

• Implement additional contact and droplet precautions until the patient is asymptomatic:

• Place patients in adequately ventilated single rooms; when single rooms are not available, place all suspected cases together in the same ward

• Wear a medical mask, gloves, an appropriate gown, and eye/facial protection (e.g., goggles or a face shield)

• Use single-use or disposable equipment

• Consider limiting the number of healthcare workers, family members, and visitors in contact with the patient, ensuring optimal patient care and psychosocial support for the patient

• Consider placing patients in negative pressure rooms, if available

• Implement airborne precautions when performing aerosol-generating procedures

• All specimens collected for laboratory investigations should be regarded as potentially infectious.

It is important to disinfect inanimate surfaces in the surgery or hospital as patients may touch and contaminate surfaces such as door handles and desktops.


Clinical presentation


The clinical presentation resembles viral pneumonia, and the severity of illness ranges from mild to severe. Approximately 80% of patients present with mild illness, 14% present with severe illness, and 5% present with critical illness. Early reports suggest that illness severity is associated with older age and the presence of underlying health conditions.


Based on an early analysis of case series, the most common symptoms are:


• Fever

• Cough

• Dyspnoea

• Myalgia

• Fatigue.


Less common symptoms include:


• Anorexia

• Sputum production

• Sore throat

• Confusion

• Dizziness

• Headache

• Rhinorrhoea

• Chest pain

• Haemoptysis

• Diarrhoea

• Nausea/vomiting

• Abdominal pain.


Approximately 90% of patients present with more than one symptom, and 15% of patients present with fever, cough, and dyspnoea. It appears that fewer patients have prominent upper respiratory tract or gastrointestinal symptoms compared with SARS, MERS, or influenza. Patients may present with nausea or diarrhoea 1 to 2 days prior to onset of fever and breathing difficulties. Most children present with mild symptoms, without fever or pneumonia. However, they may have signs of pneumonia on chest imaging despite having minimal or no symptoms. Retrospective reviews of pregnant women with COVID-19 found that the clinical characteristics in pregnant women were similar to those reported for non-pregnant adults.


Initial investigations


Order the following investigations in all patients with severe illness:


• Pulse oximetry

• ABG (as indicated to detect hypercarbia or acidosis)


• Comprehensive metabolic panel

• Coagulation screen

• Inflammatory markers (serum procalcitonin and C-reactive protein)

• Serum troponin

• Serum lactate dehydrogenase

• Serum creatine kinase.


Blood and sputum cultures


Collect blood and sputum specimens for culture in all patients to rule out other causes of lower respiratory tract infection, especially patients with an atypical epidemiological history.

Specimens should be collected prior to starting empirical antimicrobials if possible.


Molecular testing


Molecular testing is required to confirm the diagnosis. Diagnostic tests should be performed according to guidance issued by local health authorities.

Perform real-time reverse-transcription polymerase chain reaction (RT-PCR) assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in all patients with suspected infection:


Family & Child dentistry

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Royal Dental Clinic

2020-03-14 02:16:26

You may have thought that gum disease is a dental problem only seen in adults. Unfortunately for parents, this is not the case. Gingivitis and gum disease can occur in children and are actually quite common in pediatric dental patients. Gingivitis is the precursor to gum disease, and it’s often marked by red, swollen gums, and slight bleeding when your child brushes or flosses.


Signs of periodontal disease


Four basic signs will alert you to periodontal disease in your child:


1. Bleeding gums during tooth brushing, flossing or any other time.


2. Puffiness; Swollen and bright red gums.


3. Recession; Gums that have receded away from the teeth, sometimes exposing the roots


4. Bad breath; Constant bad breath that does not clear up with brushing and flossing.




Gum disease is more aggressive in children with poor oral hygiene. It often involves pain in the mouth, gum recession, and areas of swelling. In most cases, gingivitis and gum disease can be avoided if more care is taken to brush and floss daily.




Treatment may include any or a combination of the following:


1. Good dental care. Regular cleanings by a dentist can help fight gingivitis, the mildest form of gum disease. Your child will also need to brush and floss daily.


2. Deep cleaning (scaling and root planing). This treatment can help remove the plaque and tartar under the gum and infected tissue in the early stages of the disease. It can also smooth the damaged root surfaces of the teeth. The gums can then reattach to the teeth.


3. Medicine. Antibiotic medicine may be put in the periodontal pockets. Or it may be given in pill form to take by mouth.


4. Surgery. When gum disease is advanced, the infected areas under the gums need to be cleaned. The tissues may also be reshaped or replaced.


If your child has any of the symptoms of gingivitis, don’t hesitate to walk in to our facility today. Royal Dental Clinic is dedicated to making dental visits easy, fun, and enjoyable for kids of all ages.


Oral Health

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Royal Dental Clinic

2020-03-11 01:31:26

Also called a bad bite, malocclusion is caused by crowded, extra or missing teeth, or jaws out of alignment. Most malocclusions are inherited genetically and can lead to temporomandibular jaw (TMJ) disorders that can result in problems of chewing and speaking. The objective of the diagnosis, and surgical and non-surgical management of malocclusions and potential TMJ complications, is to restore normal function and eliminate pain.


Causes and symptoms


Malocclusions are most often inherited, but may be acquired. Inherited conditions include too many or too few teeth, too much or too little space between teeth, irregular mouth and jaw size and shape, and atypical formations of the jaws and face, such as a cleft palate. Malocclusions may be acquired from habits like finger or thumb sucking, tongue thrusting, premature loss of teeth from an accident or dental disease, and possibly from medical conditions such as enlarged tonsils and adenoids that lead to mouth breathing.


Malocclusions may cause no symptoms, or they may produce pain from the increased stress on oral structures. Teeth may show abnormal signs of wear on the chewing surfaces or decay in areas of tight overlap. Chewing may be difficult.




Malocclusion is usually diagnosed after a history and physical examination by a healthcare provider, who will refer a child to a dentist or orthodontist for a complete assessment. Next, the dentist or orthodontist will establish treatment goals. Tests that help to diagnose malocclusion may include X-rays and impressions (imprints of the teeth poured with plaster to make a model of the mouth—this is used to evaluate malocclusion).




Methods of treatment may include:


1. Braces or other appliances: Metal bands are placed around some teeth, or metal, ceramic, or plastic bonds are attached to the surface of the teeth. Wires or springs apply force to the teeth. Clear braces (aligners) without wires may be used in some people.


2. Removal of one or more teeth: This may be needed if overcrowding is part of the problem.


3. Repair of rough or irregular teeth: Teeth may be adjusted down, reshaped, and bonded or capped. Misshapen restorations and dental appliances should be repaired.


4. Surgery: Surgical reshaping to lengthen or shorten the jaw is needed in rare cases. Wires, plates, or screws may be used to stabilize the jaw bone.


Dental check up


There are several forms of malocclusion. Those forms include under bites, overbites, cross bites, open bites and crowded teeth. Specialists at the Royal Dental Clinic are here to diagnose the exact type of malocclusion that you might have. They will perform the treatments necessary to cure your situation and will provide you with the proper techniques used to prevent malocclusion from coming back.


Family & Child dentistry

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Royal Dental Clinic

2020-03-07 06:54:30


One of the problems that affect the oral health of children is tongue thrusting, which is the habit of sealing the mouth for swallowing by thrusting the top of the tongue forward against the lips.


Just like thumb sucking, tongue thrusting exerts pressure against the front teeth, pushing them out of alignment, which causes them to protrude, creating an overbite, and possibly interfering with proper speech development.


Why Is Tongue Thrusting Bad?


The tongue is a very powerful muscle – one that’s strong enough to push teeth out of their natural position. This bad swallowing habit is even more apparent when you realize that the average human swallows about 2,000 times a day! Over time, tongue thrusting can cause an open bite. This is when only the back teeth will come together during a bite – the front teeth won’t actually touch.


How do I know if my child has tongue thrust?


There are a number of signs that could indicate that your child has tongue thrust. If your child has an open bite, for example, where their front teeth don’t meet when the teeth are closed, it could be a sign that their tongue is in an incorrect resting position. Other signs of tongue thrust include mouth breathing; difficulty eating; a speech impediment such as a lisp; and a tongue that is visible between the teeth even when your child is resting.




It might be possible to prevent tongue thrust in children by dealing with these problems before they cause the tongue thrust disorder:


1. Ear, nose, and throat problems such as allergies or enlarged tonsils,


2. Oral habits such as thumb sucking and using a pacifier




The best way to treat bad bites and jaw problems caused by tongue thrusting is not to stop eating food, but with orthodontic treatment. The Royal Dental Clinic recommends that all children have an orthodontic evaluation by age 7. This check-up can catch many different problems early enough for orthodontic treatment to be effective, including those caused by tongue thrusting.


During treatment, tongue thrust and the type of braces and appliances that can bring teeth back to correct positions and fix any adverse jaw growth caught early enough in child growing stages are evaluated. If not caught early enough, surgery as an adult is the only alternative method to fix these problems.


Oral Health

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Royal Dental Clinic

2020-03-02 14:37:35

Problems with teeth and gums can be more common for people with diabetes, so good dental health is important to prevent dental complications. Looking after your teeth and gums is an essential part of learning to live with both type 1 diabetes and type 2 diabetes.


 In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy. In Type II diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.


Diabetes continues to be a major concern in oral health care. Oral complications with diabetes can include dry mouth, dental caries, candidiasis, periodontal disease and tooth loss.


These patients, critically dependent on oral function in the management of this condition, may have reduced or compromised therapeutic options in care.


The Symptoms of Untreated Diabetes


The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low.


If diabetes is left untreated, it can take a toll on your mouth as well. Here's how:


1. You may have less saliva, causing your mouth to feel dry. (Dry mouth is also caused by certain medications.)


2. Because saliva protects your teeth, you’re also at a higher risk of cavities.


3. Gums may become inflamed and bleed often (gingivitis).


4. You may have problems tasting food.


5. You may experience delayed wound healing.


6. You may be susceptible to infections inside of your mouth.


7. For children with diabetes, teeth may erupt at an age earlier than is typical.




Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can help to lower your HbA1c. (This is a lab test that shows your average level of blood sugar over the previous three months. It indicates how well you are controlling your diabetes.)






Treatment depends on which problem you have. People with periodontal disease will need to receive treatment from a dentist, who may do a deep cleaning of your teeth or refer you to a periodontist for gum surgery. The dentist may also prescribe a special mouth rinse.


To treat symptoms of thrush, a dentist or doctor may prescribe a medicine to kill the fungus that causes thrush. You may also need a special solution to clean dentures.


For dry mouth, a doctor or dentist may prescribe a medicine to keep your mouth wet.


Family & Child dentistry

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Royal Dental Clinic

2020-02-25 15:05:43

Baby bottle tooth decay refers to the development of cavities and early loss of baby teeth among infants and toddlers, usually brought on by prolonged milk bottle use.


Even though they are temporary, your child's baby teeth are important, and are still susceptible to cavities.  Children need strong, healthy teeth to chew their food, speak and have a good-looking smile. Their first teeth also help make sure their adult teeth come in correctly. It’s important to start infants off with good oral care to help protect their teeth for decades to come.


What Causes Baby Bottle Tooth Decay?


Baby Bottle Tooth Decay most often occurs in the upper front teeth, but other teeth may also be affected.


There are many factors which can cause tooth decay. One common cause is the frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby.


Additionally, if breastfed infants fall asleep with unswallowed milk in their mouth, they are also at risk for tooth decay. Bacteria in the mouth feed on the sugars, causing tooth decay.


If left untreated, decayed teeth can cause pain and make it difficult to chew and eat. Also, baby teeth serve as "space savers" for adult teeth. If baby teeth are damaged or destroyed, they can't help guide permanent teeth into their proper position, possibly resulting in crowded or crooked permanent teeth. Badly decayed baby teeth could lead to an abscessed tooth, with the possibility of infection spreading elsewhere in the body.


How Do I Prevent Baby Bottle Tooth Decay?


Some tips to prevent baby bottle tooth decay include:


1. During the day, to calm or comfort your baby, don't give a bottle filled with sugary drinks or milk; instead, give plain water or a pacifier.


2. Never dip your baby's pacifier in sugar, honey, or any sugary liquid.


3. Don't put your baby to bed with a bottle filled with sugary drinks (watered-down fruit juice or milk still increases the risk of decay). Give a small amount of plain water or use a pacifier instead. Too much water is harmful to a baby.


4. If your baby is nursing at night, make sure you remove your breast from your baby's mouth when she falls asleep.


5. Don't add sugar to your baby's food.


6. Use a wet cloth or gauze to wipe your baby's teeth and gums after each feeding. This helps remove any bacteria-forming plaque and sugar that have built up on the teeth and gums.


7. Ask your dentist about your baby's fluoride needs. If your drinking water is not fluoridated, fluoride supplements or fluoride treatments may be needed.


8. Teach your baby to drink from a cup by his or her first birthday. Moving to a "sippy cup" lowers the teeth's exposure to sugars, but constant sipping from the cup can still result in decay unless it is filled with plain water.




The best approach to baby bottle tooth decay is prevention, but treatment ideally focuses on saving teeth with dental restorations (fillings) or crowns; however tooth extraction will be necessary for teeth associated with dental abscesses or teeth that simply cannot be restored.


Oral Health

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Royal Dental Clinic

2020-01-28 14:38:20


When it became possible to bond tooth colored restorative materials to enamel in the early 1980’s, dental practice, as we know it was changed forever. The “Age of Aesthetic Dentistry” was born. No longer did the dentist deal with only dental disease (caries and periodontal), but now could offer solutions for aesthetic dental problems that were never before possible.


Dental Art

Dental aesthetics, also called aesthetic dentistry, is an art combined with science. It includes all the manipulations and tools available to dentists to improve the appearance of their patients’ smiles, such as veneers, dental crowns and tooth whitening. To obtain the best possible results, facial characteristics must be taken into account in order to harmonize the smile with the rest of the face.


Beautiful smile

A beautiful smile can often give you self-confidence and therefore confidence on a daily basis, which is why it is so important for some people to want to change their smile to suit their taste.


Aesthetic tools

Several different elective aesthetic options have been shown that offer patients the ability to “upgrade” their smile. By setting proper patient expectations, these services and different price points can offer the patient a dental aesthetic alternatives that are economically and aesthetically fit their needs. Clients are advised to explore different available options for aesthetical dental restoration.


Aesthetics and ethics

Technically, Prosthodontics is the only dental specialty under which the concentration of cosmetic/esthetic dentistry falls. General dentists may perform some simple cosmetic procedures. Consequently, there are questions regarding whether it is ethical for general dentists to treat "smile makeovers" or complex cosmetic and full-mouth reconstruction cases, as they are not qualified to address the complex needs of the patient.


Restorative hope.

Only a handful of lucky people can boast of having an aesthetic smile without the need for cosmetic dentistry. However, there is hope! With a good team of oral health professionals and an investment of time and money, almost any defect can now be fixed.


Oral Health

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Royal Dental Clinic

2019-12-11 07:25:59

Enamel is a term used to refer to the outer layer of the teeth. It is semi-clear in appearance and forms the hard outer layer of your teeth. Enamel protects your teeth against any form of chemical and physical damage and also from daily wear and tear. 

The enamel of our teeth is very strong and in fact, it is known to be the hardest tissue in the human body. It is even harder than your bones. The enamel is the layer that prevents you from feeling any change in temperature extremes when you eat and drink. Therefore, if you consider all these points, you will understand just important the enamel is for protecting your teeth. However, what happens when your enamel becomes eroded? Your day-to-day dental hygiene might be responsible for eroding your teeth’s enamel.

What Causes Enamel Loss?

Enamel functions as the first line of defense for your teeth and helps in fighting off the chemicals from food and drinks, and even bodily fluids. Even though it is the hardest tissue in the human body, the enamel is prone to normal wear and tear. In some cases, this wear and tear is more and can cause the enamel to erode. When you start to lose the enamel, your teeth become prone to getting cavities and can even lead to tooth decay. But what causes this enamel to decay?

The primary cause of enamel erosion is the acid which is present in foods and drinks. This acid attacks the tooth enamel and has been identified as being the main cause of enamel erosion. While your saliva works extra hard to wash away or get rid of this acid from your mouth and teeth, but over a period of time, consumption of too much acidic food and drink combined with poor dental hygiene, succeed in wearing down the enamel. At that stage, even this repairing done by your saliva does not work and slowly, bit by bit, the enamel of your teeth start eroding away.

The process of enamel erosion begins with staining of the teeth. With time, as more of the dentine present underneath the enamel becomes exposed, this makes the teeth more sensitive to pain when you drink hot or cold foods and drinks. The same is true for when you have acidic foods as well.

10 Startling Causes of Enamel Loss

Apart from the above mentioned causes, there can be some other causes of tooth enamel erosion. These include:

  1. Morning sickness caused during pregnancy – the acid in vomit works faster to erode the enamel
  2. Bulimia â€“ an eating disorder wherein the individual vomits after eating, causing stomach acids to come into the mouth, thus causing enamel erosion
  3. GERD or gastroesophageal reflux disease or any other acid reflux conditions – as these conditions cause the stomach acids to come up into your mouth, it leads to enamel erosion of the teeth
  4. Dry mouth â€“ any condition that affects the flow and presence of saliva in the mouth causes enamel erosion as saliva is not present to protect the teeth
  5. Certain medications, particularly vitamin C, iron-containing drugs, aspirin, etc.
  6. Eating too many sweets – sugar fuels the growth of bacteria in your mouth. These bacteria produce acids that erode the enamel. This gets aggravated if you have poor dental hygiene and don’t brush frequently.
  7. Sour candies or foods – these foods are high in acid content, which eat away at the teeth’s enamel
  8. Alcoholism or binge drinking – these conditions cause individuals to vomit frequently, bringing up the acids from the stomach, causing enamel erosion
  9. Brushing aggressively – even brushing your teeth too hard can cause the enamel to become eroded. Using a soft brush and brushing your teeth gently is recommended.
  10. Bruxism or grinding your teeth – if you are regularly grinding your teeth, this can do a lot of damage to the enamel.

What Are The Symptoms Of Tooth Erosion?

Once your teeth start to lose its outer covering or shell, you will begin to notice the following symptoms:

  • Sensitivity or pain while having hot or cold food/drinks.
  • Sensitivity or pain while having sweet or sour food/drinks.
  • Feeling uneven edges or feeling a roughness on your teeth – this can cause your tooth to chip easily.
  • Shiny and smooth teeth surfaces – an indication of mineral loss.
  • Dents on the teeth where you chew or bite from – these indentations are known as cups.
  • Yellowish or stained teeth.

High sensitivity or experiencing pain while having hot, cold, acidic, sweet, and spicy food and/or drinks along with discoloration of the teeth is usually a sign that you have a significant amount of enamel erosion.

What Complications Result from Enamel Loss?

Enamel loss can lead to several complications over a period of them. These include:

  • Rough edges on the teeth
  • Yellow or stained teeth
  • Increased occurrence of tooth decay
  • Clear and translucent teeth
  • Fractured tooth
  • Shiny spots visible on the teeth
  • Sensitivity to pain

Can the Tooth Enamel Grow Back or Repair Itself?

It is possible for the enamel to repair itself. Saliva is the only option you have for stopping the acid from attacking your teeth and helping in repairing the enamel.

It is possible to halt enamel loss. A dentist at Royal dental clinic can guide you on how this can be done. Once enamel loss is detected, Dentists at Royal Dental usually advise patients to practice some extra oral hygiene. Some recommendations would include using a fluoride varnish treatment, changing your toothpaste, or using a specialized mouthwash.

You may also be required to make some lifestyle and dietary changes.

Prevention & Treatment of Enamel Loss

There are certain treatments available for fixing enamel loss. If a dentist at Royal Dental determines that significant enamel erosion has taken place, he/she will recommend that you undergo a procedure known as tooth bonding. In this procedure, the dentist puts a tooth-colored material to the stained or damaged teeth. This material is known as resin. The resin is used for effectively covering up any discolorations on the tooth and also protects your tooth from being damaged further. This process is usually used if enamel loss has caused significant discoloration of the front teeth.

To prevent further decay in extreme cases of enamel erosion, Dr. Vitalis Ogola of Royal Dental recommends that you add a veneer or a crown to the damaged teeth.

However, the best treatment for enamel loss is to prevent it from happening in the first place. A good oral hygiene and the following tips can help prevent enamel loss.

  • Reduce and also limit your intake of sugary and acidic food and drinks
  • If you are having acidic drinks, using a straw makes sure that the acid in the drink stays away from the teeth. Also don’t swish the drink around in your mouth.
  • If you are having a particularly sweet or acidic meal, having some cheese or milk afterward helps counter the acid intake
  • Try chewing some sugar-free gum after each meal. This not only encourages the production of saliva, but also removes small food particles from your mouth.
  • Do not have any acidic food or drink immediately after brushing your teeth.
  • Make sure you brush your teeth twice daily, especially before going to bed at night.



Oral Health

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Royal Dental Clinic

2019-12-04 12:39:15

Dental floss is a cord of thin filaments used to remove food and dental plaque from between the teeth in areas a toothbrush is unable to reach. The Royal Dental Clinic recommends cleaning between your teeth daily with an inter-dental cleaner.

Regular use of dental floss removes plaque, helping to prevent the buildup of plaque, which can lead to tartar. Simply flossing your teeth can make them look brighter by removing plaque and excess food particles that you may not see in the mirror or in areas that your toothbrush doesn’t reach. Daily flossing doesn’t just keep your teeth healthy - practicing good oral hygiene contributes to your health in other ways, too.

It also helps prevent tooth decay and can reduce your risk of developing gum disease by removing plaque. In addition, flossing gives you the opportunity to regularly examine your mouth for any swelling or redness. Flossing gives you an opportunity to take a good look at your teeth, tongue, and gums.

Flossing and your gums

While periodontal disease is not the primary cause for pulpal death, chronically unhealthy gums can increase your risk of losing your teeth or needing a root canal. And even though twice-daily tooth brushing is essential for good oral hygiene, brushing alone may not protect you from gum disease and the tooth loss that can result.

Many people who suffer from sensitive or bleeding gums may be tempted to avoid flossing for fear of making their bleeding gums worse. But in fact, flossing can improve the health of your gums, thereby helping to prevent them from bleeding.

It's a fact, flossing daily combined with brushing and a rinse helps protect against gingivitis by removing plaque and food particles, keeping your teeth and gums healthy, while giving you a beautiful smile. Flossing is essential to your smile's health, no matter what your age. And yes, even kids should floss to get used to a healthy oral care routine. You might be asking, "Why is flossing so important?" Here's the answer: By flossing, you remove plaque and food particles in between your teeth and gums, and help prevent gingivitis.

Flossing and Gingivitis

Gingivitis is the first stage of gum disease. It is also the most treatable. Flossing is a step to keeping your gums healthy.

Does A Dental Condition Prevent You from Flossing? 

Daily flossing is an important component of plaque removal, but it’s one that many people avoid because they find flossing painful. But the right flossing products can make flossing easy and painless. Many people think that standard dental floss is the only effective product for tooth flossing. But there are many products to meet the needs of people of all ages with any type of dental condition. If one of these conditions applies to you, consider some specialized flossing options:

You have sensitive gums. 

If you have sensitive teeth and gums that bleed easily, choose a soft floss that slides easily and comfortably between the teeth.

You have braces. 

If you wear braces or have dentures, that doesn’t mean that you can’t floss. Try a specialized floss that has a stiff end that you can thread beneath the main wire of your braces and a spongy component that slides easily between the teeth.

You have a child. 

It’s important to teach children the benefits of flossing at a young age. You can start teaching children to floss their teeth at about age 5-7 years, but many children are less than enthusiastic, and they may complain that flossing hurts or is difficult.

Floss Gently

Keep in mind that cleaning between your teeth should not be painful. If you do it too hard, you could damage the tissues between your teeth. If you are too gentle, you might be getting the food out. It is normal to feel some discomfort when you first start, but don’t give up. With daily brushing and cleaning between your teeth that discomfort should ease with a week or two. If your pain persists, talk to your dentist.




Oral Health

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Royal Dental Clinic

2019-11-27 07:45:11

A dental crown is a "cap" placed over a tooth. When cemented into place, crowns fully encase the entire visible portion of a tooth that lies at and above the gum line. Crowns are used most commonly to entirely cover or "cap" a damaged tooth or cover an implant. Like most Bridges, crowns are fixed prosthetic devices.

When is a dental crown required?

When a tooth has become irreparably decayed, or infected, your dentist will recommend a root canal. Once the root canal is completed, a crown will be utilized to restore strength to the weakened tooth.

How do crowns work?

A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function.

Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

What types of crown materials are available?

Dental crowns are made from diverse materials as is explained below;


The metals that are used to make crowns include gold, palladium, nickel, or chromium. Metal crowns rarely chip or break, last the longest in terms of wear down, and only require a small amount of tooth to be removed. They can also withstand biting and chewing forces. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.


Dental crowns can be matched to the color of the teeth beside them. They have a more natural tooth color. However, sometimes the metal under the crown’s porcelain cap shows through as a dark line. Other drawbacks are that the crown’s porcelain portion can chip or break off and there is more wearing down of the teeth opposite them in the mouth. (The top and bottom tooth that come into contact when the mouth is closed.) These crowns can be a good choice for front or back teeth.


All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more likely to break than porcelain-fused-to-metal crowns.

All-ceramic or all-porcelain

This type of dental crowns provide the best natural color match than any other crown type. They are also a good choice for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns. They also may wear down the teeth opposite them in the mouth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

Pressed ceramic crowns

Pressed ceramic crowns have a hard inner core. They replace the metal liner that is used in the all-ceramic crown-making process. Pressed ceramic crowns are capped with porcelain, which provides the best natural color match. They are also more long-lasting than an all-porcelain crown.

Does it hurt to have a tooth prepared for a crown?

No. You will have a local anesthetic and the preparation work should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then you may not need a local anesthetic.

Will the crown be noticeable?

The crown will be made to match your other teeth as closely as possible. The shade of the surrounding teeth will be recorded, to make sure that the color looks natural and matches those teeth.

Will the crown feel different?

Because the shape of the crown will be slightly different from the shape of your tooth before it was crowned, you may be aware of it at first. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if your bite does not feel comfortable, and if this is the case, you should ask your dentist to check and adjust it.

How do I care for my crown?

It is important to keep the crown just as clean as you would your natural teeth. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. Brush last thing at night and at least one other time during the day with a fluoride toothpaste, and clean in between your teeth with ‘interdental' brushes or floss.

How long will the crown last?

How long your crown lasts depends on how well you look after it. Properly cared for crowns should last for many years. Your dental team will be able to tell you how long your crown may be expected to last.


Oral Health

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Royal Dental Clinic

2019-11-20 06:22:04

Your awareness on the concept of cavities or gum disease is most likely not on the same level with that of your child. This is often why he or she doesn't see the big deal when it comes regular and proper brushing of teeth. Kids can refuse to regularly and correctly brush their teeth for a number of other reasons, though, from an attempt to assert themselves to a sensitivity to the toothbrush.

Having a child who won't brush his/her baby teeth might not seem like a cause for concern; S/he will lose them soon anyway. But tooth decay is one of the most common chronic conditions in kids, affecting about 20 percent of those between the ages of five and 11, according to the Royal Dental Clinic. And not brushing now can cause your child discomfort, as well as problems with eating and speaking well into the eruption of their adult teeth. It also sets up a pattern of not brushing in the future, which can lead to health issues in other parts of the body.

In training your child to develop a habit of regular and correct brushing of teeth, here are a few techniques;

Motivate the child using some incentives.

Giving your child a reward for brushing should be a regular item in a parent's arsenal, but the reward that works best will depend on your child's age and interests. Someone under the age of eight, for example, may be receptive to a funny bedtime story before lights out – but only after he brushes.

For an older child, a good reward might be letting him watch an episode of a favorite TV show between brushing and bed. If your child fusses about brushing his teeth, remind them the time he spends complaining will cut into this bonus playtime. Keep in mind, however, that physical activity can make it harder to fall asleep; be sure to keep this incentive to a minimum.

Turn teeth brushing into a sport

Similar to offering your child a reward is turning tooth brushing into a game. Put on an upbeat song for two minutes (the appropriate brushing time) while your child brushes, and have a mini-dance party. Another option is to create a star chart wherein each time your child brushes without being asked, morning and night, he gets some points. Having earned 10 points, your child qualifies for a prize. If he makes it to 20, offer something slightly better. Two or more children might transform your teeth brushing sport into a friendly competition – the one who earns 10 0r 20 points first gets the best prize, for instance. If they tie, you can give them the same thing. Just make sure this reward doesn't counter all the hard work they did to clean their teeth!

Get a variety of dental products

You don't want to give your child the choice of not brushing teeth, because at this stage, he may take you up on it. To encourage him to embrace the routine, however, you can give him a choice of which products to use. Bring your child through the oral care aisle to pick out a brush and toothpaste that stands out. Royal Dent is a particular tooth brush which your child will definitely fall in love with.

Keep checking out on tooth sensitivity.

The refusal to brush might have little to do with assertiveness and a more do with sensory issues. Some kids are more sensitive to touch than others, which makes tooth brushing especially unpleasant. Children with autism or attention disorders are likely to have sensitivities that affect oral care, in particular. If you suspect your child's resistance to brushing is linked to a sensitive mouth, kindly visit your dental clinic for advice.

Just remember that these are stages that your will definitely overgrow, figuring out a way to work with your child through it will help everyone healthy and collected until it's an effortless part of the daily routine.


Oral Health

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Royal Dental Clinic

2019-11-08 10:44:14

Your mouth is one of the places most prone to bacteria because it’s dark, warm and wet, creating a perfect environment for bacteria to live and feed off of leftover food particles. In fact, there are billions of bacteria living in your mouth right now on your teeth and tongue. This is why we provide the main reasons to brush your tongue and its importance, because reducing the amount of bacteria that lives in your mouth will help you to achieve oral health.

Why should you brush your tongue?

Reasons to brush your tongue:

  • The majority of the bacteria in your mouth lives and breeds on your tongues rough surface. Although brushing your teeth eliminates bacteria sticking to your teeth, the bacteria on your tongue is transferred to your teeth with your saliva in just a few hours.
  • It prevents bad breath.

How to brush your tongue?

Royal Dental recommends starting at the back of your tongue working your way towards the opening of your mouth, gently brushing the entire top surface with a complete rinse of water. As an alternative/or for a more thorough cleaning, use a tongue scraper. Sold at most drugstores, this is usually made of soft, flexible plastic and gently peels the thin mucus-based layer of debris from the tongue. Don’t scrape too hard as this may break your tongue’s surface and will cause it to bleed.

Here are five reasons why brushing your tongue is important for your overall oral health:

  1. It removes harmful odour-causing build-up. The human tongue is a large organ that acts as a hosts most for most of the bacteria. Brushing your tongue on a regular basis means you can effectively eliminate odour-causing germs that accumulate on the tongue and cause halitosis.
  2. It reduces the risk of periodontal disease. Bacteria buildup on your tongue can lead to gum disease and other illnesses that spread throughout the body. If it’s not treated, the inflammation can advance to periodontal disease (when your gums become infected due to deep pockets between your teeth and gums).
  3. It enhances taste. By brushing your tongue and removing the build-up of plaque will remove dull taste buds and you’ll be able really taste and enjoy your food.
  4. It reduces your risk of oral thrush. Oral thrush is an infection caused most commonly by an overgrowth of yeast in the mouth. When the bacteria levels in your mouth build up in excessive amounts, white patches will appear on your tongue. An antifungal medication can cure it, and regular tongue brushing should keep it from returning.
  5. It boosts your immunity levels and digestive health. The tongue is part of the first line of defense in your immune system. Scraping or brushing your tongue prevents toxins from being absorbed into your body which in turn will boost your overall immune function.

Remember brushing your tongue on a regular basis  is a very important part of your oral regime and a very easy addition. If you’re curious about how to improve your dental health, visit Royal Dental Clinic to speak to one of our hygienists. 


Oral Health

No Image

Royal Dental Clinic

2019-11-05 09:19:18

What is Gum Recession?

Have you had a problem where the margin of the gum tissue surrounding your teeth wears away, or pulls back, exposing more of the tooth, or the tooth's root? If yes then you are definitely dealing with Gum recession.  When gums recede, gaps can form between the gum and tooth, allowing disease-causing bacteria to build up.

If left untreated, the surrounding tissue and bone structures of the teeth can be damaged, sometimes resulting in tooth loss. Receding gums is a widespread dental condition. Most people aren’t aware that they have receding gums since it occurs gradually. It becomes a health concern when the roots of the teeth become exposed, leaving the teeth at risk of decay, infection, and loss. If people start treatment at an early stage, they can stop or reverse the process of gum recession.

Symptoms of Receding Gum

The beginning and progression of receding gum is accompanied by the following symptoms;

Long Teeth; One symptom is the visible lengthening of the teeth. When gums recede because of periodontal disease, the teeth have the appearance of being much longer than normal.

Exposed Roots; Exposed roots are another symptom, and can be extremely sensitive and uncomfortable. They are often a sign of periodontal disease or can be attributed to brushing overly aggressively with a toothbrush with hard bristles.

Loose Teeth; When suffering from receding gums, you may notice loose teeth, attributed to the bacteria and periodontal disease under the gums around the teeth. As receding gums worsen, the gum pockets deepen due to loss of attachment structure.

Causes of Receding Gums

Numerous factors can cause your gums to recede, including:

Periodontal diseases.                                                                                                             

These are gum infections, caused by bacteria that destroy gum tissue and the bone that holds your teeth in place. Periodontal disease is the main cause of gum recession. In early stages, periodontal disease is not often painful, therefore symptoms often go unnoticed. Left untreated though, early symptoms can develop into periodontitis. Red, swollen, or purple gums, gums that feel tender to the touch, bleeding gums, and chronic bad breath are some of the symptoms of diseased gums.


Your gums' characteristics are determined by your genetics, just as the rest of your body is. If one or both of your parents have gum recession, you're at a higher risk for receding gums. Accordingly, some people are more susceptible to periodontal disease. Studies show that 30% of the population may be predisposed to gum disease, even if they take good care of their teeth.

Brushing too hard                                                                                                                         

If you brush your teeth too aggressively or incorrectly, it can cause your tooth’s enamel to wear away and your gums to recede. It's great to be enthusiastic about oral care, but according to Dr. Vitalis Ogola of RoyalDental Clinic, you should make sure that you're brushing, not scrubbing! Never use a toothbrush that isn't labeled "soft." Be gentle on your teeth, and remember that taking care of them isn't supposed to hurt.

Poor dental care.                                                                                                              

Inadequate brushing, flossing, and rinsing with antibacterial mouthwash, can make it easy for plaque to turn into tartar, a hard substance that forms on and between your teeth and can only be removed by a professional tooth cleaning.

Hormone levels

Changes in estrogen levels over a woman's life, like puberty, pregnancy, and menopause, can make gums increasingly sensitive and vulnerable to gum recession.

Grinding and clenching your teeth

Grinding your teeth, or bruxism. Do you often wake up with a headache? Does your spouse or partner complain that you grind your teeth? This habit can be the cause of many dental maladies, not just gum recession, so let your dentist know right away if you think you are grinding your teeth. Teeth grinding can be treated easily and painlessly with a mouth guard and several other options.

Other causes include use of tobacco products, crooked teeth or a misaligned bite, trauma to gum tissue, and poor oral health.

Receding Gums Treatment

The treatment for receding gums depends on the underlying cause. The following treatments can help reattach or restore gum tissue around the teeth:

Scaling and root planing

Scaling and root planing are some of the first treatments for receding gums that Royal Dental Clinic may recommend.

These procedures remove plaque and tartar from below the gumline, where regular brushing cannot reach.

Root planing removes plaque and tartar specifically from the roots of teeth. Afterward, a dentist will use special instruments to smooth the roots, which helps the gums reattach to the tooth.

Gum graft surgery

A dentist at Royal Dental may recommend gum graft surgery (GGS) if a person's gums have severely receded.

During GGS, a surgeon will take a small piece of gum tissue from elsewhere in the mouth and use it to cover the exposed tooth roots.

GGS helps prevent bone loss and the gums from receding farther. It can also protect the previously exposed tooth roots from decay.

Pinhole surgical technique

Pinhole surgical technique (PST) is a relatively new treatment for mild to moderate receding gums.

PST is a minimally invasive procedure that involves making a tiny hole in the gum tissue above the exposed tooth root.

A dentist will insert a special tool into the hole to separate the gum from the tooth, then they will stretch and reposition the gum back over the exposed tooth root.


The tips below can help slow or stop the progression of receding gums:

Practice good oral hygiene

The following oral hygiene tips can help:

  • flossing between the teeth at least once per day
  • using a fluoride toothpaste
  • brushing the teeth twice per day using a soft bristled toothbrush. Royal Dental recommends RoyalDenta Toothbrush
  • using an antiseptic mouthwash to reduce bacteria and flush out debris
  • choosing a size and shape of toothbrush that allows access to all parts of the mouth
  • replacing toothbrushes at least every 2–4 months
  • attending regular dental appointments

Wear a mouthguard

Wearing a mouthguard at night can help prevent gum recession due to teeth grinding. Mouthguards create an even pressure across the jaw and act as a physical barrier to separate the top and bottom teeth.

Mouthguards are available from most pharmacies. A dentist can also make a customized mouthguard, which will provide a better fit.

Replace ill fitting dentures

Partial dentures that were once a good fit can become incompatible with the mouth over time. This can happen for several reasons, including:

  • the bone and gum ridges shrinking over time
  • differences in jaw alignment
  • general wear and tear of the partial dentures

Ill fitting partial dentures can rub and irritate the gums, causing the gums to recede around healthy teeth. People can prevent this by replacing partial dentures as needed.

Visit the dentist regularly

Attending regular dental checkups is vital for detecting the early stages of gum recession.

Checkups also enable the dentist to identify and replace any faulty fillings or ill fitting partial dentures, which can contribute to receding gums.



Impacted Wisdom Teeth

Oral Health

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Royal Dental Clinic

2019-11-01 05:01:10

Impacted wisdom teeth are third molars at the back of the mouth that don't have enough room to emerge or develop normally.

Wisdom teeth are the last adult teeth to come into the mouth (erupt). Most people have four wisdom teeth at the back of the mouth — two on the top, two on the bottom.

Impacted wisdom teeth can result in pain, damage to other teeth and other dental problems. In some cases, impacted wisdom teeth may cause no apparent or immediate problems. But because they're hard to clean, they may be more vulnerable to tooth decay and gum disease than other teeth are.

Impacted wisdom teeth that cause pain or other dental complications are usually removed. Some dentists and oral surgeons also recommend removing impacted wisdom teeth that don't cause symptoms to prevent future problems.


Impacted wisdom teeth don't always cause symptoms. However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental problems, you may experience some of these signs or symptoms:

  • Red or swollen gums
  • Tender or bleeding gums
  • Jaw pain
  • Swelling around the jaw
  • Bad breath
  • An unpleasant taste in your mouth
  • Difficulty opening your mouth

Visit Royal Dental Clinic if you experience symptoms in the area behind your last molar that may be associated with an impacted wisdom tooth.


Wisdom teeth (third molars) become impacted because they don't have enough room to come in (erupt) or develop normally.

Wisdom teeth usually emerge sometime between the ages of 17 and 25. Some people have wisdom teeth that emerge without any problems and line up with the other teeth behind the second molars. In many cases, however, the mouth is too crowded for third molars to develop normally. These crowded third molars become trapped (impacted).

An impacted wisdom tooth may partially emerge so that some of the crown is visible (partially impacted), or it may never break through the gums (fully impacted). Whether partially or fully impacted, the tooth may:

  • Grow at an angle toward the next tooth (second molar)
  • Grow at an angle toward the back of the mouth
  • Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone
  • Grow straight up or down like other teeth but stay trapped within the jawbone


Impacted wisdom teeth can cause several problems in the mouth:

Damage to other teeth. If the wisdom tooth pushes against the second molar, it may damage the second molar or increase the risk of infection in that area. This pressure can also cause problems with crowding of the other teeth or require orthodontic treatment to straighten other teeth.

  • Cysts. The wisdom tooth develops in a sac within the jawbone. The sac can fill with fluid, forming a cyst that can damage the jawbone, teeth and nerves. Rarely, a tumor — usually noncancerous (benign) — develops. This complication may require removal of tissue and bone.
  • Decay. Partially impacted wisdom teeth appear to be at higher risk of tooth decay (caries) than other teeth. This probably occurs because wisdom teeth are harder to clean and because food and bacteria get easily trapped between the gum and a partially erupted tooth.
  • Gum disease. The difficulty cleaning impacted, partially erupted wisdom teeth increases the risk of developing a painful, inflammatory gum condition called pericoronitis (per-ih-kor-o-NI-tis) in that area.


You can't keep an impaction from occurring, but keeping regular six-month dental appointments for cleaning and checkups enables your dentist to monitor the growth and emergence of your wisdom teeth. Regularly updated dental X-rays may indicate impacted wisdom teeth before any symptoms develop.


A dentist at Royal Dental will evaluate your teeth and mouth to determine if you have impacted wisdom teeth or if another condition is causing your problems. Such evaluations typically include:

  • Questions about your dental symptoms and general health
  • An examination of the condition of your teeth and gums
  • Dental X-rays that can reveal the presence of impacted teeth, as well as signs of damage to teeth or bone


If your impacted wisdom teeth are likely to be difficult to treat or if you have medical conditions that may increase surgical risks, a dentist at Royal Dental  will likely ask you to see an oral surgeon to discuss the best course of action.

Managing asymptomatic wisdom teeth

If impacted wisdom teeth aren't causing symptoms or apparent dental problems, they're called asymptomatic. Some disagreement exists in the dental community about how to manage asymptomatic impacted wisdom teeth. Research on this topic doesn't strongly favor one strategy over the other.

Royal Dental may recommend removing asymptomatic wisdom teeth to prevent future potential problems; 

  • Symptom-free wisdom teeth may not be free of disease.
  • If there isn't enough space for the teeth to erupt, it's often hard to get to them and clean them properly.
  • Serious complications with wisdom teeth happen less often in younger adults.
  • The procedure is more difficult and more likely to cause complications later in life, particularly among older adults.

Surgical removal

Impacted wisdom teeth that are causing pain or other dental problems are usually surgically removed (extracted). Extraction of a wisdom tooth is usually required for:

  • Infection or gum disease (periodontal disease) involving the wisdom teeth
  • Tooth decay in partially erupted wisdom teeth
  • Cysts or tumors involving the wisdom teeth
  • Wisdom teeth that are causing damage to neighboring teeth




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Royal Dental Clinic

2019-10-31 07:59:31

For many people, going to the dentist is highly unpleasant. Mere thoughts of the sounds made by electric dental equipment are enough to turn both children and adults into nervous wrecks. It doesn't have to be this way. Ignorance breeds fear; many anxious patients can make dental visits easier for themselves simply by learning about the mysterious equipment they may see during their appointment. Much of the fear and discomfort that came with dental visits arose from lack of appropriate technologies.

Fortunately, there have been remarkable progress in dentistry over the past 350 years, much of which we owe to advances in technology. One of the technologies that have been invented by engineers is Dental Chairs. The evolution of the chair began from simple forms, but over the years significant improvements in comfort and versatility have been made to it. Prior to the 17th century, tooth extractions were often performed with the patient sitting on the floor, their head held firmly between the operator’s knees. Everyday armchairs occasionally served to make dental procedures less awkward and fatiguing.


In 1790, Josiah Flagg, an American dentist, took a wooden chair and created a special head rest to improve the patient’s position, keeping the head in a fixed position while operating. He used a large Windsor style chair. He attached the head rest and an arm extension where he created space for dental equipment placement, and a place for patients to cling on to during tough procedures. The adjustments were revolutionary for that time and the actual design was used for a long time.

In 1832 the reclining chair was created. James Snell of London designed and created the first fully adjustable dental chair. The adjustment features were minor, but it helped innovate our current dental chair design, and by late 1800s, they were the most popular in the market.

On August 15, 1848, Waldo Hanchett received a patent for a surgical or dental operating chair. Early dental chairs were made from wood and had basic designs, which featured a seat for the patient and a stool for the dentist. Hanchett invented the first dental chair by attaching a neck extension to a four-legged chair. According to his patent, “The nature of my invention consists in providing a more simple, durable, and convenient mode than has heretofore been used of adjusting the positions of chairs for convenience in dental and surgical operations or for other purposes.” In 1875, a fully reclining dentist chair was produced by the Buffalo Dental Group. It also came with a chair for the dentist, the first of its kind.

Improvements in Design

Today, dental chairs are ever changing and continue to offer new benefits for patients and dentists. They are ergonomic and built out of aluminium combined with plastic features and padding for greater comfort. They are highly adjustable and are equipped with adjacent dental equipment. The dentist has full control and can safely perform complex dental procedures like small scale dental surgery procedures.

Medical Aesthetics

The appearance of the modern puffy, padded, comfortable dental chair also serves an important function: its non-threatening appearance soothes nervous patients and invites them to sit down and relax. This is a particular concern with children and all patients who are in great pain. The soft corners and rounded edges of today's dental chairs are intentional design elements designed to reduce stress. The first dental chairs were visually intimidating; their bare wood frames were uncomfortable, and the metal headrests and instrument trays made the chairs look like torture devices. This fomented feelings of apprehension and fear in the patients and virtually ensured that they would have an unpleasant experience.

The next time you find yourself in a dental chair, lay back, relax, and remember that you're enjoying the finest dental chair experience that history has to offer! It is something that we as dental care providers are very thankful every single day we are in the office.




Oral Health

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Royal Dental Clinic

2019-10-13 15:09:26

As an expectant mother, you probably are aware of the changes that will happen to your body for the next nine months or so, but you might not know how oral health and pregnancy are related. The object of this article is to bring to your attention certain dental issues that might come with pregnancy.  The correlation might not be direct, however pregnancy may sometimes predispose people to certain dental problems.

Research findings

Research has found a link between gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely may risk a range of health conditions including cerebral palsy and problems with eyesight and hearing. Estimates suggest that up to 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums.

Moreover, physiologic changes during pregnancy may result in noticeable changes in the oral cavity. These changes include pregnancy gingivitis, benign oral gingival lesions, tooth mobility, tooth erosion, dental caries, and periodontitis. It is important to reassure women about these various changes to the gums and teeth during pregnancy and to reinforce good oral health habits to keep the gums and teeth healthy.

Hormonal changes

Without hormones, you wouldn't be able to make a baby. With them, though, you feel a bit moodier, your bladder seems a lot smaller, and for some reason you constantly crave weird meals like peanut butter and pickles. Hormones also play a part in making your gums swell while pregnant, leading to a condition called pregnancy gingivitis. If you notice that your gums are bleeding more frequently during pregnancy, the Royal Dental Clinic recommends being proactive about it. Your dentist might recommend more frequent professional teeth cleanings, at least until your baby is born.

Preventive measures

Pregnancy does not automatically damage your teeth. The old wives' tale that warns a woman to expect a lost tooth for every baby is false. If the mother's intake of calcium is inadequate during pregnancy, her bones – not her teeth – will provide the calcium her growing baby needs. This calcium loss is quickly made up after breastfeeding is stopped.  However, the demands of pregnancy can lead to particular dental problems in some women. With proper hygiene at home, increased uptake of calcium and professional help from your dentist, your teeth should remain healthy throughout pregnancy. 

Visiting your dentist

The dentist can be a great help in keeping your mouth (and your baby) healthy during pregnancy. Be sure to let your dentist know that you're pregnant as soon as you know. He or she may need to adjust the treatments or medications given to you, such as postponing certain procedures until after your baby is born to avoid taking any risks. According to Dr. Vitalis Ogolla, the second trimester is often the ideal time to have minor dental work performed, such as having a cavity filled, or a professional cleaning, if need be. Just be reassured that teeth cleaning and dental X-ray is safe while you are pregnant.

Oral health assessment and counseling during pregnancy

Pregnancy is a “teachable” moment when women are motivated to adopt healthy behavior. Dental and obstetric teams can be influential in helping women initiate and maintain oral health care during pregnancy to improve lifelong oral hygiene habits and dietary behavior for women and their families. For example, women with poor oral health may harbor high levels of Streptococcus mutans in their saliva. These bacteria can be transmitted to their infants during common parenting behavior, such as sharing spoons or licking pacifiers. Minimizing the number of cariogenic bacteria in pregnant mothers through good oral health may delay or prevent the onset of colonization of these bacteria in their infants.



Oral Health

No Image

Royal Dental Clinic

2019-10-13 15:08:00

As an expectant mother, you probably are aware of the changes that will happen to your body for the next nine months or so, but you might not know how oral health and pregnancy are related. The object of this article is to bring to your attention certain dental issues that might come with pregnancy.  The correlation might not be direct, however pregnancy may sometimes predispose people to certain dental problems.

Research findings

Research has found a link between gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely may risk a range of health conditions including cerebral palsy and problems with eyesight and hearing. Estimates suggest that up to 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums.

Moreover, physiologic changes during pregnancy may result in noticeable changes in the oral cavity. These changes include pregnancy gingivitis, benign oral gingival lesions, tooth mobility, tooth erosion, dental caries, and periodontitis. It is important to reassure women about these various changes to the gums and teeth during pregnancy and to reinforce good oral health habits to keep the gums and teeth healthy.

Hormonal changes

Without hormones, you wouldn't be able to make a baby. With them, though, you feel a bit moodier, your bladder seems a lot smaller, and for some reason you constantly crave weird meals like peanut butter and pickles. Hormones also play a part in making your gums swell while pregnant, leading to a condition called pregnancy gingivitis. If you notice that your gums are bleeding more frequently during pregnancy, the Royal Dental Clinic recommends being proactive about it. Your dentist might recommend more frequent professional teeth cleanings, at least until your baby is born.

Preventive measures

Pregnancy does not automatically damage your teeth. The old wives' tale that warns a woman to expect a lost tooth for every baby is false. If the mother's intake of calcium is inadequate during pregnancy, her bones – not her teeth – will provide the calcium her growing baby needs. This calcium loss is quickly made up after breastfeeding is stopped.  However, the demands of pregnancy can lead to particular dental problems in some women. With proper hygiene at home, increased uptake of calcium and professional help from your dentist, your teeth should remain healthy throughout pregnancy. 

Visiting your dentist

The dentist can be a great help in keeping your mouth (and your baby) healthy during pregnancy. Be sure to let your dentist know that you're pregnant as soon as you know. He or she may need to adjust the treatments or medications given to you, such as postponing certain procedures until after your baby is born to avoid taking any risks. According to Dr. Vitalis Ogolla, the second trimester is often the ideal time to have minor dental work performed, such as having a cavity filled, or a professional cleaning, if need be. Just be reassured that teeth cleaning and dental X-ray is safe while you are pregnant.

Oral health assessment and counseling during pregnancy

Pregnancy is a “teachable” moment when women are motivated to adopt healthy behavior. Dental and obstetric teams can be influential in helping women initiate and maintain oral health care during pregnancy to improve lifelong oral hygiene habits and dietary behavior for women and their families. For example, women with poor oral health may harbor high levels of Streptococcus mutans in their saliva. These bacteria can be transmitted to their infants during common parenting behavior, such as sharing spoons or licking pacifiers. Minimizing the number of cariogenic bacteria in pregnant mothers through good oral health may delay or prevent the onset of colonization of these bacteria in their infants.


Cavities: Causes, Treatment & Prevention

Oral Health

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Royal Dental Clinic

2019-10-07 06:21:35


Cavities are holes that develop on teeth as a result of decay. They can cause symptoms including toothache. Without treatment, cavities can worsen over time and cause other problems. Practicing good oral hygiene is the best way to prevent them.

Tooth decay occurs from a buildup of dental plaque in the mouth. This can damage the tooth structure over time.

It is possible for this damage to become permanent. Holes can then develop on the tooth, and these holes are what tooth cavities are.

Several treatments, such as fillings, are available. However, the most effective way to treat tooth cavities is to prevent them from occurring in the first place. This is possible by keeping the mouth and teeth clean.

It will also help to avoid certain foods, such as those high in sugar. Consuming too much of these foods can cause the buildup of plaque that leads to tooth cavities.

Tooth cavities do not always cause symptoms, so it is important to visit Royal Dental Clinic regularly.


The mouth contains a large number of bacteria, some of which can be harmful. They form a thin, colorless layer over the top of the teeth. This is dental plaque.

Over time, it is possible for plaque to build up. For example, this may occur due to a person regularly consuming foods high in sugar and starch.

Repeated exposure to the acid from plaques can damage tooth enamel. Enamel is the protective outer layer covering the teeth. Tooth decay depletes the minerals present in enamel.

While the enamel can repair some of this damage itself, the decay can eventually lead to tooth cavities. This occurs when permanent damage affects the enamel, causing holes to form on the surface of the tooth.

This decay can occur in people of all ages but is particularly common in children.


The main symptom of a tooth cavity is the hole itself, the size of which can vary. It is possible for cavities to occur without any further symptoms. In cases where other symptoms occur, they may include:

  • white, gray, brown, or black spots on the teeth
  • toothache
  • tooth sensitivity
  • bad breath

Without treatment, bacteria can spread to softer tissues inside the tooth. This can speed up tooth decay and cause toothaches to worsen. This can also lead to infections.


Treatments for this damage can range from a filling to root canal treatment. The exact type of treatment will depend on the location and severity of the cavity.

However, tooth cavities are easily preventable. There are ways to prevent the buildup of plaque that causes tooth cavities.

Some prevention tips include:

  • using toothpastes and mouthwashes that contain fluoride
  • brushing the teeth twice per day, using a circular motion
  • gently brushing the gums
  • using interdental cleaners such as floss in the gap between teeth
  • avoiding foods and drinks high in sugar, such as fizzy drinks, particularly those without any nutritional value
  • limiting the intake of starchy foods
  • avoiding snacking between meals or just before bed
  • avoiding tobacco products
  • having regular checkups with a dentist

It is also possible to reverse tooth decay in the very early stages. Tooth enamel can repair minor damage itself by replacing lost minerals from saliva or fluoride.

Fluoride is a mineral that can reverse the damage of tooth decay. At Royal Dental, we often prescribe fluoride gel or other fluoride products for coating the teeth.

Fluoride treatments can strengthen enamel and protect teeth against damage from plaque. Along with possibly making dietary changes, using these fluoride treatments can help the teeth repair any minor damage from tooth decay.

As tooth cavities are more common in children, it is important for caregivers to check for early signs of tooth decay regularly. This includes looking for white, gray, brown, or black spots on the teeth. These are signs of mineral loss from tooth decay. 

10 Tips to Keep Your Teeth Healthy

Oral Health

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Royal Dental Clinic

2019-09-22 10:58:05

Achieving healthy teeth takes a lifetime of care. Even if you’ve been told that you have nice teeth, it’s crucial to take the right steps every day to take care of them and prevent problems. This involves getting the right oral care products, as well as being mindful of your daily habits.

1. Don’t go to bed without brushing your teeth

It’s no secret that the general recommendation is to brush at least twice a day. Still, many of us continue to neglect brushing our teeth at night. But brushing before bed gets rid of the germs and plaque that accumulate throughout the day.

2. Brush properly

The way you brush is equally important — in fact, doing a poor job of brushing your teeth is almost as bad as not brushing at all. Take your time, moving the toothbrush in gentle, circular motions to remove plaque. Unremoved plaque can harden, leading to calculus buildup and gingivitis (early gum disease).

3. Don’t neglect your tongue

Plaque can also build up on your tongue. Not only can this lead to bad mouth odor, but it can lead to other oral health problems. Gently brush your tongue every time you brush your teeth.

4. Use a fluoride toothpaste

When it comes to toothpaste, there are more important elements to look for than whitening power and flavors. No matter which version you choose, make sure it contains fluoride.

Fluoride is a leading defense against tooth decay. It works by fighting germs that can lead to decay, as well as providing a protective barrier for your teeth.

5. Treat flossing as important as brushing

Many who brush regularly neglect to floss. “Flossing is not just for getting those little pieces of food particles that may be getting stuck in between your teeth,” says Dr. Vitalis, BDS. “It’s really a way to stimulate the gums, reduce plaque, and help lower inflammation in the area.” Flossing once a day is usually enough to reap these benefits.

7. Consider mouthwash

Advertisements make mouthwash seem necessary for good oral health, but many people skip them because they don’t know how they work.

Mouthwash helps in three ways: It reduces the amount of acid in the mouth, cleans hard-to-brush areas in and around the gums, and re-mineralizes the teeth. Feel free to consult with Royal Dental for the specific mouthwash recommendations. Certain brands are best for children, and those with sensitive teeth. Prescription mouthwash is also available.

 8. Drink more water

Water continues to be the best beverage for your overall health — including oral health. Also, as a rule of thumb, Royal Dental recommends drinking water after every meal. This can help wash out some of the negative effects of sticky and acidic foods and beverages in between brushes.

9. Eat crunchy fruits and vegetables

Ready-to-eat foods are convenient, but perhaps not so much when it comes to your teeth. Eating fresh, crunchy produce not only contains more healthy fiber, but it’s also the best choice for your teeth

10. Limit sugary and acidic foods

Ultimately, sugar converts into acid in the mouth, which can then erode the enamel of your teeth. These acids are what lead to cavities. Acidic fruits, teas, and coffee can also wear down tooth enamel. While you don’t necessarily have to avoid such foods altogether, it doesn’t hurt to be mindful.

Your own everyday habits are crucial to your overall oral health. Still, even the most dutiful brushers and flosser need to see a dentist regularly. At minimum, you should see your dentist for cleanings and checkups twice a year. Not only can a dentist remove calculus and look for cavities, but they will also be able to spot potential issues and offer treatment solutions.




Oral Health

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Royal Dental Clinic

2019-09-13 06:31:13

Have you ever thought about how animals keep their teeth clean? 

Cats and Dogs

If you have a cat or a dog you’ve probably had to clean their teeth at some point with paste or dental treats to chew on. Most wild animals don’t have to worry about tooth decay, especially if they’re carnivorous predators who rip and tear at their food. That’s because they don’t eat a lot of carbohydrates and refined sugars – those tasty foods that are full of the sugars and starches that fill our mouths with cavity-creating bacteria.

Rodents and Rabbits

Other animals, like rodents, have teeth that grow continuously and have to be ground down by eating and gnawing on hard food. Sharks and alligators are constantly losing and growing new teeth!

If your teeth are always new it’s going to be difficult to have tooth decay. This is why otters can eat fish & eels and rabbits can eat grasses & plants (and lions can eat everyone else) without having to worry about going to the dentist!

Cows and Buffalo

The diet of some herbivores naturally cleans their teeth as they chew. Fibourous plants and an extended chew-time allows animals like cows to scrub their teeth as they eat.


Humans are not alone in caring for their teeth. Scientists have filmed macaque monkeys using hair to floss their teeth. Macaques living near a Buddhist shrine in Thailand even pull out visitors’ hair to use as floss! And like all good parents, these monkeys also teach their children how to floss. They slow down their flossing, make exaggerated movements, and repeat themselves while the younger monkeys watch.

So remind your patients, if a monkey can brush their teeth, so can they!



Oral Health

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Royal Dental Clinic

2019-09-03 10:09:52

Swollen gums tend to be a sign of an underlying issue, such as gum disease or infection. Numerous issues can lead to swollen gums. Most of them relate to oral health or complications from oral health issues.

In this article, we cover the causes of swollen gums, as well as some treatment options and prevention.


Food particles stuck in the teeth

The cause of swollen gums may be simple, such as getting food particles stuck in the teeth.

For instance, eating popcorn may cause hard pieces of kernel to become stuck between the teeth, sometimes lodging in the gums. This can easily cause irritation and swelling in the area. Most of the time, these symptoms do not last long and will go away once the person brushes and flosses out the food particles.


Gingivitis is a stage of gum disease that causes swelling and irritation in the gums. It is one of the most common conditions to cause swollen gums and will likely be what dentists at Royal Dental Clinic check for first.

A person may not know they have gingivitis and only feel mild pain or sensitivity. However, treatment is very important. Without treatment, gingivitis may develop into a serious infection in the gums, called periodontitis or periodontal disease.

A few other symptoms to look out for that may indicate periodontal disease include:

  • A foul taste in the mouth
  • Very bad breath that persists after cleaning
  • Sensitive teeth
  • Loose teeth or tooth loss red
  • Painful gums
  • Pain when chewing
  • Bleeding gums 
  • Receding gums. 


Infections may occur in the mouth and lead to issues such as swelling in the gums.

For instance, chronic infections such as herpes may lead to complications that cause swollen gums. Also, oral thrush which is a yeast infection in the mouth — can cause symptoms including swelling.

Complications from infected teeth, such as an abscess, may also lead to swelling, particularly in one area of the gums.


Swollen gums may also occur when a person is pregnant, even if they have perfect oral health.

Pregnancy causes significant and rapid changes in hormones. These changing hormones may greatly increase blood flow to the gums, causing them to be more sensitive to swelling.

Other causes

Some other health issues may cause gum swelling, though they may be less common. Other possible causes of swollen gums include:

  • side effects from some medications
  • Malnutrition
  • sensitivity to oral products, such as ingredients in a toothpaste or mouthwash
  • wearing poorly fitting dentures, crowns, or other dental appliances
  • In every case, dentists at Royal Dental will review the person's other symptoms and go over their medical history with them to determine the underlying cause.


 Medical treatment for swollen gums begins with seeing a dentist. 

Visit Royal Dental clinic for regular checkups and cleaning to help identify and prevent oral health issues before they cause problems. Our dentists will evaluate and recommend appropriate medication or treatment depending on the underlying cause. 

Medical treatments for oral issues may include:

  • Regular brushing of teeth is required plus a visit to the dentist to remove plaque buildup.
  • Proper diet and nutrition is essential to avoid bacterial infection while building up the immune system.
  • Mouth rinse can help eliminate bacterial growth. Mouth rinse can be bought over-the-counter while mouth rinse of salt and water helps relieve the swelling of gums.


Taking steps to treat swollen gums is a key part of any dental treatment.

These measures may help prevent swelling or ease the symptom:

  • Brush regularly, at least twice each day or after every meal.
  • Floss regularly.
  • Use gentle oral products such as toothpaste and mouthwash.
  • Avoid sugary drinks, as they can contribute to bacteria buildup in the mouth.
  • Avoid tobacco, including smoking or chewing it.
  • Avoid alcohol and alcoholic mouthwashes, as the alcohol may dry out and irritate the gums.
  • Avoid sharp foods such as chips, seeds, and popcorn, which may get stuck in the teeth and cause pain.

It is important to note that these tips are only supplements to a proper diagnosis and treatment. Swollen or irritated gums typically signal an underlying issue.

Healthy gums are vital for healthy teeth, so never ignore swollen gums. At the first signs or discomfort of any kind Visit Royal Dental Clinic without delay or chat with us on WhatsApp!



Oral Health

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Royal Dental Clinic

2019-08-27 05:38:21

Almost one in every 10 Kenyans lacks dental insurance. Even for those who have benefits, they may not cover the services they need, or they may be left with big out-of-pocket expenses. Doling out the cash to get a toothache treated can hurt almost as much as the tooth itself.

But ignoring dental problems or skipping preventive care can harm you more. Some studies suggest that chronic gum infection is associated with an increased risk for heart attack. So how can you maintain oral health without wrecking your budget? Consumer Reports’ experts recommend these steps:

Space It Out

The twice-a-year dental checkup has been the mainstay for decades. But there’s not much evidence that everyone needs to go that often. In one study, researchers looked at 16 years of insurance claims and found that for most nonsmokers in good health, one visit a year may prevent tooth loss just as well as a checkup every 6 months. People who smoke, have diabetes, or are prone to gum disease may need to see their dentists more than twice a year. The same goes for people who naturally build plaque and tartar fast.

Ask for discounts and avoid unnecessary care

Inquire about pricing and payment policies upfront before visiting your local dental care provider. The dental office may give you a discount if you immediately pay the full bill. The Royal Dental Clinic for example offer a discount of up to 60% on scaling and polishing/ Teeth cleaning, take advantage of such discounts. The same clinic allows free WhatsApp consultations. This can considerably reduce the cost of dental care.

Nonprofit programs.

Local community service organizations can be another source of reduced-priced dental care. There are also a number of national nonprofits that specialize in connecting low-income families to dentists and orthodontists who donate services. Sometimes dental clinics conduct outreaches as part of their Corporate Social Responsibilities. The Royal Dental Clinic does this more often, take advantage of such programs to get free dental care.

Consider dental savings plans.

 An alternative to dental insurance is a dental savings plan, which is like a dental membership club. In these plans, you pay an annual fee, usually much lower than the annual cost of dental insurance. Dentists who participate in the plan give you a 10% to 60% discount, though you pay more at the visit than you would with dental insurance. Your traditional health insurance may not cover dental care, but you can pay the dentist with a health savings account or flexible spending arrangement.

 Create an emergency dental fund

Put aside money every month, save towards emergencies that may involve dental care or treatment. “Unpredictable things happen, and you have to have a way to pay for it,” says Dr. Vitalis Ogolla of the Royal Dental Clinic.

Check community health centers. Some offer low-cost dental care, though they may have limited services and waiting lists. To find a center, call the local health department or county dental association.

Do your part

It bears repeating: Prevention is the best -- and cheapest -- medicine. Brush and floss every single day. Flossing prevents plaque and the cavities that follow it. Brushing keeps your teeth and gums healthy. Brush for a full two minutes — most of us stop after 30 seconds — twice each day with a soft-bristle manual or electric toothbrush, and floss before bed. Drink tooth-friendly beverages, including plain water. (Soda and drinks with lemon and lime can erode enamel and weaken teeth.) Increase your production of saliva, which helps protect teeth, with sugar-free hard candy and gum. Avoid sugary foods and drinks. See a dentist once a year — more often if you have periodontal disease or are still getting cavities.





Oral Health

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Royal Dental Clinic

2019-08-27 05:04:25

If you have noticed or suspect that you have bleeding gums then you need to take action quickly. The first sign you’ll see to indicate this condition is when you see blood mixed in with the toothpaste you spit out after brushing or sometimes you may see spots of blood on your dental floss.

Please be aware that this is not normal and should never be ignored as it is indicative of a wider problem. Gums which bleed every time you brush can become red, sore and inflamed and the condition can eventually lead to more serious issues such as gingivitis or periodontitis. Luckily there are things you can do to prevent this from happening in the first place.

Brush Carefully

The most common cause of bleeding gums is quite simply brushing too hard and too vigorously. Try using a softer toothbrush and brush up and down the teeth and not horizontally. Avoid brushing above the gum line.

Brush Regularly to Avoid Plaque Build Up

A build-up of plaque along the gum line contributes towards gum inflammation and can turn into tartar if not dealt with. Brush twice daily using a toothpaste containing fluoride and floss regularly or use interdental brushes to avoid a build-up of sticky plaque. Try to make sure you brush all your teeth as thoroughly as you can. Change your toothbrush every six months.

Stop Smoking

It may surprise you to learn that smoking can be a contributor to gum disease. At the very least it can lead to bad breath and unsightly staining so look into how you can be helped to stop smoking.

Take More Vitamin C

Vitamin C can help to fight off any infection which may be causing your gums to bleed. Foods rich in vitamin C include oranges, carrots and peppers.

Eating a healthy diet which is rich in vitamins, minerals and nutrients rather than one which is packed with sugar and carbohydrate will go a long way to keeping teeth and gums healthy.

Drink Green Tea

Drinking green tea several times a day can help with the healing process as it contains a natural antioxidant called catechin. Green tea can also help to combat bad breath.

Rinse with Salt Water

Salt water is one of the oldest tried and tested remedies for stopping bleeding. Mix with water and use as a mouthwash twice a day.

Cold Compress Treatment

If your gums are bleeding due to trauma or injury of some kind rather than gum disease it can help to apply a cold compress such as a cold cloth or ice pack to the gum line to help stop the flow of blood. If you bleed copiously with no obvious incidence of trauma or injury then see a doctor or dentist urgently.

If your gums bleed intermittently or without improvement within about a week, visit Royal Dental Clinic for a thorough teeth cleaning to remove any plaque and tartar.

Don’t Share Toothbrushes!

The mouth is naturally full of bacteria and if a partner or family member has any kind of oral problem or gum disease then if you share toothbrushes and even water glasses then there is a high risk of you developing gum disease.

Healthy gums are vital for healthy teeth, so never ignore bleeding gums. At the first sign of any bleeding or discomfort of any kind Visit Royal Dental Clinic without delay or chat with us on WhatsApp!


Dental Hygiene and Cancer

Dental Hygiene & Cancer

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Royal Dental Clinic

2019-08-02 13:52:14

Oral health is a key indicator of overall health, wellbeing and quality of life. Oral Health is defined as state of being free from chronic mouth pain, oral and throat cancer, oral infection and sores, gum disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.

Oral diseases are a major public health problem owing not only to their high prevalence and incidence mostly in a deprived and socially marginalized section of the society but also, among the socially affluent communities.

This trend is particularly worrying with the high rise in cancer cases, as research studies increasingly point to some connections between certain dental problems and cancer.  Researchers at the University of Helsinki and the Helsinki University Hospital, Finland, and the Karolinska Institutet, Sweden for example maintain that the bacteria that cause periodontitis, a disease affecting the tissues surrounding the teeth, seems to play a part also in the onset of pancreatic cancer.

The study published in the British Journal of Cancer, has for the first time proven the existence of a mechanism on the molecular level through which the bacteria associated with periodontitis, Treponema denticola (Td), may also have an effect on the onset of cancer. Researchers found that the primary virulence factor of the Td bacteria, the Td-CTLP proteinase (an enzyme), occurs also in malignant tumours of the gastrointestinal tract, for example, in pancreatic cancer.

The study demonstrated for the first time that the virulence factors of the central pathogenic bacteria underlying gum disease are able to spread from the mouth to other parts of the body, most likely in conjunction with the bacteria, and take part in central mechanisms of tissue destruction related to cancer.

More studies also suggest that people whose teeth and gums are in poor condition may be more susceptible to an oral virus that can cause certain mouth and throat cancers as diseased gums offer an "entry portal" for the viruses.

In all these studies what was more revealing was the connection between the degree of periodontitis and incidents of cancer. For instance, comparing the results of participants with higher levels of periodontitis against those with either mild or no periodontitis at their baseline showed a 24 percent higher tendency towards developing a form of cancer.

Following this line of reasoning, the researchers then studied the results of those participants with extreme levels of periodontitis. Those participants who have lost all of their teeth due to extreme conditions of advanced gum disease showed an astonishing 28 percent likelihood of cancer. Lung cancer proved to be the highest risk assessed, with colorectal cancer coming in second. While studying selected subgroup analyses, the researchers learned that participants registering the highest degree of advanced gum disease doubled their risk of lung cancer.

Granted, certain gaps still exist regarding the correlation between dental hygiene and cancer, but more researches are still being done to fill those gaps, but the preliminary findings should elicit adequate curiosity that can catalyze a behavior change in as far as dental hygiene is concerned. Prevention is better than cure.

How long do you have to wear braces?

Dental Braces

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Royal Dental Clinic

2019-07-27 08:29:44

Dental Braces

Dental braces (also known as braces, orthodontic cases, or cases) are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health.

The following are some of the types of braces;

Metal Braces

Also known as traditional braces, Metal braces are made of high-quality stainless steel. They have two basic components. These are the metal bracket that is applied to the teeth and the bendable metal wire that is threaded through the brackets in order to apply even pressure to the teeth and ultimately move them.

Ceramic Braces

Also called clear braces, Ceramic braces are made out of a ceramic material that is the same color and has the same texture as teeth. This make it difficult to see the ceramic brackets on the teeth (virtually invisible). They are a popular choice for adults who prefer the subtle look compared to metal braces.

 Lingual Braces

Also called inside braces, lingual braces are custom made brackets designed to fit the contour on the inside of each tooth.  A wire joins the brackets together and pulls the teeth into position by pulling from the inside.  

Lingual braces are most common amongst patients who are self-conscious of how they will look with traditional braces, particularly in the workplace and social gatherings.  


This is the most common and the most effective system of invisible aligner “braces” on the market. While they are not ideal for every patient, they do provide a number of benefits, including the ability to completely remove the treatment to clean the teeth and the aligners when necessary. They are essentially invisible and once the patient is used to wearing them, they can be far more comfortable than metal braces.

 Which One Should you Choose?

It’s not just the aesthetics of the braces that will determine which one you choose. There are a few factors you should consider including cost, hygiene and the final result.


In our experience, some patients worry unnecessarily about how they will look with braces. They can remain self-conscious about the braces long after everyone else has forgotten about them. But if the look of the braces is a concern for you, then consider lingual or ceramic braces that are invisible or hardly noticeable.


Some treatment options are more expensive than others. Due to the technology required to customize the brackets and the time it takes in the lab to make the brackets, the cost of lingual braces is higher than other orthodontic treatments. Ceramic braces are more expensive than metal braces due to the materials.

Dental Hygiene

All braces require extra dental care by the patient. Braces need more attention to brushing and flossing to ensure teeth don’t stain around the braces. Some children need to wait a while before braces to improve their commitment to teeth brushing.

The final result can be determined by the treatment method you choose. Deciding on the best method of treatment is usually a collaborative decision. Our orthodontist will advise which options are available to you after an examination. If you prefer a treatment method, let our orthodontist know and ask their opinion.

How long do you have to wear braces?

Our Orthodontist will take pictures and X-rays of your jaws/teeth and create a custom treatment plan for you. These factors will influence the amount of time you’ll need to wear Dental Braces.

Severity of the Case

Mild spacing/crowding can be fixed in a year or less, while severe cases could take much longer.


Young patients (teens and children) tend to get results faster than adults because their jaws are still growing, making the teeth easier to manipulate.

Patient Compliance

An orthodontic patient needs to follow all instructions provided by his or her orthodontist to ensure a successful treatment. That includes maintaining proper oral hygiene, keeping your dental appointments and use your orthodontic appliance as directed.


Oral Health

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Royal Dental Clinic

2019-07-19 13:10:45

Tooth sensitivity is a common dental problem that involves discomfort or pain in teeth when encountering certain substances and temperatures. The pain is often sharp, and it hits you right in the nerves of your teeth.

Dr. Edon Nyagudi explains, “Sensitivity occurs when the enamel that protects our teeth gets thinner, or when gum recession occurs, exposing the underlying surface, the dentin, thus, reducing the protection the enamel and gums provide to the tooth and root. This makes it easy for hot, cold, sweet or very acidic foods and drinks to pass through the tubules, making us feel this huge amount of pain.”

Some factors which can contribute to tooth sensitivity include;

Brushing too hard

Brushing your teeth with too much force, or with a hard-bristle toothbrush, may wear down tooth enamel, expose the dentin and cause tooth sensitivity. The simplest solution is to switch to a toothbrush with softer bristles and to be gentler when brushing.

Gum disease

Having a gum disease like gingivitis can make your teeth sensitive due to the loss of supporting ligaments caused by sore and inflamed gums. Receding gums, which are increasingly common with age can also cause tooth sensitivity.

Tooth grinding

Even though tooth enamel is the strongest substance in your body, grinding your teeth can wear down the enamel hence exposing the dentin. Talk to Royal Dental about finding a mouth guard that can stop you from grinding. The best guards are custom-made to fit your bite, Dr. Miriam says.

Cracked teeth

A chipped or cracked tooth can cause pain that goes beyond tooth sensitivity. Cracked tooth can become filled with bacteria from plaque and cause inflammation in the pulp of the tooth. In more severe cases, it may lead to infection. Our dentists will need to evaluate your tooth and decide the right course of treatment, such as a cap or an extraction.

Excessive plaque

The purpose of flossing and brushing is to remove plaque that forms after you eat. An excessive buildup of plaque can cause tooth enamel to wear away. Again, your teeth can become more sensitive as they lose protection provided by the enamel. The solution is to practice good daily dental care and visit Royal dental clinic for cleaning every six months.

Long-term use of mouthwash

Some over-the-counter mouthwashes contain acids. If dentin is exposed, the acids can make existing tooth sensitivity worse and also further damage the dentin layer.  

Acidic Foods

Foods that are very acidic such as pickles, lemons, and pineapple can make your enamel erode hence causing teeth sensitivity.

Tooth whitening toothpaste

Many manufacturers add tooth-whitening chemicals to their toothpaste formulas, and some people are more sensitive to them than others. If your toothpaste contains whitening agents, consider switching to one that doesn’t.

You’ve had a dental procedure

It’s common to experience some sensitivity after procedures such as professional teeth-whitening. This is usually a temporary tooth sensitivity that goes away shortly after a day.  If symptoms don’t disappear after a short time, you should schedule another visit to your dentist, as it could be a sign of infection.


Fortunately, sensitive teeth can be treated and the condition can improve.

If you have sensitive teeth, don’t neglect your daily oral care routine. Just be sure to use a soft toothbrush and soft floss. You can also try desensitizing toothpastes. Several brands are available, and you should notice some improvement with regular use of any of them.

If your sensitivity is extreme and persists no matter what steps you take, you’ll need to visit Royal Dental clinic for an evaluation. Our dentists will determine the most likely cause of your teeth sensitivity and the best solution for your particular situation. Just remember that you can always walk in for consultations at the Royal Dental Clinic.






Teeth Cleaning Vs Teeth whitening

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Royal Dental Clinic

2019-07-04 08:51:56

Teeth cleaning and teeth whitening are two types of dental procedures that confuse patients. However, these procedures and their goals are actually quite different.

The primary goal of ï»¿ï»¿ï»¿ï»¿ï»¿teeth cleaning is to remove plaque and tartar from the surface of the teeth, in order to prevent tooth decay and gum disease.

The main objective of ï»¿ï»¿teeth whitening is to remove stains for cosmetic purposes. Teeth cleaning is important for the ongoing health of your teeth and gums, whereas teeth whitening procedures are purely cosmetic.

​Professional Teeth Cleanings

Professional cleanings are typically performed to clean and polish teeth. Dentists generally recommend a thorough and professional cleaning every 6 months, though some patients may need cleanings more often if they are prone to decay or have a history of ï»¿ï»¿gum disease.

​Types of Teeth Cleaning


Prophylaxis is a fancy name for a routine teeth cleaning procedure. This is the standard type of cleaning procedure that most patients undergo every 6 months or so at Royal Dental clinic.

Typically, prophylaxis starts with your dentist using a series of scrapers and picks to remove tartar and plaque from your teeth. Plague is the sticky substance that you regularly brush off with your toothbrush. It is a combination of sugars, bacteria, and the acid that bacteria secrete. If left on your teeth for too long, it hardens into a substance called tartar, which cannot be removed with brushing alone but only with a dentists specialized tools. Tartar often forms along the gum line and along the sides of teeth where they meet.

When your dentist has finished gently scraping tartar from teeth, he or she will generally uses a polishing tool to remove surface stains and any lingering plaque from the teeth’s surface. This polishing tool is generally made from a firm rubberized material, and spins in a circle to polish teeth. 

Though some patients may feel slight discomfort during prophylaxis, particularly if the gums are sore due to gingivitis, the procedure is relatively painless and therefore no anesthesia or numbing agents are required. You can expect your prophylaxis treatment to take about 20 to 45 minutes, depending on the amount of tartar accumulation you have and amount of time between cleaning appointments.

Root Scaling and Planing

Root scaling and planing is sometimes called “deep cleaning” or “advanced cleaning.” This type of cleaning procedure is often recommended for patients who are showing signs of gum disease. Gum disease is an infection of the gums that results in swelling, soreness, and the development of pockets between the gums and teeth. It is caused by plaque and tartar that have not been removed with good dental hygiene and regular prophylaxis.

Root scaling is performed with similar tools to prophylaxis, but we will use the scalers to clean below the gum line. Local anesthetic is generally used to numb the area that’s being cleaned. With advanced gum disease cases, you may need to come back for several scaling appointments. Your dentist will focus on one segment of your mouth at each appointment.

Gums are likely to be sore and sensitive once the anesthesia wears off following your root scaling procedure. However, with proper brushing, flossing, and mouthwash use, this soreness (and your gum disease) should begin to subside.

Some signs that you may need a dental scaling procedure, rather than just standard prophylaxis, include:

·         ï»¿Your gums are red, swollen, and sore.

·         Your gums bleed whenever you brush or floss.

·         Your teeth have begun to feel loose in your jaw.

·         You can see pockets forming between your teeth and gums.

·         You have chronic bad breath that does not go away after brushing, flossing, or using mouthwash.

​Goals and Benefits of Teeth Cleaning

After you have your teeth cleaned, you are likely to notice that they are a bit whiter. This is because the tartar that were removed had a yellow tint to it. However, whiter teeth are not the primary goal of dental teeth cleanings (but rather a positive side effect). The primary goals of prophylaxis and deep cleanings when needed are:

·         â€‹Prevention of tooth decay that results from excessive plaque and tartar buildup.

·         Prevention and relief from gum disease.

·         Relief from bad breath.

·         Detection of more serious dental issues. We will screen your mouth for signs of decay, oral cancer, and other problems during and after your cleaning appointment.

·         Regular preventative dental care can go a long way towards limiting cavities and tooth loss down the road.

​Why Teeth Whitening?

Teeth whitening is actually a group of procedures that can be conducted with the goal of yielding whiter, brighter teeth. At Royal Dental, we remove stains caused by coffee, red wine, smoking, and general exposure to food and plaque over a lifetime. These procedures do not have specific health benefits, but rather they are performed for cosmetic purposes. 

It’s common for patients to wonder if they should have their teeth cleaned prior to getting a whitening procedure performed. In most cases, the answer is “yes.” As mentioned above, dental cleaning does often result in somewhat whiter teeth. Plus, many whitening treatments are more effective on clean teeth.

​Types of Teeth Whitening

There are several different ï»¿ï»¿types of teeth whitening treatments, some of which are performed at home and others that can only be administered by a professional Royal Dentist.

Teeth whitening is generally safe. However, if you have a history of tooth sensitivity or weak enamel, you may not be a good candidate. If you choose to undergo a professional whitening treatment, we first evaluate the condition of your teeth to make sure it’s safe to proceed. If you want to use over-the-counter whitening strips and trays, it’s a good idea to check with us before you begin using these products.

To help you decide which type of whitening treatment is right for you, here’s a closer look at the most common options –

In-Office Laser Whitening

If you have more serious dental staining or very yellow teeth, the best teeth whitening treatment is one performed by your dentist. Laser bleaching is one of the most common in-office whitening treatments offered at Royal

We use zoom whitening technology. The complete procedure takes less than an hour, but a regular teeth cleaning is recommended prior to the actual Zoom teeth whitening session. The procedure begins with a short preparation to cover the lips and gums, leaving the teeth exposed. The dentist then applies the Zoom hydrogen peroxide whitening gel, which works together with the Zoom light to penetrate the teeth and break up the stains and discoloration. The gel remains in place for 15 minutes while the light is activated. During this time, you can relax, watch TV or listen to music.

The gel is applied for three 15-minute sessions of light activation, for a total treatment time of 45 minutes. Individuals with a strong gag reflex or anxiety may have difficulty undergoing the entire procedure. Immediately afterwards, a sensitivity-reducing fluoride paste-gel is applied to the teeth.

​Over-The-Counter Whitening Strips and Trays

You can find numerous brands of whitening strips and trays available over-the-counter at our facilities.

Over-the-counter whitening strips and trays may be the best teeth whitening treatment if you only wish to lighten your teeth a few shades without deep-set stains to worry about. A part from strictly adhering to the instructions it’s also important to consult with us. Our dentist will factor in your oral health and personal needs when recommending products.

​​Goals and Benefits of Teeth Whitening

The primary benefit of teeth whitening is, of course, a whiter and brighter smile. This can boost your self-confidence and also help inspire you to take better care of your teeth going forward! If you are proud of your white, bright smile, you may be more inspired to brush, floss, and schedule cleaning appointments every 6 months. By keeping your teeth clean and avoiding foods that stain (think coffee and wine), your whitening results should last for years.
Some reasons you may want to undergo teeth whitening include:

·         â€‹You are embarrassed to smile because of yellow or stain teeth.

·         You have been using whitening toothpastes and rinses but have not noticed an improvement.

·         ï»¿You have a special occasion (like a wedding or graduation) coming up, and you want to look your very best.


At Royal Dental Clinic, we are happy to give you a better idea of how these procedures differ and which may be better suited to your needs. We’re also available for same day cleaning and dental checkups. Call /WhatsApp: 0787-181-835 for more information. 


Oral Health

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Royal Dental Clinic

2019-07-02 13:54:46

The origin of toothpaste

We are all familiar with toothpaste but do you really know how the paste evolved into what it is today? Well, here is a brief history of toothpaste.

Early Egyptians since 5000BC invented a cleaning powder used for cleaning the teeth. Like more modern tooth powders and pastes, it contained an abrasive, but the Egyptians made theirs from crushed pumice, powdered, burnt eggshells, myrrh and the ashes of ox hooves!

The Romans, Greeks and Chinese invented their own version of tooth powder. It used crushed oyster shells and bones as an abrasive. Some included better tasting ingredients such as powdered fruit, honey and dried flowers. Take a look at the timeline below to learn about the evolution of modern toothpaste.

It has been reported that an Iraqi musician in the 9th century actually designed the first toothpaste which was apparently so pleasant to use that its use spread right through to Spain under Moorish influence. The exact ingredients of this toothpaste are unknown but it was reported to have been both functional and pleasant to taste.

Take a look at the timeline below to learn about the evolution of modern toothpaste.

1800s - “Modern” toothpastes, usually in powder form, were invented.
1824 - Dr. Peabody added soap to toothpaste. 

1850s - Dr. John Harris added chalk to toothpaste.
1873 - Colgate mass-produced the first toothpaste in a jar.

1892 - Dr. Washington Sheffield invented the collapsible tube.

1914 - Fluoride was added to toothpaste.

Modern Toothpastes

The most recent developments to toothpaste include whitening formulas and additives to protect against gum disease, plaque and bad breath. Toothpaste help to clean your teeth and keep your breath fresh.  There are different kinds of toothpastes for different and specific purposes. The right toothpaste can play a critical role in oral health, but it can be difficult to know what product is best. In this article we explain how you can choose the best toothpaste for your needs and preferences.

Basic Toothpaste Ingredients

Toothpastes are made of two kinds of ingredients: active and inactive. Active ingredients are those that have a therapeutic effect or make the toothpaste "work." Inactive ingredients improve the taste or ease of use of the toothpaste. Common inactive ingredients include flavoring and thickening agents, abrasives and detergents.

While most toothpastes have similar basic ingredients, some contain an extra active ingredient to treat specific problems. Here are a few tips on how to choose the right toothpastes; 

Check for fluoride content

Fluoride is an essential ingredient to look out for when buying toothpaste.

Toothpaste that is fortified with fluoride is quite useful for those who are prone to cavities and those with dry mouth.  Fluoride helps in strengthening and nourishing the tooth enamel as well as protecting it from cavities, enamel erosion, and decay. The recommended fluoride content is 500 ppm (parts per million) for children under 3, 1000 ppm for children aged 3-6 and 1450 ppm for people aged 6 and upwards.

 Choose based on Specific needs

Always choose a toothpaste that meets your individual needs. If you find that the thick white paste of toothpaste is distasteful, or that it has odd taste, consider using flavorless toothpaste or one that contains a flavor that you like. Choosing toothpaste with your favorite flavor is crucial as it can encourage you or your kids to brush more often.

Individuals with dental problems should choose a toothpaste that contains an extra active ingredient to treat specific problems. Most toothpaste tends to target one or more of the following conditions or needs;

 Toothpastes for sensitive teeth

These are toothpastes specifically designed to ease tooth sensitivity ranging from mild to severe pain. If you suffer from sensitive teeth, Potassium Nitrate and Stannous Fluoride are the ingredients to look for when choosing a toothpaste. They help to prevent nerves in your teeth from sending signals to your brain triggered by certain stimuli, such as sensations of hot and cold.

However, some people may not get enough relief from desensitizing toothpastes. If this is the case, consider visiting Royal Dental. Our dentists will help identify the underlying causes of the discomfort in your teeth and recommend appropriate treatment.

 Toothpastes for Whitening

Whitening toothpastes can be used for those looking to have a shining, radiant smile. It gives you an extra boost to the brightness of your smile.

Although whitening toothpaste can never replace the professional whitening of a dentist, it helps to prevent surface stains that can cause your teeth to lose its brightness.

Look for mild abrasives ingredients such as magnesium carbonate, hydrated aluminum oxides and calcium carbonate. Toothpaste containing hydrogen peroxide ingredient also have excellent whitening effect on teeth when used over a longer period.

It’s important to note that before you pick up a toothpaste that contains abrasive agents, check its Relative Dentin Abrasivity (RDA) level. A toothpastes that has a higher RDA may damage the teeth and gums.

 Toothpastes for Bad breath

Toothpaste that eliminates bad breath should do so by targeting the bacteria that causes plaque. It should prevent gum diseases and tooth decay, which can also cause bad breath and other common causes of halitosis.

They contain antibacterials, such as chlorhexidine digluconate, cetylpyridinium chloride and Sodium fluoride which has the ability to eliminate the harmful bacteria that cause plaque.

However, if you’re experiencing persistent bad breath even after brushing, it is important to Royal Dental. Our dentists will help identify and fix the root causes of your bad breath.

Herbal toothpastes

Herbal toothpaste use natural ingredients and herbs to remove the plaque, freshen our breath and also prevent various gum diseases. They are free of artificial chemicals, flavoring and dyes.

The ingredients found in natural toothpastes vary widely but often include baking soda, aloe, eucalyptus oil, myrrh, plant extract (strawberry extract), and essential oils such as Peppermint and spearmint which helps in destroying the bacteria. Many natural toothpastes use natural ingredients like hydrated silica to whiten teeth, which is gentler on your teeth than artificial bleaching agents found in common toothpastes

Charcoal toothpaste

Charcoal toothpaste is made with activated charcoal, a form of the chalky carbon that’s been treated to become extra porous. And because it's porous, it's able to attract toxins. The theory is that activated charcoal will grab onto stains and germs, leaving you with a whiter, cleaner smile.

Toothpaste flavors

Once upon a time, toothpaste just tasted like...toothpaste.
For many years, the only flavor choices were mint, and perhaps peppermint or spearmint.
The old standbys remain popular, but these days, toothpastes also come in spicy flavors such as fennel or cinnamon-clove, or even in fruit flavors such as apricot or peach.
Recently, toothpastes have adopted more trendy flavors. Many of these include artificial sweeteners. These also make the toothpaste taste better the flavors include: bubblegum, cinnamon, lemon-lime among others. These types of toothpaste are especially important when introducing young children to oral health.

With so many toothpaste options on the market, it is important to reading labels carefully and understanding what each ingredient does. If you’re still unsure, please consult with Royal Dental Clinic. Our dentist will factor in your oral health and personal needs when recommending products.

You can also benefit from our FREE WHATSAPP CONSULTATION



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Royal Dental Clinic

2019-07-01 05:58:35

Most adults in Kenya have gum disease to some degree, and most people experience it at least once. It's much less common in children. Gum disease refers to the inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. 

Gum disease is caused by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria.

The first stage of gum disease is known as gingivitis, which fortunately is reversible.  If left untreated, gingivitis may lead to a more serious, destructive form of gum disease known as periodontitis. Dentists at the Royal Dental Clinic recommend regular check-ups, and examinations to prevent, detect and offer early treatment to gum disease.

Some of the preventive measures against gum disease include good oral hygiene, balanced diet, and regular dental visits. Early symptoms of gum disease include gum bleeding without pain. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of gum pockets. Bacteria in these pockets cause gum infection, swelling, pain, and further bone destruction. Advanced gum disease can cause loss of otherwise healthy teeth.

In case you have a problem with gum disease, kindly do not hesitate to visit the Royal Dental Clinic for thorough check-up and quality treatment. You can also benefit from free consultations on WhatsApp


Family & Child dentistry

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Royal Dental Clinic

2019-06-18 09:14:36

When children are born, they suck either their fingers, thumbs or tongue. 
This is largely done as a sense of security and most kids will stop between ages 3-5 years.

Children who continue beyond 5 years, depending on the posture, force or frequency of the sucking, may have their upper jaw getting lengthened or teeth being protruded/crooked. 

The front upper jaw assumes posture of the fingers being sucked thus growing both forward and downward.
The lower front teeth gets pushed back. As a result, an open bite forms, i.e. the inability of upper and lower teeth meeting.

Help your child break the habit. 
Often times such children are lonely, stressed or lack attention, hence seeking solace in the sucking.
Provide calmness and comfort.

It’s worth noting that not all cases are due to habits. Some are created by skeletal challenges which could be genetic. These may require surgery to correct. 

If the damage is done, treatment is necessary using braces to correct the anomaly while attempting to stop the cause. 
Foregoing treatment means inability to bite with the front teeth which are best designed for biting hence leading to strains on the jaw.
Such teeth are also prone to injuries as a result of struggling to close lips unintentionally. 
Gums also tend to be dry due to loss of saliva.

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