Inroduction

Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Food (typically meat) bolus impaction above a preexisting esophageal stricture or ring is by far the most common cause of esophageal foreign body obstruction in adults. Coins are the most common ingested foreign body in children. Three groups of people that are at a higher risk of ingesting foreign objects are children and adolescents, mentally handicapped patients or patients with psychiatric illness, and abusers of illicit drugs or alcohol. Foreign body ingestion more commonly occurs in males, with some studies suggesting approximately a: 1 male to female ratio.

 Epidemiology and the Types of Foreign Bodies

Children make up to 80% of patients that ingest foreign bodies, with 20% of all children between the ages of 1 and 3 having ingested some type of foreign body. Several studies have proposed that coins are the most frequently ingested foreign body in children. Button batteries are also commonly ingested foreign bodies in children, with one study estimating 2519 battery ingestion-related emergency department visits each year in children under 18 years of age. As batteries come in multiple forms, they can predispose patients to distinct types of damage. Sodium or potassium hydroxide batteries can cause damage to the gastrointestinal mucosa through chemical burn, while lithium batteries likely damage tissues by eliciting an electric current through them. Risk of complications from button battery ingestion is importantly associated with the size of the battery being >20 mm in diameter, children under 4 years of age, and length of time (>2 hours) in the gastrointestinal system. Children have additionally been known to ingest toys, crayons, coins, and other objects found around the household.

Adults with psychiatric illnesses are also at an increased risk of foreign body ingestion, which can occur accidentally or intentionally, and many of these patients often present multiple times with recurrent foreign body ingestions. Psychiatric patients frequently present after ingesting multiple ingested foreign bodies, as described by a case report where a 15-year-old male with mental retardation and psychiatric disorder was found to have 15 foreign bodies lodged in the stomach and lower esophagus and in numerous other reports. Psychiatric patients have also been known to swallow foreign objects as a response to stress and a result of poor impulse control directed at their caregivers. Incarcerated individuals may ingest foreign bodies as a method of obtaining secondary gain. A careful history should be taken when assessing these patients due to increased risk associated with ingesting multiple foreign bodies.

Individuals under the influence of drugs and/or alcohol often present to emergency departments after ingesting multiple foreign bodies. The types of foreign bodies ingested tend to be spontaneous, and frequently patients do not remember swallowing the object. There have been cases reported in the literature in which patients have ingested crack-cocaine pipes in an effort to evade detection by police.

Accidental ingestion by adults, the geriatric population, and patients with decreased palate sensitivity is far less prevalent than in the aforementioned groups of individuals, but it does occur nevertheless with several notable patterns. 20% of adults that ingest foreign bodies do so while eating, and most foreign bodies discovered are from food boluses due to fish bone impaction. The most common esophageal foreign body in the western world is impacted food, and meat in particular. In adults, a food bolus impaction is commonly due to an underlying structural abnormality such as eosinophilic esophagitis or a stricture. Less common etiologies include dentures, chicken bones, crab shells, wires, and bread bag clips.

Complications of Foreign Body Impaction

The majority of foreign bodies pass through the digestive system spontaneously without causing any further harm, symptoms, or necessitating any further intervention. Occasionally, complications will arise from ingested and impacted foreign bodies. These complications are directly related to the type of foreign body and the location of impaction within the gastrointestinal tract.

A complication frequently reported associated with foreign body ingestion is intestinal perforation, which is predominantly caused by fish bones, yet <1% of foreign bodies are actually known to cause perforation. Perforations often present with erythema, crepitus, or tenderness. Fish bones are easily swallowed unnoticed and have sharp, pointed ends that predispose them to impaction at intestinal areas of acute angulation or narrowing, such as the duodenal loop,

Tooth extraction is one of the most basic dental procedures performed by dental professionals worldwide. As its name suggests, a tooth is extracted or removed by the dentist. Dr. Kalra and his team have performed many tooth extractions for our patients, young and adult. We will first assess your condition and see whether your tooth needs extraction or will benefit more from another dental procedure.

We can best determine if your tooth needs to be extracted or if it can be saved. A tooth that is broken but not badly decayed may be fixed with a crown, onlay or some other procedure before extraction is recommended. We at Kalra Dental Clinic feel it is best to go with the conservative approach to help you keep more of your natural teeth. We do our best to save a permanent tooth and keep it healthy for as long as possible. Tooth extraction is only done when a tooth is too far gone for other dental treatments to work.

In addition to tooth decay, there are other reasons why we may recommend a tooth extraction. A patient with over-crowded teeth may benefit from an extraction, and patients who will be receiving braces often have teeth extracted to make room for the necessary movement to occur. We may need to extract a tooth that prevents other teeth from growing in properly. Moreover, a tooth that causes major health issues, most notably an impacted wisdom tooth, will also need to be removed. Dr. Kalra and his team are well-trained to diagnose any dental situation and will recommend the best treatment solution for your dental concerns.

When A Tooth Can’t Be Fixed…

It needs to be removed. Your dentist may recommend extracting a tooth if:

• Your tooth is too damaged by a fracture or deep cavity to repair.
• You have a sizable infection that cannot be resolved by a root canal alone.
• You have teeth that are blocking other teeth from coming in. These may be extra teeth or baby teeth that have not fallen out yet.
• You are getting braces and need to get rid of a tooth that is crowding others.

Wisdom teeth, which typically come in during your teens or twenties, may need to be extracted if they are decayed, infected, or causing pain. They may get impacted—stuck underneath other teeth—which also requires extraction.

Types of Extraction

Most visible teeth can be removed with a simple extraction, where your dentist loosens the tooth, then removes it carefully with forceps. This procedure typically requires just a local anesthetic (an injection).

A surgical extraction may be needed if:

• The tooth has broken off at the gum line.
• The tooth hasn’t come in yet (wisdom teeth, for example)
• The tooth has especially large or curved roots

During a surgical extraction, you may have a local anesthetic along with an IV or general anesthetic.

Both procedures are virtually painless. You might feel pressure or pulling, but no pain.

Tip: Don’t smoke on the day of surgery, as it can increase the chance of dry socket, a painful condition that occurs when a blood clot doesn’t form in the hole, breaks off, or breaks down too early.

 ROOT CANAL

Has your dentist or endodontist told you that you need root canal treatment? If so, you’re not alone. Millions of teeth are treated and saved each year with root canal, or endodontic, treatment.   Remember, root canal treatment doesn’t cause pain, it relieves it. Watch our videos below to learn more!

Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.

Contrary to jokes about the matter, modern endodontic treatment is very similar to having a routine filling and usually can be completed in one or two appointments, depending on the condition of your tooth and your personal circumstances. You can expect a comfortable experience during and after your appointment.

Saving the natural tooth with root canal treatment has many advantages:

Efficient chewing

Normal biting force and sensation

Natural appearance

Protects other teeth from excessive wear or strain

Overview
A root canal is a treatment to repair and save a badly damaged or infected tooth. The procedure involves removing the damaged area of the tooth (the pulp), cleaning and disinfecting it and then filling and sealing it. The common causes affecting the pulp are a cracked tooth, a deep cavity, repeated dental treatment to the tooth or trauma. The term “root canal” comes from cleaning of the canals inside the tooth’s root.

What to Expect During a ROOT CANAL
If you think you need a root canal, consult your dentist. There are a number of steps that occur over a few office visits.

X-ray – if a dentist suspects you may need a root canal, he will first take X-rays or examine existing X-rays to show where the decay is located.

Anesthesia – local anesthesia is administered to the affected tooth. Contrary to popular belief, a root canal is no more painful than a filling.

Pulpectomy – an opening is made and the diseased tooth pulp is removed.

Filling – the roots that have been opened (to get rid of the disease pulp) are filled with gutta-percha material and sealed off with cement.

A Deep Infection

Root canal treatment is needed when an injury or a large cavity damages the tooth’s root. The root becomes infected or inflamed.