About Toothwise

Toothwise is a multidisciplinary dental care center, located in Kemps corner, where we aim to provide treatment of the highest quality to adults and children, keeping international standards and patient comfort in mind.We are continuously upgrading our skills, resources and techniques in order to provide result oriented,pain and stress free dental care to our patients.Your feedback after your visit to our clinic is of immense value to us. A very warm welcome to our clinic from the two of us.DENTAL FACTS : ANTIBIOTICS AND DENTISTRYMany of you take an antibiotic prior to dental treatment. The purpose is to use an antibiotic prior to an infection to prevent an infection. It may be because of a mitral valve prolapse, certain types of implants, a joint replacement, or a heart murmur cause by a roughened heart valve. Antibiotic prophylaxis began initially to prevent bacterial endocarditis. Endocarditis is the collection and colonization of bacteria in the heart muscle. This leads to inflammation and deformation of the heart and is a life-threatening condition.ANTIBIOTIC PROPHYLAXIS WAS RECOMMENDED FOR THE FOLLOWING:HIGH-RISK CATEGORYProsthetic cardiac valves,including bioprosthetic and homograft valvesPrevious bacterial endocarditisComplex cyanotic congenital heart disease (e.g., single ventricle states, transposition of the great arteries, tetralogy of Fallot) Surgically constructed systemic pulmonary shunts or conduitsMODERATE-RISK CATEGORYMost other congenital cardiac malformations (other than above and below)Acquired valvar dysfunction (e.g., rheumatic heart disease)Hypertrophic cardiomyopathyMitral valve prolapse with valvar regurgitation and/or thickened leafletsANTIBIOTIC PROPHYLAXIS IS NOT RECOMMENDED FOR THE FOLLOWING:NEGLIGIBLE-RISK CATEGORY (NO GREATER RISK THAN THE GENERAL POPULATION)Isolated secundum atrial septal defectSurgical repair of atrial septal defect, ventricular septal defect, or patent ductus arteriosusPrevious coronary artery bypass graft surgeryMitral valve prolapse without valvar regurgitationPhysiologic, functional, or innocent heart murmursPrevious Kawasaki disease without valvar dysfunctionPrevious rheumatic fever without valvar dysfunctionCardiac pacemakers (intravascular andFOR HIGH & MODERATE RISK PATIENTSANTIBIOTIC PROPHYLAXIS IS RECOMMENDED FOR THE FOLLOWING DENTAL PROCEDURES:Dental extractionsPeriodontal procedures including surgery, scaling and root planing, probing, and recall maintenanceDental implant placement and re-implantation of avulsed teethEndodontic (root canal) instrumentation or surgery only beyond the apexSubgingival placement of antibiotic fibers or stripsInitial placement of orthodontic bands but not bracketsIntraligamentary local anesthetic injectionsProphylactic cleaning of teeth or implants where bleeding is anticipatedFOR HIGH & MODERATE RISK PATIENTSAntibiotic prophylaxis is not recommended for the following dental proceduresRestorative dentistry (operative and prosthodontic) with or without retraction cord Local anesthetic injections (nonintraligamentary)Intracanal endodontic treatment; post placement and buildup Placement of rubber dams, postoperative suture removal, taking of oral impressions, and fluoride treatmentsPlacement of removable prosthodontic or orthodontic appliances and orthodontic appliance adjustment Taking of oral radiographsShedding of primary teethTHE NEW AMARICAN HEART ASSOCIATION GUIDELINESCardiac Conditions Associated With the Highest Risk of Adverse Outcome From Endocarditis for Which Prophylaxis With Dental Procedures Is ReasonableProsthetic cardiac valve or prosthetic material used for cardiac valve repair Previous IE Congenital heart disease (CHD)*Unrepaired cyanotic CHD, including palliative shunts and conduitsCompletely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedureRepaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)Cardiac transplantation recipients who develop cardiac valvulopathyDENTAL FACTS : BAD BREADTH/ HALIOSITSWHAT IS HALITOSIS?More than 90 million people suffer from chronic halitosis or bad breath. In most cases it originates from the gums and tongue. The odor is caused by bacteria from the decay of food particles, other debris in your mouth, and poor oral hygiene. The decay and debris produce a sulfur compound that causes the unpleasant odor.CAUSESANAEROBIC BACTERIAStudies have shown that about 85% patients suffering from halitosis have an oral condition as the source. If a person has healthy teeth and gums (i.e. no cavities, periodontitis, or abscesses), the next most common source of oral malodour is the tongue. Bacteria which produce volatile sulfur compounds (VSCs) have been found to congregate on the tongue, especially the posterior one third.These bacteria can be found on the surface of the tongue, throat, teeth, and periodontal pockets in the gums.TONGUE AND THROAT COLLECT BACTERIASaliva from nearby glands drips down on the posterior region of the tongue, which is full of irregularities where bacteria love to hide. The anaerobic bacteria (bacteria which thrive without oxygen) break down specific components (amino acids) of the saliva, creating certain gases or VSCs. These VSCs have been implicated as a major contributing factor to halitosis.If your Tongue has a white coating, this is evidence of excessive anaerobic bacteria buildup.MEDICATIONSOne of the most common side effects of thousands of medications is dry mouth (xerostomia). Bacteria tend to thrive in this environment.DRY MOUTH / MOUTH BREATHING:Mouth breathing during sleep dries the mouth, creating the dreaded 'morning breath'. Other causes of dry mouth include medications, exercise, dieting, alcohol or alcohol based mouth rinses, smoking.Other contributing oral factors of halitosis include inflammatory conditions, oral cancer, oral candidiasis,etc.SYSTEMIC CONDITIONSWhile the oral cavity is by far the most common source of bad breath, systemic conditions can also be responsible for this condition. Nasal and sinus problems, including foreign bodies inserted in the nose and neglected for a period of time, can be a cause. Repetitive tonsillar infections, infections of the oropharynx, pulmonary diseases (such as bronchitis and pneumonia), and gastrointestinal problems are all possible contributing factors. Certain systemic diseases produce particular odours. A few of these relationships include liver failure producing a rotten egg smell, diabetes producing a sweet smell, intestinal dysfunction producing heavy sour breath, and scarlet or typhoid fever producing a musty smell.DIETMany foods (ie: Dairy) contribute to the ability of bacteria to create VSCs.Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach and the odor is then excreted through the lungs. Studies even have shown that garlic rubbed on the soles of the feet can show up on the breath. Acids in foods such as coffee decrease oxygenation and can cause this bacteria to thrive.TREATMENTBRUSH AND FLOSS YOUR TEETH PROPERLYBacteria thrive on food particles on our teeth to create VSCs, which cause bad breath. At least 2 minutes of brushing is necessary to properly clean all tooth surfaces. In addition 30% of the surfaces of our teeth is not cleanable with a brush. This makes flossing absolutely critical!USE BAD BREATH RELIEF PRODUCTSHalitosis Toothpaste, Non-alcoholic Sulfur reducing mouth rinses, sugar free chewing gum and breath mints.CLEAN YOUR TONGUEAnaerobic bacteria thrive in the fissures and mucous layer of the tongue, sometimes creating a visible whitish layer. They live safe from oxygen under a protective layer of mucous, food particles and proteins . Tongue cleaners can remove this layer and much of the bacteria which resides on your tongue.One of the easiest and most efficient treatments for halitosis is mechanical debridement. This means thorough, regular flossing and brushing of your teeth and your tongue. A tongue scraper can be very helpful as well. When using a tongue scraper, it is best to clean as far back on the tongue as possible, starting from the back and moving toward the front. This scraping motion is done several times in row.DRINK PLENTY OF WATERKeeping hydrated allows proper salivary flow to help rinse and flush out unwanted bacteria.USE MOUTHWASHESEffective oral rinses must eliminate the problematic bacteria while maintaining the balance of normal bacteria in the oral environment. The assorted types of rinses being developed and marketed contain quaternary ammonium, zinc, chlorhexidine (already in use to help treat periodontitis), chlorine dioxide, or triclosan. Chlorhexidine and chlorine dioxide rinses have received the most press lately. Because chlorhexidine is such a strong antimicrobial rinse, it is advised to only use this type of rinse as a short-term adjunct for treatment. At present, chlorine dioxide can be used on a long-term basis, although some researchers do question its safety. In lab experiments, chlorine dioxide has been shown to be effective by breaking the sulfide bonds in VSCs, but this finding has not yet been substantiated using live subjects.Chlorine dioxide neutralizes the sulfur compounds which cause bad breath. A majority of mouth rinses contain alcohol, which actually dries out the mouth and can end up contributing to halitosis.CHEW SUGARLESS GUMChewing stimulates saliva and aids in cleaning out noxious bacteria.CHECK FOR SIGNS OF GINGIVITIS AND OTHER DENTAL PROBLEMSPeriodontal disease is a bacterial infection of the gums and ligaments which support the teeth. This leads to bone loss and deep pockets between the teeth and gums which are not easily cleanable. Extremely high amounts of bacteria can live in these pockets and need aggressive cleaning therapies to reduce bad breath. Signs of periodontitis include red or swollen gums, loose teeth, bleeding gums, pus, pain on chewing.SYSTEMIC DISEASE MANAGEMENTOther management tools include antibiotics, nasal mucous control methods, avoidance of certain foods and medications, salivary substitutes, and management of systemic diseases.GET REGULAR DENTAL CHECK-UPSTwice yearly dental check-ups are a good idea for all adults. This is because people often do not become aware of dental problems until considerable damage has occurred. A dentist can recognize potentially damaging problems early. In addition, the dentist can diagnose other problems which cause bad breath including abscesses, periodontal disease, cavities, and impacted teeth.DENTAL FACTS : FLOSSINGFlossing is a simple oral hygiene procedure that, when performed daily, can insure healthy gums and teeth that last a lifetime. Experts say it's as indispensable to a healthy mouth as brushing, yet most people find it uncomfortable and don't do it regularly. FLOSSING:: THE RIGHT WAYTake a piece of floss (12-18 inches), and wind it around the index finger of each hand.Grasp floss firmly between the thumb and index finger arriving at the flossing position.The fingers are separated by about an inch Using a gentle sawing motion, guide the floss between your teeth. Never snap the floss into the gums.Curve floss around the tooth.Gently slide the floss up and down the side of the tooth and under gumline. Advance floss, after cleaning each side of tooth, by wrapping the floss around the finger of one hand, and unwrapping it on the other. Assume the flossing position,and continue to floss the side of each tooth until done. There are many kinds of disposable and easy to use flossing devices available,so take your pick!PREGNANCY AND DENTISTRYPregnancy is a time of anticipation and change. There are many obvious changes throughout a woman's body and some not so obvious, that occur within the mouth, or oral cavity. While temporary, pregnancy does affect how and when dental care is provided.MYTHSThere is a long standing myth that a woman loses a tooth for every child she has. Of course this is not the case, but circumstances and changes in the mouth may make it appear so. The myth goes on to claim that the fetus draws calcium directly from the mothers teeth and results in weakened teeth that decay and may be lost. In fact the mothers diet (and nutritional supplements) give the developing fetus all the calcium he or she needs to develop. Increased cavities are the result of many factors such as an increase in snacking and poor oral hygiene.INTRAORAL CHANGESStarting about the second month of and continuing for the rest of the pregnancy, hormone changes affect the gums or gingiva. The gingiva is much more susceptible to irritation from plaque (soft) or calculus (hard) deposits on the teeth. An exaggerated inflammatory response can result in mild redness or gingivitis, to swelling of the gingiva between the teeth. These swellings are painless, but do bleed easily. Most pregnant women experience some form of inflamed gums even with good dental hygiene. Additionally, looseness of the teeth may be noticed, especially in the third trimester. These gingival changes usually reverse after the baby is born.Cavities or decay, as noted above, can increase during or after pregnancy. Factors related to the pregnancy, not the pregnancy itself, can lead to this increase. The inflamed gums that many women experience can be tender so she may avoid brushing and flossing. Plaque accumulates. As the fetus increases in size, the stomach capacity decreases and to compensate, frequent small meals and sugary snacks are common. With more plaque present and more available sugars, there is an increase in decay.DENTAL CARE DURING PREGNANCYDental care during pregnancy is important. While many treatments are elective and usually postponed until after pregnancy, there is care that a pregnant woman needs and sometimes treatment cannot wait, but can be done with minimal risk. Consultation with a woman's physician also helps minimize risks.FIRST TRIMESTERA dental exam and routine hygiene care (cleaning) is important so that the irritants (plaque and calculus) that lead to gingival inflammation and cavities, can be removed. Instructions in home care can help the pregnant woman maintain her oral health. Other dental treatment is usually postponed until after the pregnancy, and more pressing treatment is delayed until the second trimester, if possible.SECOND TRIMESTERRoutine hygiene care again is advisable. Necessary dental treatment is relatively safe and comfortable for the woman at this stage.THIRD TRIMESTERIf needed, due to inflammation or swelling of the gums, another hygiene appointment may be appropriate, but early in this trimester is the best time. Appointments are kept short as the woman is usually uncomfortable reclining in the dental chair.FAQ SWILL PREGNANCY AFFECT MY ORAL HEALTH?Expectant mothers (and women who take some oral contraceptives) experience-elevated levels of the hormones estrogen and progesterone. This causes the gums to react differently to the bacteria found in plaque, and in many cases can cause a condition known as “pregnancy gingivitis” 65 to 70% of all pregnant women developed gingivitis during this time! Symptoms include swollen, red gums and bleeding of the gums when you brush. Pregnancy gingivitis usually starts around the second month of pregnancy and decreases during the ninth month. If you already have gingivitis, it will most likely get worse during pregnancy. Remember that the bacteria in plaque (not hormones) are what cause gingivitis. Brush twice a day and floss before you go to bed to help avoid plaque buildup.Gingivitis is most common during the second to eighth months of pregnancy.WHAT ARE “PREGNANCY TUMORS”?Pregnancy tumors (pyogenic granuloma) are inflammatory, benign growths that develop on the gums as part of an exaggerated response to the irritants that cause periodontal disease. These "tumors" are rare, usually painless and develop on your gums in response to plaque. Although they are not cancerous, they should be treated. Pregnancy tumors usually subside shortly after childbirth.COULD GINGIVITIS AFFECT MY BABY’S HEALTH?New research suggests a link between pre-term, low birth weight babies and gingivitis. Excessive bacteria, which cause gingivitis, can enter the bloodstream through your mouth (gums). If this happens, the bacteria can travel to the uterus, triggering the production of chemicals called “prostaglandins”, which are suspected to induce premature labour.SHOULD I RECEIVE DENTAL TREATMENT WHILE I’M PREGNANT?Good oral health care is vital during your pregnancy. Continue with your regular dental cleaning and check ups to avoid oral infections that can affect the fetus, such as gingivitis and periodontal disease. Dentists recommend that major dental treatments that aren’t urgent be postponed until after your child is born. The first trimester, the stage of pregnancy in which most of the baby’s organs are formed, is the most crucial to your baby’s development, so it is best to have procedures performed during the second trimester to minimize any potential risk. Dental work is not recommended during the third trimester because the dental chair tends to be too uncomfortable for the mother. If you lie back, the chair may cut off circulation by placing pressure on the vein that returns blood to the heart from the lower part of the body.IF I DO NEED TREATMENT, WHAT DRUGS ARE SAFE?Be extremely cautious of all drugs during pregnancy. If you have gingivitis or periodontal disease, your dentist may want to treat you more often to achieve healthy gums and a healthy baby. Although dental anesthetics such as Novocaine or lidocaine can enter the placenta, which filters out most drugs, the doses used in most dental procedures are considered safe. If you need to have dental work done during your pregnancy, research has shown that some acceptable antibiotics include penicillin, amoxicillin, and clindamycin but avoid tetracycline, which can cause discoloration of your child’s temporary and permanent teeth. Products containing paracetamol, such as Crocin, are approved, but you should be wary of other over-the-counter medications such as aspirin or ibuprofen. Avoid using narcotics for dental pain until after your child is born.PREVENTIONYou can prevent gingivitis by keeping your teeth clean, especially near your gumline and:Brush your teeth at least twice a day and after meals when possible.Floss dailyIf you suffer from morning sickness, repeatedly rinse our mouth with water and brush your teeth as often as possible to neutralize the acid caused by vomitting.If brushing your teeth causes morning sickness, rinse your mouth with water, brush without toothpaste and follow with anti-plaque fluoride mouthwash.Eat a well-balanced diet with plenty of vitamin C and B12.See your dentist for help in controlling plaque and preventing gingivitis. Also schedule routine exams and cleaning to maintain good dental health.Remember, the healthier your mouth is, the healthier and happier your pregnancy and baby will be. Pregnancy is an exciting time and proper dental care can help keep everything going smoothly.LINK BETWEEN GUM DISEASE AND EARLY BIRTHSIn a study of 1,313 pregnant women, researchers at the University of Alabama found that women with severe periodontal disease, in their second trimester of pregnancy tended to give birth anywhere from 3 to 8 weeks before their due dates!It is advised that expectant mothers increase their level of oral hygiene and seek regular professional care during their pregnancies.NIGHT GRINDINGBruxism or night grinding is characterized by the grinding of the teeth and typically includes the clenching of the jaw. It is an oral parafunctional activity that occurs in most humans at some time in their lives. In most people, bruxism is mild enough not to be a health problem.While bruxism may be a diurnal or nocturnal activity,it is bruxism during sleep that causes the majority of health issues and can even occur during short naps. Bruxism is one of the most common sleep disorders. Although the noise may disturb people sleeping next to a bruxer,in the long run it is far more distressing to the bruxer ,than to the listener..WHY DOES IT HAPPEN?Bruxism was believed to be a consequence of psychological differences and emotional stress.It has been found that in most cases stress maybe a contributory factor but the main cause lies in the patients mouth.Most people grind their teeth in an effort to correct irregularities of the chewing surfaces of the teeth.They grind away to eliminate a spot which is too high or so as to find a comfortable place to fit the upper and lower teeth together. You may not know that you grind your teeth but your dentist will know after a careful examination.SIGNS OF GRINDINGThe top surfaces of teeth gradually become worn down to flat dull nubs.Bruxism can actually crack a tooth,chip enamel,or even cause teeth to shift,thereby creating open spaces in the teeth which collect food and encourage gum disease and tooth decay.There can be patches of chipped enamel near the neck of the teeth due to the constant pressure on the biting surface.These may weaken the tooth structure and also cause sensitive teeth.The stresses of bruxism can sometimes be transferred to the jaw joint which is called the temporo-mandibular joint.This can result in pain in the side of the face,in the area around the ears.HOW DO YOU TREAT IT?Occlusal interferences should be removes first and foremost.Orthodontics may be required to correct malocclusion.The dentist can also make a mouth guard for you to wear at night to protect your teeth from the damaging effects of bruxism.Medications in the form of muscle relaxants and anti inflammatories may lessen pain but this is a temporary measure.DENTAL FACTS : TOOTHPASTESTOOTHPASTESWHY IS BRUSHING WITH TOOTHPASTE IMPORTANT?First and foremost, a toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes caries, gum disease, and eventual tooth loss if not controlled.Second, the toothpaste if contains fluoride, makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage can even be seen.Third, special ingredients in the toothpaste help to clean and polish the teeth and remove stains over time.Fourth, toothpastes help freshen breath and leave your mouth with a clean feeling.WHAT TYPE OF TOOTHPASTE SHOULD I USE?As long as your toothpaste contains fluoride, the brand you buy really does not matter. All fluoride toothpaste work effectively to fight plaque and cavities and clean and polish tooth enamel. If your teeth are hypersensitive to hot or cold, consider trying a toothpaste designed for sensitive teeth.Some prefer a tartar control toothpaste containing pyrophosphates to prevent the buildup of soft calculus deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can't nearly match the effectiveness of a professional bleaching formula administered or prescribed by a dentist.HOW MUCH SHOULD I USE?Contrary to what toothpaste commercials show, the amount of paste or gel needed on your brush for effective cleaning does not have to be a heaping amount. Simply squeeze on a pea-sized dab of paste on the top half of your brush. If you brush correctly holding the toothbrush at a 45-degree angle and brush inside, outside and between your teeth, the paste should foam enough to cover all of your teeth. Children under 6, however, should only be given a very small, baby pea-sized dab of dentifrice on their brush.DIFFERENT KINDS OF TOOTHPASTESAdvertising can be very seductive! This statement is especially true with respect to dentifrices (toothpastes).The recent proliferation of specialty toothpastes has clogged store shelves and confused many patients. Advertisements seem to suggest that we need a tartar control toothpaste for removing tartar, a whitening toothpaste to brighten teeth, and even a gum care toothpaste to prevent gum disease. What is the most effective toothpaste?TOOTHPASTES VS GELSOnly their physical appearance and a taste is the difference between pastes and gels. While gels may seem less abrasive than pastes,this is not the case. Actually, gels can be more abrasive because of the silica used to make them. However, both are safe, effective cleaners; use whichever you like!DESENSITIZING TOOTHPASTESThese pastes do actually work for a majority of the people using them. Generally, they are needed when a patient has had gum recession, thereby exposing the root of the tooth. Once this exposure occurs, a tooth can be sensitive to cold, hot, touch, sweet, or sour. Senquel,Thermoseal,Thermodent K,Colgate sensitive pro-relief, are some of the brands on the market.New ones come on the market regularly. Some brands have different ingredients; therefore, if one brand does not work, try a different brand. Note: you should have any sensitivity checked by your dentist first to be sure it is not a more serious problem.WHITENING TOOTHPASTESOne must be careful when using these due to their abrasiveness. These should not be used exclusively but should be incorporated into a routine using a fluoride paste. Do not use a whitening paste every time you brush; use only once every day or two. Certain brands can be more abrasive than others. Their efficacy is questionable.Some people claim to notice a brightening of tooth color, while others notice no change. This difference is partly due to variety in diet and tooth structure among people. If you are serious about whitening your teeth, you should discuss various options, including bleaching, with your dentist.DENTURE PASTESWhile it's true that more people are keeping their teeth, those who use full or partial dentures need to keep them clean. What to use? Not surprisingly, there are denture cleansers that safely and effectively clean dentures. These products contain a mild abrasive and detergent plus a flavoring agent. If you run out of denture paste, use soft hand soap or mild dishwashing liquid to clean dentures.IN CONCLUSIONBrush with a FLUORIDE toothpaste for 2 minutes at least twice a day using a soft bristled toothbrush. Most people only brush their teeth for about 15-20 seconds on average! The mechanical action employed using the proper brushing technique is more important than the brand of toothpaste you purchase. Flossing at least once a day is also very important because it removes food from between teeth where even the best toothbrush and toothpaste are ineffective.DENTAL FACTS : TOBACCO & DENTISTRYUse of Tobacco & DentistryChewing tobacco affects your dental health as well as the rest of your body. If you use smokeless tobacco and have thought about quitting, your dentist can help. In the meantime, here are a few facts that may help you decide to join the many who are tobacco-free.CHEWING TOBACCOChewing tobacco includes snuff, a finely ground version of processed tobacco, and chewing tobacco in the form of shredded or pressed bricks and cakes, called plugs, or rope-like strands called twists. Users "pinch" or "dip" tobacco and place a wad in their cheek or between their lower lip and gums. In India it comes with 'katha' -lime.ISN'T IT SAFER THAN SMOKING?Absolutely not. Some wrongly believe that chewing tobacco is safer than smoking cigarettes. But chewing tobacco is more addictive because it contains higher levels of addictive nicotine than cigarettes and can be harder to quit than cigarettes. One can of snuff delivers as much nicotine as 60 cigarettes. About 8,000 people die every year from tobacco use. About 70 percent of those deaths are from oral cancer. Other cancers caused by tobacco include cancer of the pancreas, nasal cavity, urinary tract, oesophagus, pharynx, larynx, intestines and the stomach.EFFECTS ON DENTAL HEALTHIt causes bad breath, discolours teeth and promotes tooth decay that leads to tooth loss. Chewing tobacco users have a decreased sense of smell and taste, and they are at greater risk of developing cavities. The grit in snuff eats away at gums, exposing tooth roots which are sensitive to hot and cold temperatures and can be painful. Sugar in chewing tobacco causes decay. Chewing tobacco users also have a hard time getting their teeth clean. Oral-effects of chewing TobaccoMOUTH SORESThe most common sign of possible cancer in smokeless tobacco users is leukoplakia, a white scaly patch or lesion inside the mouth or lips, common among many chewing tobacco users. Red sores are also a warning sign of cancer. Often, signs of precancerous lesions are undetectable. Dentists can diagnose and treat such cases before the condition develops into oral cancer. If a white or red sore appears and doesn't heal, see your dentist immediately for a test to see if it's precancerous.Chewing tobacco users also should see their dentist every three months, to make sure a problem doesn't develop. Make the following goals to quit and never resume chewing: Pick a date and taper use as the date nears. Instead of using chewing tobacco, carry substitutes like gum, hard candy and sunflower seeds. Cut back on when and where you dip and chew. Let friends and family know that you're quitting and solicit their support. If they too chew, ask them not to do it around you. Make a list of three situations you're most likely to chew, and make every effort to avoid using tobacco at those times. Switch to a lower nicotine brand to help cut down your dose.DENTAL FACTS : WISDOM TEETHWHAT ARE WISDOM TEETH?Wisdom teeth, or third molars, are the last teeth to develop and appear in the mouth. They are called "wisdom teeth" because they usually appear during a person's late teens or early twenties, which has been called the "age of wisdom" The normal position of wisdom teeth is behind the upper and lower second, or 12-year molars. Many times the jaws are not large enough to accommodate the four wisdom teeth. This is why wisdom teeth cause more problems than any other teeth in the mouth. In fact, for nine out of ten people at least one wisdom tooth remains underneath the gum due to lack of space in the mouth.IMPACTED WISDOM TEETHWhen a wisdom tooth is blocked from erupting or coming into the mouth normally, it is termed "impacted". A tooth may be only partially impacted, meaning it grows in crooked and breaks through the gum only partially, or it may fail to break through at all and thus remains totally impacted. Serious problems can develop from partially impacted teeth, such as pain, infection, and crowding of, or damage to, adjacent t