It consists of a metal and/or acrylic base mounted with porcelain or acrylic teeth.
The artificial teeth are matched to be similar to the original teeth.
Denture baseplates, created from impressions taken from the upper and lower gums, fit the mouth accurately.
Development of such mechanical and biomechanical devices points the way to a much wider use of e?ective prostheses, enabling people who would previously have died or been severely handicapped to lead normal or near normal lives. The technical hazards that have already been overcome provide a sound foundation for future successes. Progress so far in producing prostheses should also ensure that organ replacement is free from the serious ethical problems that surround the use of genetic manipulation to cure or prevent serious diseases (see ETHICS).
Limbs These are best made to meet the individual’s requirements but can be obtained ‘o? the shelf’. Arti?cial joints normally comprise complex mechanisms to stimulate ?exion and rotation movements. Leg prostheses are generally more useful than those for arms, because leg movements are easier to duplicate than those of the arm. Modern electronic circuitry that enables nerve impulses to be picked up and converted into appropriate movements is greatly improving the e?ectiveness of limb prostheses.
Eyes Arti?cial eyes are worn both for appearance and for psychological reasons. They are made of glass or plastic, and are thin shells of a boat-shape, representing the front half of the eye which has been removed. The stump which is left has still the eye-muscles in it, and so the arti?cial eye still has the power of moving with the other. A glass eye has to be replaced by a new one every year. Plastic eyes have the advantage of being more comfortable to wear, being more durable, and being unbreakable. Research is taking place aimed at creating a silicon chip that stimulates the visual cortex and thus helps to restore sight to the blind.
Dental prostheses is any arti?cial replacement of a tooth. There are three main types: a crown, a bridge and a denture. A crown is the replacement of the part of a tooth which sticks through the gum. It is ?xed to the remaining part of the tooth and may be made of metal, porcelain, plastic or a combination of these. A bridge is the replacement of two or three missing teeth and is usually ?xed in place. The replacement teeth are held in position by being joined to one or more crowns on the adjacent teeth. A denture is a removable prosthesis used to replace some or all the teeth. The teeth are made of plastic or porcelain and the base may be of plastic or metal. Removable teeth may be held more ?rmly by means of implants.
Heart The surgical replacement of stenosed or malfunctioning heart-valves with metal or plastic, human or pig valves has been routinely carried out for many years. So too has been the insertion into patients with abnormal heart rhythms of battery-driven arti?cial pacemakers (see CARDIAC PACEMAKER) to restore normal function. The replacement of a faulty heart with an arti?cial one is altogether more challenging. The ?rst working attempt to create an arti?cial heart took place in the early 1980s. Called the Jarvik-7, it had serious drawbacks: patients had to be permanently connected to apparatus the size of an anaesthetic trolley; and it caused deaths from infection and clotting of the blood. As a result, arti?cial hearts have been used primarily as bridging devices to keep patients alive until a suitable donor heart for transplantation can be found. Recent work in North America, however, is developing arti?cial hearts made of titanium and dacron. One type is planted into the chest cavity next to the patient’s own heart to assist it in its vital function of pumping blood around the body. Another replaces the heart completely. Eventually, it is probable that arti?cial hearts will replace heart transplants as the treatment of choice in patients with serious heart disorders.
Liver Arti?cial livers work in a similar way to kidney dialysis machines (see DIALYSIS). Blood is removed from the body and passed through a machine where it is cleaned and treated and then returned to the patient. The core of the device comprises several thousand ?exible membrane tubules on which live liver cells (from pigs or people) have been cultured. There is an exchange of biological molecules and water with the ‘circulating’ blood, and the membrane also screens the ‘foreign’ cells from the patient’s immune system, thus preventing any antagonistic immune reaction in the recipient.
Nose The making of a new nose is the oldest known operation in plastic surgery, Hindu records of such operations dating back to 1,000 BC. Loss of a nose may be due to eroding disease, war wounds, gun-shot wounds or dog bites. In essence the operation is the same as that practised a thousand years before Christ: namely the use of a skin graft, brought down from the forehead. Alternative sources of the skin graft today are skin from the arm, chest or abdomen. As a means of support, the new nose is built round a graft of bone or of cartilage from the ear.... prosthesis
Causes: smoking, alcohol, friction of dentures, habitual diet of hot curries and spices; genetic.
Topical. No known cure. Goldenseal and Myrrh have their advocates. Fresh juice of Houseleek and Aloe Vera are old traditional remedies. Blueberries. (Ellingwood)
It is known that Vitamin A protects against oral cancer, from which it is believed that it might have an effect upon leukoplakia which is common among tobacco chewers in India and the Philippines. ... leukoplakia
Over the past four decades the ?nancial outlay on NHS dental services has been around 5 per cent of total NHS funding. This contrasts with 10 per cent during the service’s early years, when the NHS was coping with decades of ‘dental neglect’. The population’s dental health has, however, been steadily improving: in 1968 more than one-third of people had no natural teeth; by the late 1990s the proportion had fallen to 13 per cent.
Dentistry is divided into several groupings.
General dental practitioners Concerned with primary dental care, the prevention, diagnosis and treatment of diseases of the gums and teeth – for example, caries (see TEETH, DISORDERS OF). They also deal with diffculties in biting and the effects of trauma, and are aware that oral disorders may re?ect disease elsewhere in the body. They will refer to the hospital dental services, patients who require treatment that cannot be satisfactorily carried out in a primary-care setting.
Most routine dental prevention and treatment is carried out in general dental practitioners’ surgeries, where the dentists also supervise the work of hygienists and dental auxiliaries. Appliances, such as dentures, crowns, bridges and orthodontic appliances are constructed by dental technicians working in dental laboratories.
There are around 18,800 dentists providing general dental services in the UK. These practitioners are free to accept or reject any potential patient and to practise where they wish. Those dentists treating patients under an NHS contract (a mixture of capitation fees and items of service payments) can also treat patients privately (for an appropriate fee). Some dentists opt for full-time private practice, and their numbers are increasing in the wake of changes in 1990 in the contracts of NHS general dental practitioners.
Community dental practitioner Part of the public-health team and largely concerned with monitoring dental health and treating the young and the handicapped.
In the hospitals and dental schools are those who are involved in only one of the specialities.
Around 2,800 dentists work in NHS hospitals and 1,900 in the NHS’s community services. In some parts of the UK, people wanting NHS treatment are having diffculties ?nding dentists willing to provide such care.
Restorative dentist Concerned with the repair of teeth damaged by trauma and caries, and the replacement of missing teeth.
Orthodontist Correction of jaws and teeth which are misaligned or irregular. This is done with appliances which may be removable or ?xed to the teeth which are then moved with springs or elastics.... dental surgeon
The condition is irreversible thus no cure is possible. However, pituitary gland normalisers can assist and possibly avert decline.
Alternatives. Tea: Combine equal parts: Gotu Kola, Yarrow, Horsetail. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup once or more daily.
Tablets/capsules. Bladderwrack, Borage, Kelp, Liquorice, Ginseng, Wild Yam, Damiana, Helonias. Formula. Combine: Sarsaparilla 1; Ginseng 1; Fringe Tree half; Thuja quarter. Dose: Powders, quarter of a teaspoon. Liquid extracts: 30-60 drops. Tinctures: 1-2 teaspoons. In water, morning and evening. ... acromegaly
It may be due to absence of tooth buds at birth or the result of damage to developing tooth buds by infection or other widespread disease.
If only a few teeth are missing, a bridge can fill the gap; if all the teeth are missing, a denture is needed.... anodontia
Thrush is characterised by the presence of white patches on the mucous membrane which bleeds if the patch is gently removed. It is caused by the growth of a parasitic mould known as Candida albicans. Antifungal agents usually suppress the growth of candida. Candidal in?ltration of the mucosa is often found in cancerous lesions.
Leukoplakia literally means a white patch. In the mouth it is often due to an area of thickened cells from the horny layer of the epithelium. It appears as a white patch of varying density and is often grooved by dense ?ssures. There are many causes, most of them of minor importance. It may be associated with smoking, SYPHILIS, chronic SEPSIS or trauma from a sharp tooth. Cancer must be excluded.
Stomatitis (in?ammation of the mouth) arises from the same causes as in?ammation elsewhere, but among the main causes are the cutting of teeth in children, sharp or broken teeth, excess alcohol, tobacco smoking and general ill-health. The mucous membrane becomes red, swollen and tender and ulcers may appear. Treatment consists mainly of preventing secondary infection supervening before the stomatitis has resolved. Antiseptic mouthwashes are usually su?cient.
Gingivitis (see TEETH, DISEASES OF) is in?ammation of the gum where it touches the tooth. It is caused by poor oral hygiene and is often associated with the production of calculus or tartar on the teeth. If it is neglected it will proceed to periodontal disease.
Ulcers of the mouth These are usually small and arise from a variety of causes. Aphthous ulcers are the most common; they last about ten days and usually heal without scarring. They may be associated with STRESS or DYSPEPSIA. There is no ideal treatment.
Herpetic ulcers (see HERPES SIMPLEX) are similar but usually there are many ulcers and the patient appears feverish and unwell. This condition is more common in children.
Calculus (a) Salivary: a calculus (stone) may develop in one of the major salivary-gland ducts. This may result in a blockage which will cause the gland to swell and be painful. It usually swells before a meal and then slowly subsides. The stone may be passed but often has to be removed in a minor operation. If the gland behind the calculus becomes infected, then an ABSCESS forms and, if this persists, the removal of the gland may be indicated. (b) Dental, also called TARTAR: this is a calci?ed material which adheres to the teeth; it often starts as the soft debris found on teeth which have not been well cleaned and is called plaque. If not removed, it will gradually destroy the periodontal membrane and result in the loss of the tooth. (See TEETH, DISORDERS OF.)
Ranula This is a cyst-like swelling found in the ?oor of the mouth. It is often caused by mild trauma to the salivary glands with the result that saliva collects in the cyst instead of discharging into the mouth. Surgery may be required.
Mumps is an acute infective disorder of the major salivary glands. It causes painful enlargement of the glands which lasts for about two weeks. (See also main entry for MUMPS.)
Tumours may occur in all parts of the mouth, and may be BENIGN or MALIGNANT. Benign tumours are common and may follow mild trauma or be an exaggerated response to irritation. Polyps are found in the cheeks and on the tongue and become a nuisance as they may be bitten frequently. They are easily excised.
A MUCOCOELE is found mainly in the lower lip.
An exostosis or bone outgrowth is often found in the mid line of the palate and on the inside of the mandible (bone of the lower jaw). This only requires removal if it becomes unduly large or pointed and easily ulcerated.
Malignant tumours within the mouth are often large before they are noticed, whereas those on the lips are usually seen early and are more easily treated. The cancer may arise from any of the tissues found in the mouth including epithelium, bone, salivary tissue and tooth-forming tissue remnants. Oral cancers represent about 5 per cent of all reported malignancies, and in England and Wales around 3,300 people are diagnosed annually as having cancer of the mouth and PHARYNX.
Cancer of the mouth is less common below the age of 40 years and is more common in men. It is often associated with chronic irritation from a broken tooth or ill-?tting denture. It is also more common in those who smoke and those who chew betel leaves. Leukoplakia (see above) may be a precursor of cancer. Spread of the cancer is by way of the lymph nodes in the neck. Early treatment by surgery, radiotherapy or chemotherapy will often be e?ective, except for the posterior of the tongue where the prognosis is very poor. Although surgery may be extensive and potentially mutilating, recent advances in repairing defects and grafting tissues from elsewhere have made treatment more acceptable to the patient.... mouth, diseases of
Dribbling of saliva is normal in infants.
In adults, it may be due to poorly fitting dentures or may be the result of facial paralysis, dementia, or another disorder of the nervous system, most commonly Parkinson’s disease.
Dribbling of saliva may also be caused by obstruction to swallowing.... dribbling
Glossitis occurs in various forms of anaemia and in vitamin B deficiency.
Other causes include infection of the mouth (especially by herpes simplex), irritation by dentures, and excessive use of alcohol, tobacco, or spices.
Treatment is for the underlying cause.
Rinsing of the mouth with a salt solution and good oral hygiene may help.... glossitis
Causes include gingivitis, persistent breathing through the mouth, the anticonvulsant drug phenytoin, and ill-fitting dentures.
Surgical treatment may be needed.... hyperplasia, gingival
A quick-setting material, such as alginate, is placed in a mould over the teeth.
The mould is removed, and plaster of Paris is poured into it to obtain a model of the area.
This model is then used as a base on which to build a denture, bridge, or dental inlay.
Dental impressions are also used in orthodontics to study the position of the teeth and to make orthodontic appliances to correct irregularities.... impression, dental
Professional treatment to remove calculus and stubborn plaque by scaling and polishing is usually carried out by a dentist or dental hygienist during a routine check-up.
In periodontal disease, treatment may be needed more often.... oral hygiene
protease inhibitors A type of antiviral drug used to delay the progression of HIV infection (see AIDS).... prosthetics, dental
Action. Bactericidal against staphylococcus aureus, streptococcus viridans and five strains of streptococcus mutans – the cause of dental plaque. Antibiotic, Demulcent, Coagulant, Analgesic for mild degree pain. Antiviral.
Astringent, Vitamin B12 precursor, growth stimulator, vulnerary. Contains 18 amino acids and vitamins. Helps eliminate toxic minerals from the body. Neutralises free radicals created by toxic substances.
Uses: An important use: protection against radiation burns. Sunburn. A segment of the fresh leaf rubbed on the skin was a centuries-old sun-screen used by desert Arabs against sunburn, and who regarded the plant as a natural medicine chest. Internal: indigestion, stomach ulceration.
External. Ulceration (leg ulcer, etc.), acne, chapped skin, nappy rash. To allay the itching of dry skin conditions including shingles, eczema, poison ivy and other plant allergies, detergent dermatitis, ulcers on cornea of eye, purulent ophthalmia. Dry scalp, poor hair (shampoo), ringworm. Stretch marks of pregnancy, age lines and liver spots.
Dentistry. “In 12 years of dental practice I have not found any one item which is so versatile for the healing needs of the mouth . . . an ancient plant for modern dentistry”. (Dr B. Wolfe, “Health Consciousness”, Vol 6. No 1) Increasing use as a dental anaesthetic, and for oral infections. Uses include gel on new dentures, rinsing every 4 hours. In canal filling the gel is used as a lubricant.
Combines with Vitamin E for allergies; with Eucalyptus oil for sinus and nasal congestion; with Comfrey for healing of fractures. Combines with Jojoba oil as an invigorating body lotion. Combines with Chamomile or Henna for hair conditioner.
Preparations: Part of fresh leaf cut and thick sap-juice squeezed on affected area for sunburn, burns, injury, wounds. Pulp leaves for use as a poultice for inflamed joints, arthritis. (East Africa). Tablets: Combined with papaya, pineapple, apricot or acerola fruits.
Tincture: 4oz pulped leaf to 8oz Vodka. Shake bottle daily for one week. Filter. Dosage: 1 teaspoon in water, thrice daily, for internal conditions.
Aloe gel. Many preparations on the market contain pure Aloe Vera, cold-pressed to preserve its moisturising and healing properties. Most are free from artificial fragrance and colour being made without lanolin or mineral oil.
Undiluted juice. 1-2 tablespoons (20-40ml) on empty stomach. (Internal) Pregnancy. Not used during. ... aloe vera
Causes include: dental problems, ill-fitting dentures, laughing, yawning, bad teeth.
Symptoms: nervous exhaustion, contracted pupils, flushed face.
Alternatives. Black Cohosh, Cactus, Celery seed, Bogbean, Chamomile, Lady’s Slipper, Ginseng, Hops, Jamaica Dogwood, White Willow, Wild Lettuce, Skullcap, St John’s Wort, Valerian.
Tea. Combine equal parts: Chamomile, Hops, Skullcap. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup freely.
Decoction. Combine: Rosemary 2; Ladyslipper 1; Jamaica Dogwood 1.1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup every 2-3 hours.
Tablets. Passion flower. Ginseng. St John’s Wort, White Willow.
Formula. Equal parts: Jamaica Dogwood, Wild Lettuce, Valerian. Dose: Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Cayenne pepper (Capsicum). Frequently successful.
Practitioner. Tincture Gelsemium BPC (1973). Dose: 0.3ml (5 drops).
Topical. Poultice: Chamomile, Hops, Linseed or Bran. Acute cases (cold), chronic cases (hot). Grated or bruised Horseradish root. Evening Primrose oil. Hot cider vinegar. Tincture Arnica or Hypericum. Aromatherapy. 2 drops each: Juniper, Lavender, Chamomile to 2 teaspoons vegetable oil. Light massage. Diet, and supplements. Same as for general neuralgia. Australian researchers found that hot curries and spices actually trigger the trigeminal nerve causing a burning sensation. ... neuralgia, facial
Predisposing causes of mouth cancer are poor oral hygiene, drinking alcoholic spirits, tobacco-smoking, chewing tobacco, and inhaling snuff. Irritation from ill-fitting dentures or jagged teeth are other factors. Men are affected twice as often as women; most cases occur in men over the age of 40.
Mouth cancer usually begins with a whitish patch, called leukoplakia, or a small lump. These may cause a burning sensation, but are usually painless. As the tumour grows, it may develop into an ulcer or a deep fissure, which may bleed and erode surrounding tissue.
Diagnosis is based on a biopsy. Treatment consists of surgery, radiotherapy, or both. Extensive surgery may cause facial disfigurement and problems with eating and speaking, which may require reconstructive surgery. Radiotherapy sometimes damages the salivary glands (see mouth, dry).
When mouth cancer is detected and treated early, the outlook is good.... mouth cancer
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