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University of Dental Medicine, Yangon
Bulletin
SINCE 1964
Vol. 1, No.3
www.udmyangon-edu.com
AN EMERGING EPIDEMIC IN DENTISTRY:
CONTENTS
An emerging epidemic in
(DRY MOUTH)
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AN Thein
EMERGING EPIDEMIC IN DENTISTRY:
Zaw Moe
Dentistry: (Dry Mouth)
Orthodontic Reposition of
Traumatic Intruded Maxillary
Right Incisors and Canine
January, 2017
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(DRY MOUTH)
With the advent of the medicine and increase in the
elderly population, there are escalating numbers in patients
suffering from dry mouth. In a systematic review, the
prevalence of dry mouth ranged from 8% to 42%. Basically,
As knowledge is an unique powerful tool for
continuing medical education, the aim of
circulation of this bulletin is to share the
information to our colleagues what we are doing;
what we can do and what will be done in near future
for our profession. This bulletin is going to be
published every two months and The Editorial
Committee cordially invites academic
contributions about research activities and findings
in the field of dentistry.
this condition is a problem of older people; however, it was
Please address all your correspondence to:
subdivided into drugs, irradiation and graft versus host diseases.
Prof. Zaw Moe Thein
Professor/Head
Department of Oral Medicine
University of Dental Medicine, Yangon
Email: [email protected]
Phone: 0943134014
explored in daily basis with entire patient population, regardless
of age. Dry mouth is commonly found in smokers, people with
multiple medications, anyone with autoimmune disease, people
underwent for head and neck cancer therapy, mouth breathers
and old aged people.
Two main causes of dry mouth are iatrogenic and
diseases affecting on salivary glands. The former could be
The latter includes dehydration, psychogenic, Sjögren
syndrome, sarcoidosis, salivary gland aplasia and certain
systemic diseases for instance, Parkinson’s and diabetes.
For dentist, its diagnosis is based on clinical
presentations; however, investigations are indicated for proper
The Editorial Committee
Email: [email protected]
Phone: 01-571270, 01-570847, 01-571273
Fax: 01-571270, 01-571767
Address: No. 582, Than Thu Mar Road,
Thut Wine Gyi Ward, Thingangyun
Township, Yangon, Myanmar
management. Blood tests (ESR, SS-A and SS-B antibodies),
eye tests (eg. Schirmer’s test), urinalysis, salivary flow rate,
labial salivary gland biopsy, imaging including sialography,
scintiscanning, and ultrasound are generally essential based
on the history and clinical presentation of individual patient.
Management of dry mouth must be initiated with
Restricted for Internal Use Only
educating the patient to avoid factors that may increase dryness,
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and to keep the mouth moist. Any underlying cause of dry mouth should if possible be rectified; for instance,
drugs caused dry mouth may be changed for an alternative, and causes such as diabetes should be treated.
To keep the dry mouth moist, here are some useful tips. Drink enough water, and sip on water and other
non-sugary fluid throughout the day. Rinse the mouth with water after meals. Better keep the water at bedside.
Stimulate saliva with sugar-free chewing gum, or diabetic sweets. Eat soft creamy soups (eg. casseroles, soups)
or cold food with a high liquid content (eg. melon, grapes or ice cream) instead of dry or hard crunchy food.
Moisten food with gravies, sauces, extra oil, margarine, salad dressing, sour cream, mayonnaise and yogurt.
Avoid spices, alcohol (including in mouthwash), smoking, caffeine (coffee and some soft drinks such
as Colas) and drugs, unless they are essential (eg. Antidepressants).
Protect the lip with a lip slave or petroleum jelly (eg. Vaseline). Avoid hot dry environment (consider
humidifier for the bedroom).
References:
Joanna and Thomson (2015) SDJ 36: 12-17, Scully and Felix (2005) BDJ 199: 423-427
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ORTHODONTIC REPOSITION OF TRAUMATIC INTRUDED
MAXILLARY RIGHT INCISORS AND CANINE
a
Toe Pyi Aung, aAung Myat Shein and bHla Hla Yee
a
Demonstrator, and b Professor and Head, Department of Orthodontics ,University of Dental Medicine, Yangon
A 15 year-old male patient reported with
intruded maxillary right central incisor, lateral incisor
and canine due to accidental hitting with hand water
pump. Bruising on the lower lip was seen in extraoral
examination. The intraoral examination revealed
lacerated lower lip, gingival inflammation, bleeding
from gingival sulcus around these intruded teeth. 4 - 5
mm intrusion of maxillary right central incisor, 3 - 4
mm intrusion of lateral incisor and about 1 mm
intrusion of maxillary right canine were seen. There
were grade III mobility at central and lateral incisor
and grade II mobility at canine. There was no alveolar
bone fracture around intruded teeth. There was no
relevant medical and dental history.
The radiographic examinat ion showed
intrusion of maxillary right permanent central incisor;
lateral incisor and canine with complete root formation
were seen. The incisor edges of the intruded central
and lateral incisors were located at the half of the crown
of the adjacent teeth.
The patient had taken orthodontic treatment 3
days after injury.
Orthodontic treatment plan is orthodontic
reposition of the traumatic intruded teeth.
Bondable buccal tube and standard edgewise
bracket placement was done 3 days after injury and
0.012 inch niti upper arch-wire was used for initial
alignment and leveling. The vitality, discoloration and
mobility of traumatized intruded teeth were checked
at every appointment.
Vitality of these teeth was still vital and no
discoloration was seen after 1 month of orthodontic
treatment. But mobility of these teeth was still present.
2 mm extrusion of intruded teeth was seen one month
after initial alignment but spacing between two upper
central incisors was found about 2 mm. 0.012 inch
niti upper arch wire was changed with 0.014 inch niti
upper arch wire for better alignment. On the next
appointment, intruded teeth were repositioned to nearly
same level with contra lateral teeth and mobility was
reduced into grade II. Vitality and discoloration were
not changed. 0.014 inch niti upper arch wire was
changed with 0.016 inch niti upper arch wire.
In orthodontic clinical examination, skeletal
pattern is Class II with average facial height and
mandibular plane angle. The overjet is 4 mm.
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Final space closure was done by using power
At 4 month after injury, maxillary right canine
and lateral incisor were same level with adjacent teeth
and mobility was not seen. Central incisor had very
slight mobility and close to the level of contralateral
central incisor. There were no changes in vitality and
color of traumatic intruded teeth. Median diastema was
found between two central incisors.
chain.
All the bondable buccal tube and brackets
were removed after one year.
0.016 inch niti upper wire was changed with
0.016 X 0.022 stainless steel upper archwire. The
closure of median diastema was done by reducing the
overjet by using intrusion and retraction arch spring.
Possible complications
Traumatic intruded teeth may be nonvital , root
resorption and ankylosis. (Proffit ,2013)
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