Role of calcium in the body

Calcium is the fifth abundant element in the body which plays a vital role in skeletal structural units. The total calcium in the body is 100-170 gms, in which 99% present in the bones. The normal serum calcium levels are between 9-11 mg/dl. Values that are lower/higher than this will have its own consequences.

Factors that control the calcium homeostasis are parathyroid hormone, calcitonin by thyroid hormone, vitamin D and dietary intake of calcium and phosphate.

 Roles of calcium in the body  :

A large role in the formation of bones and teeth and maintance of skeletal structures :

The organic matrix of the bones and teeth are composed of calcium and phosphate in the larger amount. Hormonal imbalance like hypo/hyper secretion of thyroid,  parathyroid, corticosteroids, and sunlight exposure will have a major effects on bone density and skeletal structures.

For membrane permeability :

Apart from sodium and potassium, ionised form of calcium in the extracellular fluid also have a role in membrane permeability, thus helps in balancing the inner and outer fluid content of the cells.

For normal heart rhythm :

Calcium ions are essential for the contraction of heart muscles thus help in maintaining the proper rhythmicity of the heart beat. Low blood calcium levels will increase the risk of ventricular tachycardia ( too rapid contraction of the lower chamber of the heart).

For neuromuscular excitability and muscle contraction :

Calcium ions are required for the electrical signalling process to generate impulse for neuromuscular excitability and muscle contraction. Low serum calcium level can cause hyper irritability and tetany ( muscle spasm) with characteristic carpopedal spasm, while the high concentration can cause depressed nerve conductivity and muscle rigor.

For coagulation of blood :

Calcium is one of the factor in the blood coagulation (blood clotting) cascade. Low blood calcium level will cause reduction in blood clotting ability and increased internal hemorrhage.

As secondary and tertiary messenger in hormone action :

Calcium acts as a messenger for the hormones to act on their target organs and to elicit desirable function. Low level of calcium will impair the adequate target – action ability.

References :

Textbook of physiology by Guyton

Review of internal medicine by Harrisons

Textbook of oral pathology by Shafers.

 

 

Dry socket – Reason and treatment

After removal of tooth, blood clot formation is an essential element for the healing to take place. When the blood clot is dislodged from the socket, healing becomes extremely slow or nil and the condition is called as dry socket.

Reasons for dry socket :

  • Dislodgement of blood clot from the socket
  • Difficulty in tooth removal due to its anatomical hinderance
  • Person underwent radiotherapy recently
  • Use of oral contraceptives

signs and symptoms of dry socket :

  • It usually occur couple of days after tooth removal, sometimes may appear after five to ten days as well.
  • The tooth removed region becomes very painful with necrotic bone, foul smelling and without pus formation.
  • The pain may get radiate to neck and ear region
  • Some patients may encounter mild fever and lymph node enlargement

Treatment and instructions :

  • Do warm saline gargle and immediately report to the dental surgeon
  • Complete debridement with ample of irrigation and ZOE + iodoform dressing will be given
  • The dressing should be changed every day
  • Usually the pain will be subsided in a day or two after debridement and dressing process.

 

Reference:

Textbook of oral pathology by shafers

 

Dry mouth – cause and effect

Less amount of saliva secretion cause dry mouth. It is a clinical manifestation of salivary gland dysfunction. There are various factors that causes dry mouth.

Various causes for dry mouth : 

Radiation induced 

Radiation therapy to head and neck region for cancer treatment affects the salivary gland cells (dose dependent) causing dry mouth.

Medicine/ drug induced

Certain drugs that are taken for vomiting, allergy, blood pressure, muscle spasm and convulsions can cause decreased salivary flow because of reduced activity of para-sympathetic action.

Local factors

Like smoking, mouth breathing and decreased chewing can lead to dry mouth

Developmental abnormality

When abnormality of salivary gland occurred during the formation of fetus, or tumor or autoimmune states can cause dry mouth

Systemic alternations

Nutritional deficiency like anemia, vitamin A deficiency and hormonal imbalance can cause dry mouth.

Fluid loss associated with hemorrage, sweating, diarrhea, vomiting and dehydration, Diseases like diabetes, certain syndromes and graft versus host resistances can  cause dry mouth.

Signs and symptoms of dry mouth:

Increased thirst, increased uptake of fluids, frequent use of means like chewing gums and sour candy, difficulties in swallowing, speech and eating dry foods.

Burning and tingling sensation in the mouth, frequent oral infection, intolerance to dental appliance, abnormal taste in mouth, tongue may adhere to soft palate, painful salivary gland enlargement, increased incidence of dental caries. Saliva consistency becomes thick, foamy and ropey.

Suggestions to the people have dry mouth :

Try sweet and tart food and beverages like lemonade, they may help to produce more saliva

chewing of sugar free candy and ice cubes

Use soft and liquid foods, which may be easier to swallow

Hydrate well and drink frequently

Avoid chewing vitamin c and acidic lozenges, dry, sticky and salty foods.

Report to your physician for taking proper medical management.

 

References

Textbook of oral medicine by Anil Govindrao Ghom, 2nd edition

 

 

 

 

 

 

Instructions to be followed after tooth removal

There are certain instructions that should be followed after removal of tooth for better healing process. All these precautions are taken inorder to provide a healthy environment for the blood clot formation and enhance the healing of the tooth removed socket.

On the day of extraction ,

  • Bite the cotton firmly for about one hour
  • Avoid hot and spicy food for three days
  • Do not spit the saliva instead keep swallowing for a day.
  • Do not rinse the mouth heavily for a day
  • Do not use straw kind of stuffs for drinking liquid, just do sipping.
  • Avoid forceful sneeze and cough for three days
  • Keep ice pack on the cheek over the tooth removed region ( particularly during the extraction of wisdom tooth and on the other tooth region when the extraction of the tooth was in difficulty level )
  • Hydrate well
  • Take the medications properly as prescribed by your surgeon.
  • Avoid smoking and alcohol consumption for a week.
  • Do not bite and check the cheeks or lips for three hours after extraction because of numbness feel.
  • If any abnormal bleeding encountered or if mild bleed does not stop for 6 hours after extraction, immediately report to the hospital.

From the next day of extraction,

  • Rinse the mouth well for 4-5 times with warm saline water ( 2 ml of salt mixed with 250 ml of lukewarm water)
  • Brush and floss every day to remove plaque formation
  • Avoid brushing on the tooth removed region for three days or do gentle brushing
  • Gently start with mouth opening exercise after 48 hours of extraction
  • Do not stop antibiotics (if prescribed) in a day or two just because the symptoms are subsided , complete the full course as recommended by your surgeon.
  • If sutures are placed, report to the hospital and get it removed after a week of extraction
  • Maintain proper oral hygiene for asymptomatic healing
  • If any abnormal pain encountered after three days of extraction, it could be due to dry socket Dry socket – Reason and treatmentand report to the hospital.
  • If not able to open the mouth adequately or encountering pain while opening after 4-5 days of extraction , it could be due to trismus, indicating inadequate mouth opening exercises. Keep hot pack on the cheek on such condition for 4-5 times on regular interval and report to the hospital.

 

For the better future environment

On behalf of world’s environmental day, here i am coming up with a few ideas that we can apply it on in our day-to-day life, to give a positive impact on our environment.

Our little contribution can bring a huge change on the nature, that we are blessed to have with ever.

To save our future environment,

Avoid the use of plastics.

  • Rite from using straw to carry bag and storage box we do have alternatives. Those are actually an essential practice rather than being alternative.
  • Sipping the juice will provide better digestion rather than drinking with the straw.
  • Likewise storing food in the glass or metal box will have better shelf life.

 Conserve thermal energy.

  • Use compact fluorescent light bulbs.
  • Turn off your house device when you do not use it. 
  • Do remember to switch off the electricity while leaving the room.

Conserve water.

  • Judicious use of water is mandatory for future survival.
  • Simply close the tap when not in use, even if the missed out time is for a minute.
  • Reduce the water flow and get use to it.
  • Fix the leaky faucet.
  • Water your lawn in the early morning.
  • Wash a full load of laundry or adjust the water level to the size of your load.
  • Avoid contaminating the sources of water.
  • Conserve rain water.

Minimize air pollution.

  • For travelling shorter distance, prefer walking or bicycle rather than opting motor cycle. This also helps to keep you fit.
  • Do not overfill the fuel tank, that may cause leakage of hydrocarbons.
  • Do not burn your yard waste.

Plant a tree.

  • Develop the habit of planting a tree on a regular basis. May be on the weekly or monthly once !!!In this concrete jungle, Let that bring a fresh feel for sore eyes..

Do not waste food.

  • Do not make dishes until you have a full load and make only as how much required.

Proper use of waste bin.

  • Do not put hazardous materials in the trash.
  • Follow proper waste management protocol
  • Do not litter.

Donate clothes.

Donate clothes and other gently used household items to the charitable organization rather than throwing it away.