Dental Stories


Blog posts : "dental implants"

why dental implants can be your best options

Have you lost a tooth or multiple teeth through an accident or an oral disease? Do your missing teeth make it
uncomfortable for you to laugh in public? Has your missing tooth impacted your speech and…

Read more

root canal cost in singapore of indian minister

Every tooth in a man's head is more valuable than a diamond. ~Miguel de Cervantes, Don Quixote, 1604.
a news is viral these days about remursement of root canal treatment of an AP minister of rs 2.9 …

Read more

free dental implant treatment in lucknow

free dental implant placement at our clinic.

free implant surgery

free dental implant at rama dental clinic and implant centre lucknow
As our responsibility towards society we placed free dental implant to an u…

Read more

3 Blog Posts

Dental Blog

Covid 19 and Ibuprofen

Over the previous couple of days, social media has lit up with reports, picked up by means of some media stores, that taking pills like ibuprofen to ease COVID-19 signs and symptoms could actually worsen the development of the infection.particularly because of mix statements over increased mortality rate in italy and france

but most infectious disease experts say there may be no proper medical evidence at this factor to help that claim.

The furor turned into sparked by means of a tweet via the French fitness minister, Olivier Véran, over the weekend. He warned humans not to take non-steroidal antiinflammatoy drug tablets, or NSAIDS — a category of pain relievers and fever reducers that includes ibuprofen — because some French COVID-19 patients had experienced serious side effects. The warning become additionally covered in a bulletin from the French health ministry, which cautioned that patients have to alternatively use acetaminophen, the prevalent call for Tylenol.
The questions about ibuprofen's safety for COVID-19 sufferers appear to have stemmed, in component, from a letter posted in the Lancet ultimate week hypothesizing the ways various medications could, perhaps, boom the hazard of infection with the coronavirus. research has proven that the virus attaches itself to cells within the lungs by using way of an enzyme — angiotensin-changing enzyme 2 (ACE2). The Lancet statement advised that taking ibuprofen may growth the quantity of ACE2 receptors on a cellular, that could make a person taking the drug greater vulnerable to contamination.

but just because you have got more ACE2 receptors would not mean you're greater at risk of contamination, says Rachel Graham, a virologist at the college of North Carolina Gillings college of worldwide Public health. She's one of the researchers who located how the coronavirus binds to cells.
Tylenol is the go-to medicinal drug for patients who are unwell enough to be hospitalized for any contamination. it's due to the fact these patients are at better risk of harm to internal organs, along with kidneys. And kidney damage can be a facet impact of ibuprofen for some sufferers who use it long-time period in higher doses.But in mild and safer dossage ibuprofen is good pain reliever.

Of course Tylenol, like several medicine, is not danger-free either; Rogers notes it is able to reason critical liver harm in excessive any other drug if precautions are not taken ,it too can backfire.till now we have no concrete evidence that ibuprofen and covid 19 patient mortality has direct connections,but it is best advised to take any medication under your doctor's guidence and prescription.


blog post

रमा डेंटल क्लिनिक महानगर मे एक महिला मरीज़ जिनका सामने का दांत सालों पहले टूट गया था उनका डेंटल इम्प्लांट लगा कर एक घंटे में दांत लगा दिया गया.महिला मरीज़ जिनका सामने का दांत सालों पहले टूट गया था कई हॉस्पिटल्स एवम डेंटल कॉलेजेस में संपर्क किया  लेकिन उन्हें बोन ग्राफ्टिंग एवम ६ महीने के इंतज़ार की सलाह दी गयी.रमा डेंटल क्लिनिक एंड इम्प्लांट सेंटर लखनऊ में डॉक्टर ामय त्रिपाठी ने १ घंटे के अंदर डेंटल इम्प्लांट कर  उसपर दांत लगा दिया.उन्होंने बताया की बोन रिज एक्सपेंशन एंड इमीडियेट लोडिंग तकनीक से यह संभव हुआ .मरीज़ को १ साल बाद दोबारा चेकउप के लिए बुलाया गया.तथा चेकउप में दांत एवम इम्प्लांट बहोत अच्छी अवस्था में काम करता पाया गया. इसका पूरा वीडियो यूट्यूब पर " टीथ इन  an  ऑवर H Q " के नाम से देखा जा सकता हैं.
डेंटल इम्प्लान्ट्स  के द्वारा खोये हुए दाँतो को वापस पाने के विश्वसनीय विकल्प हैं.पूर्व के निकले  हुए दाँतो या हिलते हुए दाँतो को तुरंत निकल कर तुरंत इम्प्लांट डाल दिया जाता हैं.अलग से कोई सर्जरी नहीं होती हैं.३ महीने के औसत समय के लिए छोड़ दिया जाता हैं तथा उसके बाद दांत फिक्स कर दिया जाता है.टाइटेनियम जैसे नोबेल मेटल से बने होने के कारण ये कोई रिएक्शन नहीं करता मुख मे.एक बार ओस्सेोइंटेग्रेटे कर जाए तो इम्प्लांट सारी ज़िन्दगी साथ निभा सकता हैं.कुछ केसेस मे तो ३ महीने रुकने की ज़रुरत भी नहीं होती और ७२ घंटो के अंदर दांत लगा दिया जाता हैं..बहोत लोगों के सारे दांत निकल गए होते हैं और उनको निकलने लगाने वाले denture  का उपयोग करना पड़ता हैं.उनके लिए भी डेंचर्स को इम्प्लांट के द्वारा फिक्स किया जा सकता. उनको उसे निकलने की जरुरत नहीं पड़ेगी .जिनका नीचे का डेंचर्स ढीला हो गया है हड्डी काम हो जाने के कारण उसे भी इम्प्लांट सपोर्टेड या फिक्स किया जा सकता हैं.. 
अधिक जानकारी के लिए मिले
रमा डेंटल क्लिनिक एंड इम्प्लांट सेंटर 
५४४/५२८ महानगर गोल मार्किट चौराहा,


Brushing in night is more important than brushing in morning

Brushing in night is more important than brushing in morning
 Brushing in night is more important than brushing in morning” this information was given by Dr Amay Tripathi at Dental health checkup camp organized by Rama dental clinic & Implant Centre Mahanagar at Fun N Learn school Hazratganj on 23rd November 2019.” during night time when proper brushing is not done before sleeping, bacterial activity is very high and food debris can accentuate their activity thus causing tooth decay and gum damage. Brushing should be done twice, first in the morning and secondly in night after meals. Brushing your teeth before you go to sleep at night helps protect against plaque buildup, tooth decay, and gum disease. If you are particularly susceptible to cavities and gum disease, dentists recommend that you brush immediately after dinner, then again right before bedtime”
He also added “Night time is also an important period of rest and recovery for your teeth when they will remineralize from the wear and tear of the day.  Disrupting this natural cycle with food is not good for your teeth. Nursing bottle caries, or tooth decay in children in a very young age of even 1 to 2 years, can be caused by children sleeping with bottles. This is also called baby bottle tooth decay. It is caused when a child goes to bed with a bottle filled with milk or juice - anything except water. Breastfed infants who fall asleep while breast feeding are also at risk. So it’s the lack of brushing or cleaning the teeth at night that causes early caries in children.”
around 150 students in age group 4 to 13 yrs. were checked up and advised. Students and their parents were also educated about how to maintain oral and dental hygiene through models and examples. Free distribution of toothpaste was also done. This was a huge initiative for children welfare, taken by chairman of the school Dr R DAYAL, Principal Samina Anis ma’am and Mr. Abdullah khan. Dr Amay Tripathi gave a detailed lecture to parents about how dental disease and abnormalities can be avoided or spotted early and timely treated. Proper brushing and oral hygiene instructions were given. “children learning good oral hygiene technique will maintain their teeth lifelong” he added. Under guidance of Principal Samina Anis ma’am, whole staff conducted in smooth conduction of the camp as there was more than 150students with their parents. Emoform and Colgate toothpaste were distributed.




Dengue (pronounced DENgee) fever is a painful, debilitating mosquito-borne disease caused by any one of four closely related dengue viruses. Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. This may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Recovery generally takes two to seven days. In a small proportion of cases, the disease develops into severe dengue, also known as dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.
Dengue viruses are spread to people through the bite of an infected Aedes species (Ae. aegypti or Ae. albopictus) mosquito. These mosquitoes also spread Zika, chikungunya, and other viruses.
Dengue is common in more than 100 countries around the world.
Forty percent of the world’s population, about 3 billion people, live in areas with a risk of dengue. Dengue is often a leading cause of illness in areas with risk.
Each year, up to 400 million people get infected with dengue. Approximately 100 million people get sick from infection, and 22,000 die from severe dengue.
Dengue is caused by one of any of four related viruses: Dengue virus 1, 2, 3, and 4.  For this reason, a person can be infected with a dengue virus as many as four times in his or her lifetime.
Preventing Dengue Fever
The best way to prevent the disease is to prevent bites by infected mosquitoes, particularly if you are living in or traveling to a tropical area. This involves protecting yourself and making efforts to keep the mosquito population down. In 2019, the FDA approved a vaccine called Dengvaxia to help prevent the disease from occurring in adolescents aged 9 to 16 who have already been infected by dengue. But, there currently is no vaccine to prevent the general population from contracting it.
Prevent spread of dengue inside your house
Mosquitoes that bite the affected family member can go on to bite and
infect others.
• Allow the sick child or family member to rest and sleep under a
bed net or use insect repellant while feverish.
• Kill all mosquitoes in the house and empty containers that carry
water on patios.
• Place screens on windows and doors to prevent mosquitoes from
entering the house.
Symptoms of Dengue Fever
Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include
Sudden, high fever
Severe headaches
Pain behind the eyes
Severe joint and muscle pain
Skin rash, which appears two to five days after the onset of fever
Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)
Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults. However, serious problems can develop. These include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure of the circulatory system. The symptoms may progress to massive bleeding, shock, and death. This is called dengue shock syndrome (DSS)
Diagnosing Dengue Fever
Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If you become sick after traveling to a tropical area, let your doctor know. This will allow your doctor to evaluate the possibility that your symptoms were caused by a dengue infection. Differential diagnosis is made by your physician for similar disease like chikungunya etc. 
Treatment for Dengue Fever
There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications. Apart from attempts to control the spread of the Aedes mosquito there are ongoing efforts to develop antiviral drugs that would be used to treat attacks of dengue fever and prevent severe complications.
Bed rest
• Let your sick child or family member rest as much as possible. Control high fever
• Do not give ibuprofen (Motrin, Advil), aspirin, or aspirin containing drugs.
• Sponge the patient’s skin with cool water if fever remains high.
• Give acetaminophen or paracetamol (Tylenol) every 6 hours if needed for high fever (maximum 4 doses per day).
Prevent dehydration
Give plenty of fluids, and watch for signs of dehydration, which occurs when a person loses too much body fluid from fever, vomiting, or if he or she does not drink enough fluids. 
For children and infants, bring your child or sick family member to a clinic or emergency room if any of the following signs appear:
Decrease in urination (check number of wet diapers or trips to bathroom
Few or no tears on crying
Dry mouth, tongue, or lips and toes
Cold or clammy fingers
Listless, overly agitated or confused
Rapid heartbeat (more than 100 per minute)
Sunken or soft spot on (fontanel) in an infant head

How To Choose The Best Dentist Lucknow For Yoursel

Prevention is considered as the best treatment for all dental problems. The prevention and maintenance regimen includes a couple of checkups on an annual basis that includes professional cleaning and evaluating one's teeth and gum condition.


Choosing the best dentist lucknow service provider is very essential. Every single day you will find brand new methods becoming launched with regard to improving associated with dentist care cleanliness together with all around health of the person's the teeth. It's resulted in the necessity of the much more specific dentist care professional, that may carry out each one of these methods successfully. When you begin trying to find the dentist professional, it is very required that you simply choose the ideal dental care company.


This might not necessarily end up being simple as much dental practitioners tend to be promoted every day, nevertheless via looking with the internet as well as talking to family and friends you'll find an ideal dentist professional for that work. Keep in mind absolutely no 2 dentist practitioners would be the exact same. Considering the dentist's significance so far as dental care cleanliness as well as wellness can be involved, it is very essential that you choose a specialist as well as experienced dental professional who's recognized with regard to their efficient providers, has experience as well as competent.


So far as strategies for finding the lucknow best dentist can be involved, listed here are a few needs that needs to be adopted to find the ideal dental care company.


Checklist just about all dentist practitioners existing in your town as well as ask regarding what kinds of dental care providers they offer. A few dental practitioners provide aesthetic providers as well as other providers while a few dental practitioners don't. Verify if the particular dental professional you want to select provides the providers you're looking for.


Understanding on which your own insurance coverage handles assists whenever selecting a dental professional, because your own chosen dental professional ought to a minimum of supply those providers which are protected inside your dental care strategy or even insurance coverage.


Following choosing that support you're looking for, ask about the medical encounters from the dental professional and when the actual dental professional retains any kind of unique learning any kind of unique region.


Ask regarding regardless of whether any kind of crisis support is actually supplied just in case an abrupt dental care turmoil occurs. Additionally ask upon regardless of whether this particular support is actually supplied within away several hours.


Discover in which the workplaces of the chosen dentist professional can be found all around the region. You ought to have a good workplace near to your dwelling in the event you need to go to instantly or even in the center of the night time, or even within an crisis. Additionally, in the event you need regular appointments for your dental professional, getting a good workplace close to your home is definitely advantageous.


Additionally, go to the workplace of the chosen dentist professional as well as check up on the entire situation from the workplace as well as individual cleanliness from the dental professional as well as their assistants together with workplace staff as well.


All these issues are very important in selecting the best dentist in lucknow, as your teeth and gums are dependent on you in taking the right decision.


How to clean food between your teeth

Everyone is fedup from cleaning food that is stuck between your teeth.particularly if you are eating fibrous food, fruits or non veg then you are more prone for this.

the teeth-gum juntion is also another place whichis hard to clean.and often periodontitis starts from here.we reommend three ways to clean your nterdental/gums region

1) dental floss

2)interdental brush

3) water floss (easiest)

dental floss- threads have been used from ages to clean inter teeth waxed thread which are sturdy and dont injure your gums are designed and known as 

dental floss.

few good flosses available in market are of colgate , oral b.

interdental brsuh- small brush used for cleaning interdental spaces.prominent in market are colgate, stim

use mouthwash to clean afterusing floss.

Inter-dental brush- specifically designed for the ares between your teeth where normal brush cant have to put the brush in wedging motion between your teeth very lighly.birstle will gently go between the interdental groove thereby taking out any food debris inside.

Water floss

these are most effective devices to clean your interdental spaces.

The water flosser are also known as water floss and are tools for cleaning the teeth. In addition to the teeth and teeth in the mouth, there are deep wrinkles and gingival sulcus in the mouth, especially the gingival sulcus.

At the junction of the teeth and the gums, there is a ditch about 2 mm deep called the gingival sulcus, which is an important passage to the root of the tooth and the most vulnerable to dirt, but it is not easy to be The clean area, that is to say it is often one of the main culprits in our oral diseases.

According to the research, as many as 40% of the oral cavity cannot be cleaned with toothbrushes and dental floss. According to research by related agencies in the United States, the use of water flow impact is the most ideal oral cleaning method. The pressure water column of the red teeth can be washed deep into the gingival sulcus. With a depth of 50-90%, it can thoroughly clean the gaps of the teeth as well as the uneven surface.

water pik

The water flosser device pressurizes the water through the pump body to generate a high-frequency pulse water column, and the water column impacts the teeth or the gingival sulcus through the nozzle to achieve a clean effect. The impact of water flow is also divided into different technologies. Sometimes the difference in technology gives us different cleaning effects and feelings of use.

the best ones to buy are  dr trust 

why dental implants can be your best options

Have you lost a tooth or multiple teeth through an accident or an oral disease? Do your missing teeth make it
uncomfortable for you to laugh in public? Has your missing tooth impacted your speech and how you chew?
While there are several solutions to the problem, dental implant is your best option for several reasons. It is
the process of implanting metal frames or posts in the jawbone to allow for the mounting of replacement
teeth onto them. 

How does dental implant work?

A metal frame is drilled into your jawbone before a tooth or some teeth are mounted on it. This fastens the teeth to your jawbone. That way, they won’t shift or slip in your mouth. The best part is that dental implants feel natural. Dental implants have the following benefits.

best dentist in lucknow

Benefits of a dental implant
• It is very convenient as it does not require any adhesive and you don’t have to remove it often.
• It is very durable. It can last a lifetime but dentists often put a 25-year guarantee on it.
• It does not require the removal of any other tooth as does a tooth-supported bridge.
• It will give you a great smile and restore your self-esteem and self-confidence.
• Since dental implant functions like your natural teeth, it can easily correct any chewing difficulty that you
may have suffered.
• It is very comfortable.
• The surgical procedure can also improve your speech if your missing teeth have affected it already

However, you can only get all the benefits listed above if your dental implant is carried out by a highly experienced dentist. In other words, it is important to get your dental implant done in a highly reputable dental clinic. Rama Dental Clinic & Implant Centre is the best clinic in Lucknow. It is owned by Dr. Amay Tripathi, the best dentist in Mahanagar. In fact, he is the best dentist in Lucknow and he has been carrying out dental implants for so many years. 

While Rama Dental Clinic is not the only clinic where you can fix your teeth, it is head and shoulders above
others in many ways. Here are a few reasons to consult Dr. Tripathi for your dental implant.


Availability of state-of-the-art equipment
The clinic offers the latest technology-driven equipment to make oral surgery effective, fast, and painless.
By virtue of their top-notch equipment, the clinic can offer advanced diagnostics and treatment of many
dental or oral diseases or anomalies. 

Dr. Tripathi is a highly experienced dentist that has been providing dental services to patients from all over
the world. So, when you choose his clinic, you’ll get experience, premium dental services, and peace of
mind. He is not only a dentist; he is also a mentor and coach to other dentists.

Dr. Tripathi is a highly experienced dentist that has been providing dental services to patients from all over
the world. So, when you choose his clinic, you’ll get experience, premium dental services, and peace of
mind. He is not only a dentist; he is also a mentor and coach to other dentists.

Apart from dental implant, the clinic also provides many other dental treatments. More importantly, the
environment in the clinic is comfortable and hygienic. 

Free consultation
New patients get free consultations. It is needless to remind you that having consultation with a dentist of
Dr. Tripathi’s caliber is priceless.
For more information about the dental services in Rama Dental Clinic, you can visit or contact them to book an appointment. 

dental implants trends

A dental implant is a substitute tooth root that serves the same function as a natural tooth root. It preserves bone and provides a stable foundation for a replacement tooth that look, feel and function like a natural tooth. Dental implants are made of titanium, which is a biocompatible material used in orthopedic implants.

Dental implants can last a lifetime, unlike bridges, partials and dentures that may need to be replaced several times. Since dental implants prevent the bone resorption that occurs when teeth are missing, the natural appearance of the smile is preserved. With implant treatment, there is no compromise to adjacent teeth; they are not cut down to place a bridge, or loosened by the hooks on removable partials. Dentures and partials have the added disadvantage of accelerating the bone resorption process, which causes the appearance of premature aging.

Your new replacement teeth will look, feel and function like natural teeth. And since implant treatment is the only solution that prevents bone resorption, which can cause your smile to look unnatural, the long term esthetics will be superior to any other treatment option.

Nearly everyone who is missing one or more teeth and in general good health is a candidate for dental implant treatment. There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes. However, there are very few conditions that would keep someone from having implant treatment altogether. Quality and quantity of available bone for implant placement is more often a factor in qualifying for dental implants than medical conditions. However, even people who have lost a significant amount of bone can qualify for dental implant treatment with additional procedures to add bone or create new bone. Advances in this type of treatment have made it possible for most people who would not previously have been considered candidates to have successful implant treatment.

Overall health and a desire to improve the quality of life are much more important considerations than age. When dental implants were first developed, back in the 1950's, implant supported replacement teeth were originally designed as a solution for older patients who were missing all of their teeth. Since then, many patients well into their nineties have had dental implant treatment without a single problem.


As we have discussed in our previous article, the optimal amount of potassium in our blood serum is 3.5 to 5.0 mmol/L. whenever its level falls down below 3.5 mmol/L then the condition is known as Hypokalemia. Hypokalemia is also termed as hypokalemic syndrome, low potassium syndrome, hypopotassemia syndrome. Mild hypokalemia does not present any symptoms but if level of potassium falls below 2.5 mmol/L then it is classified as severs Hypokalemia and can pose life threatening complications.

Signs & Symptoms

Hypokalemia can be differentiated into three types, and we will discuss their symptoms in these categories.

Mild hypokalemia – level of potassium in blood serum from 3.5 mmol/L to 3.0 mmol/L can be termed as mild hypokalemia. This condition is symptom free and therefore difficult to trace unless someone is routinely getting his/her potassium levels checked.
Hypokalemia – level of of potassium in blood serum from 3.0 mmol/L to 2.5 mmol/L can be termed as hypokalemia. The symptoms are
muscle cramping
severe hypokalemia -– level of potassium in blood serum below 2.5 mmol/L can be termed as severe hypokalemia. This condition can be life threatening. symptoms are
respiratory failure
breakdown of muscle tissue
ileus (lazy bowels)

The causes of hypokalemia can be broadly divided into three groups

due to low potassium intake
due to excessive loss of potassium from our body
side effect of other medical conditions or medications
Low potassium intake

This is most obvious and somewhat rare cause of hypokalemia. Whenever someone take less potassium in his/her diet then the normal prescribed amount, hypokalemia happens. This type of condition is usually seen in

ketogenic diet
anorexia nervosa
Excessive loss of potassium

Excessive loss of potassium is seen in many conditions but mainly seen when associated with heavy flush of fluid from our body. For example, vomiting, diarrhea, excessive perspiration, muscle crush injury and urinary losses. Out of theses Urinary losses is one which is often ignored and should be discussed in detail

Urinary loss-patients who have uncontrolled diabetes have condition called polyuria meaning frequent urination. This can lead to hypokalemia. Patients who are on prolonged use of loop diuretics such as furosemide or blood control medication are often prone to loss of excessive potassium from body. A special case of potassium loss occurs with diabetic ketoacidosis. Hypokalemia is observed with low total body potassium and a low intracellular concentration of potassium. In addition to urinary losses from polyuria and volume contraction, also an obligate loss of potassium from kidney tubules occurs as a cationic partner to the negatively charged ketone, β-hydroxybutyrate.

A low level of magnesium in the blood can also cause hypokalemia. Magnesium is required for adequate processing of potassium. This may become evident when hypokalemia persists despite potassium supplementation. Other electrolyte abnormalities may also be present.

An increase in the pH of the blood (alkalosis) can cause temporary hypokalemia by causing a shift of potassium out of the plasma and interstitial fluids into the urine. Disease states that lead to abnormally high aldosterone levels can cause hypertension and excessive urinary losses of potassium. These include renal artery stenosis and tumors (generally nonmalignant) of the adrenal glands, e.g., Conn’s syndrome (primary hyperaldosteronism).

Cushing’s syndrome can also lead to hypokalemia due to excess cortisol binding the Na+/K+ pump and acting like aldosterone. Hypertension and hypokalemia can also be seen with a deficiency of the 11-beta-hydroxysteroid dehydrogenase type 2 enzyme which allows cortisol’s to stimulate aldosterone receptors. This deficiency—known as apparent mineralocorticoid excess syndrome—can either be congenital or caused by consumption of glycyrrhizin, which is contained in extract of licorice, sometimes found in herbal supplements, candies, and chewing tobacco.

Other factors

In addition to alkalosis, other factors can cause transient shifting of potassium into cells, presumably by stimulation of the Na+/K+ pump. These hormones and medications include insulin, epinephrine, and other beta agonists (e.g. salbutamol or salmeterol), and xanthines (e.g. theophylline).

Rare hereditary defects of muscular ion channels and transporters that cause hypokalemic periodic paralysis can precipitate occasional attacks of severe hypokalemia and muscle weakness. These defects cause a heightened sensitivity to the normal changes in potassium produced by catecholamines and/or insulin and/or thyroid hormone, which lead to movement of potassium from the extracellular fluid into the muscle cells.

A handful of published reports describe individuals with severe hypokalemia related to chronic extreme consumption (4–10 l/day) of colas. The hypokalemia is thought to be from the combination of the diuretic effect of caffeine and copious fluid intake, although it may also be related to diarrhea caused by heavy fructose ingestion.

Pseudo hypokalemia is a decrease in the amount of potassium that occurs due to excessive uptake of potassium by metabolically active cells in a blood sample after it has been drawn. It is a laboratory artifact that may occur when blood samples remain in warm conditions for several hours before processing. Fructose ingestion.

Rare hereditary defects of renal salt transporters, such as Bartter syndrome or Gitelman syndrome, can cause hypokalemia, in a manner similar to that of diuretics. As opposed to disease states of primary excesses of aldosterone, blood pressure is either normal or low in Bartter’s or Gitelman’s.


Blood test normally confirms hypokalemia. The levels of potassium are checked. if it falls below 3.5 mmol/L hypokalemia is diagnosed.

Electrocardiogram- Hypokalemia leads to characteristic ECG changes (QRS prolongation, ST-segment and T-wave depression, U-wave formation).


Treatment of hypokalemia consists of treating life threatening symptoms and eliminating there causes. Instant hospitalization is required if symptoms worsens with constant monitoring of heart rate and rhythms. Treating low potassium levels in the hospital requires a multi-step approach:

Remove causes: After identifying the underlying cause, your doctor will prescribe the appropriate treatment. For example, your doctor may prescribe medications to reduce diarrhea or vomiting or change your medication.
Restore potassium levels: You can take potassium supplements to restore low potassium levels. But fixing potassium levels too quickly can cause unwanted side effects like abnormal heart rhythms. In cases of dangerously low potassium levels, you may need an IV drip for controlled potassium intake.
Monitor levels during hospital stay: At the hospital, a doctor or nurse will check your levels to make sure the potassium levels don’t reverse and cause hyperkalemia instead. High potassium levels can also cause serious complications.
After you leave the hospital, your doctor may recommend a potassium-rich diet. If you need to take potassium supplements, take them with lots of fluids and with, or after, your meals. You may also need to take magnesium supplements as magnesium loss can occur with potassium loss.

Hypokalemia which is recurrent or resistant to treatment may be amenable to a potassium-sparing diuretic, such as amiloride, triamterene, spironolactone, or eplerenone. Concomitant hypomagnesemia will inhibit potassium replacement, as magnesium is a cofactor for potassium uptake.

Mild hypokalemia (>3.0 mmol/L) may be treated by eating potassium-containing foods or by taking potassium chloride supplements in a tablet or syrup form (oral supplements). Foods rich in potassium include leafy green vegetables, avocados, tomatoes, coconut water, citrus fruits, oranges, or bananas. However, the quantities of potassium present in these foods are often not high enough to correct hypokalemia and additional potassium is generally required.

Hope you enjoyed this part. Stay tuned for next.share with family and friends.

Dr Ameya Tripathi is celebrated dental surgeon, social worker, writer, dental implantologist working at Rama Dental Clinic & Implant center Mahanagar Lucknow and Gomti Nagar Lucknow as its director. His works can be visited at


MPD is a pain disorder characterized by spontaneous pain and jaw function-induced pain in the joint and muscles of mastication of the TMJ because of the interplay between the muscles and joints, a problem with either one can lead to stiffness, headaches, ear pain, malocclusion, clicking sounds, or trismus.

“I want to take a bite” Anita snatched the apple from her husband’s hand and bit a huge hunk.

 click” a sound came from her jaw, nearby her ear.

“what’s that” Anand asked. “I’m hearing these sounds frequently while u move your mouth or try to bite something.”

“yes, I’m also feeling them, but nothing to worry, may be some muscle soreness.” Anita ignored this for a while.


But gradually the pain increased to significant level, accompanied by headache and neck pain so much, that they had to visit their consulting dentist. on examination their dentist told them that Anita was suffering from TMPD (temporomandibular joint disorder). doctor explained to him that there is a joint in their jaw known as temporomandibular joint which acts like a sliding hinge, connecting your jawbone to your skull. You have one joint on each side of your jaw. TMJ(temporomandibular joint) disorders — a type of temporomandibular disorder or TMD — can cause pain in your jaw joint and in the muscles that control jaw movement.

he exact cause of a person’s TMJ disorder is often difficult to determine. Your pain may be due to a combination of factors, such as genetics, arthritis or jaw injury. Some people who have jaw pain also tend to clench or grind their teeth, although many people habitually clench or grind their teeth and never develop TMJ disorders. like Anita millions of individuals suffer and ignore the early signs of TMPDS and there by worsening it.

TMPD is a pain disorder characterized by spontaneous pain and jaw function-induced pain in the joint and muscles of mastication of the TMJ because of the interplay between the muscles and joints, a problem with either one can lead to stiffness, headaches, ear pain, malocclusion, clicking sounds, or trismus. It is a common but misunderstood muscular pain disorder involving pain referred from small, tender trigger points within myofascial structures in or distant from the area of pain. The disorder and the resultant dysfunction can result in significant pain and impairment.

Temporomandibular pain dysfunction syndrome (TMPDS) comprises a variety of signs and symptoms which may be present in any combination, dependent upon the progress and stage of the disorder. The diagnostic criteria are pain on palpation of the temporomandibular joint (TMJ), muscle tenderness on examination, joint sounds, and limitation or deviation of jaw movement on opening. Headache may also be a symptom. Physiotherapy is commonly used to treat this disorder but there is little published material in the field of clinical trials comparing different methods of physiotherapy. Most reports are anecdotal. This paper reports four different physiotherapy modalities in the management of TMPDS when compared with a placebo group. Short-wave diathermy, megapulse, ultrasound and soft laser were tested.


Signs and symptoms of TMJ disorders may include:

Pain or tenderness of your jaw

Clicking sound while opening or closing of your mouth

Pain on biting from one or both the sides


Pain in one or both of the temporomandibular joints

Aching pain in and around your ear

Difficulty chewing or pain while chewing

Aching facial pain

Locking of the joint, making it difficult to open or close your mouth


TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.

The temporomandibular joint (TMJ) combines a hinge action with sliding motions. The parts of the bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disk, which normally keeps the movement smooth.


Many theories and etiological models have been presented by various authors in the literature which includes dental occlusal interferences, extraction of teeth for orthodontic treatment, use of certain orthodontic appliances, non-concentricity of the mandibular condyle, internal derangements, hyperactivity or hypo activity of masticatory muscles, hyperactivity or hypo activity of central nervous system, emotional disturbances with or without bruxism and increased psychological strain of life. The etiology of TMDs is multidimensional. Biomechanical, neuromuscular, biopsychosocial and neurobiological factors may contribute to the disorder. These factors are classified as:

  • Predisposing (structural, metabolic and/or psychologic conditions)
  • Initiating (e.g., trauma or repetitive adverse loading of the masticatory system)
  • Aggravating (parafunction, hormonal or psychosocial factors) to emphasize their role in the progression of TMD

Generally speaking, there can be various causes, sometimes they cannot be diagnosed also but to pin point we can list the following

  • Bruxism
  • Various types of arthritis, such as rheumatoid arthritis and osteoarthritis
  • Malocclusion
  • Stress
  • Jaw injury
  • Long-term (chronic) grinding or clenching of teeth
  • Certain connective tissue diseases that cause problems which may affect the temporomandibular joint
  • The disk erodes or moves out of its proper alignment
  • The joint’s cartilage is damaged by arthritis
  • The joint is damaged by a blow or other impact
  • In many cases, however, the cause of TMJ disorders isn’t clear


In mild case many times these pain go away on their own, but majority of cases need early diagnosis, and proper treatment.

Treatment comprises basically of three parts i.e. prevention (identify the disease or disease causing conditions early and work on them), interception (interrupting the cause there by arresting the future deterioration of joint) and treatment (restoring the joint to its normalcy. the options can be non-surgical like splints, crowns to more complex like surgical intervention.


Along with other nonsurgical treatments, these medication options may help relieve the pain associated with TMJ disorders:

Pain relievers and anti-inflammatories. If over-the-counter pain medications aren’t enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others), are a mainstay of treatment.

Tricyclic antidepressants. These medications used to be used mostly for depression, but now are sometimes used for pain relief.

Muscle relaxants- These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.

Nondrug therapies for TMJ disorder include:

Oral splints or mouth guards -Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well-understood.

Physical therapy- Treatments might include ultrasound, moist heat and ice — along with exercises to stretch and strengthen jaw muscles. They have proved useful in reducing the pain.

Counseling –proper and guided education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails. Special precaution should be taken against self-medication and google doctoring

Surgical or other procedures

When other methods don’t help, your doctor might suggest certain invasive procedures such as:

Arthrocentesis. Arthrocentesis is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.

Injections-botulinum toxin has found its way into medical practices decades ago. Now they and steroids are used to relieve TMJ pain. In some people, corticosteroid injections directly into the joint may be helpful. Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.

TMJ arthroscopy- In many cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted, and small surgical instruments are used for surgery. TMJ arthroscopy has fewer risks and complications than open-joint surgery does, but it has some limitations as well.

Modified condylotomy. Modified condylotomy addresses the TMJ indirectly, with surgery on the mandible, but not in the joint itself. It may be helpful for treatment of pain and if locking is experienced.

Open-joint surgery. – Considered by some as last resort. If your jaw pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, your consulting oral surgeon or dentist may suggest you to go for open-joint surgery (arthrotomy) to repair or replace the joint. However, due to its strategic presence near bifurcation of facial nerve and other anatomic structures open-joint surgery involves more risks than other procedures do and should be considered very carefully, discussing the pros and cons.

Summoning Up


The story of Anita and Anand is just an example that how clicking sound, pain in biting and other early symptoms of your jaw discomfort should not be ignored and brushed aside. A normal medical checkup can inform you about your conditions and management. individuals should never shy away from a diagnostic checkup if they think something is not right. “stitch in time, saves nine” that’s an old proverb but fits beautifully here. catching the disorder in its infancy will make sure that individual will not suffer. read it and share it with your loved ones if you really care.

View older posts »