Gingival Depigmentation with Dental Lasers for Management of Gingival Hyperpigmentation

Introduction – Gingival hyperpigmentation is a common esthetical concern in patients with gummy smile or excessive gingival display. It is an overproduction of melanin, beyond the normal expected degree in the oral mucosa, induced by various causes.

Etiology – Several physiologic and/or pathologic factors can cause hyperpigmentation. Gingival hyperpigmentation is mostly caused by the physiologic deposition of a brown pigment, melanin produced by melanocytes in the basal and supra-basal cell layer of the gingival epithelium. The colour of gingiva depends on the intensity of the melanogenesis, degree of epithelial cornification, depth of epithelialization and the arrangement of gingival vascularity.

Treatment Modalities – Gingival depigmentation is a treatment to remove melanin hyperpigmentation of the gingiva and various methods have been used for this procedure with different degrees of success including gingivectomy, gingivectomy with free gingival autografting, electrosurgery, cryosurgery, chemotherapy with 90% phenol and 95% alcohol and abrasion with diamond bur. Moreover some of these techniques are prone to side effects and complications.

However, Laser therapy is an effective and noninvasive treatment option for Gingival Depigmentation. In depigmentation process the epithelial tissue exhibiting excessive melanin pigments is ablated using diode lasers. PIOON Laser offers different wavelengths like 450nm, 810nm/980nm which can either be used in contact or non-contact manner to perform this procedure.

Most recommended for an effective treatment procedure is the blue light (450nm) which can be backed by a report by Kenneth Luk in 2017 where he studied the comparison between the 810nm and 445nm working in a noncontact mode to perform depigmentation of gingiva. He stated that 445nm is much better absorbed by melanin and haemoglobin than 810 nm and hence, a much lower power density can be used for the treatment. Manaf Agha in 2020 concluded that lesser the power settings used for the procedure, faster would be the healing with much less discomfort to the patient leading to greater acceptance of the procedure.

Before laser irradiation, the operating staff, assistant and the patient wears special laser-protective eye glasses corresponding to laser wavelength, highly reflective instruments or instruments with mirrored surfaces are avoided and most of the times only the use of topical anesthesia suffices for a painless laser tissue ablation.

Rationale behind Use of Lasers – Laser ablation has been recognized as a pleasant and reliable technique. It has the advantage of easy handling of tissues because of bloodless field, shorter chairside time, treatment finishes in single visit and property of potential decontamination. Additionally, protein coagulum formed on the depigmented surface as a result of irradiation act as a biological wound dressing sealing the ends of sensory nerve endings and hence lesser pain and discomfort is experienced by the patients.

Conclusion – Diode dental laser is a safe and effective treatment modality that provides optimal aesthetics with minimal discomfort to patients with gingival hyperpigmentation.

Reference – Luk K. Non-ablative melanin depigmentation of gingiva. Cosmetic dentistry. 2017. 36-39 and Agha M. Laser Treatment for Melanin Gingival Pigmentations: A Comparison Study for 3 Laser Wavelengths 2780, 940, and 445nm. Int J Dent.2020. March: 3896386.

What Is 9 Months Pregnant In Weeks? Full Pregnancy Calendar

This is the start of an exciting and blessed journey. It commences at the start of your last period and lasts about four weeks.

Baby’s life starts this month, i-e, about two weeks from the commencement of your last period, conception takes place inside your uterus.
There will be more than 36 weeks (8 months, 12 days) until the birth when the month ends.
The fetus (your baby) will be 2 weeks old at the end of this month.
He/she will be the size of a pinhead.
Pro Tip: Refrain from taking any medicine without consulting a health professional during your pregnancy. Tell them about your condition so they can prescribe a medicine that is safe for both you and your baby.

The Second Month (5th-8th Week)
This starts after the beginning of your last period and it will last four weeks.

32 more weeks to birth (7 months, 14 days) at the end of this month.
The fetus will be six weeks old at the end of this month.
At the end of the second month, the baby will be 1.5 cm in length.
The fetus will start to develop limbs.
In this month, the umbilical cord, the nervous system, spine, heart, nose, eyelids, and ears begin to develop.
Pro Tip: Tobacco smoking and alcohol drinking can seriously hamper the development of your baby. They can also have adverse effects on your lungs.

The Third Month (9th-12th Week)
The third pregnancy month starts 8 weeks (2 months) after the beginning of your last period.

Until birth, there will be 28 weeks (6 months, 16 days) at the end of the third month.
The baby will be 6 weeks old at the start of this month and will be 10 weeks old at its end.
The fetus will weigh around 20 grams and will be 9 cm long at the end of the third month.
For the first time, the baby’s heart will beat. (Already excited?)
The fetus will get the nourishment through the umbilical cord and will float in a sack of amniotic fluids.
Pro Tip: Mother’s health and wellbeing are very important to the child. Plenty of exercises and a healthy diet will be beneficial for both mother and child.

The Fourth Month (13th-16th Week)
This month will begin 12 weeks (3 months) after the start of your last period.

24 weeks (5 months, 18 days) will be left until birth at the end of this month.
The fetus will be 2.5 months old at the beginning of this month and will be 3.5 months old at its end.
The fetus will weigh around 100 grams at the end of the fourth month and will be 16 cm long.
The uterus will be stretched to about the size of a fist.
The face will begin to acquire its own features and the head will be big, about half of the total length. Ears and genitals will be developing around this time.
The fetus will practice breathing and swallowing movements. It will turn its head, will move its thumb and toes, and kicks. However, the mother will not yet feel any such tiny movements.
Pro Tip: You must visit a clinic or a doctor before the beginning of the seventeenth week in order to qualify for maternity benefits.

The Fifth Month (17th-20th Week)
The fifth month starts 16 weeks after the start of your last period.

There will be 20 weeks (4 months, 20 days) until the birth at the end of this month.
The fetus will be 14 weeks old at the start of the fifth month and 18 weeks at the end of this month.
The baby will be 25-27 cm in length at the end of the month and weighs around 250-300 grams.
By that time, the fetus will have grown its own circulatory system, and its heartbeat will be twice as fast as adults.
The fetus will now have eyebrows. Its skin will be covered in fine downy hair that will vanish by birth time.
By this time, the placenta will be as big as the fetus and it will protect it from some but not all harmful substances.
If the mother had a baby before, the mother can now feel the baby’s movements.
Pro Tip: In this month, the time is ripe to talk to the health nurse about antenatal classes.

The Sixth Month (21st-24th Week)
This month begins 20 weeks (5 months) after the commencement of your last period.

At the end of this month, there will be 16 weeks (3 months, 2 days) until birth.
The fetus will be 4.5 months old at the start of this month and will be 5.5 months old at the end of the sixth month.
The baby’s heartbeat can be heard or felt at this time. Even a primipara (a woman expecting her first kid) can feel its movements. The fetus will weigh around 400-600 grams and will be 30 cm long at the end of the sixth month.
The faster growth of the uterus indicates the possibility of twins.
The uterus (the fundus) will be up to the navel at the end of this month.
The protective film begins to grow into the skin.
The baby will practice sucking and its thumb will often find its way into the baby’s mouth.
During this period, the baby will sleep most of the time but can be woken by external vibration or noises.
Pro Tip: You should keep your paperwork in order by this time because, in the 22nd week, you will be eligible for maternity, paternity, or parent’s pay (and absence leave) or for maternity benefits.

Choose Driving School in East Kilbride

Many people can’t wait to get their driving licence and be on the road. But there is also the category of people who are afraid of making the big step, as they find the driving experience quite stressful and daunting. It is essential to find a driving school East Kilbride that puts a lot of accent on making driving a pleasant experience and which has a driving instructor East Kilbride with some specific qualities: patient, trustworthy, calm, and understanding. With the right instructor, every aspiring driver can pass the final exam, get the licence, and finally enjoy the freedom of driving a car.

At a driving school East Kilbride, future drivers don’t learn just about driving, legislation and theory; they also get to experience how it really is behind the wheel. It doesn’t compare with anything else. Also, the driving instructor East Kilbride has the required qualifications and training to be able to prepare any person. Legislation, laws tend to change on a constant basis and perhaps with someone unauthorized, aspiring drivers will not learn everything about driving. On the other hand, at a driving school, the experience is worthwhile, since both theoretical and practical aspects are covered.

There are some people who prefer to have someone familiar next to them when they learn how to drive. It is not always the best solution, because in such cases, people tend to panic and not trust the person at the wheel. The driving instructor East Kilbride has certain skills that will relax drivers and make them feel comfortable. Driving can be stressful, especially since there are many accidents occurring and there are junctions at every step. But one must have confidence and be in control of the situation. At a driving school East Kilbride, people also learn what to do in such situations, how to avoid dangerous drivers and possible accidents.

It is always recommended to be vigilant while on the roads, but driving should also be enjoyable. There is nothing like getting in the car and knowing that you can reach any destination you have in mind. It gives you a sense of freedom, especially since you know you are in control of everything. Another great benefit of attending a driving school East Kilbride is that drivers get to be inside some of the best cars and they can understand how a car actually functions. There are cases in which some of the best car models are provided and people choose a certain driving school based on such an aspect.

Choosing a driving school is crucial, but what is also important is how you get along with the driving instructor East Kilbride. During the preparation, you will learn the basics of driving and the actual experience that will help you a lot at your final exam. If you care a lot about safety and being a conscious driver, then you certainly have to go to a driving school. It is the only way to learn everything about driving.