Archive

Category Archives for "Dental Health"

Gum Disease: What You Need To Know

Gum Disease: What You Ought To Know

Gums and teeth, or periodontal disease isn’t an enjoyable experience! If you wish to avoid gums and teeth, or you have diabetes already and wish to fight it, look at this article.

Signs and symptoms of Gums And Teeth

How can you tell for those who have gums and teeth? Here are the signs and symptoms you need to search for. Frequently you will observe inflammation from the gums and mouth – soreness, bleeding, and/or redness. Another common symptom is bed breath (a.k.a. Halitosis), or a poor style of the mouth area. Other indications of gums and teeth include shaky or loose teeth, receding gums, and spaces between your gums and teeth.

Reason For Gums And Teeth

What can cause gums and teeth? Basically, gums and teeth is because bacteria growing inside your mouth. These bacteria normally begin growing on particles of food left inside your mouth. The problem then keeps growing, causing inflammation and introduction to the gums and mouth.

Protection Against Gums And Teeth

Gums and teeth could be avoided by discouraging the development of bacteria within the mouth. Proper oral cleanliness goes a lengthy means by stopping bacteria development in the mouth area. Also useful is a healthy diet plan lower in refined sugars along with other foods which make perfect bacteria fodder.

Management of Gums And Teeth

If you have Gums And Teeth, there are many methods to address it. The foremost and apparently most typical is really a professional cleaning. A periodontist will clean the mouth area to get rid of the plaque, etc that harbors the bacteria resulting in the disease. Drugs could also be used to deal with gums and teeth. Lately, several natural cures happen to be produced for gums and teeth too.

Hopefully, the data in the following paragraphs may have provided the data you need to prevent or treat gums and teeth, also referred to as periodontal disease. Believe me when i state that you won’t want to get gums and teeth – it’s worth stopping, and prevention is straightforward whenever you stick to the steps outlined in the following paragraphs!

Handling The Usual Oral Health Issues

Handling The Typical Dental Health Problems

Everyone knows that to possess healthy gums and teeth, you ought to brush and floss daily, eat well, and go to the dental professional regularly. But may these aren’t enough. So many people are bothered with dental health condition for example tooth decay, foul breath, receding gums, mouth sores, and erosion which essentially remove their confidence to smile. These dental health issues occur whenever we don’t correctly take proper care of our dental health. There’s also many different ways to stop this from happening, and also the simplest factor for the time being is understanding – and doing – the best preventive steps against these dental issues.

Your diet plan as well as your dental hygiene are big factors inside your dental health. Regular appointments with the dental professional might make a significant difference. What should you were unable stop this from happening? What if you suffer from from this right only at that moment? This could only mean one factor. You’re searching to find the best treatment options. The following are the common dental issues and the way to treat them, and concepts on stopping these common troubles.

Foul breath. Halitosis or foul breath is treated according to what caused it. Flossing and brushing is essential since it protects the mouth area from bacteria that create the foul smell. Even when your dental professional assures you you have healthy gums and teeth, you need to dig just a little much deeper as possible an indicator of the different problem. Bronchitis, sinus problems, respiratory system infections, diabetes, trouble with the liver or kidneys, and gastro intestinal disturbance like Acid reflux, are types of illnesses that may be shown by foul breath. Other possible culprits are extremely much garlic clove and onion, smoking, and certain kinds of medication.

Cavities and tooth erosion. Brushing the teeth a minimum of two occasions each day and taking advantage of a verbal floss daily with regular appointments with the dental professional can prevent cavities and erosion. There’s also protective plastic sealants that reduce one’s chance of getting tooth decay. Avoid developing plaque and erosion by reduction of your snacking and getting a healthy diet plan. Research has shown that acidic drinks and food make the enamel to put on off so avoid sodas, sports drinks, citrus fruits and juices, tomato plants and pickles. Also, for those who have bulimia or experience acidity refluxes, visit a physician for treatment since gastric acidity is among the reasons for teeth erosion.

Receding gums. Periodontal or gum problems have serious effects. Gum disease in the initial phase causes the gums to swell and redden as well as more vulnerable to bleeding. In severe installments of periodontitis, the gums and bones supporting one’s teeth are broken which eventually results in losing one’s choppers. It’s suggested that you simply practice flossing and brushing every single day and visit the dental professional regularly. Dental experts suggest utilizing a toothbrush with soft bristles and putting on an evening pads since gum recession can result from hard-bristled toothbrushes, clenching, grinding, contact of gums with dirty objects, and malposition of teeth.

Mouth Sores. The most popular sores that people get are canker sores and fever blisters. Canker sores are located within the mouth while cold ones are outdoors in most cases show up on the advantage from the lips. they’re painful and uncomfortable but fortunately treatable with more than-the-counter drugs and antimicrobial mouth washes and topical anaesthetics to temporarily relieve fever blisters.

Regardless of what mouth problems you’re experiencing, there’ll always be treatment options available. The end result is that it may be avoided. It just takes discipline to go to the dentists regularly, healthy diet and understanding about dental health.

Oral Health Care Tips For All Women

Oral Healthcare Strategies For All Ladies

Women and men are unique within their health needs. This really is so because women have a tendency to undergo lots of bodily changes at various stages of existence. In the stage of existence like adolescence, pregnancy or menopause women’s dental health needs also varies. While women tend to be more meticulous and may take better care and manage their matters well, due to women’s genes and hormonal fluctuations, men generally stand out more within their dental health status than women. Using the many hormonal alterations in a woman’s existence, their all around health such as the gum tissues may become affected.

Based on research, 23 percent of ladies inside the age bracket of 30-45 already developed periodontitis. As women become older, the percentile arrived at up to 44%. With this particular we’re able to infer that as women age, the incidences of gum problem resulting in cavities becomes more and more greater. And thus, it’s very important to complete preventive treatment to safeguard one’s health at each stage of the woman’s existence so they won’t be taken in by the silent gums and teeth also referred to as periodontitis. A lot of women oftentimes realize they have an dental problem once the gum infection already arrived at a sophisticated condition.

At adolescence stage a woman’s existence becomes if perhaps you are. It’s at this time that producing progesterone and oestrogen is more and more high. With this particular, bloodstream circulation even going to the gums comes into action inducing sensitivity to irritants, plaque and food itself. Tenderness, swelling and reddening from the gums could be expected. It’s at this time so good dental hygiene for example daily flossing and brushing ought to be practiced. Appointments with the dental professional will also help just because a youthful lady may require periodontal therapy. The therapy cure gum tissue irritation and can strengthen the bone round the teeth area. Because the youthful lady passes happens of adolescence, gum sensitivity may also lessen. Before their period, you will find ladies who are afflicted by the monthly period gum disease. This can be a condition where gums also bleed and be reddish and inflamed even at the purpose of developing sores close to the gum line. When the period began, the swelling would also subside.

If there’s the monthly period gum disease there’s also what we should call pregnancy gum disease. This problem starts in the second month of being pregnant to the eighth month. You will find occasions the inflamed gums form large protuberances. We refer to this as as pregnancy tumors but they’re not harmful or painful. When the condition becomes severe, tumors may then be removed with a periodontist. Periodontal condition similar to this ought to be given preferential attention since it will impact the unborn baby. An pregnant woman can provide birth in an earlier date to some low birth weight baby. So they won’t have this negative experience, dental care treatment ought to be incorporated in each and every woman’s prenatal care. Even ladies who use contraceptives aren’t safe from getting dental gum disease. It ought to be noted however the antibiotic medications for periodontal disease can diminish the potency of contraceptives.

During menopausal and publish-menopausal stage, dental hygiene is required still. Merely a small population of ladies is impacted by the menopausal gingivostomatitis. The problem is marked by dry or shiny gums that bleed easily. Dryness of mouth, burning, altered taste and pains around the gums a few of the signs and symptoms from the disease. Hormone substitute therapy for menopausal women can alleviate calcium loss and may strengthen teeth which help combat brittle bones.

To safeguard a woman’s dental health at various stages of existence, she should visit a dental professional regularly. Two occasions annually visit or even more is going to do. It’s important and to be aware of dental disease indicators for example bleeding gums, receding gums, foul breath, pus, loose teeth, alternation in bite or fit of dentures. Any medications ought to be reported for your dental professional and also the daily regimen of flossing and brushing a minimum of two times each day ought to be adopted religiously.

Gum Disease

Gum Disease

Many people have a tendency to disregard that bleeding gums are among the important symbol of gums and teeth. Gums and teeth or also referred to as “periodontal disease may be the inflammation from the gingiva or even more referred to as gums. Periodontal (literally means “around the tooth”) illnesses are microbial infections that damage the attaching fibers and also the supporting bone store the teeth within the mouth. If gum illnesses remain untreated, it can result in loss of tooth or heart illnesses.

There’s two stages of gum illnesses. They are: gum disease and periodontitis. Gum disease may be the inflammation from the gums with no bone loss while periodontitis may be the inflammation from the gums that leads to losing the bones round the teeth.

Gum disease may be the early phase from the gums and teeth. Gum disease may be treatable and reversed when the disease is diagnosed early. Gum disease come from the buildup of plaque and tartar because of poor dental hygiene or by gum trauma brought on by hard brushing. The warning signs of gum disease are inflamed, shiny, and vibrant red or crimson colored gums. Sore mouths, gums that painful when touched, gums that bleeds easily despite gentle brushing and itchy gums in a variety of severity will also be signs and symptoms of gum disease. Another symbol of this stage of gums and teeth may be the receding gumline. Gum disease could be avoided by brushing one’s teeth completely and lightly with tooth paste and daily flossing from the teeth.

Periodontitis may be the more severe and advanced phase of gums and teeth. Lack of the bone round the teeth can be done within this later stage of gums and teeth and it is irreversible. Attachment fibers and supporting bone round the teeth might be destroyed, and can eventually result in the loosening and falling from the teeth. The signs and symptoms of the advanced stage of gums and teeth are periodic redness or bleeding from the gums while brushing or flossing one’s teeth or biting hard or crunchy foods. Periodic swelling from the gums that recur, constant bad tastes within the mouth and foul breath or halitosis can also be certainly one of its signs and symptoms. Depressions of gums which lead to the lengthening from the teeth are also signs and symptoms of periodontitis. It’s because the brilliant brushing from the teeth with a hard bristled toothbrush. Pockets between your gums and teeth will also be a sign of periodontitis. Loose and shaky teeth exist in the later phase of periodontitis.

There are numerous factors that create gums and teeth. Smoking cigarette and taking advantage of spit tobacco are among the risk factor. Defective fillings, ill fitting bridges or dentures and poor dental hygiene are among the main reasons for gums and teeth.

Exercising regular dental hygiene is the greatest protection against gums and teeth. Regular dental examinations and dental cleanings are highly advised. Go to your dental professional at least one time every six several weeks to identify of if at all possible avoid any gums and teeth.

Signs and Symptoms of Gum Disease

Signs and Signs and symptoms of Gums And Teeth

Gum illnesses are serious infections from the gums if not treated may lead, to loss of tooth or serious dental condition or perhaps cardiovascular disease. Gums and teeth or also referred to as “periodontal illnesses are illnesses which involves the soreness from the gingiva (or even more referred to as gums). Periodontal disease or gums and teeth may develop painlessly. A couple of signs and signs and symptoms of gums and teeth might even develop within the later phase from the gums and teeth. Whether or not the signs and signs and symptoms of gum illnesses are faint, the problem isn’t unexpectedly signs. Some signs and signs and symptoms of gum illnesses may indicate other kinds of disease.

In case your gums bleed during or once you brush the teeth is easily the most common sign and signs and symptoms of gums and teeth. Gums which are red, inflamed or tender will also be one sure signs and signs and symptoms of gums and teeth. The development of pockets between your gums and teeth, loose and shifting teeth, persistent bad tastes, foul breath or halitosis and receding gumline are only a couple of from the signs and signs and symptoms of gums and teeth.

Even though you may not identify any signs and signs and symptoms of gums and teeth, you might still possess some degree periodontal illnesses. Many people don’t realize that they have periodontal disease as they do not show any signs and signs and symptoms of gums and teeth since the periodontal disease they have are just around certain teeth, for example teeth which are found at the rear of the mouth area. Merely a dental professional or periodontist could make out and conclude the advancement of the gums and teeth.

Prevention is the greatest strategy to gums and teeth. Regular dental hygiene is the easiest method to prevent gums and teeth. Brushing one’s teeth correctly a minimum of two times each day is suggested. Flossing daily and interdental brushes is extremely suggested. Utilizing an antibacterial mouthwash together with regular dental hygiene cuts down on the perils of getting gum illnesses in addition to regular dental examinations and professional dental cleaning. Throughout a routine dental check-up your dental professional will take away the plaque and tartar of the gumline, thus, minimizing the potential risks of gums and teeth.

Should you identify early signs and signs and symptoms of gums and teeth, go to your dental professional immediately for correct dental check-up. To understand for those who have gums and teeth, find out about the most typical signs and signs and symptoms of gums and teeth. Don’t let the gums and teeth get rid of the smile in your face. For those who have any doubts relating to your dental health, don’t hesitate to talk to your dental professional. Your dental professional provides you with the best way forward relating to your dental problem. Always keep in mind that early recognition of gums and teeth may save your valuable existence. Gum illnesses can lead to heart disease like artery blockage and stroke.

Gingivitis Symptoms and Treatment

Gingivitis Signs and symptoms and Treatment

Periodontitis (gums and teeth) is a very common human affliction, affecting 1 / 3 of adults, and also over half of people older than 50.

Signs and symptoms

Gum disease signs and symptoms may include: inflamed gums, redness from the gums, tenderness once the gums are touched, tenderness when eating, pus round the teeth, or perhaps a bad style of the mouth area. A typical gum disease symptom is noticeable accumulations of tartar or plaque around the teeth. Another common gum disease symptom is bloodstream around the toothbrush while brushing teeth. When gum disease signs and symptoms are advanced, the condition frequently spreads towards the bony tissues, that are located underneath the gums and offer the teeth. In later stages of periodontal disease, one’s teeth may become loose and seriously have contracted pus that oozes from round the sockets.

Gum disease treatment methods are extremely effective when the disease is caught over time. The very best gum disease treatment or gums and teeth treatment methods are to avoid gum disease and gums and teeth from getting began. Gum disease treatment starts with regular daily brushing from the teeth to get rid of plague and tartar. Scraping from the tongue can also be vital that you remove bacteria. Lots of people overlook these important areas of dental hygiene, but they’re required for gum disease treatment.

Gum disease treatment, including strategy to receding gums, bleeding gums, canker sores, along with other problems from the gums and teeth, doesn’t have to become a difficult task

Treatment

Non-antibiotic method for treating the actual infection accountable for periodontal disease. After routine scaling, the dental professional will use the compound into the periodontal pockets and round the gumline of affected teeth. The compound rapidly penetrates the plaque preferentially binding to multiple structural components in bacteria, including their toxic secretions. Laser light will be applied straight to the affected sites utilizing a fiber optic probe. A effective free-radical reaction destroys the targeted bacteria and also the connected toxins for example collagenase.

Periowave is really a revolutionary new adjunctive treatment getting the ability and easy photodynamic disinfection¹ to treating periodontal illnesses. The patented process was created by Professor Michael Wilson and colleagues in the Eastman Dental Institute, London, England and it is licensed to Ondine Biopharma Corporation by UCL Biomedica PLC, College College London.

Prescribed Meds & Its Effects On Your Mouth

Prescribed Meds & Its Effects In Your Mouth

Some medications can impact your gums and teeth. It’s mainly due to the composition from the medicine that you’re consuming. When you’re experiencing these, you need to consult the physician in order that it is going to be treated immediately. So, do you know the common results of the medications towards the teeth and also the gums?

Abnormal Bleeding. Some medications such as the anticoagulants and also the aspirin may cause the gums with an abnormal bleeding. They decrease the clotting ability from the bloodstream and this can lead to abnormal bleeding throughout an dental surgery. Before undergoing any surgical treatment within the mouhth, it’s vital that you enable your dental professional know that you’re consuming some aspirins or anticoagulants to ensure that safeguards can be achieved to reduce the bleeding of the gums. Also, kids the teeth, you need to use your fingers with soft bristles to lessen the gum bleeding.

Tissue Reactions. If you’re consuming some medications for bloodstream pressure, chemotherapy, dental contraceptives and immunosuppressive agents, there’s possible that you could develop some tissue reactions in your gums. Your gums could be inflamed, you are able to create a mouth sore, or even the tissues in your gums as well as your mouth might have some discoloration. When getting this sort of medication effect, you need to enable your dental professional realize it in advance. A unique dental hygiene is going to be prescribed for you to alleviate the discomfort or even the discomfort that you’re feeling and also to prevent these tissue reactions whenever possible.

Gum Swelling. The gum enlargement can happen when you’re taking medications for epilepsy along with other antiseizures, cardiovascular medications for example calcium funnel blockers, and immunosuppressant drugs. The gum enlargement may sometimes have you feeling uncomfortable. Also, an enlarged gum is much more sensitive than the usual normal gum. When you are taking these medications that induce gum enlargement, you need to take an additional care kids the teeth and flossing. The very best solution with this medication effect would be to talk to your dental professional so that she or he can provide you with the particular dental instructions to deal with this gum enlargement.

Tooth Cavity Risks. Medications which contain sugar, especially individuals which are prescribed to kids, may cause the cavity to create around the teeth. The medicines which contain sugar include antacid tablets, cough drops, chewable tablets, antifungal agents, and vitamins. Consuming an excessive amount of these medicines can result in the development of tooth decay around the teeth.

To prevent getting tooth decay while taking these medicines, it is advisable to drink these medicines within the tablet form and they must be drawn in after getting meals to be able to brush the teeth later on. Don’t take during these medicines just before you go to bed. The sugar is going to be left around the teeth which will result in the formation from the cavity. You may also chew a sugarless gum as a substitute for brushing the teeth.

Teeth and Gum Discoloration. There are several drugs additionally that can transform or alter the colour of your teeth and gums. A number of medicines range from the minocycline, cure for acne, and also the chlorhexidine, a gums and teeth treatment. The minocycline leaves a black pigmentation around the gums. Also, it leaves a grayish color around the teeth. The chlorhexidine, however, can leave a stain around the teeth.

Discuss a tooth-whitening procedure together with your dental professional if you wish to take away the stains which were left in your teeth.

Common Issues Surrounding Periodontitis

Common Issues Surrounding Periodontitis

Vitality ? from periodontitis? Really, this is probably the main reasons why people lose their teeth or are afflicted by serious dental problems. It’s common among adults aged three decades or more, as well as youthful adults who weren’t as conscious of the oral cleanliness and care within their childhood and teenage life. This short article aims to provide you with the data overall issue surrounding periodontitis, its treatments and diagnosis.

To begin with, it’s a gum infection that requires an intensive dental care. This can lead to a loss of tooth otherwise treated immediately. Periodontal disease or gums and teeth includes gum disease and periodontitis. This kind of gums and teeth is because microbial infection because of poor dental hygiene. If you suffer from from gum disease and correctly treated, this makes to periodontitis. Normally the condition causes gums to bleed and inflamed.

The signs and symptoms of the periodontitis include red gums, sore gums, sour style of the mouth area, inflamed gums, bleeding gums, sensitivity on teeth, pulling away of gums on teeth, teeth loss, dentures fitting poorly, difficulty eating and biting and foul breath. Many people struggling with this serious dental disease usually experiencing couple of signs and symptoms but when couple of signs and symptoms might be felt, it’s still better to talk to your dental professional to prevent loss of tooth.

This problem usually comes from many factors. Mostly people getting ascorbic acid deficiency usually are afflicted by bleeding gums and loss of tooth. Plaque buildup can also be among the reasons for periodontitis. There’s also several kinds of periodontitis that you ought to consider and they’re aggressive periodontitis, chronic, periodontitis associated with some conditions and necrotizing periodontal disease.

Aggressive periodontitis is really a microbial disease from the teeth occurring prior to the aged 35 in most cases present with prepubescent children. The very first sign includes swelling of gum tissue in most cases occurs with discomfort or sometimes there’s no discomfort. Chronic periodontitis is easily the most common kinds of periodontitis and also the inflammation occurs gradually and may lead to loss of tooth not correctly treated. Some periodontitis can happen because of other health issues like heart illnesses, diabetes and lung disorder.

If you suffer from from signs and symptoms of periodontitis, make certain to talk to your dental professional immediately for correct treatment. On your go to your dental professional asks you concerning the good reputation for your disease. Then your inspection of the gums and teeth has been observed particularly the color and also the firmness. Your dental professional would also test out your teeth for looseness and also the fitness of the teeth together. Mostly, x-ray is requested to understand if you suffer from from bone loss because of periodontitis. Your dental professional would also employ a periodontal probing in testing for gum illnesses.

Prevent this to occur by brushing the teeth regularly not less than 2 to 3 occasions after meals. Make use of a soft bristled brush and replace your toothbrush if there’s put on. Soft bristled toothbrush is superior in removing plaque of the teeth. Brush the teeth effectively and spend some time kids as well as brush your tongue. Have regular floss along with a regular checkup out of your dental professional.

Untreated periodontitis can result in severe types of illnesses. So, you shouldn’t be afraid to talk to your dental professional for correct treatment. As it’s frequently stated, an oz of prevention is preferable to one pound of cure. Besides, fixing your teeth and gums lessens the potential risks of heart along with other cardiovascular illnesses, in addition to much more serious ailments that prevent you from supplying your very best smile more frequently!

Periodontal Disease in Adolescents

Periodontal Disease in Adolescents

This is from the word “periodontal” is about your tooth. Also referred to as gum illnesses periodontal illnesses aren’t anything but serious infections brought on by bacteria that harm the gums and tissues near the mouth area. While dental tooth decay or caries only affects your tooth Periodontal disease is devastating affecting the bones that surround your tooth, gums, coverings of teeth root and tooth membrane. A health care provider focusing on treating periodontal disease is called Periodontist.

The condition shouldn’t be taken gently and when it’s not treated it may spread and modify the bones underneath the teeth which may eventually dissolve and wouldn’t longer offer the teeth instead. The chronic type of the condition accounts for loss of tooth in 70 percent from the cases affecting 70 5 % of those at some point within their lives.

What causes periodontal disease act like every other dental disease in which plaque buildup and bacteria have the effect of the problem. Statistically plaque buildup may be the primary reason for gum related illnesses. In addition to the causes listed, another possible reasons for periodontal disease include: Genetics, ungroomed dental hygiene, food getting stuck to frequently within the gums, mouth breathing, low nutrient diet or ascorbic acid deficient diet, smoking, diabetes, autoimmune/systemic disease, alterations in hormonal levels, certain medications and also teeth grinding.

Statistically nearly 60 6 % youthful adult population is affected with periodontal disease and nearly 50 percent of teenagers are afflicted by periodontal disease. Also, it’s the most prevalent loss of tooth cause in grown-ups. But, do you know the signs and symptoms of periodontal disease? There are numerous signs and symptoms also it could vary from one adolescent to another which might include inflamed, tender, and red gums if a person will get bleeding during brushing or flossing one’s teeth it’s also among the signs and symptoms of periodontal disease receding gums constant odorous breath loose teeth dentures not fitting any more alternation in alignment of jaw and bite. The signs and symptoms from the disease might be much like other health conditions and doctor’s consultation is the greatest in connection with this.

Periodontal disease could be diagnosed with a dental professional or perhaps a periodontist after reviewing the entire health background as well as physical study of the teenager’s mouth. Usually x-ray from the teeth is come to assess the disease. Periodontal disease is classed into differing types according to what stage the condition is within. The mildest type of gums and teeth is called “gingivitis” by which gums become inflamed, red and tender leading to bleeding while daily flossing and brushing. Gum disease is again split into 4 groups mainly acute, sub-acute, recurrent and chronic. Acute gum disease is certainly not but sudden appearance which can last for shorter duration and is painful. Sub-acute gum disease is more gentle kind of gum disease. Recurrent gum disease is the one which returns after treatment. Chronic gum disease is the one which onsets gradually, lasts longer and it is generally painless. A dentist’s treatment and proper and continuous care can certainly solve the issue of gum disease but when not treated could cause periodontitis.

Periodontitis is further classified into mild and moderate to succeed. Periodontitis is a result of untreated gum disease. Within this stage the degeneration from the bone near your tooth becomes apparent. The most popular signs and symptoms include red gums that bleed mouth tastes bad loose teeth loss of tooth. Medicine is essential to manage the condition and stop further degeneration. Periondontitis that is in moderate to advanced stage shows indications of major lack of tissue and bone loss close to the teeth.

There are numerous treatments readily available for periodontal disease that is made the decision through the dental professional based on teenager’s age, health background and health generally. The treatment also depends upon the level that disease has arrived at. The tolerance from the teen to particular medicines, therapies and operations will also be taken into account. Expectations and opinion from the parents or teen can also be the factors in deciding the kind of treatment. The therapy usually involves plaque removal, medication as well as in worse cases a surgical procedure.