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{{distinguish|GGGT}}
It is very common to have a dental emergency -- a fractured tooth, an abscess, or severe pain when chewing. Over-the-counter pain medication is just masking the problem. Seeing an emergency dentist is critical to getting the source of the problem diagnosed and corrected as soon as possible.<br><br><br><br>Here are some common dental emergencies:<br>Toothache: The most common dental emergency. This generally means a badly decayed tooth. As the pain affects the tooth's nerve, treatment involves gently removing any debris lodged in the cavity being careful not to poke deep as this will cause severe pain if the nerve is touched. Next rinse vigorously with warm water. Then soak a small piece of cotton in oil of cloves and insert it in the cavity. This will give temporary relief until a dentist can be reached.<br><br>At times the pain may have a more obscure location such as decay under an old filling. As this can be only corrected by a dentist there are two things you can do to help the pain. Administer a pain pill (aspirin or some other analgesic) internally or dissolve a tablet in a half glass (4 oz) of warm water holding it in the mouth for several minutes before spitting it out. DO NOT PLACE A WHOLE TABLET OR ANY PART OF IT IN THE TOOTH OR AGAINST THE SOFT GUM TISSUE AS IT WILL RESULT IN A NASTY BURN.<br><br>Swollen Jaw: This may be caused by several conditions the most probable being an abscessed tooth. In any case the treatment should be to reduce pain and swelling. An ice pack held on the outside of the jaw, (ten minutes on and ten minutes off) will take care of both. If this does not control the pain, an analgesic tablet can be given every four hours.<br><br>Other Oral Injuries: Broken teeth, cut lips, bitten tongue or lips if severe means a trip to a dentist as soon as possible. In the mean time rinse the mouth with warm water and place cold compression the face opposite the injury. If there is a lot of bleeding, apply direct pressure to the bleeding area. If bleeding does not stop get patient to the emergency room of a hospital as stitches may be necessary.<br><br>Prolonged Bleeding Following Extraction: Place a gauze pad or better still a moistened tea bag over the socket and have the patient bite down gently on it for 30 to 45 minutes. The tannic acid in the tea seeps into the tissues and often helps stop the bleeding. If bleeding continues after two hours, call the dentist or take patient to the emergency room of the nearest hospital.<br><br>Broken Jaw: If you suspect the patient's jaw is broken, bring the upper and lower teeth together. Put a necktie, handkerchief or towel under the chin, tying it over the head to immobilize the jaw until you can get the patient to a dentist or the emergency room of a hospital.<br><br>Painful Erupting Tooth: In young children teething pain can come from a loose baby tooth or from an erupting permanent tooth. Some relief can be given by crushing a little ice and wrapping it in gauze or a clean piece of cloth and putting it directly on the tooth or gum tissue where it hurts. The numbing effect of the cold, along with an appropriate dose of aspirin, usually provides temporary relief.<br><br>In young adults, an erupting 3rd molar (Wisdom tooth), especially if it is impacted, can cause the jaw to swell and be quite painful. Often the gum around the tooth will show signs of infection. Temporary relief can be had by giving aspirin or some other painkiller and by dissolving an aspirin in half a glass of warm water and holding this solution in the mouth over the sore gum. AGAIN DO NOT PLACE A TABLET DIRECTLY OVER THE GUM OR CHEEK OR USE THE ASPIRIN SOLUTION ANY STRONGER THAN RECOMMENDED TO PREVENT BURNING THE TISSUE. The swelling of the jaw can be reduced by using an ice pack on the outside of the face at intervals of ten minutes on and ten minutes off.<br><br>If you beloved this posting and you would like to receive additional information with regards to [http://www.youtube.com/watch?v=90z1mmiwNS8 Washington DC Dentist] kindly go to the web site.
{{Pfam_box
| Symbol = G_glu_transpept
| Name = Gamma-glutamyltranspeptidase
| image =
| width =
| caption =
| Pfam= PF01019
| InterPro= IPR000101
| SMART=
| Prosite = PDOC00404
| SCOP =   
| TCDB =
| OPM family=
| OPM protein=
| PDB=
}}
{{Infobox enzyme
| Name = gamma-glutamyltransferase
| EC_number = 2.3.2.2
| CAS_number = 9046-27-9
| IUBMB_EC_number = 2/3/2/2
| GO_code = 0003840
| image =
| width =
| caption =
}}
{{Infobox protein
| Name = [[GGT1|gamma-glutamyltransferase 1]]
| caption =
| image =
| width =
| HGNCid = 4250
| Symbol = [[GGT1]]
| AltSymbols = GGT
| EntrezGene = 2678
| OMIM = 231950
| RefSeq = NM_001032364
| UniProt = P19440
| PDB =
| ECnumber = 2.3.2.2
| Chromosome = 22
| Arm = q
| Band = 11.1-11.2
| LocusSupplementaryData =
}}
{{Infobox protein
| Name = gamma-glutamyltransferase 2
| caption =
| image =
| width =
| HGNCid = 4251
| Symbol = GGT2
| AltSymbols = GGT
| EntrezGene = 2679
| OMIM = 137181
| RefSeq = NM_002058
| UniProt = P36268
| PDB =
| ECnumber = 2.3.2.2
| Chromosome = 22
| Arm = q
| Band = 11.1-11.2
| LocusSupplementaryData =
}}
 
'''Gamma-glutamyltransferase''' or '''gamma-glutamyl transpeptidase''' (also '''γ-glutamyltransferase''', '''GGT''', '''GGTP''', '''gamma-GT''') ({{EC number|2.3.2.2}}) is an [[enzyme]] that transfers gamma-glutamyl [[functional group]]s. It is found in many tissues, the most notable one being the [[liver]], and has significance in [[medicine]] as a diagnostic marker.
 
GGT<ref name="PUB00003561">{{cite journal |author=Tate SS, Meister A |title=gamma-Glutamyl transpeptidase from kidney |journal=Meth. Enzymol. |volume=113 |issue= |pages=400–419 |year=1985 |pmid=2868390 |doi=10.1016/S0076-6879(85)13053-3 |series=Methods in Enzymology |isbn=978-0-12-182013-8}}</ref> catalyzes the transfer of the gamma-glutamyl moiety of [[glutathione]] to an acceptor that may be an amino acid, a peptide or water (forming [[glutamate]]). GGT plays a key role in the gamma-glutamyl cycle, a pathway for the synthesis and degradation of glutathione and drug and xenobiotic detoxification.<ref name="PUB00006169">{{cite journal |doi=10.1016/0006-2952(92)90140-E |author=Siest G, Courtay C, Oster T, Michelet F, Visvikis A, Diederich M, Wellman M |title=Gamma-glutamyltransferase: nucleotide sequence of the human pancreatic cDNA. Evidence for a ubiquitous gamma-glutamyltransferase polypeptide in human tissues |journal=Biochem. Pharmacol. |volume=43 |issue=12 |pages=2527–2533 |year=1992 |pmid=1378736}}</ref> Other lines of evidence indicate that GGT can also exert a prooxidant role, with regulatory effects at various levels in cellular signal transduction and cellular pathophysiology,<ref name = dominici />
 
== Function ==
 
GGT is present in the [[cell membrane]]s of many tissues, including the [[kidney]]s, [[bile duct]], [[pancreas]], [[gallbladder]], [[spleen]], [[heart]], [[brain]], and [[seminal vesicles]].<ref name = goldberg /> It is involved in the transfer of [[amino acid]]s across the [[cellular membrane]]<ref name = meister /> and [[leukotriene]] metabolism.<ref name = pmid2860060 /> It is also involved in [[glutathione]] [[metabolism]] by transferring the [[Glutamic acid|glutamyl]] [[Functional group|moiety]] to a variety of acceptor molecules including water, certain [[Levorotation|L]]-[[amino acid]]s, and [[peptides]], leaving the [[cysteine]] product to preserve [[intracellular]] [[homeostasis]] of [[oxidative stress]].<ref name = pmid238530 /><ref name = pmid17665541 /> This general reaction is:
 
:(5-L-glutamyl)-peptide + an amino acid <math>\rightleftharpoons</math> peptide + 5-L-glutamyl amino acid
 
==Structural studies==
In prokaryotes and eukaryotes, it is an enzyme that consists of two polypeptide chains, a heavy and a light subunit, processed from a single chain precursor by an autocatalytic cleavage. The active site of GGT is known to be located in the light subunit.
 
==Medical applications==
 
GGT is predominantly used as a diagnostic marker for liver disease in [[medicine]].
 
[[Blood test results interpretation#Liver function|Blood test results for GGT]] suggest that the normal value for men is 15-85 IU/L, whereas for women it is 5-55 IU/L.<ref>{{cite book |url=http://www.humc.com/lab_outreach/lab_services_10U.pdf |title=General Laboratory Manual |page=117 |publisher=Department of Pathology, Hackensack University Medical Centre |year=2010 |accessdate=20 November 2011}}</ref>
 
Elevated [[Serum (blood)|serum]] GGT activity can be found in diseases of the liver, biliary system, and pancreas. In this respect, it is similar to [[alkaline phosphatase]] (ALP) in detecting disease of the [[biliary tract]]. Indeed, the two markers correlate well, though there is conflicting data about whether GGT has better [[Sensitivity and specificity|sensitivity]].<ref name = betro /><ref name = lum /> In general, ALP is still the first test for biliary disease. The main value of GGT over ALP is in verifying that ALP elevations are, in fact, due to biliary disease; ALP can also be increased in certain bone diseases, but GGT is not.<ref name = lum /> More recently, slightly elevated serum GGT has also been found to correlate with [[cardiovascular diseases]] and is under active investigation as a cardiovascular risk marker. GGT in fact accumulates in [[atherosclerotic plaques]],<ref name = emdin /> suggesting a potential role in pathogenesis of cardiovascular diseases,<ref name = pompella /> and circulates in blood in the form of distinct protein aggregates,<ref name = franzini />  some of which appear to be related to specific pathologies such as [[metabolic syndrome]], [[alcohol addiction]] and [[chronic liver disease]]. High [[body mass index]] is associated with [[diabetes mellitus type 2|type&nbsp;2 diabetes]] only in persons with high serum GGT.<ref>{{cite journal | author=Lim JS, Lee DH, Park JY, Jin SH, Jacobs DR Jr | title=A strong interaction between serum gamma-glutamyltransferase and obesity on the risk of prevalent type 2 diabetes: results from the Third National Health and Nutrition Examination Survey | journal=CLINICAL CHEMISTRY  | volume=53 | issue=6 | year=2007 | pages=1092–1098  | url = http://www.clinchem.org/content/53/6/1092.long | pmid=17478563 | doi=10.1016/j.jacl.2011.05.004}}</ref>
 
GGT is elevated by large quantities of [[Ethanol|alcohol]] ingestion. Determination of total serum GGT activity is however not specific to alcohol intoxication,<ref name = lamy /> and the measurement of selected serum forms of the enzyme offer more specific information.<ref name = franzini /> Isolated elevation or disproportionate elevation compared to other liver enzymes (such as ALP or [[alanine aminotransferase|ALT]]) may indicate alcohol abuse or [[alcoholic liver disease]].<ref name = kaplan /> It may indicate excess alcohol consumption up to 3 or 4 weeks prior to the test. The mechanism for this elevation is unclear. Alcohol may increase GGT production by inducing hepatic microsomal production, or it may cause the leakage of GGT from [[hepatocyte]]s.<ref name = barouki />
 
Numerous drugs can raise GGT levels, including [[barbiturate]]s and [[phenytoin]].<ref name = rosalki /> GGT elevation has also been occasionally reported following [[nonsteroidal anti-inflammatory drug|NSAIDs]], [[St. John's wort]], and [[aspirin]]. Elevated levels of GGT may also be due to [[congestive heart failure]].<ref name = ruttmann />
 
==Human proteins==
[[GGT1]];      [[GGT2]];      [[GGT6]];      [[GGTL3]];    [[GGTL4]];    [[GGTLA1]];    [[GGTLA4]];
 
== References ==
{{reflist | refs =
 
<ref name = meister>{{cite journal | author = Meister A | title = The gamma-glutamyl cycle. Diseases associated with specific enzyme deficiencies | journal = Ann. Intern. Med. | volume = 81 | issue = 2 | pages = 247–53 |date=August 1974 | pmid = 4152527 | doi = | url =  }}</ref>
 
<ref name = dominici>{{cite journal | author = Dominici S, Paolicchi A, Corti A, Maellaro E, Pompella A | title = Prooxidant reactions promoted by soluble and cell-bound γ-glutamyltransferase activity | journal = Meth. Enzymol. | volume = 401 | pages = 483–500 | year = 2005 | pmid = 16399404 | url = | doi=10.1016/S0076-6879(05)01029-3}}</ref>
 
<ref name = goldberg>{{cite journal | title = Structural, functional, and clinical aspects of gamma-glutamyltransferase | last = Goldberg | first = DM | journal = Crit Rev Clin Lab Sci | year = 1980 | volume = 12 | pages = 1–58 | pmid = 6104563 | doi = 10.3109/10408368009108725 | issue = 1}}</ref>
 
<ref name = pmid17665541>{{cite journal | author = Yokoyama H | title = [Gamma glutamyl transpeptidase (gammaGTP) in the era of metabolic syndrome] | language = Japanese | journal = Nihon Arukoru Yakubutsu Igakkai Zasshi | volume = 42 | issue = 3 | pages = 110–24 |date=June 2007 | pmid = 17665541 | doi = | url =  }}</ref>
 
<ref name = pmid238530>{{cite journal | author = Schulman JD, Goodman SI, Mace JW, Patrick AD, Tietze F, Butler EJ | title = Glutathionuria: inborn error of metabolism due to tissue deficiency of gamma-glutamyl transpeptidase | journal = Biochem. Biophys. Res. Commun. | volume = 65 | issue = 1 | pages = 68–74 |date=July 1975 | pmid = 238530 | doi = 10.1016/S0006-291X(75)80062-3 | url =  }}</ref>
 
<ref name = lum>{{cite journal | author = Lum G, Gambino SR | title = Serum gamma-glutamyl transpeptidase activity as an indicator of disease of liver, pancreas, or bone | journal = Clin. Chem. | volume = 18 | issue = 4 | pages = 358–62 |date=April 1972 | pmid = 5012259 | doi = | url =  }}</ref>
 
<ref name = emdin>{{cite journal | author = Emdin M, Pompella A, Paolicchi A | title = Editorial - Gamma-glutamyltransferase, atherosclerosis, and cardiovascular disease: triggering oxidative stress within the plaque | journal = Circulation | volume = 112 | pages = 2078–80 | year = 2005 | pmid = 16203922 | doi = 10.1161/CIRCULATIONAHA.105.571919| url = | issue=14}}</ref>
 
<ref name = pompella>{{cite journal | author = Pompella A, Emdin M, Passino C, Paolicchi A | title = The significance of serum gamma-glutamyltransferase in cardiovascular diseases | journal = Clin. Chem. Lab. Med. | volume = 42 | pages = 1085–91 | year = 2004 | pmid = 15552264 | doi = 10.1515/CCLM.2004.224| url = | issue=10}}</ref>
 
<ref name = franzini>{{cite journal | author = Franzini M, Bramanti E, Ottaviano V, Ghiri E, Scatena F, Pompella A, Donato L, Emdin M, Paolicchi A | title = A high performance gel filtration chromatography method for gamma-glutamyltransferase fraction analysis | journal = Anal. Biochem. | volume = 374 | pages = 1–8 | year = 2006 | pmid = 18023410 | doi = 10.1016/j.ab.2007.10.025| url =  }}</ref>
 
<ref name = betro>{{cite journal | author = Betro MG, Oon RC, Edwards JB | title = Gamma-glutamyl transpeptidase in diseases of the liver and bone | journal = Am. J. Clin. Pathol. | volume = 60 | issue = 5 | pages = 672–8 |date=November 1973 | pmid = 4148049 | doi = | url =  }}</ref>
 
<ref name = rosalki>{{cite journal | author = Rosalki SB, Tarlow D, Rau D | title = Plasma gamma-glutamyl transpeptidase elevation in patients receiving enzyme-inducing drugs | journal = Lancet | volume = 2 | issue = 7720 | pages = 376–7 |date=August 1971 | pmid = 4105075 | doi = 10.1016/S0140-6736(71)90093-6| url = http://www.sciencedirect.com/science/article/pii/S0140673671900936 }}</ref>
 
<ref name = pmid2860060>{{cite journal |author=Raulf M, Stüning M, König W |title=Metabolism of leukotrienes by L-gamma-glutamyl-transpeptidase and dipeptidase from human polymorphonuclear granulocytes |journal=Immunology |volume=55 |issue=1 |pages=135–47 |date=May 1985 |pmid=2860060 |pmc=1453575 |doi= |url=}}</ref>
 
<ref name = kaplan>{{Cite book | author = Kaplan  MM, '''et al.''' |  title = Biochemical basis for serum enzyme abnormalities in alcoholic liver disease | in = Early identification of alcohol abuse | editor = Chang NC, Chan NM | work = Research Monograph No. 17  | publisher = NIAAA | year = 1985 | page = 186}}</ref>
 
<ref name = barouki>{{cite journal | author = Barouki R, Chobert MN, Finidori J, Aggerbeck M, Nalpas B, Hanoune J | title = Ethanol effects in a rat hepatoma cell line: induction of gamma-glutamyltransferase | journal = Hepatology | volume = 3 | issue = 3 | pages = 323–9 | year = 1983 | pmid = 6132864 | doi = 10.1002/hep.1840030308 }}</ref>
 
<ref name = lamy>{{cite journal | author = Lamy J, Baglin MC, Ferrant JP, Weill J | title = Determination de la gamma-glutamyl transpeptidase senque des ethyliques a la suite du sevrage | journal = Clin Chim Acta | year = 1974 | volume = 56 | page = 169}}</ref>
 
<ref name = ruttmann>{{cite journal | author = Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H | title = Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults | journal = Circulation | volume = 112 | issue = 14 | pages = 2130–7 |date=October 2005 | pmid = 16186419 | doi = 10.1161/CIRCULATIONAHA.105.552547 | url = }}</ref>
 
}}
 
==External links==
* {{MedlinePlusEncyclopedia|003458}}
* {{MeshName|gamma-Glutamyltransferase}}
 
{{Acyltransferases}}
{{Amino acid metabolism enzymes}}
{{Eicosanoid metabolism enzymes}}
{{Clinical biochemistry blood tests}}
 
[[Category:Chemical pathology]]
[[Category:EC 2.3.2]]

Revision as of 05:19, 26 February 2014

It is very common to have a dental emergency -- a fractured tooth, an abscess, or severe pain when chewing. Over-the-counter pain medication is just masking the problem. Seeing an emergency dentist is critical to getting the source of the problem diagnosed and corrected as soon as possible.



Here are some common dental emergencies:
Toothache: The most common dental emergency. This generally means a badly decayed tooth. As the pain affects the tooth's nerve, treatment involves gently removing any debris lodged in the cavity being careful not to poke deep as this will cause severe pain if the nerve is touched. Next rinse vigorously with warm water. Then soak a small piece of cotton in oil of cloves and insert it in the cavity. This will give temporary relief until a dentist can be reached.

At times the pain may have a more obscure location such as decay under an old filling. As this can be only corrected by a dentist there are two things you can do to help the pain. Administer a pain pill (aspirin or some other analgesic) internally or dissolve a tablet in a half glass (4 oz) of warm water holding it in the mouth for several minutes before spitting it out. DO NOT PLACE A WHOLE TABLET OR ANY PART OF IT IN THE TOOTH OR AGAINST THE SOFT GUM TISSUE AS IT WILL RESULT IN A NASTY BURN.

Swollen Jaw: This may be caused by several conditions the most probable being an abscessed tooth. In any case the treatment should be to reduce pain and swelling. An ice pack held on the outside of the jaw, (ten minutes on and ten minutes off) will take care of both. If this does not control the pain, an analgesic tablet can be given every four hours.

Other Oral Injuries: Broken teeth, cut lips, bitten tongue or lips if severe means a trip to a dentist as soon as possible. In the mean time rinse the mouth with warm water and place cold compression the face opposite the injury. If there is a lot of bleeding, apply direct pressure to the bleeding area. If bleeding does not stop get patient to the emergency room of a hospital as stitches may be necessary.

Prolonged Bleeding Following Extraction: Place a gauze pad or better still a moistened tea bag over the socket and have the patient bite down gently on it for 30 to 45 minutes. The tannic acid in the tea seeps into the tissues and often helps stop the bleeding. If bleeding continues after two hours, call the dentist or take patient to the emergency room of the nearest hospital.

Broken Jaw: If you suspect the patient's jaw is broken, bring the upper and lower teeth together. Put a necktie, handkerchief or towel under the chin, tying it over the head to immobilize the jaw until you can get the patient to a dentist or the emergency room of a hospital.

Painful Erupting Tooth: In young children teething pain can come from a loose baby tooth or from an erupting permanent tooth. Some relief can be given by crushing a little ice and wrapping it in gauze or a clean piece of cloth and putting it directly on the tooth or gum tissue where it hurts. The numbing effect of the cold, along with an appropriate dose of aspirin, usually provides temporary relief.

In young adults, an erupting 3rd molar (Wisdom tooth), especially if it is impacted, can cause the jaw to swell and be quite painful. Often the gum around the tooth will show signs of infection. Temporary relief can be had by giving aspirin or some other painkiller and by dissolving an aspirin in half a glass of warm water and holding this solution in the mouth over the sore gum. AGAIN DO NOT PLACE A TABLET DIRECTLY OVER THE GUM OR CHEEK OR USE THE ASPIRIN SOLUTION ANY STRONGER THAN RECOMMENDED TO PREVENT BURNING THE TISSUE. The swelling of the jaw can be reduced by using an ice pack on the outside of the face at intervals of ten minutes on and ten minutes off.

If you beloved this posting and you would like to receive additional information with regards to Washington DC Dentist kindly go to the web site.