Toothaches are one of the most uncomfortable sensations that usually comes to us at night and its pain cannot be denied. We all like to go to bed and sleep peacefully at the end of a long day. However, many people are deprived of this peace and will face problems such as toothache. Unfortunately, this pain is very frustrating and one of the biggest difficulties is that you do not have access to a doctor.

Why do toothaches come to us at night? The general definition of the cause of toothache at night is that when we lie down, the pressure in the head area increases. When standing, due to gravity and blood pressure, there is some pressure in the arteries of the head and neck, and as we lie down, the internal pressure of the arteries increases. This chamber is located around the hard tissue of the tooth and in addition to the blood vessels, there are also tooth nerves in this chamber. In the supine position, when the pressure on the arteries increases, the pressure is also applied to the adjacent nerves and there is a feeling of pain in the teeth.

In addition to the general explanation mentioned above, there are various other reasons for this that unfortunately cause bad pain in our teeth. For this reason, we will continue to examine the reasons for this.

The simplest and most common cause of this is stuck food residue between the gums and teeth. The skin of apples, puffs, nuts or seeds can be part of the food that causes more pain by sticking to the toothpaste, which is eliminated by brushing and flossing.

Many people grit their teeth at night; Especially when they have too much stress. If you have a habit of grinding your teeth, then wait for jaw burning or toothache at night or in the morning. However, despite the infection or decay, the pain is exacerbated by bruxism.

Lower head when lying down at night can increase blood flow to the head and make the tooth feel rejected.

Tooth decay is also a factor for toothache at night.

Sinus infections can also put pressure on the maxillary teeth and cause toothache and jaw pain.

Pulpitis is also one of the most common types of pain, which is a serious infection and will cause inflammation, swelling, pressure and pain.

Sometimes you may be so busy during the day that you do not even notice your toothache. In this case, you think that toothache only occurs in your mouth at night. So at night, you should warm your head to see a doctor as soon as possible and find out the cause.

Foods that you eat at night, especially late, can cause your toothache at night. Cold, acidic, hot or high-sugar drinks at night can cause burning and sensitivity of your teeth; Especially if you have gum disease, tooth decay or other problems.

Try to keep your head above your body while sleeping: For this purpose, you should use a relatively thick pillow or several pillows. This prevents pressure on the bloodstream in your head and mouth. Holding the head up will also help relieve pain and improve blood circulation and reduce swelling and inflammation.

Home treatment of toothache:

Observe oral hygiene routine: Your mouth should be free of any contaminants that cause pain. So before going to bed, be sure to brush and leave it for two minutes and then use fluoride and floss. This will allow any food residue to come out of your teeth and eliminate the pain.

Apply some olive oil to the sore spot: This method is effective and eliminates pain and discomfort.

When your gums become sore and sore, rinse your mouth with salt water: This will keep your mouth free of any dirt, sores or infections.
To manage pain in the short term, you can use painkillers that eliminate inflammation and toothache: Of course, if in doubt, consult a doctor before using painkillers

If you see swelling in your gums or face, you can use an ice pack or cold compress to relieve the inflammation and soothe the sore spot. However, all of the above solutions only relieve pain in the short term, and you should see a dentist for permanent pain relief.

It is good to know that the pressures from chewing food are applied to the teeth in a balanced and appropriate way, and the teeth also transfer this pressure to the upper and lower jaws, but if a person loses several teeth for any reason, the force that when chewing enters the rest of the teeth by the masticatory muscles, it will be more than normal and each tooth’s share of the chewing pressure will be higher than normal. In such cases, vertical fracture of the tooth, which usually extends to the root, is expected.

This condition is more common in teeth that have been denervated due to extensive cavities or have large fillings. The pressure on the tooth may also be too high and cause it to crack, which over time can become a large fracture.

Some of the cracks that form in the enamel are allergies to cold and heat and sweet foods. A sign of some cracks that form at the root of the tooth is that the tooth hurts when you press your teeth together.

Fractures of denervated teeth are associated with symptoms such as dental abscesses, meaning that bacteria invade the tissues around the root of the tooth from the fracture site and can cause inflammation and infection of the gums.

In most cases, the cracks on the crown of the tooth can be repaired well, but in most cases, if the crack has occurred in the root of the tooth, it is not curable. Especially if a vertical root fracture has occurred, its treatment will not be successful in the long run.

Vertical root fracture is an unfortunate event in the treatment of the root canal (tooth denervation) that often causes the tooth to be extracted. Its clinical signs and symptoms are often similar to those of failed root canal treatments.

What are the effects of neglecting treatment?

Neglecting the treatment of any disease has consequences for the person. In the field of dentistry, delays in diagnosis and treatment are associated with medical problems or other complications for the person, including vertical tooth fractures. Because these teeth are often unmaintainable, they cannot be repaired, and the only treatment is to extract and replace them with implants or dentures.

Is it possible for a vertical tooth fracture to occur asymptomatically?

People should know the symptoms of this type of fracture and not ignore it. The onset of this problem in denervated teeth is accompanied by symptoms such as dental abscess, meaning that bacteria invade the tissues around the root of the tooth from the fracture site and can cause inflammation, gum infection and cavities.

In such cases, the dentist will first perform clinical examinations, then with further examinations through radiography will seek to discover the cause of the patient’s discomfort. Of course, diagnosing this type of fracture is not easy for the dentist. The dentist can use newer diagnostic tools in cases where this type of fracture is not visible in the photograph due to the two-dimensional nature of the radiograph. Undoubtedly, with early detection of tooth decay, the dentist can prevent it from turning into a fracture and causing more pain and discomfort.

Small stains are removed by ultrasonic cleaning, rotary polishing with anti-wear paste, or air polishing with abrasive powder. Teeth whitening can also be removed by whitening teeth and other methods. Note that whitening teeth will temporarily worsen the appearance of teeth with fluorosis.

Laminate veneer: Using porcelain veneers is another solution to remove white spots on the teeth. Veneers are custom veneers made to improve the appearance of each patient’s teeth. These veneers are used for people with severe fluorosis. Laminers, duratin veneers, nano veneers and very thin Imax veneers are very thin types of veneers that are used by cosmetic dentists at the right time.

Bonding: Bonding is a type of dental coating that is attached to tooth enamel with hard resins.

Dental crowns: Dental veneers are fixed prostheses that are attached to existing teeth or implants. Veneers usually cover the entire stained tooth.

MI pastes: MI pastes are made from calcium phosphate, which in some cases is used in conjunction with micro-abrasion techniques to reduce tooth discoloration.

Home care: Home remedies for blackheads and whiteheads focus primarily on remineralization (conversion of organic or organic matter to mineral). Our dentists believe that with increasing brushing and flossing, white spots disappear over time.

Brown and black spots on the surface of the teeth:

Cause: These stains are common stains on teeth. Causes of tooth blackening include excessive drinking of tea, coffee, smoking, and colored foods that are absorbed by the tooth surface.

Treatment: We use scalar to remove stains on the teeth and polishes and preventative pastes to smooth the surface of the teeth. Teeth whitening also helps to remove these stains.

Prevention: Avoid dark drinks such as tea, coffee and red wine. Also, avoid smoking.

Green and orange spots:

Cause: Accumulation of bacterial and fungal plaque on teeth due to improper and inadequate brushing

Treatment: Simple scaling of teeth and teeth polishing to remove accumulated plaque (hardened dental plaque) on the tooth

Prevention: Observing the correct principles of oral hygiene, brushing twice a day in the morning and at night and flossing regularly

Causes of mottled white, bluish-gray, yellowish-brown tooth stains:

Cause: Abnormal mineralization or tooth formation during tooth growth, disease, or the use of certain antibiotics can cause discoloration and staining of the teeth on growing teeth. These spots are usually present when the teeth come in and grow.

Treatment: The treatment of these stains is more complicated than the treatment of existing stains. The treatment of these stains includes acidic abrasions (removal of very thin layers of enamel from damaged teeth with the help of strong acids and coarse polishes), teeth whitening, filling teeth with white materials or use It is made of veneers and dental veneers.

Grayish black teeth:

Cause: In fact, the cause of black teeth in children and adults is tooth decay.

Treatment: The dentist can remove the decayed part of the tooth and use white fillings to replace the lost tooth tissue. Recent dental caries can be treated with topical fluoride therapy.

A single dark tooth:

Cause: This complication usually occurs after an injury or tooth decay that destroys the tooth nerve. We call that pulp necrosis. In some cases, the teeth become darker as a result.

Treatment: Dead teeth should be denervated. Then you can improve the appearance of your teeth by whitening your teeth, veneers or using dental veneers.

Different materials are used in tooth filling, also known as tooth restoration. The type of material used depends on several different factors, including the size and location of the decay, as well as the cost of filling. Two of the more common options are filling the teeth with porcelain or filling silver amalgam.

Silver amalgam fillers are actually a combination of several metals that are retained with a small amount of mercury. Although the idea of ​​having mercury in the mouth may scare some people, it has been found that the level of mercury in dental amalgam is harmless in this regard. These fillings usually last for at least 10 to 15 years on the teeth and can sometimes stay well on the teeth for decades. The reason for their longevity is that they are made of metal, which means that they show a hard surface. This is just one of the reasons why many dentists use this substance to fill large cavities.

When is it necessary to fill a tooth?

Almost all of us have or have had at least one tooth cavity at one point or another. It is very rare for a person to live their whole life without ever having this type of tooth decay. Some unlucky people seem to have regular cavities in their teeth, while many others may take years to develop the next tooth cavity in their mouth.

Cavities form when the hard, outer layer of your natural tooth is damaged. Damage occurs when bacteria make acid with the sugars in your teeth. This acid then combines with saliva and food to form plaque. Plaque and acids damage teeth by creating holes or cavities in the upper layers of the tooth until the inner pulp is affected. This can eventually lead to the need for root canal treatment and denervation.

These dental caries can occur in both adult and deciduous teeth. These injuries can often be painful, causing tooth sensitivity and pain when biting, and can even be seen as a hole or pit that can be seen with the naked eye. There are several reasons for this tooth decay, including:

Consume sugary drinks

Inadequate and irregular dental care

Eating regular meals and snacks

Excess bacteria in your mouth

Going to the dentist can reveal cavities on your teeth during the examination that you still cannot identify. This is why it is very important to see your dentist twice a year for cleaning and examination, as this can prevent any dental problems from getting worse. For example, sometimes a course of fluoride therapy is enough to treat a small cavity in the early stages.

As soon as the cavity is present, it is essential to treat the caries as soon as possible to prevent it from spreading.

Is the mercury in dental amalgam safe?

Most people know dental amalgams as silver fillers. Tooth amalgam is a mixture of mercury, silver, tin and copper. Mercury, which makes up about 50 percent of the compound, is used to bind metals together to create a strong, hard, and durable filler. It has been found that after years of research, mercury is the only element that binds these metals together so that they can be easily used in cavities.

Mercury is not toxic to dental amalgam. When mercury combines with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless. The amount of mercury released in the mouth under the pressure of chewing and grinding food is very small and there is no reason to warn. In fact, it is much less than the mercury that patients are exposed to in food, air and water.

Ongoing scientific studies over the past 100 years continue to prove that amalgam is not harmful. Allegations of mercury-induced diseases in amalgam, as well as claims of miraculous therapies obtained by removing amalgam. These claims have not been scientifically proven.
Why do dentists use dental amalgam?

Dental amalgam has withstood the test of time, which is why it is the material of choice for filling dental cavities. This method has a proven history of 150 years and is still one of the safest, most durable and least expensive materials used to fill cavities. It is estimated that more than 1 billion teeth are repaired amalgam (fillings) annually. Dentists use dental amalgam because it is easier to work with than other options. Some patients prefer dental amalgam to other options because of their safety, cost-effectiveness, and ability to be placed in the dental cavity quickly.

This material is a valuable option in suitable conditions because it can withstand the load and high pressure of chewing for molars (back). It is also useful in areas where it is difficult to keep the cavity dry when replacing fillings, such as deep fillings below the gum line.

Contact your dentist if you have any more questions or require a consultation about tooth fillings.

It is very important to clean the interdental space and finish the unfinished work of the toothbrush. Toothbrushes, both regular and electric, have access to only three of the five tooth surfaces. Therefore, if you do not clean the space between the teeth, 35% of the tooth surface remains uncleaned every day. As a result, plaque and food particles get stuck between the teeth, and if they are not removed in time, you will face tooth decay or gum disease. Depending on the distance between your teeth, flossing or brushing your teeth every day will help prevent these problems. If the interdental spaces are large enough, it is best to use an interdental toothbrush. But if your teeth are clenched, flossing is a better option. Of course, there are different floss and toothbrush sizes that you can choose the right type according to the size of your mouth.

Other care to maintain oral health:

The best way to keep your teeth clean and healthy is to have healthy, pink, and fragrant gums. Take your daily oral hygiene routine seriously.

Reduce snack consumption: Sweet and sugary snacks are ideal food for bacteria that cause tooth decay. If you eat these snacks during the day, the acid produced by the bacteria will always be present in the oral environment and the teeth will be exposed to constant acid attack. So if you insist on eating sweet snacks, try to eat them with the main meal. We recommend substituting healthy foods such as fruits, vegetables and yogurt for these harmful snacks.

Quit smoking: Continued smoking, whether smoking or not, increases the risk of oral cancer, gum disease and tooth decay; The harms of smoking and its role in lung cancer and heart disease are also familiar to everyone. So if you smoke, ask your dentist or doctor about how to quit.

Regular examination of the mouth and periodic visits to the dentist: If you maintain good oral hygiene, you will quickly notice changes in your oral environment, such as clenched and broken teeth, red or swollen gums, or unusual sores. If you notice a problem, be sure to see a dentist. Early treatment is the best way to solve many problems.

Use a mouth guard / night guard: If you or your child is an athlete, be sure to use a mouth guard when exercising. Using a guard is especially important during orthodontics or when restoring teeth. Also, if you have a habit of grinding or clenching your teeth, ask your dentist if you need to use a night guard.

The two most important organs of the face are the upper and lower jaws, which in the absence of fit between the two, such as the back or front of the jaw, excessive overlap, asymmetry, etc., a phenomenon called jaw and facial abnormalities occurs. Oral and maxillofacial abnormalities are caused by a variety of causes, such as genetics, or from the time a baby is born with symptoms, environmental factors, and damage to the jaw area due to an accident or injury to the jaw growth center in children when they fall from a swing or fall.

Genetic malformations are not preventable, but abnormalities related to environmental factors can be identified and the complication can be prevented by timely removal of the causative agent. In people with jaw and facial abnormalities, the function of this area is impaired, which includes chewing, speaking, breathing, as well as the aesthetic aspect of the person, and it is necessary to treat and correct as soon as possible.

Impairment of fetal development, consumption of certain drugs in pregnant mothers and exposure to certain chemical compounds are among the causes of maxillofacial abnormalities in children and cause disorders in the development of the dental-maxillary system. Smoking or drinking alcohol during pregnancy increases the risk of these problems.

Genetic disorders: In the early stages of fetal development, the occurrence of specific genetic mutations will cause a variety of syndromes.

Trauma to the mandible in childhood: The area of ​​the mandible that joins the skull is very vulnerable, and a small blow to it causes a fracture of this area, which is often asymptomatic. Falling a child while cycling, the fading of a tooth in some children causes the asymptomatic development of the mandible and the deviation of the jaw or the smallness of the mandible compared to the maxilla, which can be prevented by timely diagnosis.

Causes of jaw deformities:

The growth of the mandible on one side over the other occurs for obscure reasons and causes a deviation in the jaw that occurs between the ages of 15 and 25.

Shapes in the size of the teeth

Extra teeth: The most common extra tooth is a front tooth in the midline of the maxilla between the first two front teeth.

Early loss of baby teeth: One of the functions of deciduous teeth is to maintain the space in the jaw until a suitable time for the eruption of permanent teeth. Falling out of a baby tooth prematurely will cause adjacent teeth to move into the empty space and the underlying permanent tooth will remain hidden or will grow out of order.

Hereditary background: The protrusion of the mandible over the maxilla is the most common and well-known hereditary problem with the hereditary background, which is treated by orthodontists with treatments called orthopedics.

Habits: Finger sucking in older children and prolonged pacifier sucking by the baby have devastating effects on the dental system.

Tooth sensitivity to heat and cold can be more than a minor inconvenience. If you have to change your eating and drinking habits so that your teeth do not have an upsetting reaction to you, then perhaps your problem is more advanced than a normal allergy. It is not uncommon for your teeth to grind or become sensitive when eating ice cream or drinking hot or cold beverages, but it is important to understand the difference between sensitive and normal teeth and sensitive and abnormal teeth. The pain and tenderness you feel may be related to a number of oral health issues. Consider these potential reasons. They can help you respond to your problem effectively.

Causes of tooth sensitivity are divided into several categories:

Enamel erosion: Our teeth are protected by enamel. Enamel is the first defender of teeth to deal with tooth sensitivity to heat and cold, adhesives and abrasives. If tooth enamel decays, it can also lead to tooth decay.

Enamel erodes under the influence of multiple factors. These factors include:

Aging

Acidic or sweet diet

History of GERD

Excessive use of dental cleaning products

Hydrogen peroxide is one of the main ingredients in most teeth whitening, both at home and professionally and by a dentist. The use of this product has been shown to stimulate the nerves of the teeth.

These external factors that can cause sensitive teeth include:

Brushing too much

Excessive use of teeth whitening treatments

Drinking substances such as wine, coffee and tomatoes

Bruxism and stress

Nerve roots: The biological cause of tooth sensitivity is nerve roots. Things happen when the tooth root is exposed to cold air due to the retraction of the gums. Pathways called dental tubes are filled with fluid. When a cold air stimulator or cold liquid hits the large tubes, the liquid in the tube moves. The movement of this fluid in the dental tubes causes pain in the nerve and sensitivity of the teeth to heat and cold.

Tooth sensitivity to heat and cold is often a warning sign that cavities are forming. If that’s the case, it may be time for you to show your teeth to a dentist. Likewise, filling small cavities in your teeth can eliminate tooth sensitivity to heat and cold.

Clenching or squeezing the teeth together, intentionally or unintentionally, is called bruxism or gnashing of teeth. Those who suffer from bruxism rub their teeth only during sleep, which is called “nocturnal bruxism” or “sleepy bruxism”, while others wear their teeth during the day, which is thought to be caused by stress or anxiety.

Stress can occur for many reasons, including tragic events such as the death of a friend or the loss of a job; It can also come from happy events such as a new job or the birth of a child.
If you have the following symptoms, you may be at risk for bruxism:

Rhythmic contractions of jaw muscles

The sound of teeth chattering during the night, which may annoy someone sleeping with you in a room

Jaw muscles that are tight or painful

Prolonged pain in the face

Existence of damaged teeth, splitting of filled teeth and damage to the gums

Headache

Swelling (sometimes) on the side of the mandible caused by pressure on the teeth.

Bruxism can have many causes, some experts do not consider bruxism as something out of the ordinary, it can also be the result of the body’s reaction, when the teeth do not overlap. Some experts consider bruxism to be a habit, while others attribute it to one of the following:

Stress, anxiety, frustration and anger

A small weakness, or when the teeth and jaws are not aligned properly

Symptoms of rare diseases of the nerves and muscles of the face

In rare cases, it may be a side effect of some antidepressants, including Prozac (Fluoxetine), Zoloft (Sertraline), and Paxil (Paroxetine).

Bruxism can also be a sign of certain rare diseases of the nerves and muscles.

People with severe bruxism can break dental fillings or damage their teeth.

Grinding the teeth together can destroy the outer layers of tooth enamel and expose them to dentin. This can lead to tooth sensitivity.

Some cases of jaw disorders, as well as headaches caused by temporomandibular disorders (tmd), become unknown when you wake up in the morning.

If you experience any of these signs and symptoms, see your dentist, who can determine if you suffer from bruxism and will give you the best possible treatment. Your dentist will ask questions about the general health of your teeth, what sources of stress are in your life, and what medications you are taking. If you share your bedroom with someone, the dentist may want to talk to that person as well. The dentist will ask about your sleeping habits, especially any unusual noises during the night, and will examine you.

To alleviate bruxism, dentists will often prescribe a custom night guard, or if the cause is stress, will recommend some methods that may reduce stress or anxiety.

Preserving baby teeth

Preserving baby teeth is as important as puberty teeth. Drinking fruit juice with a glass of milk will increase children’s tooth decay.

One-third of children suffer from tooth decay by the age of 3 because they drink a glass of juice. These sugary drinks directly affect the teeth and produce acid, which causes premature tooth decay and loss of enamel, which in turn causes the tooth to become brittle.

Parents think that baby teeth are falling out and do not care if keeping these teeth is very important and it is better for their children to mix 5 fruits and vegetables instead of sweet juices and to Give the shape of fruit juice to children every day.

According to doctors, this recipe is increasingly useful and better than packages of sweet juices that are harmful to the teeth; The worst thing parents can do is pour the juice into a glass and give it to the child while he is napping; During the rest period, saliva secretion causes tooth loss, and this is worse than when the child is awake.

Usually when a baby is six months old, the first baby teeth appear in his mouth. The rest of these teeth take until the end of two or three years. The number of deciduous teeth in each jaw is 10 and in the whole mouth is 20.

Chewing teeth is the responsibility of baby teeth until the age of six. At this age, permanent teeth begin to grow and gradually replace them. At the age of 12 to 13, there are no more deciduous teeth and all teeth are permanent.

Most people believe that baby teeth are not important because of their short lifespan and do not need to be cared for. But the reality is different.

If the deciduous tooth is lost prematurely, the adjacent teeth move to the empty space of the tooth and narrow the existing space, so the eruption of a permanent replacement tooth in this space becomes problematic.

Unfortunately, this perspective often causes us to become overwhelmed when it’s time to start a new tooth. In this way, with insufficient care, they cause premature caries and their loss, which results in ectopic eruption or lack of eruption of permanent lower teeth.

Avoid putting your baby to bed with bottles and breastfeeding at night. Instead, offer water as a beverage whenever possible and clean a baby’s gums and teeth after each meal and before bed.

Gum disease is very dangerous and can cause tooth loss in adults. It can occur at any age, but is more common in adults. It can be easily treated with an initial diagnosis by a doctor.

Not brushing regularly and not flossing can cause plaque to form, and the bacteria in dental plaque, in addition to affecting the gums and teeth, can also have a detrimental effect on the gum tissue and the bone that supports the teeth. Turn the gums. Therefore, poor oral hygiene is the most common cause of gum disease.

In the early stages of gum disease, we can refer to it as gingivitis because it is caused by inflammation of the gingival tissue and accumulation of plaque on the teeth. If the dentist diagnoses the inflammation in time, treatment is easier. Prevent gum damage by going to the dentist and having a proper diet and regular use of toothbrushes and floss.

Periodontitis is an advanced form of gum disease, although it can be treated, but it forces dentists to use more difficult techniques such as deep root canal cleaning or germs and scaling the gums. But periodontitis not only affects a person’s gums, it can also cause tissue and bone loss throughout the mouth. If this happens, your dentist will recommend that you see a periodontist who can recommend more advanced methods to rebuild lost bone and tissue.

Symptoms of gum disease

Bleeding gums: Some people experience bleeding gums when eating or brushing, which is a mild sign of gingivitis. Fortunately, the disease is cured by brushing and flossing regularly as well as cleaning.

Bad Breath: Certainly, many people have experienced bad breath in some situations. If this odor is permanent, it is a sign of gum disease, because bacteria go under the gums and flossing is not possible with a toothbrush, and it smells like rotten apples. And alcohol is created.

Changes in the distance between the teeth: If you have gum disease, after a while the front teeth tend to move forward or backward, in a situation that did not exist before.

Inflamed and red gums: Red, inflamed or narrow gums can be another sign of gingivitis. To prevent the disease from progressing, be sure to see a dentist, because in more serious cases, it can cause the gums to recede from the teeth and the gums to become sac-like.

Sensitive teeth: The sensitivity of your teeth can be caused by brushing hard on the tooth, or by reducing the gum tissue, the root of the tooth, which is less than the outer enamel and causes allergies, appears.

Loose teeth: Adults usually do not have loose teeth, but if you move your teeth by touching your tongue or touching your finger, you may have gum disease.

Tooth scaling: The white or yellow substance on the teeth (mass) becomes hard and tartar with progress, which must be scaled by a doctor, toothbrush and floss have no effect in this case.

Some habits that cause gum disease:

Wear and compression of teeth: Some people grind their teeth as a result of sleeping or waking habits, which causes gum disease because it puts a lot of pressure on the tooth tissues.

Smoking : Research shows that smokers have more tooth mass than non-smokers. In addition, tobacco damage damages the teeth and gums, leading to infection and gum disease.

Stress : One of the reasons that may increase the risk of gum disease is chronic stress because it makes it harder for the body to fight infections.

Be sure to see your doctor if you see any symptoms.