DR. Mahfujul Haq Khan BDS, DDS, FSDCE (USA), PhD (Japan), Post Doc. (Japan) Specialised: Crown and Bridge work, and Periodontal plastic surgery (USA) Senior Medical Officer, Department of Dentistry, BIRDEM Hospital
Q. Dear Dr Khan,
I found a question raised by Mr. Zulhash from Chittagong very interesting. I too sometimes feel and believe that medical service is no longer service oriented but rather is a global business. You mentioned about silent dental disease. Can you give us some more information on silent dental disease and its prevention? Thanks, Anita sarkar
A. Gum (Periodontal) disease is your silent enemy and silent epidemic of oral disease, because you may not know you have it. Gum Disease is the number one reason for tooth loss. Recent reports have indicated that "a relationship exists between Periodontal disease and stroke, heart disease, diabetes, and pre-term low-birth-weight babies." Gum disease is almost universal, and is chronic and progressive, and generally not self-correcting. Most adults with gum disease are unaware that they have it. However, if diagnosed early, teeth can be saved. Periodontal disease is the primary cause of lost teeth after the age of 35. But the good news is that if caught in its early stages, gum disease can be reversed.
I have compiled the latest information about this silent disease that you can use to retain your smile for a lifetime.
What is Gum Disease?
Gum disease is caused by plaque, a colourless film of bacteria that forms on teeth. If not removed daily, plaque mixes with sugars and starches in the diet to form acids and other by-products in the mouth. Plaque irritates the gums, causing them to become red, tender and swollen. It also causes the gums to bleed easily. If not removed, plaque hardens to form calculus (tartar) around the necks of the teeth.
Eventually, the irritants in plaque destroy the tissue that attaches the gums to the teeth. The gums pull away from the teeth and small pockets form between the teeth and gums. These pockets become filled with more plaque. Eventually, the jawbone supporting the teeth is destroyed.
In addition to plaque, a number of other factors can cause gum disease including:
1. Physical and Chemical Irritants: Impacted food, smoking, chewing tobacco, excessive alcohol consumption, improper use of dental floss and toothpicks.
2. Poor Habits: Oral conditions of habits that cause abnormal stress on mouth tissues include badly aligned teeth, poor fitting bridges or partial dentures, defective fillings; also habits such as grinding or clenching the teeth, or chewing ice.
3. Unbalanced Diet: Evidence shows a link between nutritional deficiency and the body's ability to fight off infection. Vitamin C deficiency has been linked to gum disease.
4. Pregnancy: Increased hormone levels may aggravate a condition commonly referred to as "pregnancy gingivitis."
5. Diseases: Diabetes, uremia, liver cirrhosis, anemia and leukemia may affect the health of your gums.
6. Certain Medications: Oral contraceptives, anti-epilepsy drugs, steroids and Cancer therapy drugs may also effect the gums.
What Are The Symptoms?
Gums that bleed when you brush your teeth
Red, swollen or tender gums
Gums that have receded or shrunken away from your teeth
Pus between your teeth and gums when you press your gums with your finger
Teeth that seem loose or that change position; often the front teeth tend to "fan" out
A change in your bite
A change in the way your partial dentures fit
Of course, the only way to confirm a diagnosis of periodontal disease is to have your mouth thoroughly examined, and the necessary oral x-rays taken. We also recommend a thorough prophylaxis (tooth cleaning) for adults at least twice a year. At that time we may use a special instrument called a periodontal probe to measure the depth of the crevice (pocket) -- the space between the tooth and the gum tissue. Pocket depth measurement, clinical examination and x-rays determine the precise extent of gum disease.
The type of treatment required depends upon the stage of the disease. Individualized treatment may include any of the following:
Scaling and root planing. Scaling is removing the calculus deposits from your teeth; root planing is the smoothing of the root surfaces so that the gum tissue can reattach to the tooth.
Curettage removes the soft tissue lining the periodontal pocket. This helps the gum tissue to heal.
Gingivectomy is surgical removal of the periodontal pockets when the disease does not involve the jaw bone.
Flap surgery allows us to gain access to the root of the tooth for removal of calculus, plaque and diseased tissue. The gum is then secured back into place. Flap surgery is sometimes accompanied by osseous (bone) surgery, in which the bone around the tooth is reshaped or part of it is removed.
You need not lose your teeth to gum disease.
Thoroughly brush and floss.
Eat well-balanced meals.
Examine your mouth.
Visit your dentist at least twice a year.
Please Visit Dr.Khan's website www.aikodental.com for more information.
Nighat Ara, Psychiatrist
Continues from last week's issue
I take a decision after lots of analysis and discussion, but unfortunately I can never concentrate in a particular work. When I am doing one thing, I think about hundreds of other things. Though I am a very talented person as others say, and I don't have to give much effort in any work as I can grasp the big picture very easily, I still cannot concentrate for a very long time. On many an occasion, I had studied only 2-3 hours before an exam. Though I know studying more will help me to do better I cannot sit down to read. I roam here and there, watch tv, read magazines. The same thing applies for all other kinds of work that I do. How do I concentrate and focus on one particular thing at a time?
Ans: Your concern is about your ability to concentrate and focus on issues that deserve priority. I think it is a very common problem and can result from various causes. In general, the usual attention span is around 20 minutes, and it is difficult to pay full concentration on a particular subject for a period longer than this. Therefore, people find it easier to focus on a particular topic for a longer duration, if it is interspersed with different kinds of activities (writing, reading, discussing, diagram etc.) and take breaks in between. Attention span and intellectual capacity are two different mental functions. ADHD ("attention deficit hyperactivity disorder") and ADD ("attention deficit disorder"--hyperactivity is not a feature here) are specific psychiatric conditions where short attention span and easy distractibility are the main features. ADD children are often viewed by their teachers as bright and capable but "lazy and unmotivated".
A neurochemical imbalance (abnormal level of neurotransmitters like--adrenaline, noradrenaline, dopamine etc) in the brain has been particularly attributed to ADHD syndrome. Neuro-physiological findings indicating maturational delay of the brain can also manifest symptoms of ADHD in children before 5years. Genetic predisposition and psychological factors (particularly prolonged emotional deprivation, chaotic family life etc.) are also linked to these conditions. Complete remission of symptoms usually takes place between 12-20years, although in 15-20% cases, persistence of symptoms of ADHD into adult life has been reported.
In adults with ADHD, early employment history does not differ much from those people with similar educational background. However, these people always carry a higher risk of interpersonal conflicts, lower achievement level compared to their intellectual capacity, substance dependency problem, and mood disorders etc in later life. Dextroamphetamine and Methylamphetamine are very effective in these conditions and need to be assessed and monitored closely by a psychiatrist. Family therapy can also play an important role in the over all treatment plan.
Rushing of thought and short attention span can also be symptoms of Bipolar Disorder (manic phase). Ability to take a decision after lots of analysis and discussion is good, though excessive rumination may require further exploration. It is always wise to go to a specialist and get appropriate help in this situation.
Did you know…
That adding a handful of rock salt to a bag of rice will keep insects away? To keep your kitchen ant free, place bits of cucumber peel all over. Ants are repelled by the smell of cucumber.
A DIFFERENT SKY
The inevitable depression
I knew it was coming, and I knew I wouldn't be able to express it with tears or facial expressions of any sort, I knew I would fall into it as soon as I had entered the too-late-to-turn-back and too-near-to-turn-around zone. Dhaka airport and my messily packed suitcases. Many shades darker, a bit thinner and with a new addition of a nose ring to redefine the old traditions I walked in using all my rights of being a female in Bangladesh, which basically translates to walking in without having to wait in line.
Each step I took I wondered do I really have to return, I looked around at everyone to see if anyone was turning back towards the gate and freeing themselves to Dhaka and it's polluted air. But no, no one was. Most just wore their gloomy faces, a few had left over tears. I closed my eyes, tried to listen to my brain, which gave me back fragments of music that was being played in my Discman, an Urdu song this time,"…Na jane kab se ummidei kuch baki hai. Mujhe phir bhi teri yaad keu ati hai…? Dur jitna tu mujshe paash teri mei, ab to adaat si mujko aise jine mei, zindegi se koi sikya bhi nehi hai, ab to zinda hu mei ish nile asma mei…" "…
Don't know since when a few strands of hope remained,
Why does my sore soul still drown in your memories…?
A completely unrelated song, perhaps written for some heartless lover who left her man in some cold blue reality, and now the desparate pains of the lyrist and mine seemed so similar. Can all pain, of all different shapes and sizes get translated into the same random few words? Do they all blend together to create the exact harmony that will hit the heart? My feelings the same as the one who made it a habit to hope and live in the dreams of blue skies, the sky that might take me far or bring me near, the sky that's so different yet looks just so disturbingly alike. Or is it all in my mind? A habit?
I tried to distract myself, I tried to listen to the other passengers, some swearing that they will never come back to the miserable Bangladesh and the even more miserable people, some banging the phone receiver repeatedly to make it work, the phone that gives false hope of the last connection to the Dhaka outside, the phone that predictably doesn't work, the phone that only sits in the dirty shelve of Dhaka airport lounge as the last shot at some dark comedy…
It was time then to board the plane, as a habit most competed to be the first in, and then there were some like me, who waited and stood up with no interest, and slowly tried to make it in or rather, hoped that the plane would leave if we took slow enough steps. I closed my eyes…
they say you see your whole life flash in front of you before you die, I saw my Dhaka in fragments in front of me, the street of Sakari bazaar where I waited for a rickshaw while the statues of Sarswati were being made right next to the garbage dump, the floor of Deshal in Aziz Super Market where I had familiar yet never heard music with my second cup of teas, a hand conquering me with hundred of belies, a best friend who fought and loved and still brought me closer to her through thick and thin, the face of a sick one who had fallen ill after eating "kangali bhoj" at the funeral of some terrorist who was executed by RAB.
But to mend with my habits I still walked on, my Dhaka remained and it's left over cries still sang to me while I stopping my last tear voluntarily fell into the inevitable depression.