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Dental wise

I am 25 years old and just graduated from Dhaka University. I have severely decayed front teeth and because of it I have to always avoid smiling. It does not ache but half of the crown part is already destroyed. What to do? Can I preserve that? How much will it cost?

Dear Mr Alam,
Yes, you can preserve it. Even if you have only the root (without the crown part), still we can preserve it by the root canal treatment followed by cast core technology. If you do not have any pain and the x-ray reveals no infection or no pulpal involvement then only bonding filling can replace the normal shape of your front teeth. So do not be frustrated. Please do not waste your time - visit your dentist right now.

Hello Dr. Khan,
Please tell me something about oral cancer. My uncle has died from oral cancer. He never had any dental problems; he was non-smoker and never even chewed paan. Moreover the final diagnosis of cancer was made after 18 months of initial dental complaints. Why was it too late to diagnose? Is it very rare in your practice? How many similar cases do you receive every month? Where should we go and when should we go? How will we find out if it may be a cancer? Will appreciate your comments.
Razu Ahmed

Dear Mr.Razu
Oral cancer is very common in our daily practice. In south east Asia (India, Srilanka, Bangladesh), it accounts for about 20-30% of all cancer.. whereas in USA, Japan, UK it accounts for only 3-4%. Why this geographic variation? This is because of abnormal oral habits such as paan, gul, chewing tobacco, lime, areca nut, bidi etc. Moreover poor oral/dental hygiene and lack of awareness greatly contribute to the high incidence of oral cancer in this region. You will be surprised to know that in my practice 50% of the patients having oral cancer came to me with other problems (e.g dental pain, bleeding etc). That means they even don’t know that they are suffering from oral cancer. Regular dental check up can contribute as an initial diagnosis of oral cancer.

The Importance of Early Detection
Early Detection Saves Lives
With early detection and timely treatment, deaths from oral cancer could be dramatically reduced.
The five-year survival rate for those with localized disease at diagnosis is 76 percent compared with only 19 percent for those whose cancer has spread to other parts of the body.
Early detection of oral cancers is often possible. Tissue changes in the mouth that might signal the beginnings of cancer often can be seen and felt easily.
Two lesions that could be precursors to cancer are
1. Leukoplakia (white lesions)
2.Erythroplakia (red lesions)
Other possible signs/symptoms of oral cancer
Possible signs/symptoms of oral cancer that my patients may report:
A lump or thickening in the oral soft tissues. Soreness or feeling that something is caught in the throat. Difficulty chewing or swallowing. Ear pain. Difficulty moving the jaw or tongue. Hoarseness. Numbness of the tongue or other areas of the mouth. Swelling of the jaw that causes dentures.
To fit poorly or become uncomfortable If the above problems persist for more than two weeks, a thorough clinical examination and laboratory tests, as necessary, should be performed to obtain a definitive diagnosis. If a diagnosis cannot be obtained, referral to the appropriate specialist is indicated.
Risk Factors for developing oral cancer
Tobacco/Alcohol Use
Tobacco and excessive alcohol use increases the risk of oral cancer. Using both tobacco and alcohol poses a much greater risk than using either substance alone.
Using Betel (Pan) Chewing, Zarda, Chewing tobacco, Lime, Areca nut, Gul
Virus: Human papilloma virus
Chronic fungal infection: It may lead to formation of epithelial dysplasia but overall, this accounts for a very small proportion of cases.
Malnurition: In south east Asia, malnutrition is widespread and may contribute, together with betel quid chewing, to the high incidence.
Oral Sepsis: Most common in low socioeconomic groups, which tend to have the most neglected mouths.
Poor oral hygiene
Ill fitted denture
Sharp edge of tooth

Exposure to sunlight is a risk factor for lip cancer
Oral cancer is typically a disease of older people usually because of their longer exposure to risk factors. Gender
Oral cancer strikes men twice as often as it does women.
What You Can Do
A thorough head and neck examination should be a routine part of each patient's dental visit. Clinicians should be particularly vigilant in checking those who use tobacco or excessive amounts of alcohol. All my patients get an oral cancer screening at each check up. All suspicious lesions are followed up and biopsied. Early detection of oral cancer is the key to curing this disease.
For further information, visit Dr. Khan’s website www.aikodental.com

By the way

Over-affection in public may not be received well. Remember our social norms and act accordingly.

Under a different sky

By Iffat Nawaz


I have this innocent tendency that can classify as small level prying. I have tried to get rid of it, but somehow I always justify it as a harmless habit, so I continued doing it ever since I was young till today, and I don't see myself stopping anytime soon, if ever.

The habit: well, if there is an open window that gives me a glimpse of a household when I am walking or driving by, I can not for the life of me deny myself the pleasure of staring right into someone else's private space. This urge started when I was a child. I assume the urge had something to do with the restriction factor. Since in Bangladesh, people are avid believers of curtains to separate their lives from the outside world to have some privacy, I always wondered what was happening on the other side of the veil. And if I was lucky some windows would move their curtains, letting sunlight in, and in-between those moments I would try to take in as much as I could through those convivial windows, I would try to stare far into the rooms, to the furniture, the unwashed clothes, the expensive clocks, the depressed teenager, whatever it offered. And almost always it was a pretty picture, even if it showed strands of sadness, it still made a beautiful portrait of something unreachable. After all, curtains don't move unless what's behind is ready for the outside world, to paint a pleasant image, for moments or hours, and to offer me just one glimpse of what seemed like the perfect world. A perfect world of others.

I was walking through the rain the other day. It was drizzling, a bit chilly. I was getting wet, but not enough to run or stop my walk. It was the kind of rain that gets you half wet, and you don't realize how much water has covered you until you get to a dry place. I was busy. Busy looking at open windows of a quite DC street. A street with pretty houses and tall trees. Cyprus and Magnolias. The houses were unaffordable for me, but I knew even if they were cheap as dirt I would still have the same attitude that I carried towards them; my desire drew me into lives of the different faces on their Sunday night. The different colors of walls, the arrangement of seasonal flowers sitting at the window, one last kiss bidding good bye to long distance lovers, good bad television watchers, intentional emptiness to accentuate beauty, beds being made, perfection in pieces, as if happiness is flooding their spaces, not reaching far enough to affect me, only making me curious to find out the rest of the story.

I know that these pieces of happiness, these strings of perfection only exist for moments. And only when you are outside looking in. Because I have been a part of it, the inside, we all have, behind the windows offering seconds of flawlessness to the outside world, performing one second acts, only meant to be watched for moments and not a drop longer, every moment dedicated to a different passerby, unintentionally but perhaps more consciously than we realize.

I smiled the other day to a passerby with curious eyes. She was watching me scrutinize my face in a hand mirror, she caught me looking deep into my own eyes, I was buried in my reflection. I looked up and smiled, she nodded. I saw a shadow of sheer pleasure on her face, she had just grabbed a perfect image and with her footsteps she was on to the next, in the next open window. My eyes followed her, from my imperfect world to her collection of perfections, all being stored in an imperfect bag of curiosity.


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