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Dear Dr. Khan
Hello, this is Mahmood, aged 39. I have bad breath but no caries or gum infection. I brush my teeth after every meal. Why is it still persisting? Is there any other cause?

Dear Mr. Mahmood,
There are several causes for bad breath. Among them more than 60% are from oral and dental origin and rest from other systemic causes such as liver diseases, intestinal problems, sinusitis, pharyngitis etc. I recommend that you visit your dental surgeon to exclude any oral and dental problems.

Dear Dr.Mahfuj,
Hello how are you doing? I was your patient before. My name is Azam and I am 33 years old and currently residing in Saudi Arabia. You carried out some root canal treatment and cap on me. Those seem perfectly alright but recently my wisdom tooth has been creating problems (pain, swelling etc). A local dental surgeon suggested an extraction. But I am against tooth extraction. Is it possible to preserve those wisdom tooth by root canal?

Dear Mr. Azam,
Though I haven't seen your condition clinically or viewed an X-ray, but usually we strongly recommend for wisdom teeth extraction if it creates or may create problem in the future. I usually do not recommend root canal treatment of a wisdom tooth unless it has perfect functional position.

Dear Dr.Khan,
I am a banker. I have dental caries (black spot) in my front tooth, which is visible. I also noticed morning breath. I cannot usually take my breakfast before 10.00am. Can I use mouthwash on an empty stomach? What I should do for those black spot though I do not have any other complaints.
These days I rarely find your columns anymore..

Dear Mr Monir,
Yes you can use mouthwash on an empty stomach. Unless you take your breakfast, the typical morning breath usually stays. Any black spot means you have dental caries and in that case you should go for dental filling. I will try to be more regular in the future!

Dear Dr.Mahfuj,
I am Rubana, 33 years of age and .I have carious front tooth. It became black in colour, but there is no pain. What can be the treatment? Actually, I visited a dentist and he suggested a root canal and a cap. But I am confused as to why I need root canal as I do not have any pain. Can you explain to me what I should do?

Dear Rubana,
For your carious front tooth, root canal with porcelain cap will be the permanent solution. But as you mentioned that you don't have any pain, in that case you can try with a special type of tooth color filling (composite/bonding).

Dear Dr.M.H.Khan,
Hello how are u doing? I wrote to you two years back and very happy to see that you are still continuing with this effort. According to your instructions I got tremendous improvement about my bad breath. Now I have few questions about my regular scaling. Actually now I am residing abroad and scaling even seems very expensive. You told me every six months, but will it be okay if I do every two years? Here I saw all most every citizens do scaling every six months. I will appreciate your valuable advise.
Thanking you

Yes I am doing fine. Thanks for your appreciation and my pleasure that you got some improvement about your bad breath. I will recommend you to do dental scaling every year.

Dear Doctor
I am a 26 year old woman and I have been a skinny child all my life. I have tried many things to put on weight but nothing seems to work. I am not happy with my figure especially my hips and chest. I love to wear saris but with my figure it looks awful and makes me more miserable. Please help.

It's very frustrating if you don't like the way you look or can't wear THE clothes you like. My first advice will be to change your thoughts process. I am sure there are many positive things about your looks, so try to look at those and work on them. Start by going to a gym to work out as it helps to build up your body. Gyms are not only important for losing weight. As for your problem with your bust, we can help you by augmentation mammoplasty which is done by silicone implants. This is very safe and used worldwide. For the hips we can do an augmentation where silicone implants are used as well. These procedures are very safe and practiced very widely. The results are excellent and give patients desired results.

Dear Doctor
I have a son who is 7 years old and he has been suffering from earaches for some time. He wakes up in the middle of the night because of the pain. We took him to a doctor who told us that he had a middle ear infection. He asked us to do an X-ray and now he is of the opinion that our son has enlarged adenoids and needs surgery. This has us worried as he is so young. Could you please advice us on what to do?

It does make a parent worried to hear that his 7 year old needs surgery. But if your son has enlarged adenoids which are causing middle ear infections, he does need surgery. Adenoid is a lymph gland located behind the nose on the nasopharynx. When it becomes enlarged, it blocks the tubes which drain the middle ear and so the child has earaches and feels his ears are blocked. Also the child breathes by mouth all the time. These can cause problems for the child's health. The adenoid gland gets enlarged between ages 3 to 12.So this is the time the child usually suffers. Your ENT consultants will be able to best decide whether surgery is required or not.

Dear Doctor
I am a 29 year old male and I had a deviated septum. I got surgery done for it but I developed complications and the middle of my nose became flat. This makes me look very bad. Can anything be done to fix this?

Yes, of course it can be fixed. You probably need an augmentation rhinoplasty. The bridge of your nose probably got flattened and this can be augmented by an implant which can be taken from behind your ear or a bone graft from your elbow or elsewhere. Nowadays, we also use silicon implants and so we don't have to do surgery elsewhere to get the graft. The procedure is done under general anesthesia but you don't have to stay overnight in the hospital, although you will have a bandage for a few days.

Dear Doctor
I am a 25 year old female and I fell off a rickshaw when I was a child and got abrasions on my cheek. They are healed but are dark in colour. I have to apply a concealer when I go out. Can anything be done?

Well I can't tell you precisely without examining. If it's only a simple scar then scar revision might be done, but if it's a scar with dirt tattooing then dermabrasion might help. Scars are of many types and it is hard to advise without examination.



Know your herbs

Under a different sky

By Iffat Nawaz


Then you were young, a tiny-tiny thing, but not too tiny to have memories of being tiny, did you ever feel while laying on a bed that the bed was as big as an ocean, that there was so much space around you that you could swim in it?”

“Yes, I do remember that. Even though the bed might have been a queen size or a king size at the most, I remember feeling like there was nothing I could do to fill this space up.”

“Yes, exactly, me too. My Grandfather and Grandmother had huge beds which they had brought over from India during the partition of '47, they were all so grand, beautiful wood work, I could easily play pretense princess around them. Then I fell twice from the beds and once it left me with a huge bump on my forehead. I remember being hurried to my mother's uncle, my “Phul nana” who was a doctor and lived in our neighborhood. Ever since then I was a bit scared of the giant beds. I think there was a humongous bed like that in the Dhaka Museum; one needed stairs to get to the mattress. But you know now when I am on those beds they feel so much smaller, except the wood work, which are still beautiful I suppose, but the bed itself is so conquerable.”

“Conquerable…yeah, I know that feeling. How many times did you fall from beds and stairs, missy? Such a clums!”

“I know, I used to be so clumsy!”

“Used to? You still are! You almost tripped down a mountain the other day, stepping on loose rocks, remember?”

“How am I suppose to know there were loose rocks, I am no longer a clums, get off it!

But I do remember falling off beds and stairs, broke my nose once falling from the old stairs of my Grandma's house and the first thing I said with a bloody face after they rescued me was “Baba ke bolo na” (“Don't tell Father”), I don't know why I was so concerned.”

“I never fell when I was young, I was a strong little one, and if I fell, I fell intentionally, I would jump down trees, holding on to branches and hanging on the way down, and yelling for my Mom, trying to show her how cool I was ”

“Show off! You were always a show off “bandor”! I never did things like that.”

“Yeah right, you did that and more, miss chatty Kathy, you were a little talker, ham as we call it, talk-talk-talk, attention grabber, and you never stopped”

“Yeah, yeah, whatever! Anyway…do you have any memories from when you were born?”

“Ummm, no, and neither do you. No one has memories from when we are born, silly!”

“Okay I meant memories that others have told you and you after hearing the stories many times over have created a whole set of images from that time of your birth and the people who were there.”

“Yes I guess, but mine was the usual I think, Mommy goes to the hospital, gets a new baby and some soft toys.”

“I doubt it! I have to ask your mom when I see her next about the stories from your birth. Apparently when I was born it was raining hard for a few days, monsoon of June, my mother was in labour all night at some clinic in Dhanmondi, and next to it there was a lake where frogs ribbited or as we say “ghangor ghangor ghanged” all night, and in that morning after I was born, a blue baby with no scream or tears. My Father told me they bought me from the frogs, while he slept in the clinic all night waiting for Ma to give birth the frogs had kept him awake, and somehow got thoroughly involved with my birthing process.”

“You miss Dhaka today don't you?”

“I do…it's becoming obvious isn't it? …I know…I always do this…I miss Dhaka and the past, and my nostalgia is acting up once again, piecing reality and figuring out how much of it really existed.”


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