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Dear Dr. Khan,
How are you? I am a 23 years old medical student. I have a few questions regarding bad breath. Do you think scaling can cure bad breath? Would you suggest using mouthwash and lastly, what kind of toothpaste do you recommend?

Dear Ms Nusrat,
Scaling is essential for maintenance of healthy oral environment, but it alone cannot cure bad breath. Actually the aetiology of bad breath is multifactoral. One of its important causes is improper cleaning of tongue. Another cause is carious cavity on tooth surface or periodontal pocket in inter proximal area (space between two teeth), which acts as a food stagnation area. Some systemic problems like indigestion, chronic sinusitis, and pharyngitis can also cause bad breath.

So to avoid bad breath it is necessary to brush teeth before taking breakfast and before going to sleep. Cleaning of tongue by tongue scraping, cleaning inter-dental area by dental floss and cleaning of cheek and palate is also necessary. If there is any carious cavity, proper filling should be done; scaling should be done at least once in a year if also essential.

No antiseptic mouthwash should be used for a prolonged period. Warm water with salt is a good mouthwash.

No, I don't recommend any specific toothpaste. You can choose any toothpaste containing fluoride. Toothpastes of the same brand should not be used for several months.

Dear Doctor,
I am having dental pain for quite some time. When I take antibiotics, I feel perfectly okay but for the last 2-3 months nothing seems to work. I also have problems in opening my mouth wide. What do I do?

Dear Ms Shaznin,
You did not mention your age and location of the effected tooth. However, from your question it seems that you have problem on your wisdom tooth (3rd molar). During eruption of the 3rd molar, if it is partially impacted, it is difficult to clean the area properly and sometimes can cause a painful condition called pericoronitis. It is not wise to take antibiotics regularly. If the tooth is in normal position, then with proper antibiotic coverage you may need to go through a small surgical procedure called operculectomy (removal of overlying gum). Please do dental x-ray and visit your dentist.

Dear Dr. Khan,
For a long time I could not find your column. I make a note of never missing the dental wise section. Anyway, I have a missing lower, first molar. I am 41 years old and a diabetic. Can I opt for dental bridge?
Nahid Sultana

Dear Ms Sultana,
Yes, you can easily go for dental bridge, if your 1st premolar and 2nd molar is ok. There is no contra indication about dental bridge and diabetics. But a diabetic patient is more prone to have periodontal disease. So you need to take special care after fixation of dental bridge, like proper cleaning of oral cavity, dental flossing after intake of food and regular check-ups with dentist is essential for the success of treatment.

Dear Dr. Khan,
Would you please tell me if it is important to do filling/root canal treatment of milk tooth on a 7 years old boy? Is it possible to suppress infection by prescribing antibiotics?

Dear Monira,
It is very important to preserve milk tooth or deciduous tooth up to its normal shedding time. In case of deciduous molar teeth, the shedding time is 10-12 years. So a 7 years old boy must try to preserve his molar teeth. But deciduous incisors that will shed within 6-8 years can be extracted if necessary at the age of 7.
Deciduous teeth are the best space maintainer for permanent teeth. So, early loss often aggravates a developing malocclusion (bad shape) and normal masticatory action will be lost. Deciduous teeth can be restored by filling or pulp therapy like pulpotomy, pulpectomy etc., which are much simpler than traditional root canal treatment.

Yes it is possible to suppress infection by taking antibiotic only for a certain time. But if the source of infection (like carious tooth, infected pulp) is not treated properly, the infection will aggravate. So, it is necessary to take antibiotics and proper treatment of affected tooth as per suggestion of your dentist, to cure infection completely.

Under a different sky

The darkness of the Sun

Mili woke up with the noise of the phone ringing. Her eyes glanced over to the clock, 6 am, she got up in a hurry, who could it be so early in the morning? Mili waited for another ring, but there weren't any more. She picked up her phone and looked at her caller ID…no calls; last call was last night at 10 pm from Rupa, her daughter. Mili could swear she heard the phone ring, she closed her eyes and searched for her most recent memories and realized the ring of the phone sounded foreign, it sounded like the old Dhaka phones, one of those generic screeching loud ones, the only kind that existed when phones were first around in Bangladesh. Mili laid down again annoyed at herself, knowing the phone didn't ring; it was her mind that rang wanting her to pick up a heavy old receiver. She doesn't have one of those here in America, even in Bangladesh those old phones are gone from most households that she knows of.

These days she feels like her phone is becoming a live object. When it rings she stares at the set before picking it up, and Mili can almost swear that the phone has an expression while it rings, sometimes a positive one, sometimes an urgent one, and most of the time a fearful one. She hates the rings, she likes picking it up as soon as possible, stopping the phone set from making faces at her.

Not that she gets tons of phone calls, enough to not make her an introvert but definitely not enough to make her a socialite. The calls that she waits for the most are from Rupa who lives in a nearby state but still far enough where things can happen…bad things…things that Mili can't prevent Rupa from…Rupa's marriage, Rupa's temper, worse of all Rupa's husband Dipu's violence.

Mili has lived in America long enough to know she shouldn't interfere in her daughter's marriage. She can only be supportive of whatever Rupa decides, either to stay in that marriage of anger, lies, tears and violence with few good days here and there or to walk out…but Mili also wonders about the options that are in the middle of these two, it is obvious that Rupa is depressed and she wonders if Rupa ever thinks of suicide. What if that animal kills her in the middle of the night, what if Rupa kills herself.

But she holds herself back from saying anything, instead she waits for the phone to ring, Rupa in the morning, Rupa at night. Rupa crying, Rupa complaining, Rupa depressed, Rupa snapping, Rupa lost, lost, lost, rotten…

When Mili was younger in Bangladesh, when she was just a daughter or a young wife and a young mother, she remembers how everything in need of preservation and cure in Dhaka had to be laid out in the sun. Comforters, blankets, bottles of aachar, even little babies with oil massaged bodies bathing in the sun to suck in vitamin c from the rays. Sometimes there were old damp things like record players and tapes even, and old pretty clothes, wedding saris of grand mothers and mothers. Sunlight reached all the hidden folds, untouched tears, unseen molds; sunlight cured it all.

Last night when Rupa called she said, “Ma I am done with this, I am going to leave, I might move in with you by this weekend”.

Mili replied, “I am here ammu, just let us know, amra jeye niye ashbo tomake, just tell us when.”

Rupa silently cried on the other side and Mili knew Rupa won't come home this weekend or the next … not yet, not soon enough. This was a routine; Mili said her part, Mili waited for phone calls.

The sun was now shining on Mili's feet- warm, cathartic sun. She wanted to call Rupa and tell her to go outside, lie under the sun, let the sunlight cure all; Rupa's inside, outside, her entire being…but Mili didn't call… instead she lowered the blinds, and in her dark room she waited for the phone to ring again and again…

Check It Out

Of manners and etiquette

“While our young professionals can learn most things from books, fine manners have to be learnt from observation, absorption and practice.”

An Executive's Handbook of Etiquette and Manners is possibly the first of its kind in Bangladesh. Akhtar Sanjida Kasem has done a commendable job in compiling corporate etiquette in a user friendly version for the local readers. Spread across ten chapters, Kasem has artfully presented the rules of the game: first impression, dining etiquette, communication etiquette, workplace etiquette so on and so forth. Use of relevant diagrams when need be has contributed to the greater appeal of the title. The section on communication etiquette seemed most relevant to the needs of the time; we as a nation are fast forwarding into a world dominated with communication and the well presented chapter would be a handy aid not just to executive, but people in general.

The hardbound book in an attractive cover, published by Oitijjhya Publications is well worth the price tag of Tk 200.

By Mannan Mashhur Zarif

Fresh forward this Boishakh

Bochorer aborjona
Duur hoye jak, jak, jak
Esho, esho
Esho hey Boishakh…

Get a fresh start on the Bengali New Year with a special offer from Farzana Shakil's Hair and Makeover salon. With 30% off on all grooming services like hair treatments, manicure and pedicure and more, you can rid your skin of the winter dullness and face the coming summer on a fresh note. This offer is valid between April 7-14, so hurry up and head to a Farzana Shakil outlet near you.

By the way

Confidently gorgeous…

You are in front of your mirror…for the final touch! Are you content with the reflection in the mirror? Does it say everything about you and your attitude? Whether you are heading for an interview, party or social gathering, your attitude is what attracts attention more than your looks...it is what adds that something extra to your persona...

Make a big impression without actually shouting down from the rooftops:
Modulate your voice…
And you will certainly go places! Whether it's deep and resonant or sweet and high-pitched, your voice should neither be too 'screechy' nor too deep that it degenerates into a growl.
Maintain eye contact…
But don't stare creepily. When you look at someone squarely in the eye, it creates a sense of connection and openness.
Stand and walk erect…
With your shoulders down, head high and chest fully expanded. A slouch can suggest lack of interest or enthusiasm. Stand straight to look confident and relaxed.
Alter your body language…
To inspire trust and facilitate communication. Covering your mouth with hands as you speak signals that you are lying; folding your arms or crossing your legs is a classic defensive posture.
Shake hands firmly…
But without crushing the hand offered. A handshake should convey confidence not dominance. There is a difference between shaking and holding hands.
Well, there is nothing quite like looking absolutely amazing. And with that confident move! Spring in your step and that sparkle in your eyes and the world will be yours for the taking.

By Zubaida Munny



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