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Dear Dr. Khan,
I am 49 years old. My teeth are gradually becoming bigger in size. On consultation, a dentist told me that it is because of gum recession. Would you kindly explain what is gum recession and its possible prevention or cure?
Hasmot Ali

Dear Mr. Ali,
Gum recession occurs when the underlying bone melts away. There are several reasons for this, depending on the patient's age and condition. Many attribute this problem with brushing too hard. However, many patients with this problem never pick up a toothbrush. Almost all toothbrush manufacturers make soft bristle brushes to avoid abrasion. As observed in young people, receding gums are most often caused by tooth grinding.

The most common reason for gum recession is gum disease. Gum disease usually strikes patients over the age of thirty and destroys the bone around the teeth. Eventually the diseased teeth become loose and their bone is lost rapidly. The recession becomes more obvious.

An older person who makes less saliva often complains of a dry mouth. The exposed root surfaces are at risk of getting a special type of tooth decay called root caries. Some diseases and nutritional deficiencies can contribute to this problem. Diabetics tend to have more gum problems. Vitamin C and calcium deficiencies can also contribute and in rare cases, trauma can be a cause.

Gum recession looks terrible and it's difficult to correct. Most often gum grafting is performed but because there is no underlying healthy bone, the results may not be lasting. The best way to handle it is to prevent the problem by visiting the dentist regularly.

Dear Dr. Khan,
I have cavity in my posterior tooth. I did amalgam filling twice but its not working properly. It seems dislodged and broken. My dentist suggested dental cap. What is your opinion? Is there any alternative treatment?
Thanking you.

Dear Mr. Akbar,
I think you can go for inlay (laboratory based filling) instead of cap. Inlay is a relatively new and very effecting filling. Normal amalgam filling contains mercury, but inlay contains no mercury but a biocompatible and friendly material for the oral environment. For inlay preparation we do not need to reduce the tooth structure, only measurement of cavity with minimum adjustments suffice.

Dear Doctor,
I am a 25-year-old man. I have a nose that looks crooked. I also have breathing problems, especially at night when I turn on my sides. I have consulted with ENT surgeon who has advised surgery but I am scared whether they will be able to fix the shape of my nose or not. Can it be treated with medication? Could you give me some advice please?

No, I don't think this can be treated with medicine as it sounds like you have problems with your bone structure. You definitely need surgery, as bones cannot be remodelled by medicine. You need a septorhinolasty where the problem from both inside as well as outside can be fixed. The problem inside the nose and also the problem with the shape of the nose can be fixed. Any ENT specialist or plastic surgeon familiar with doing the procedure will be able to do the surgery.

Dear Doctor,
I am a 35-year-old woman. I have had a discharging ear for the last ten years or so. I have consulted ENT specialists many times, who have prescribed different drops and oral medicines but the problem keeps coming back. What can be done to solve it permanently?

You are suffering from chronic suppurative otitis media or simply CSOM. It is an infection of the middle ear and should be treated very seriously. The more infections you get the more trouble you will get with hearing. You probably already have some amount of hearing loss. Anyways, you should try to keep your ear dry and let no water enter. Also make sure you don't have any problems with your nose or throat as those conditions will be a hindrance in treating your ear. If you do have that kind of a problem they should be treated simultaneously. After your ear is dry try to keep it dry for about a month, a tympanoplasty can then be done. In this surgery a graft is placed on the perforated tympanic membrane to seal. Its a procedure done by the help of microscope and is quite successful. After the surgery your ear will remain dry, as no perforation is present, and also further hearing loss is prevented. Please get the proper treatment as soon as possible.

Dear Doctor,
I have a very bad and depressing problem. I am getting bald. I am only 28 years old and single. As I want to get married now, I find that this baldness has become a drawback. What can I do?

Yes this can be a problem, but not a bi g one. A person should be able to look beyond the appearance where marriage is concerned. But as first impressions are important this can be a drawback. You have an option of doing hair transplant where hair follicles are transplanted into the bald areas. The follicles are taken from the patient's own head and then grafts cut out and placed. This is a very sophisticated procedure where loops and microscope are used all along. The results are very good and hair growth takes four to six months to start. The hair is totally natural and will grow at the same rate as the rest of the hair.

Dear Doctor
I am a 25-year-old woman. I had pierced my nose from a parlour two months back, but it's not healing. There is a swelling on both the inside and outside of my nose and sometimes it becomes painful and pus comes out. I tried taking off the nose pin and put in a tiny pick as my mother suggested but that seems to have aggravated the situation. I don't know what to do now. Can u help?

First of all you definitely need to take out the pick, as it is something that will aggravate the condition. Then you have to start an antibiotic both local and systemic. Also. please consult a surgeon for further treatment. It can be ENT or Cosmetic Surgeon but if you don't treat the nose you will develop a keloi, which is hard to treat.

Dear Doctor,
I am a 34-year-old man. I am getting married in about a year's time. I think I look older than I am, especially because I have baggy eyelids. This also makes me look very fatigued. Can you help me?

Baggy eyelids can make a person look older and fatigued. If you are overweight loosing a few pounds might help, if not then a surgery known as blepharoplasty can be done. Here the excess fat from under your eyes is reduced and that makes the bagginess go away.

Dear Doctor
My son is 15 years old. He has a discharging ear, which doesn't seem to dry. I am very worried as I think he is partially loosing his hearing. I have heard of surgery where the tympanic membrane can be repaired. Do you know how reliable this surgery is and whether it can be done in Bangladesh?

You should get his ear treated right away otherwise he will steadily keep on losing his hearing power. As the infection spreads, his hearing ability will diminish greatly. He has to keep his ears dry by not letting any water in during bathing. Earplugs should help.
The surgery you are asking about is known as tympanoplasty. This is being done successfully in Bangladesh and your son probably needs it. Please see an ENT consultant for further information.

News Flash

Bridal Asia comes to Kolkata

HERE'S good news for those going out and out in December for their weddings. Bridal Asia is making a one-stop destination to Kolkata, with the finest of Asia's trousseau collection, in August 2008. Bridal Asia Kolkata, Hotel Hyatt Regency, Salt lake City, Kolkata, India; info@bridalasia.com; www.bridalasia.com; Contact number: 91 11 45055576

Kebab @ Cafe Bazar

THE grilled love affair, if we may call it, draws us to mouth watering smouldered beef, mutton boti, or delightful chicken tikka, be it at the make-shift way side joint or an upscale restaurant. Enjoy an assortment of kebab with the aura of burning charcoal at Café Bazar in Pan Pacific Sonargaon from Thursday 3 July till Saturday 12 July. Augmenting the Indian delight, each buffet dinner will have a myriad assortment of international cuisines. For more information contact: Café Bazar # 8111005 ext.-4139.

Euro Asia CMYK workshop

URO Asia Cosmetics Ltd. a renowned importer of premium skincare products has revolutionised the skincare industry with CMYK, a leading Italian brand offering derma-cosmetic solutions for holistic skincare. On June 15, 2008, Euro Asia Cosmetics Ltd. held a workshop on "CMYK Product Knowledge Enhancement" amongst its sales team. The product training was conducted by Marin Walter, the CEO of Euro Asia Cosmetics Ltd.
-LS Desk

Under A Different Sky

By Iffat Nawaz

Falling down the moving machine

THE long-steel-moving stairs lead up to light, and next to them another set of identical stairs lead down to darkness. They always strike you when you see them even if you had ridden millions of others elsewhere. Getting used to them takes time. Yeah, sure they are mere escalators in the DC metro, yet that's not all that they are, they are way more. They are these tall-tall things with gazillion people moving up and down with a purpose, they differentiate personalities, break backs, test your stamina, lets you look at the faces coming up while you are going down and vice versa. I have been riding the DC metro for 11 years now and these long, scary escalators have become a part of my day and night more than I ever wanted them to be.

And like every metro rider, I feared that day, that day when I would fall. It was bound to happen. If you take the metro a few times a week, every week for years, isn't it a given that you would fall one day? But I hadn't once fallen in the last 11 years and it started to scare me, because I knew it was coming. The fall. When and which set of escalators I didn't know. I hoped it was a less steep one, and not a long, hopeless one where your fall would continue on without a pause and in the end you could be toothless, broken nosed.

To me these escalators look like death. The way they move, the sound they make, their tainted silver colour, the sharp edges, the effect it creates when shoes and heels hit them up and down….scary. If anyone took a bad enough fall it could cause serious injury.

There are two kinds of escalator riders. The first one are those who even in the biggest hurry stand still on the right side and let the escalator do the job of carrying them to the top or bottom. And then there is the second kind, the leftscalators, my group, who always choose to walk up or down the escalator, no matter how long the stairs are. The left side of the escalator is reserved for us to hurry up and down. For us leftscalators the speed of the escalator is too slow to stand still, we move while the escalator moves us and we get up and down faster. And anyone who stands on our way gets a loud and cold “Excuse me” until they move to the right side, the lazy side, the side that's safe.

So yesterday, I was doing my usual. Both hands occupied with purse and shopping bags going down the escalator to catch the metro. There were 50 in front of me and 50 behind. We were all climbing down at the same pace and then it happened. My high heels that made me almost 5'6 couldn't take it anymore, they slipped. I fell down a few stairs and hit the people in front. Good thing there was no domino effect, I stopped my fall with a scrapped knee and leg and a very shaken body. I moved to the right side so others could go ahead. I have feared this fall for a decade now and my body and mind were prepared to protect me from the worst, from being toothless and broken-nosed. But it was really not that bad though I was bruised, though I felt embarrassed.

The lazy right side that I mocked year after year took me in as a refugee; I sat on a stair all the way down to the bottom. I could barely get up to get off the escalator and didn't want to look back or around. There were a few muffled “are you okay?” which I ignored.

I am okay of course; it was only a short fall, nothing serious. I know people who had to get knee surgeries done from their fall from DC metro escalators, mine is just a scratch and a bruise. The escalator had mercy on me; our relationship must have been sweeter than I thought. But I am still not ready to ride the moving machine, how can you trust something that's heard before it is seen, just like anything mighty and vicious. And if I do go back I am sticking to the right side; I am converting to the slower side, which I know now was always the wiser side. When you run up and down a moving machine you are bound to break something, and I love my teeth too much and my nose even more.


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