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I am 29 years old. For the last three months I am suffering from occasional gum bleeding. This occurs specially during brushing and taking any hard food. After that I am reluctant to brush as it causes gum bleeding. Nowadays the gum on my front teeth is swollen and a little painful. What do I do?
It seems you are suffering from simple gingivitis. Don't worry; just go for dental scaling (professional cleaning) immediately. Before visiting your dentist you can do gum massage using your finger and warm saline mouth rinses. One should never stop tooth brushing even if it causes mild gum bleeding.

My son, 17 years old, is a diabetic patient (Insulin dependant). He has several loose teeth that cause occasional pain. The doctor told him to go for dental extraction five months ago but we really don't want dental extraction at this young age. Nowadays, he feels that the surrounding teeth are becoming loose. Please give us some advise on how we can preserve these valuable teeth.
Many factors contribute to the loss of teeth in someone who has diabetes. A poor healing response combined with gum disease and destruction of bone anchoring the teeth in place may result in teeth that become loose and eventually fall out.

Although diabetics have no control over their response to infection, they can practice good oral hygiene (brushing, flossing and interdental brushing). Removing plaque will reduce or eliminate infections.

Ensuring the diabetes is controlled (taking insulin, altering diet) is also a way of decreasing the risk of tooth loss. For this particular case, it seems very difficult to preserve your son's loose teeth but still if you have some bony support then it may be possible to preserve it by some special treatment (root planning, bone graft, etc). But still, diabetes is a factor and I strongly recommend you to take your valuable treatment from BIRDEM hospital.

Why should wisdom teeth be removed if they have not caused any trouble? I went to my dentist for regular scaling and he found a partially erupted wisdom tooth on the right side of the lower jaw and did an X-ray. After careful examination of that X-ray, my dentist advised me to go for dental extraction as it may cause trouble in future. I am in a real dilemma. Please advise me on what to do?
Without seeing your X-Ray and oral cavity it is certainly difficult for me to give proper advice. But Impacted (Unerupted) wisdom teeth are almost certain to cause problems if left in improper positions. This is particularly true of the lower wisdom teeth. Such problems may occur suddenly and often at the most inconvenient times. I strongly believe that your dentist gave you a right decision. It is now recommended by some group of specialists that impacted wisdom teeth be removed between the ages of 14 and 22 years whether they are causing problems or not!

Dear Doctor,
I am a regular reader of your column and I find your suggestions very helpful. My son is 16 years old and has pimples only on his face. He also has developed black spots. Can you please give me some solution regarding this matter?
- Worried nas

Hello Worried nas,
Thanks for the letter. It's good to know that you find my suggestions helpful.

Your son's problem is a common one for his age group. First of all, you have to make sure he takes good care of his skin. He needs to avoid direct sunlight, as that increases the chances of black spots to develop.

He has to use a non oil base sun screen SPF30 or above at least two times daily. As most people who have pimples tend to have oily skin, he has to cleanse his face with face wash at least thrice daily, and use a toner on every alternate day.

Despite all these, if he still develops fresh pimples, medication can be prescribed by a good cosmetic surgeon. He may also need phototherapy, which is a treatment with light on the skin. It really helps a lot. Once his acne stops, the pits and scars can be treated. The last thing I have to say is that acne problems can be very frustrating and both of you need to be patient.

Dear Doctor.
I have slit marks on my wrists from suicide attempts from my teen days. The marks show deposition of tissue in colours different from my skin. Is there any surgery that can solve the problem?

Dear Troubled,
Yes, your problem is troublesome. I hope you are past that stage of your life and in a stable position now. Suicide cut marks are very visible and can be identified easily, which in turn creates social problem. These marks are very difficult to remove as they are usually long scars on wide areas. They cannot be totally removed; what is possible is to camouflage them either by skin grafting or scar revision.

In case of skin grafting, the old scar will be taken off and replaced by skin from your thigh or arm, the colour match will not be 100 percent. It will re-appear even after surgery was done on the spot.

As for scar revision, if the previous marks are small we can replace them by skin from adjacent areas, again there will be a mark but not so prominent. If you consult with a cosmetic surgeon they will let you know which the better choice is for you. I would not suggest any kind of laser for this.

Dear Doctor,
I have a problem with my left eye. These days it twitches a lot and is causing me much distress. I have heard this problem is caused by faulty nerves and can be fixed by surgery. Is it true?
- Atiq

Dear Atiq,
Thank you for your letter. Actually I am an ENT and Cosmetic Surgeon, so I am not familiar with problems related to the eye. You need to consult with an Ophthalmologist. What I can tell you is that you should not wait long as that will make the condition worse.

Dear Doctor,
I am 24 years old and have scar marks from chicken pox. There are about seventeen marks, spread all over my face. I want them removed. Can anything be done?
- Fauzia

Dear Fauzia,
Thanks for your letter. Chicken pox usually leaves behind marks, which are dark and pitted. They don't go away totally but the condition can be helped by a procedure known as dermaroller; the pits are released from the underlying surface so it looks smoother and creams can be used to make the scars lighter.
Microdermabrasion also helps as it polishes off the top layer of skin and so makes it smoother. In some patients we also opt for scar revision. In all of these procedures the important thing to remember is that the scars will not disappear totally but definite improvement will occur.

By the Way

Get a pet

Owning a pet reduces the number of visits to the doctor, prolongs survival after a heart attack, and wards off depression.
Pet ownership also protects against a major problem of aging: high blood pressure. But pick your pet with care. There is nothing stress-reducing about a dog that chews shoes to bits.


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