Home   |  Issues  |  The Daily Star Home | Volume 5, Issue 69, Tuesday May 26, 2009



Dear Doctor,
I have always been a fussy teenager. I never could drink water from my friends' bottles; always felt a compulsion to clean my glasses before drinking at home. I considered this to be part of good hygiene but recently things have simply blown out of proportion. I simply cannot dine outside in restaurants, images of horror stories shown in Chefs' Attack still vivid in my mind. My friends and colleagues tease me a lot and this is causing a lot of mental agony. Please help.
- Obsessed

Dear Obsessed,
People with obsessive personality traits are usually big on hygiene. At an optimum level this trait is helpful for a healthy productive living but creates unnecessary problems when it goes out of control.
I'm assuming this “Chefs' Attack” is a horror film about food items and kitchen activities. You have indicated that watching horror stories shown in Chefs Attack has tripped the balance of your life. Under usual circumstances people watching these stories, develop some aversion. They become extra vigilant over the next few days and start getting relaxed as the memory fades out.
The brain can develop “condition reflex” towards neutral objects like food, restaurant, kitchen, etc., if some intense negative stimuli (horror images) are presented simultaneously with those neutral stimuli in a way that the brain fails to discriminate between the two groups of stimuli.
This condition reflex of the brain is a learned behaviour as the left-brain associates new meaning to previously neutral stimuli. The automatic negative response, which is irrational fear and avoidance in this case, can grow stronger by playing the two images (restaurant and horror image) together in the head over and over again.
The stronger the pairing gets, the longer it takes to wipe out the automatic response. The memories remain vivid if you keep rehearsing them in your mind and reinforce the negative behaviour by repeated avoidance.
In order to break this self-defeating automatic thought-feeling-behaviour cycle, it would be important to learn and practice living in the present moment, which is a right brain function to bring back balance in life.
If you make a conscious choice to expose yourself to the restaurant environment and watch others eating there carefree (modelling by others), that would help you to break this maladaptive cycle of avoidance.
Gradual systematic desensitization method recommends doing it step by step while practicing some relaxation tips (soothing visual images, music, pleasant thoughts, etc.) to stop anxiety provoking thoughts from overwhelming you. Sometimes forcing yourself to dine with others in one sitting (flooding method) also seem to work if the first attempt succeeds without major setbacks.
Anxiety feelings will surely make you uncomfortable but it can never kill you! Once you face the fear, it will lose its power on you. The core issue in any Phobia is the irrational, exaggerated and persistent fear. This fear stops one from experiencing the real world. If you don't nip it in the bud, it will cost you highly in the future, particularly if you are in a job that requires you to socialize in public places like restaurants.
If these simple measures don't work, see a psychiatrist to get proper help.

Dear Doctor,
I want to know about bridge (Fixed replacement of missing teeth). Do you think bridge is better than dental implant? Please let me know the merits and demerits of bridge. Can a diabetic use bridge?
- Alamgir kabir

Dear Mr. Kabir,
There is no absolute contraindication to do any kind of prosthesis in a diabetic patient. But careful pre-assessment of his/her oral health condition should be an important step before doing any fixed prosthesis of a diabetic patient.
When teeth are missing and there are teeth on either side of the space, a bridge is the ideal way to replace the missing teeth. You cannot compare bridge and implant to each other. These are two different technologies and both have merits and demerits. But dental implant is the latest technology and it is expensive.
When there has been the loss of a tooth or teeth and there is a tooth on either side of the open space, replacement teeth can be attached to two crowns constructed for the two teeth on either side of the open space. This is called a bridge because it bridges the open space.
When a tooth is lost, five or more other teeth may drift so it is essential to place a replacement tooth as soon as possible. The space left from missing teeth may cause one of several problems. Teeth may drift into the space changing your bite. This changed bite may result in sore jaws, gum disease, or decay (due to more difficult hygiene).
Bridges are not removable by the patient. As with other types of crowns (caps), a bridge can be made of metal or porcelain, or a combination of these two.

Dear Doctor,
I think dental caries is a very common problem. How can we prevent dental caries from early childhood?
- Roksana

Dear Ms. Roksana,
Proper brushing, food habit and regular dental check up can prevent dental caries. Every child should do fissure sealant to prevent dental caries. This is a protective layer, which greatly prevents dental decay. If your children are between 9-13 years old, then go to your dentist for fissure sealant.

Dear Doctor,
I have dental caries (black spots) on my front tooth, which is visible. I also noticed bad breath in the morning. Can I use mouthwash on an empty stomach? Also, what should I do about the black spots?
- Rahman

Dear Mr. Rahman,
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, so please go for dental filling.

Dear Doctor,
I am suffering from dental pain. But it is very difficult for me to explain the character of this pain. This is occasional, increasing only whenever I take tea. I stopped taking tea for the last two months. There is no cavity or swelling. What do I do? Should I do any X-Ray? Please mention the name of that X-Ray. Thank you.

Dear Mr. Robert,
Yes you need an X-ray and you must go for the Orthopantomograph (OPG) X-Ray. You may have micro crack (Crack tooth Syndrom) or hidden caries. You can use desensitising tooth paste (Sensodyne tooth paste or Mediplus tooth paste).

Back in those days

Back in those days when you still used an alna, where your mother's sari and your father's panjabi would hang neatly next to your frock, holding you securely in the middle, even through their superficial shells. It was during those days that you had learnt to spell and cheat on exams, it was then you had learnt the art of lying and the simplicity of telling the truth.

It was sometime during those afternoons when you discovered the line that runs straight down the middle of your body starting right under your belly button. It was then that you understood the perfect symmetry of a human body and geometry became your favourite subject, the underrated portion of mathematics that you excelled in.

It was even before then, when VCR was just a new phenomenon in Dhaka, and your film crazy parents had marathon movie watching sessions, and the face of little Drew Barrymore got sketched in your brain, and E.T. taught you how to pronounce Spielberg.

It was during those nights when you learnt to stay up till dawn, reading, talking, and dreaming of becoming older, wiser, prettier, taller and different. During those nights you slept with your little cat, which eventually didn't want to sleep with you anymore but would roam around the neighbourhood. You cried when she left one night and never returned.

It wasn't until after that when you started reading novels you weren't suppose to read, and songs you weren't suppose to listen to and you wanted to wear outfits you weren't allowed to wear. All your wants seemed to get lost in implementation, your mother became stricter, your father became busier and your brother became a bully. You cried like a girl, and felt lonely. You still didn't know what loneliness meant…then…

It was back then when you got affected by everything and infected by all. You had measles and mumps, jaundice and chicken pox, you ran a fever every week and you were pale from sun-less days and moon-filled nights. It was then when you started to fear things from your past, dead people and imagined accidents, which seemed real. It was then when you started reciting surahs while passing graveyards.

It was before that when you started reading the Qur'an and visited Ajmer. It was then that you had gone to temples in South India and monasteries in Sikkim. It was then that you learnt how to clap and kill mosquitoes and started getting disgusted by fruit flies. That's around when you also started hating science.

Around then you wanted to become a professional dancer and a journalist. You also thought about becoming a teacher but that was only for a week. You had your first crush without knowing what a crush is. Around then you wanted to fall in love, with no one specific but with almost anyone.

It was then, during those days when you met me. And we started getting to know each other, wanting to become one. It was then that you heard your inner voice for the first time and wondered about the word “mon,” and the phrases “mon bhalo” and “mon kharap.”

Back in those days between the shadows of drying clothes on your rooftop you held my hand, we flew plastic bags like kites and your two front teeth had just fallen off. We buried the two teeth in a flower tub and forgot to believe in tooth fairies. Back in those days…

By the way

Gender harassment
It is a form of sexual harassment that consists primarily of repeated comments, jokes, and innuendoes directed at persons because of their gender or sexual orientation. This behaviour may or may not be aimed at eliciting sexual cooperation from those addressed, but it contaminates work environments. Gender harassment closely resembles racial and ethnic slurs. It may include disparaging a person's intellectual abilities and potential, using sexist humour as a corporate teaching technique, ridiculing specific works because they deal with a specific gender's perceptions or feelings etc.



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