Dental Wise


Dear Doctor,
I am 19 years old and I have gaps in my upper set of teeth. With time, it seems that the gaps are widening and my gums are lowering to fill in the blank spaces. Is there any treatment for this? If yes, how much will it cost?
Mukta
Chittagong

It seems that you have spacing (gaps) in between your upper incisor teeth. You have three options to fill up the gaps:

1) Individual porcelain cap: This offers the most exciting and revolutionary advancement in Aesthetic Dentistry. Dynamic results can usually be achieved within a week or ten days to correct somewhat misaligned, spaced, broken, discoloured or misshapen teeth

2) Tooth colour filling (Bonding/Composite): This was one of the first and most promising techniques developed for "instant" smile enhancement. It is still suitable in many circumstances to correct broken or misshapen teeth, but is neither as durable as porcelain caps nor as spectacular in addressing more complex cosmetic concerns.

3) Orthodontic approach (Braces): The option that you choose depends on your oral heath condition, teeth alignment, age, time and expenses. As you mentioned that your gum is lowering to fill the spaces, you may need minor surgical intervention to repair the excess gum tissue before going for any cosmetic treatment. You can consult me at BIRDEM hospital any time.

Dear Dr. Khan
I am 18 years old. Sometimes I feel pain in my gums. I used to brush my teeth twice a day but the pain is still there. What should I do? Is brushing twice bad for my teeth?
Bina

Dear Ms Bina,
If your pain is localised or in any particular area of your gums and if it occurs after taking meals, then you might have some pockets (food impaction in between two teeth which may cause infection). I strongly recommend that you use Dental Floss and an Interdental brush after deep cleaning of that particular pocket by your dentist. If your pain is generalised in both your lower and upper jaws then you may have Chronic Gingivitis (gum infection). In that case, you need scaling and some medication with instructions of correct maintenance of oral hygiene. Brushing two times (before going to bed and after breakfast) is sufficient but should be done in the correct method.

Dear Dr. Khan,
I am 38 years old and working in a private bank. The colour of my teeth is brownish yellow and I feel embarrassed because of my teeth. A dentist I consulted suggested that I get a porcelain cap that is very expensive. Can you give me another option instead of a cap? I learnt about a teeth-whitening technique (bleaching) from TV. Is it possible to do that in Bangladesh? Will it work on my teeth?
Thanking You
Akbor. Gulshan. Dhaka

Dear Mr. Akbor,
Everybody wants a beautiful, bright smile - it helps give you confidence and adds to your overall appearance. Many people hesitate to smile because their teeth are stained or discoloured. Eating certain foods and drinks and using tobacco may cause tooth staining. Teeth can also darken as a result of injury, or from the natural ageing process. If you have generalised yellowish discolouration, then I strongly suggest that you go for simple bleaching right away. But before that your dentist needs to assess whether you are fit for bleaching or not.

Many questions have been asked about bleaching and I would like to give you some brief tips regarding this system:

Bleaching (now available in Bangladesh)
Bleaching is a process of whitening teeth by applying a chemical solution directly to the teeth. The enamel on the exposed crown of the tooth is bleached.

There are many options available today for bleaching your teeth. Here are two options that are administered by your dentist:

1.The dentist applies a bleaching solution directly to the stained teeth. The applied solution is activated by heat (alternatively, this process can be activated by a combination of heat and light). After the solution is rinsed off, whiter teeth are revealed. This process can take about an hour, and six to eight teeth can be bleached during one appointment.

2.The dentist provides a special tray (a bleaching tray) to fit on the top and bottom teeth. Under his or her guidance, you are provided with a bleaching solution to use at home with the trays. They need to be worn for about three to eight hours per day (they can be worn at night) and this process takes a variable amount of time depending on the product - ranging from one to six weeks.

There are also home bleaching kits available for purchase at retail stores (not common in Bangladesh). Some of them are used in a similar ways in the second option mentioned above. These are less expensive because the bleaching tray is a standard size and not custom-made to fit your teeth precisely.

Is bleaching suitable for everyone?
Your dentist will evaluate suitability and he or she can tell you whether this procedure will be effective for you. There are many factors that must be considered before you can start bleaching.

Are there any side effects to bleaching?
There are virtually no side effects if it is done properly and using the latest technology. The bleaching solutions contain peroxides that bleach the tooth enamel. In some cases, this has been shown to cause sensitivity. If you do choose an at-home bleaching product, be sure to keep your dentist informed of what you are doing and contact him or her immediately if you suffer from any adverse symptoms. Many people have definite aesthetic problems from internal or external stains whereas others worry needlessly about the overall colour of their teeth. In the latter instance the dentist must decide if the colour of the teeth can be improved enough to justify treatment even though the patient insists on having something done. For example people with light complexions may believe that their teeth are too dark when actually they are normal in colour.

Bleaching generally has an approximate life span of 1 to 3 years, although this change may be permanent in some situations.

I am a 25-year-old male. I am not happy with the shape of my nose. I have been teased about it a lot since my teens and so I feel very self-conscious about it. I have heard of rhinoplasty operation but don't know if it's done in Bangladesh or not. Could you please help?

The shape of your nose does make a big difference in the way you look and it can affect your self-esteem a lot. Rhinoplasty operation is regularly being done at cosmetic surgery centres .You didn't say what was wrong with your nose. If it is blunt or short then you need an augmentation rhinoplasty that is done using an implant that can be bone or silicon. If your nose is too big then you need a reduction rhinoplasty; if too broad then that can also be corrected. You need to be seen by a surgeon and he will assess what needs to be done and then advice you accordingly.

I am 29 years old. I broke my nose when I was 14. It looks crooked from the outside and I have breathing problems at times. Can this be fixed?

Yes, you need a septorhinoplasty where the deviation inside your nose as well as the crooked appearance will be corrected. This has to be done by someone experienced in doing these surgeries.

I am 17 years old and suffering from very bad acne. I have taken some treatment but it didn't work.

Acne can be a big problem at times. If your acne is infected then you need to take some antibiotics and phototherapy as well. It has been seen that the combination of both gives a good result. Phototherapy is a procedure where light is used to treat acne. These light rays kill the bacteria causing acne and also close the pores. Eight sessions at three day intervals are given. The results are usually good.

On Different Note

Rethinking our routes

Every time a politician gets away with something, or you read sarcastic stories of unpunished corruption in the papers or come by a Jinjira manufactured item that looks and feels exactly like the original counterpart, we hear ourselves saying that ours is a 'shob shombhober desh'. But are we really a country where anything is possible? We may have a 'lot of potential' as new countries doing business with us would say on TV and may have strange ways of getting things done somehow, but do we really have it easy?

On the day of university admission tests, students crowd around campus talking and inevitably a student will say, 'I always wanted to study English in college'. Somebody else asks, ' What happened?' And the reply comes, ' Oh I am taking it up as a side subject.' Of course they would have to, since there is no reason to study subjects such as history, philosophy or literature in Bangladesh unless you want to be teachers or will not really be looking into 'serious' money making careers in them! In a speech on some special occasion, Mohammed Zafar Iqbal said he hoped someday soon, students here could study the sciences for their own sake and still get jobs when they graduate. Soon after I discovered that the person in charge of coordinating our courses, our DCO at the architecture department was a Physics major! It got me thinking. There are thousands of students who ace science subjects in their SSC and HSC exams only to get into medical or engineering school, but hardly ever to become scientists. They don't do it because it's simply 'not done'. Who would give them a job? Would it pay as much as a career in something else? Is there a field for it here, a need, an audience? The few who do manage such degrees somehow end up getting odd jobs not suited to their area of study. Like our DCO, graduates in science or literature take up jobs in management and in banks and so on. Some even get diplomas in interior design or something else on the side to get things going!

Let's ask ourselves some questions. What if somebody in Bangladesh wanted to be a genetic engineer or a marine biologist or an architectural theorist? How would we react to them? We would write them off as dreamers, detached from reality, who would have to move somewhere else if they really wanted to make a living. We would hardly take them seriously. And thanks to this attitude and lack of foresight, there is no teacher qualified to guide you if you wanted to do something a little out of the box, no process you know you can follow to get there, no support from those you would inevitably end up serving if you succeed. It is like walking through a dense forest of trees near the ocean. You can hear the waves roaring in the distance and know you are so close, but you can't see the right path clearly, you don't know for sure which way you should go to get there.

Most of our universities only offer degrees that can't go wrong- those that sell and anyone interested in unusual majors apply abroad and attend foreign universities. They usually also end up pursuing careers in those countries. The important question to ask is why can't we provide these opportunities in the right fields right here in Bangladesh? We have come a long way as far as education is concerned, why can we not take this extra step forward, change our attitudes and our approach? We need trained professionals who can teach in these fields, guide students and help them see the world without having to travel halfway across it in order to do so! We need to understand the need for professionals in every field who can theorise our own unique perspectives, give us new research and technology for which we are still dependent on the West. There will always be pressing issues and more pressing issues and even more pressing issues in the developing world, but we need to pull out these little things from underneath all the paperwork, spreadsheets and media debates and put them on the top of our priority lists. We need to rethink our ways into the future…before we trip on our own labels and fall!

By Diya