Home   |  Issues  |  The Daily Star Home | Volume 3, Issue 20, Tuesday December 20, 2005




Dental wise

DR. Mahfujul Haq Khan BDS, DDS, FSDCE (USA), PhD (Japan), Post Doc. (Japan) Specialised: Crown and Bridge work, and Periodontal plastic surgery (USA) Assistant Professor and Consultant, Department of Dentistry, BIRDEM Hospital

Dear Dr.Khan
I am 36 years old. The colour of my teeth is brownish yellow. I really feel social embarrassment because of my teeth. I visited many dentists regarding this problem and they gave me two options (Porcelain cap or Bonding filling). Making Porcelain cap is very expensive, on the other hand I am not convinced with the idea of bonding filling. Can you give me other option instead of cap or bonding filling? What to do?
Please help me.
Jaglul Karar

Dear Mr.Karar,
Many people have definite aesthetic problem from internal or external stains, where as others worry needlessly about the overall color of their teeth. In the latter instance the dentist must decide if the color of the teeth can be improved enough to justify treatment even though the patient insists on having something done. For e.g. person with light complexion may believe that their teeth are too dark when actually they are normal in color. A Sun tan, darker makeup or a darker lipstick will usually make teeth appear much whiter by increasing the contrast between the teeth and the surrounding facial features.
Most external stains can be removed by thorough cleaning of teeth, with an instrument called “ultrasonic scaler”. This instrument removes most of the stains caused by tobacco, food debris or bacteria. If a broken down filling or a cavity is the cause, filling the defect will improve the discoloration.

Discoloration resistant to cleaning can be corrected or greatly improved through conservative procedures such as Bleaching, it generally has an approximate life span of 1 3 years. Other best treatment option is making porcelain cap/crown. Stains caused by tetracycline medications are usually much difficult to treat, and might require a radical approach.

Dear Dr Khan,
I've had a cavity in one of my lower jaw molars for a long time. However, I have not had it repaired by a dentist. It has not posed any serious problems, neither is it very painful or sensitive (only slight sensitivity when biting hard). The hole of the cavity isn't too big either. However, it seems that the cavity has spread to other teeth (if that is possible). I have noticed slight black marks on the top of the crown of some teeth, that do not go away with brushing. I try to maintain a good hygiene, brushing twice a day (sometimes missing to brush at night). What are causes for forming those cavity? What are the potential problems that I face from not having my teeth repaired? Are they likely to fall out? Also, I have noticed the same marks on an incisor on the lower jaw, and the tooth is sensitive (when tapped gently), and it seems to me that it is slightly tilting. I've never heard of anyone having their incisors filled! What can I do if I develop a cavity in the incisor? I am very worried, but unfortunately haven't taken any steps to correcting the problems. Could you also please suggest a diet healthy for teeth?
Thank you.

Dear Mr/Ms RM
Though you did not mention your age but this is not a good idea to keep untreated cavity. Actually 'Caries' is Latin for 'rot' or 'rotten'. Rot happens in wood and other materials. Dental Caries or cavity is the most common of all oral diseases, and since the average individual has his first experience with this disease in childhood. It is recommended that between 11/2-2 years of age, children must have their first checkup before any extensive cavities are established. Dental Caries very often appears as a white chalky area on the enamel. It later softens and then the tooth structure breaks down. If not treated in the initial stages, it progresses towards the pulp and will then require extensive treatment to save the tooth.

How Caries develop?
Bacteria are normally present in the mouth. The bacteria converts all foods -- especially sugar and starch -- into acids. Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. Plaque begins to accumulate on teeth within 20 minutes after eating (the time when most bacterial activity occurs). If this plaque is not removed thoroughly and routinely, tooth decay will not only begin, but flourish.

The acids in plaque dissolve the enamel surface of the tooth and create holes in the tooth (cavities). Cavities are usually painless until they grow very large inside the tooth and destroy the nerve and blood vessels in the tooth. If left untreated, a tooth abscess can develop. Untreated tooth decay also destroys the internal structures of the tooth (pulp) and ultimately causes the loss of the tooth.

Destroyed tooth structure does not regenerate. However, the progression of cavities can be stopped by treatment. The goal is to preserve the tooth and prevent complications. In filling teeth, the decayed material is removed (by drilling) and replaced with a restorative material such as silver alloy, porcelain, or composite resin,Inlay and onlay . Porcelain and composite resin more closely match the natural tooth appearance, and may be preferred for front teeth. Many dentists consider silver amalgam (alloy)and these materials are often used on back teeth. But remember it contain mercury and now a days in some develop countres its already banned item. Crowns are used if decay is extensive and there is limited tooth structure, which may cause weakened teeth. Large fillings and weak teeth increase the risk of the tooth breaking. The decayed or weakened area is removed and repaired. A covering jacket or "cap" (crown) is fitted over the remainder of the tooth. Crowns are often made of gold, porcelain or porcelain fused to metal.

A root canal is recommended if the nerve in a tooth dies from decay or from a traumatic blow. The center of the tooth, including the nerve and blood vessel tissue (pulp), is removed along with decayed portions of the tooth. The roots are filled with a sealing material. The tooth is filled and a crown may be placed over the tooth if needed.

Oral hygiene is necessary to prevent cavities. This consists of regular professional cleaning (every 6 months), brushing at least twice a day, and flossing at least daily. X-rays may be taken yearly to detect possible cavity development in high risk areas of the mouth.

Chewy, sticky foods (such as dried fruit or candy) are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth with water after eating these foods. Minimize snacking, which creates a constant supply of acid in the mouth. Avoid constant sipping of sugary drinks or frequent sucking on candy and mints.

Dental sealants can prevent cavities. Sealants are thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves on these vulnerable surfaces. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants.

Fluoride is often recommended to protect against dental caries. Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions (applied to a localized area of the teeth) as part of routine visits.

Visit Dr . Khan's website www. aikodental.com for more information.

By the way

Cracked lips

WHY is it that guys say no to chap sticks? With the mercury dropping, your lips suffer from a loss of moisture and thus they crack up. Having a chap stick handy would solve the problem of rough lips.

Under a different sky

By Iffat Nawaz

From his Icy palms
SKY, I can not forgive you today. You promised me freezing rain yet you stopped in the middle after freckles of snow, where is my freezing rain? Where is the ice? Why do you build yourself up and then don't let your self pour down, we are down now, all of us here, government wont give us a half day, we will work till the sky is black and the full moon wont shine brightly either because your clouds are on it's way. Why Sky? Why have you made empty promises of ice and stopped at snow?

Winter, I am impressed with you. You have really made a name for yourself this year haven't you? Here in the East Coast you rarely show up with such preparations, but you did this year. Blowing cold winds, requiring furry clothes and comforters, and the heaters full blow. I am impressed. You have done good. Are you promising a white Christmas for those who care? Are you helping the retail industry with all their over priced winter clothing lines? I saw coats were 40% off the other day, but none of them were warm enough for you, you are digging a hole in my pocket Winter, in ours, I don't get you winter, so demanding and so forceful. And there is no way to ignore you, you are so on-our-face, you are so do-or-die, your dominance wins over summers sweats and humidity, springs subtleness and definitely over fall's mild orange hues. I am impressed by you….I am…you are the only one who makes such statements, capable of killing, capable of making all obey you, big or small, young or old, rich or poor, from George Bush to all the homelesses in Pennsylvania Ave. You are the only one who forces them all to submit to you. Everyone seeking warm clothes let it be in closets, stores or garbage cans, everyone just trying to cover every inch of their body so you can proudly rule our town, our city, and our own private universes.

Winter, does it ever bother you that you are usually associated with depression and cruelty? Have you seen the recent movie called the “Chronicles of Narnia: the Lion the Witch and the Wardrobe?” If you haven't I suggest you make yourself into one of those heated theaters grab yourself a cozy seat and watch what they have done. They have completely villainized you, Winter, you were the symbolism for dark days and unfairness, you were the crown on the Witch's head. You should protest perhaps, maybe you should strike? Stop coming our way for few years? Let people see how it feels to have warm Decembers and hot Januaries? I think that would make a really strong statement, don't you?

Winter, I want to thank you for making me more home-bound. Since you lock me in pretty much every other night with your cold breezes and numbing chills, I have been spending much of my time tidying up my place, catching up on emails and reading everything I had piled up since last spring. I thought I would never catch up! Thanks to you for keeping me on the right page.

Winter, do you enjoy watching people gain 5-10 lbs during your months? Do you let out chuckles and giggles when a skinny face stuffs herself with holiday cookies and never makes it outside to run it out, to burn her unneeded calories? Why do you promote corpulence Winter? Why do you have such a wicked sense of humor?

Winter, where do you see yourself five years from now? How about ten? Do you plan to change any kind of structure or ambitions, any growth or reorganization? Do you laugh at the weather men everyday when they struggle to guess your temperature, characteristics and moods? Why have you been so temperamental Winter? Anything you want to talk about? Talking helps sometimes you know…

Winter, I am here for you if you need me, you can find me bundled up on the street or scattered around at my place, I know you will welcome yourself from under the cracks of my door, or from the gaps between my gloves and jacket, hold me tight Winter and carry me to Spring.


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