“SECRET OF BEAUTIFUL SMILE”

Healthy living is a secret of happiness. Most of the people are aware of keeping a sound body image and workout daily to remain fit. But when it comes to dental health, many people living in the underdeveloped countries neglect it that leads to poor oral condition with halitosis (bad smell), periodontal problems, calculus deposits, stains and multiple other oral and dental problems.

Always keep in mind that healthy teeth not only give you a brighter smile but also enhance your confidence amongst peers. Being a dentist, I would like to share some basic points that everyone should know.

First of all, it is important to remember that “PREVENTION IS BETTER THAN CURE” so try to save your teeth before it’s too late.

ALWAYS BRUSH YOUR TEETH AFTER EVERY MEAL

Get into the routine of brushing your teeth twice a day, every morning and evening after meal time. Always use a toothbrush with soft and round bristles. Replace your toothbrush whenever bristles become shapeless. Place the brush at 45 degrees between your teeth and gums and gently rock the brush back and forth in the circular motion. Brush your front teeth vertically and avoid any horizontal movements. Never forget to clean your teeth from the back side of your teeth i.e. towards the tongue.

Electric toothbrushes are also available for people who are aged, febrile and handicapped. They have rotating and oscillating movements and run through the battery. They are helpful in case you are lazy and do not want to use manual toothbrushes.

SELECTION OF TOOTHPASTE:

Use fluoride containing toothpaste as fluoride helps in remineralization of demineralized dental tissues. It prevents tartar control and inhibits growth of bacteria.

You can use fluoride-containing mouthwashes if you have a problem of bad smell (halitosis) or on the occasional basis.

FLOSSING:

Proper brushing technique cleans all the tooth surfaces except interdental surface (between the teeth). Flossing is required to clean interdental surfaces.

The finger-wrap method: Cut off a piece of floss 18 to 20 inch long. Wrap one end around your left middle finger and the other end around your right middle finger, until your hands are about 2 to 3 inches apart. Gently use the floss between the teeth, do not impinge on the gums otherwise, you will injure them. Flossing is usually required every alternative day and especially after eating meat.

HEALTHY DIET

Eat fibrous food like fruits, vegetables, whole grains and whole wheat. Decrease intake of juices containing sugar, sticky sweets and chocolates, raisins and always brush after you take them. Avoid taking snacks between meals.

It has been researched that yogurt, cheese, and sugar-free chewing gums (containing xylitol) are good for the teeth. It prevents accumulation of plaque by increasing level of saliva and hence provides an alkaline medium that inhibits cavity formation.

Avoid Tea, tobacco, pan and smoking. These products lead to bad stains on your teeth and ugly smile. Tobacco, chalia, pan, gutka (usually taken in Asian countries) may cause mouth cancer.

TAKE CARE OF YOUR CHILD’S TEETH AS WELL

Many people have a misconception that taking care of primary (baby teeth) teeth is not important as they will shed away. THIS CONCEPT IS COMPLETELY WRONG!!

Primary teeth are guides to permanent teeth, if you don't take care of your children's primary teeth, it will lead to the delayed eruption, shifting and crowding of the permanent dentition.

Hence, dental care starts from the birth. When your baby is on breastfeeding, good nutrition of mother plays a vital role in your baby's dental health.

If you bottle feeds a child, do not put your baby to bed with a bottle of juice, milk, or other sugary liquid. The opportunity for tooth decay to develop increases while these liquids stay in the mouth. Always remove the bottle from the mouth when a child is asleep, also clean baby mouth with wipe cotton or cloth.

First primary teeth erupt at the age of six months, start cleaning or brushing with a soft brush. In the case of dental cavities, consult a pediatric dentist.

Do not use adult toothpaste for children as they usually swallow it and swallowing fluoride in excess can lead to fluorosis (systemic disease causing mottling of enamel and brittleness of bone)

First permanent tooth appears in the oral cavity at age of 6 years. Consult a dentist for use of sealants which are flowable resins inserted into pits and fissures of teeth to inhibit cavity formation in the deep grooves and fissures.

Encourage your children for brushing twice a day by giving them cartoon brushes and flavored toothpaste.

If accidentally your child primary teeth fall off before time then consult your child's dentist. They give your child a device called space maintainer which will prevent shifting or drifting of adjacent teeth and will keep the place for future permanent teeth. In this way, the chances of crowding will minimize.

If your child has actively participated in sports, give them mouth guards to protect tooth injury.

Keep your teeth clean and healthy and spread the smile of life!

Braces vs Invisalign Orthodontic Treatment

The common question that is being asked by most of my patients is which treatment choice is better for straightening teeth Invisaligh or conventional braces?

The answer to this question is based on number of parameters that need discussion. First of all, I would like to give a brief overview of both treatment methods and then we will shed light on the pros and cons of each method. 

Braces consist of either visible metallic or less visible nonmetallic (polycrystalline, monocrystalline, polycarbonate, ceramic with metal slots etc.) brackets that are glued to your teeth individually and are secured together through arch wires and elastomeric bands. These are fixed and cannot be removed on patient's choice. 

On the other hand, Invisalign consists of series of aligners (plastic trays) which are removable and nearly invisible. On your initial visit to an orthodontist, impressions and pictures of your teeth and gums are taken and sent to the Align's dental laboratory. The Align laboratory uses CAD/CAM technology (computer aided design/computer aided manufacture) to fabricate the series of aligners. These trays are advised to be worn for 24 hours a day except for meal times to be effective. They will work by slowly and subtly moving the teeth with each new tray providing better results. 

Here are the few major differences between braces and Invisalign for straightening teeth:

Braces	vs	Invisalign
Fixed appliances, cannot removed by patient	Versatility	Clear/ nearly Invisible, can be removed by patient on sensitive occasions
24/7 for an average of 2 years  depending on patient’s severity of crooked teeth	Wearing time	22-24 hrs/day for 12-18 months
Metallic braces are comparatively cheaper	Cost	Comparatively expensive
Brushing brackets and wires by inter-dental tooth brush and superfloss is recommended; water pick may be helpful.	Oral hygiene maintenance	Brushing teeth without trays in mouth. Invisalign cleaning system or dipping trays in warm water.
Every three to four weeks	Follow up visits	Change aligner trays every two weeks; visits every four to six weeks
Retainer likely needed for minimum of 1 year depending on patient needs. Later, ongoing retainer wear  only at night	Retainer after treatment	Retainer likely needed for minimum of 1 year depending on patient needs. Later, ongoing retainer wear  only at night

Although, Invisalign attracts a lot of patients due to its less visible quality, it is not suited for every candidate. It is limited in terms of treating complex malocclusion cases where traditional braces are more effective. However, it is ideal for adults who have mild to moderate malocclusion. It also offers other advantages of being less invasive, easy to remove and wear, no issues with food getting caught between wires and brackets, less pain and easy to clean. Nowadays, Invisalign offers versatility in providing treatment to teenagers in whom teeth are in the process of eruption (Invisalign Teen). These aligners have eruption tabs that guide or allow the teeth to erupt as well as compliance buttons that determine the wearing time of teenager children. 

The traditional braces may look worse and non-attractive but they are more effective for complex and difficult cases. They are fixed appliances so chances of leaving them out is not possible and hence they give better results without patient's compliance. However, you may feel pain or discomfort from wires and brackets on initial visits that can be relieved by simple painkillers. Other disadvantages could be breakage of brackets on eating hard and sticky food stuff and hence particular attention has to be given on food items. In addition, there may be more chances of white spot lesions or tooth discoloration after braces removal if proper oral hygiene measures are not taken during the treatment.

The bottom line is: Whatever treatment is chosen for your teeth, it is important to strictly adhere to the guidelines or instructions provided by your orthodontist.

For any further questions or comments, you are most welcome!

Cheers,

Dr. Aisha Khoja

Finding a good dentist is important

Whether or not you were made to feel guilty by snarky TV commercials promoting dental services or you have an oral emergency, the point is you have decided that now is the right time to make an appointment to see a dentist. Good for you! Now, the next step in the process is to find a dental care provider in your area that is worth your money. Believe it or not, selecting a dentist, much like finding a primary care provider, can be laborious and very much confusing if you are not sure what you are supposed to be looking for. However, with the help of the Internet, performing due diligence in locating the right dental care provider, can prove to be well worth it in the end.

The first thing any potential dental patient needs to do is determine what exactly you are seeking dental services for. For example, a dental cleaning, a severe toothache or looking to purchase braces. Although, this information is critical in determining whether or not a dental specialist (i.e. orthodontist for dental braces) will be required, the dental specialist will likely instruct you to first see a dentist in order to ensure that a general exam was performed.

Knowing ahead of time that you will need to see a specialist and what kind of specialist can and will prepare you for your initial consultation with the general dental care provider, at which point you can ascertain if he/she is indeed knowledgeable. Once the initial consult is performed by the general dental care provider, he/she will then recommend the specific specialist needed to adequately address your problem.

The next pertinent pieces of information needed in selecting a dentist pertain to research regarding the dental care provider’s specific credentials as well as aspects of patient care (i.e. reputation). First, you should inquire about the dental care provider’s training, specifically with respect to any procedures you want him/her to perform.

Additional research may also be required once a specialist is recommended to perform further treatment; while you may want to initially trust your dental care provider, it never hurts to make sure that the recommended specialist meets your own expectations. Second, in researching dental care providers, be sure to locate one within a reasonable distance from your residence. This piece of the puzzle will play a significant role, particularly in times of emergency.

Third, find out the office hours, i.e. is the potential dental care provider you are interested in available for emergency services. Next, inquire about services available to promote patient comfort. While this information may seem like frivolous nitpicking, it can be especially beneficial to know ahead of time whether or not the dental care provider will take care to ensure your comfort during a procedure. 

Last, but certainly not least, be sure to find out about costs as well as if the dental care provider offers payment plans. It should go without saying that knowing what the financial expectations are upfront can better prepare you as a patient before any procedures are performed.

Clearly, not only does selecting a dentist require a decent amount effort on the part of the potential patient, but such effort can and will prove beneficial for the life of the relationship between you and the dental care provider. Built on more than just trust, such a relationship between the patient and doctor should be established in a manner that fosters the healthy exchange of knowledge and respect for one another.

How to overcome patient's fears or phobias for dental treatment.

I am myself a dentist and i have encountered a number of patients who are afraid of dental treatment or procedures. It is very important that to deal these patients gently and politely. There are certain tips that I want to share with you that helped me overcoming my patients fears from needles, drills, files, probe and sometimes only the sound of triple syringe :) .

1. Always be on time , do not let your patient wait for long intervals between appointments. This will increase their level of stress and anxiety. Try to give appointments to new and nervous patients in advance.

2. Always introduce yourself to your patient first and then ask about her bio data in a very polite and friendly way. Do not rush towards knowing the patient complaint and his clinical examination. Wherever possible keep the conversation flowing about daily life stuffs.

3. After building friendly environment, ask about his concern and his reason for visiting you. You really need to listen all the patient story with patience . In this way you will get the clues about patient fears, his triggers, his past bad experience of visiting dentist and then u can find a way to deal with his fears. Ask questions from patient in a manner that you are here to help him finding the solution to his problem.

4. After all the question answer session, Ask patient if he is comfortable enough to let me look into his teeth ? Tell him about the dental unit that it will move like a swing and he will enjoy it.

5. It is very important that all the sharp instruments should be out of sight of the patient. Before putting the dental mirror , assure patient that it will not cause any pain or discomfort. If you sense that the patient is in any kind of discomfort however mild, stop and remind them that it is OK to raise a hand at any time. Remember that some patients have fears or histories that prevent them from actually doing this even if you give them permission. So respond to a raised hand immediately but don’t rely on it.

6. You have to be very honest with your patient before doing any treatment. You must have to inform the expectations of the treatment done, you have to tell about different options and its cost and about multiple visits if necessary for that treatment. In this way your patient will build trust and confidence on you.

7. Some patients are not interested about what dentist doing while others are very picky and ask every minor details. In either way communication is the key of helping nervous patients. Sometimes a slow music in the clinic setup is very helpful in making patient's mind relax.

8. Give frequent breaks to your patient. Let patient breathe , give them chance to move and spit if required. This might waste your precious time and you may do few patients a day rather than hundreds but those patients will be very happy and satisfied with your work in the end. This reminds me of my teacher words " Its the quality that matters not the quantity ".

9. Last but not the least , treat patients as a whole rather than confining yourself with only oral cavity. It means you should know about his medical status , drug allergies, past dental visits etc. Also you should take proper measures of sterilization to prevent cross infection. Moreover treat every patient as a human respecting his emotions and concerns even if its a minor thing for you.

Love God, Love humanity, Love yourself

WHAT MAKES HEALTHY TEETH OF YOUR BABIES?

It is very important to realize that crowns of all teeth are formed inside the tooth buds before birth and its is during that time mother should take healthy diet which is vital for strong teeth. Among the food elements Calcium and Phosphorus , Vitamin D , Vitamin C are essential.

Flouride in a minute amount in the water ( 1 ppm ) is crucial for children when the permanent teeth are about to erupt ( at 6yrs) . In those parts of world where flouride is not incorporated in water, it is vital to recommend flouride in tooth paste or formulations to help prevent the decay. But always remember that excess flouride is also dangerous so its quantity should be strictly checked by Public Health services.

Another thing that should be kept in mind is your baby should never put to bed and fall asleep with a bottle of juice or milk because it gives bacteria to enjoy producing lactic acid and destroy enamel by creating holes. So always keep the gum pads of your children clean by using wet cotton pads.

It is recommended that babies teeth to be brushed or at least properly cleaned with wet towel when the first tooth erupt in the mouth that is around at the age of 6 month. Parents usually neglect to clean the milk teeth thinking that they will ultimately fall down and new teeth will replace them. It is very true that new teeth will replace the old milky teeth but milky teeth are the basic guide for proper eruption of permanent teeth. If you didn't take care of your primary (milk) teeth then they will fall off before time and leads to later crowding of your child permanent teeth.

Proper Dental checkups should also be done every 6 months so that early caries can be prevented by giving pit and fissure sealants , to restore the carious teeth with GIC, to correct the detrimental effect of certain habits on the positioning of teeth, those include thumb sucking, tongue thrusting and mouth breathing. Moreover, growth modification appliances can be used if your child has under developed lower jaw and head gears can used to restrict the over growth of upper jaw.

Having good and healthy teeth boost your child confidence and help him to spread the smile of life.

Love God, Love humanity and Love yourself.

Air Abrasion

Many people avoid going to a dentist because they had at least one very painful procedure in the past and after that they start believing all dental procedures are painful.
Air abrasion technology is advantageous for those who hate dental drills and needles. It is primarily used to treat small to medium sized cavities, preparing teeth for dental sealants and also for removing stains on teeth. It is ideal for placement of composite fillings ( white resin fillings).
How It works?
Air abrasion works by blowing 27 micron aluminium oxide powder using compressed air through very fine tips. Some devices add water to the powder stream ( hydro abrasion). When powder stream hits the tooth if removes the surface it is pointing at in a very gentle and efficient way. The concept of air abrasion originates decades ago but only recently has advances in technology.

ADVANTAGES :
Air abrasion is a conservative nature of procedure where only small amount of tooth is removed at a time. No need of anaesthesia and patients like the near absence of voice and vibration. All that is left after treatment is small residue of powder that can be suctioned later or it can be prevented using rubber dam. It is ideal treatment for anxious patients and small children.

How to get rid of yellow teeth

Yellow and discolored teeth indeed look pretty disagreeable and they are source of embarrassment in society। Bright smile give beauty to your face and people who have discolored or yellow teeth often do not smile to offset their       unpleasant teeth.

Before I will tell you the treatment options for yellow teeth , you should know what are those factors that are causing your teeth look yellow.

1. Some people have yellow teeth from birth (originally yellow). If you belong to this category you don't need worry about anything because your teeth aren't diseased. All you have is defective enamel (outer layer) mineralization defect and the second layer which is yellow coloured called dentin is showing off from thin enamel.

2. SMOKING: I don't understand why people smoke?? Its more of a fashion in teenagers and adults but they don't know the long term harms of this crappy thing. People who smoke often have ugly teeth that are brown to black in colour which is because of nicotine(component of cigarrete) that makes salivary pH acidic. No argument , smoking is indeed a major cause of tooth yellowing as well as discoloration.

3. TEA and COFFEE : Excessive intake of tea and Coffee causes extrinsic staining and yellowing of teeth over a period of time because it contains color imparting substances.

4. BAD ORAL HYGEINE : Most of you do not take care of your teeth as much as your skin,hairs,nails etc. Your teeth also need some time to care for them. If you do not brush them properly then they will ultimately appear yellow so no matter how tired you are always brush your teeth before going to bed and also between meals.

5. BEVERAGES and ENERGY DRINNKS: Avoid taking lots of carbonated drinks as they are very dangerous for your teeth, they are corrosive in nature and make your teeth weak and brittle and once they become weak they acquire extrinsic pigmentation easily. Use Mineral water instead of harmful drinks.

6. AGING: As u grow older your enamel wear down due to attrition and underlying dentin appears yellow. Moreover with age people do not take care of their teeth and their bad oral hygeine causes teeth to appear yellow.

7. SYSTEMIC FACTORS : Diabetes mellitus , Congenital porphyria, Amelogenesis imperfecta, Dentinogenesis imperfecta all of them leads teeth to become brittle, porous and less mineralized leading to yellowing with time.

8. SWIMMING: It is not a very major factor but some research has shown that swimmers have weak teeth becausa of high chlorine content in swimming pools which might cause teeth to become brittle and yellow.

9. ATTRITION, ABRASION, EROSION : Do not use your teeth for opening cans and packages. Also people living in rural areas eat hard sugarcane that causes attrition(wearing off enamel). Do not insert needles, pins, pencils between your teeth because this habit again causes fragile teeth.

Improper brushing technique (horizontal brushing) causes abrasion so avoid it.

Excessive vomiting in people who have anorexia nervosa/bilimia nervosa causes erosion which is chemical wearing of teeth (this is usually seen in teenager girls who have fear of gaining weight even if they are underweight and for doing it they vomit out forcibly after taking meal).

TREATMENT OPTIONS:

1. Bleaching and whitening

2. Crowning if one or two teeth affected

3. Porcelain Veeners

4. Composite Veneers

5. Laser technology/treatment