Dental care: a window to health

Keep children away from sweet supari to protect teeth

Dr Zia Abbas is a dental surgeon and the former head of the Oral and Maxillofacial Surgery Department at Dow Ojha Campus. He had also previously served as vice principal of Dow International Dental College. His research work includes an article titled ‘Notch 1 Mutation in Oral Cancers among the Pakistani Population.’. During his 16 years of service in Punjab. He also worked as a dental professional at Sialkot Allama Iqbal Memorial Hospital for seven years. In 1999, he shifted to Karachi’s Baqai Medical University as an assistant professor of oral and maxillofacial surgery. Bolnews discussed dental hygiene with him. Following are excerpts.

Dental hygiene is a must, yet many people fail to understand this. How do you feel about the lack of oral care in our society?

It’s true that the majority do not understand oral hygiene. There are also affordability issues that prevent people from immediately addressing their own or their loved ones’ dental issues. Whether rich or poor, we as a society must focus on keeping our teeth and mouth clean. We must visit a dentist regularly and yet our people seem to visit the doc only when there is shooting pain. Having said this, we must have awareness camps and teach more to our people about the importance of oral hygiene. When we [dental professionals] examine the oral cavity, we often come across the same issues in the urban population —swelling in the gum and bleeding gums. Frankly speaking, certain patients don’t give a damn about issues such as bad breath and other dental problems and they only show up when the toothache is unbearable for them. Sometimes, they even go to a physician with hopes of treatment. Such physicians also prescribe them medication instead of instructing them to go see a dentist.

Which kind of patients do you come across mostly at your hospital?

If, generally speaking, people come for extraction of teeth. As mentioned earlier when the pain is unbearable, the patients think now is the time to visit a dentist. They are primarily interested in the cause of this pain and whether or not it will be extracted. There’s always this anxiety about any other dental problem that might be diagnosed by the healthcare professionals, which they see as a ‘minor’ issue. No dental issue is minor. Despite this, there are many ways to protect the teeth. Those with shooting pain can be treated with a root canal but they prefer extraction; so most patients come to us [dentists] for extraction.

Is it true that only the affluent can afford dental treatments? Or is it because of a lack of personal care that people end up abandoning their dental health?

It’s very important to understand that care begins with the will to protect yourself from damage. I don’t agree with the argument that only affluence can help you stay healthy. In our urban centres, many people have developed a habit of chasing cheaper solutions to their medical woes. I’ve seen people coming from the USA and the UK and they come for quality treatment here. They need to understand that it’s their ignorance that accumulates the problems. They are too preoccupied with the cosmetic aspect of teeth than the dental health situation.

Which dental issues are most common among Pakistanis? What are the effects of these issues, if left untreated, in adult and child patients?

When I was an associate professor, we would send our dental students on community visits. Our students gave us their feedback during presentations that people living in some villages didn’t even know what dental hygiene was. Many would wash their teeth with coal and that was pretty much it. They simply went with the availability of resources. This shows that our negligence toward oral care is hazardous. Gum disease was also common in the region. Due to this particular issue, the tooth would become loose, and then fall. There were other issues identified as well including cavities, bleeding gums and bad smell. Here’s one thing about minors, whether in villages or cities: the betel nut and sweet ‘supari’ are available at cheap rates. These are ‘non-consumable’ items, the kind no one should be chewing or ingesting. However, the producers make these items colourful, sweet-smelling products in good packaging and sell them for low rates. This consumption can cause cancer or the pre-cancer condition of oral submucous fibrosis.

What should parents do to ensure their new-borns have healthy, strong teeth? Do you recommend any foods or medicines that are more effective on dental health in today’s society?

Growing up with dental issues, young parents are now aware of how to prevent dental damage to their babies. Infants go through tooth eruption at the age of six months. At this point, finger brushes can be used for oral hygiene. The double-sided toothbrush allows the parent to clean their child’s teeth conveniently. Moreover, infants are consistently fed milk and its sugary content can affect their dental health. It is recommended that the infants are given water through their baby bottle to help them flush this content out of their teeth. Later when they grow up, the minors can eat relatively heavier food but it should be chewable food such as cucumber, English cucumber or apple. And they should develop a habit of eating it over time. Avoid teethers and soothers. They should chew apples as the pressure infants put with their teeth on ‘harder’ food helps strengthen their teeth. As they grow older, children should be made conscious of protecting their teeth. I don’t recommend immediate medication for any dental problems but healthy food is a must for both minors and adults.

What foods should you completely avoid and why? What are some eating habits that damage dental health?

It’s common in our urbanised society that parents and even grandparents, who are more experienced citizens, tend to buy anything for their children to make them happy. When it comes to food, these shopping habits can ruin the little one’s dental health. Our culture encourages children to over consume chocolates and other sweet items including beverages and ‘mouth fresheners’ that damage the teeth by plaque build-up. Sugar content in these items will encourage the overnight build-up of cavities. Even in babies, due to bottle feeding, rampant caries grow due to the sugar content in feeder milk. The bacteria multiply due to moisture and darkness in the mouth. Gradually lactobacillus bacteria grow which may play a role in dental decay. So whatever healthy food you eat, encourage minors to eat better than what they are currently consuming. This will make them disciplined and more conscious of their eating habits in the future.

What other suggestions or warnings do you have for people at risk of dental damage? What tools should they use or what lifestyle practices should they adopt for better teeth?

Our oral health situation can tell us about our overall health. So clearly there are benefits to cleaning our teeth. I think a good practice we should adopt in our lifetime is to actively check our teeth for oral hygiene, and we should do so on time. We often assume our teeth are fine just because there’s no sharp pain or because the teeth feel strong enough when they could be decaying at that particular stage. Brushing regularly and properly is always recommended before sleep, and after breakfast. Flossing is still alien to most people in our urban centres but it is advantageous as it helps alleviate bacteria and the gums remain protected. Gargles and certain brushing techniques are very important. Every individual must be able to identify the interior, right and left sides of the teeth while brushing. The rolling action on the right side of the teeth followed by the sweeping action is an appropriate and effective way to disinfect the teeth. For the upper teeth, move your brush from soft tissue to hard tissue. Also gently brush the tongue to avoid bad breath and, later, you will also feel your appetite. Take a few minutes out every day for oral care and make it a habit to follow these basics, regardless of the medical problems you are going through. Eat healthily, keep your teeth clean and visit the dentist.