Dental Wise

Dr. Mahfujul Haq Khan, BDS, DDS (BSMMU), PhD (Japan), Assistant Professor, Department of Dentistry, BIRDEM Hospital and Ibrahim Medical College, Shahabag, Dhaka. www.aikodental.com 9885426

Dear Dr. Khan,
I read your last week's topic about dental problem of diabetic patients. I have one question regarding their root canal treatment. Is it safe to do root canal and cap for diabetics? Are there any special measures that need to be taken during these procedures?

My parents are both diabetic and our dentist told us about the limitation of dental treatment for them. I came to know from you that BIRDEM has dental outdoor facilities.

Please let me know about the limitation or special measures. We live in Mymensingh.

Yes it is safe to do all kinds of orodental procedures on well-controlled diabetic patients. We usually take extra care for aseptic (Germ free environment) conditions during dental procedures for diabetic patients and prescribe antibiotics. This is simply to prevent secondary infection. But there are some limitations that we take during the surgical procedure (Dental extraction, minor oral surgery etc) of diabetic patient. Sometimes we need to take special measures.

Yes we have modern dental outdoor facilities at BIRDEM (4th floor).

Dear Dr. Khan
Hi, I am 30 years old. I have dental cavity, but there is no pain. Do I need root canal?
Mahtab

Dear Mr. Mahtab,
Without seeing your X-Ray, it is difficult to say whether you need root canal treatment or not. But usually if the cavity is shallow and there is no history of pain, then you may not need a root canal.

Hello Dr. Khan
Will you please tell me about bad breath? Please discuss proper brushing and which tooth paste is better for sensitive teeth in your answer?
Ali

Dear Mr. Ali,
I wrote several articles about bad breath before in Dental Wise. I am giving you a brief explanation about bad breath .The majority of bad breath problems begin in the mouth, especially from tongue. Bacterial plaque and food debris accumulate on the back of the tongue. The tongue's surface is extremely rough and bacteria can accumulate easily in the cracks and crevices. Large amounts of sulphur compounds can be produced in this area, making it a frequent site of origin for bad breath. The tooth attracts bacteria containing plaque and if not cleaned regularly and thoroughly, this can result in large accumulations of bacteria, which result in bad breath. People who have periodontitis (gum disease) often experience bad breath because of bacteria accumulating in areas that cannot be cleaned easily, such as deep pockets around teeth. If your bad breath continues once potential oral health problems have been treated, see your doctor to find out any other causes. Treatment begins with a complete oral examination and health history. Periodontal disease and/or cavities should be treated and repaired. Good oral hygiene must be stressed, including cleaning the teeth and tongue (by using a tongue scraper). Once the oral infection is treated and cured, mouth rinses and toothpastes may have some effectiveness in managing bad breath.

Dear Dr. Khan,
My mother is 67 and diabetic. She was your regular dental patient while in Dhaka. Unfortunately we cannot meet with you right now as we live abroad. Her name is Kanan Bala. She is now suffering from dental pain and some of her teeth are very loose. A local dentist suggested that she go for an urgent dental extraction, as she is diabetic. But my mother believes that BIRDEM is the only institution in the world where she can get her treatment as a diabetic.

I would like to know if she could go for dental surgery if her diabetes is under control. What precautions should we take before her surgery as a diabetic? I think if you answer positively, she maybe convinced to do the surgery here. Otherwise we may need to fly to Dhaka for your treatment.
Thank you
Abdul Quayum
NY, USA

Dear Mr. Quayum,
If her sugar level is well controlled (less than 10 mmol) then I believe it is absolutely safe to do it in USA or in any other place by a qualified dental surgeon. But she may need preoperative antibiotics. And for a diabetic, we usually prefer to do any kind of surgery in the morning. She does not need to fly back to Dhaka for a mere tooth extraction but rather she can visit Dhaka to meet her old friends, relatives and also her loving dentist!

Screwdrivers- uses and types

Screwdrivers are self-explanatory. They are used to drive in and remove screws. Too often they are wrongly used - for chipping, punching holes, scraping, prying, and so forth.

The Philips head is a common screw and screwdriver. Its design reduces blade slippage from the cross-shaped slot and lends itself to driving with a power bit. The conventional screwdriver has a single blade and is used with screws of matching heads.

Battery-powered cordless screwdrivers are now in the market and are very helpful tools.

Screw heads are usually flat, oval or round, and each has a specific purpose for final seating and appearance.

Flat heads are always countersunk or rest flush with the surface.

Oval heads permit countersinking, but the head protrudes somewhat.

Round-headed screws rest on top of the material and are easiest to remove.

Screw types include the wood screw for when stronger joinings than nails are needed, or for when other materials must be fastened to wood. This screw is tapered to help draw the wood together as the screw is inserted.

A sheet metal screw can also be used to fasten metal to wood, as well as metal to metal, plastic or other materials. Sheet metal screws are threaded completely from the point to the head, and the threads are sharper than those of wood screws.

Machine screws are used for joining metal parts, such as hinges to metal doorjambs. These are inserted into tapped (pre-threaded) holes and are sometimes used with washers and nuts.

Lag screws, or square-headed bolts with screw heads, are for heavy holding and are driven in with a wrench rather than a screwdriver.

When choosing screw length, remember that the screw should penetrate 2/3 of the combined thickness of the materials being joined. Consider as well moisture conditions and the make-up of the materials being fastened, to avoid corrosion. Use galvanised or other rust-resistant screws where rust could be a problem.

Tips on screwdriving:
Lubricate screws with soap or wax for easier installation.
Whenever possible, hold the work in a vise or clamp when inserting a screw. If this is not possible, keep your hands and other parts of the body away from the tip of the driver.

To remove a screw with a damaged slot, another slot can be cut with a hacksaw blade if the head is exposed enough.

A pilot hole (usually 2 sizes smaller than the shank of the screw) should always be made before driving a screw. This is especially crucial in hardwoods or when driving a screw near the end of the board. When working with screws of larger diameter, a pilot hole of the same diameter as the shank of the screw should be drilled into the wood to a depth of 1/3 the length of the screw.

Always keep the screwdriver shank in line with the screw shank. This will avoid damaging the screw slot and pushing the screw out of line.

-LS Desk

When you're melting something like butter or chocolate over the stove, add a teaspoon of oil to the pan. This will keep the butter or chocolate from burning and bring the item to a consistent melted mixture.

Under A Different Sky

By Iffat Nawaz

Old Worries

I am always scared boredom will slap me all over my face. The fat that collects from every minute of stalling and feeling uninspired…and that fat does cover my face. Often, my face feels heavier, and my neck has to make extra efforts to hold it up…why do I get bored so easily on some days?

When I am away, out travelling, boredom touches me less, like when I am in Dhaka, or some other place that seems as far way. Or maybe boredom touches me just as much but it melts quicker when I am away; the humidity you see, it melts everything, sweat off boredom, sweat it all off. DC has its humidity too, but not here, not inside, not in this office, it's cold in here. My next-door co-worker owns the power of temperature as his room holds the magical controlling device for my office. And he is always hot even in the winter, so we are always freezing here, at least I am, and my boredom is frozen and stuck to my face, and often it feels permanent.

The other night I had a dream that mushrooms were growing on the right side of my face, they were black, with black stems. There were four or five of them, short and stubby and in my dream I was looking at them closely, trying to pluck them out and I couldn't. They felt so real. I woke up feeling a strange imaginary ache tickling my face, I touched it a few times to make sure there was no vegetation growing. Nothing was, except maybe my boredom, and I touched her, I told her I was disappointed at her for scaring me, for visiting me even in my dreams these days.

I have been day dreaming a lot too. But they are not carrying the right zing that usually keeps me entertained. I am not seeing clearly, not always, frozen sticky boredom is making my mind hazy, but I am not lost. I am not searching, I am just bored.

I am not only bored but I am also spoilt. Boredom has spoilt me, it has given me the luxury of time, of slacking off, of staring out the window looking at the river where men and women swim, then dry off on their boats, bright bikinis and speedos flaunting their immodesty, American flags blow childishly as their boats disappear, and I am left to find the next rich person taking time off in the middle of the day to sun and river bathe. And they come one by one, their worry-free souls make me mad, I get jealous, insecure, upset, and I count my worries as I watch them from my office with my spoilt eyes, spoilt brain and boredom slapped face.

But I can never finish, counting my worries that is…there are too many, or too little maybe. But there are a few, and they have existed silently and vocally, raised their heads in different corners of my life, but I love them still. Especially the old worries, they are like old pets that are dead, you get over them, but you do think of them once in a while and then you think of their deaths, and your youth…and I visit their graves during my boredom filled hours, each of my old worries and their worry-free graves, and I reminisce what they were and what they could have become.

But I know to stop as well, I have learnt to get up, run on treadmills on humid hot summer days to sweat harder; I have started climbing rocks, benches, walls and ladders to be shaken up and fall; I am practicing staring at the monitor long enough without staring out; my spoilt boredom and I cannot co-exist, so there will be death…soon…adding another grave to my old worries.