Sunday, March 30, 2008

its there, its not there


hmmm why does this nasik feels like batu??
whhooppss.. its my tooth filling!!!


i just did that filling about a week ago!!!!!!!


trust me, its a dentist's worst nightmare.. having to face your patient again after you've just filled his teeth just one week before. worse still, now he's complaining of pain that has not been there before..

and now i feel obliged to explain how can a filling become loose. it might because of one or multiple reasons. but first and foremost, please dont come banging on the clinic's counter... at least go inside and let your dentist have a look at the tooth and explain to you, okay.. we are also human, we really dont like to let our patient feels dissatisfied, really we dont,.. so satisfy yourself by hearing our explanation.

so my preaching today would be aptly titled-
why does and how can tooth filling become loose/fallen:

1. the filling has probably become too large for the tooth to handle. the tooth will be unable to withhold the filling, the tooth structure becomes weak, and after slight pressure onto the tooth while we are eating, the filling become loose. there are cases in which the remaining tooth structure is fractured. the solution: crowning. for this type of problem dentist will always suggest crowning for that tooth. just like our socks will cover our feet, the crown will cover the whole tooth structure so the tooth will become stronger and able to withheld great pressure (i.e chewing/biting).

2. there might be a secondary infection/caries underneath the old filling. tooth filling is bonded to a cleaned surface, but when the area become infected it will become soft, causing the filling to dislodge. this will usually accompanied by pain because the infection will further deepen the previously restored tooth. your dentist will have to remove the old filling, scoop out the infection until no more is left and refill the tooth. when needed some type of medication will be placed so that the floor of the filling is stronger and void of further infection.

3. our material is very sensitive to moisture. if ever our saliva is mixed with the material, the material itself will become weak. so please avoid putting your tongue whilst having your tooth filled, okay. that's the need of the suction, and some dentists resort to using rubber dams (rubber sheet placed over your mouth to prevent any water/saliva into entering the tooth preparation, but some people claim its really uncomfortable). but contrary to popular believe that expensive material will bond better, well, it wont. the price of material depends more on the polishability/cosmetic/colour/strength, not how they bond to tooth surface.

4. there is one condition called abrasion cavity, this is caused by usage of hard or medium-bristled toothbrush that is just too harsh for tooth surface. the cavity is triangular shaped, situated at the neck of your tooth near the gum, and it will cause sensitivity. your dentist can fill it easy, with one really important condition: change your toothbrush!! your naturally hard enamel tooth surface itself cannot withstand the harsh effect of hard/medium-bristled toothbrush, let alone tooth fillings. preferably change it into a supersoft/extrasoft-bristled toothbrush. you might have to change your toothbrush more frequently, but i supposed that is so much better than to have your teeth filled repeatedly!

5. erm... you might accidentally bite on a really hard thing i.e small stone or chicken bone that may have caused the filling to break. i encountered one patient with his whole, unfilled, healthy back tooth split straight into two after he indulged in his favourite snack during a man u game: kacang cap tangan. i assure you the pain is terrible, i really feel sorry for him. i had to extract his tooth, there was no other choice. :( . anyway, if a healthy tooth can break, so can filled tooth..

mmm.. i'm pretty sure your eyelid will become heavy if i continue droning on this subject. so that's it. the important ones, that is. there are more to these, of course, but they are less important and less frequently happen.

if ever your tooth filling become loose after only a few weeks having it filled, please visit your dentist a.s.a.p. its never good to leave your tooth unfilled, because it may lead to more problem. and as a normal practice, dentist will usually charge you nothing if you come back (to the same dentist) within 30 days to redo the less than a month old filling.
its free! so why delay??

Tuesday, March 11, 2008

what about me?

and what about the rest of our children? those in primary and secondary school?

i used to work in the government for almost 4 years before i resign, and i know for sure they do have a solid dental program for schoolchildren. basically the program involves dental check ups and simple treatments for all schools.

this is how it works:

every start of the year the klinik kesihatan in the constituency (for example klinik kesihatan in sec 3 bandar baru bangi) will draft a schedule as to where and when they will pay a visit to each of the schools within that area. the program will be two tiered: they will first call all students class by class to do a general check up. then the next step they will call, also class by class, only those who needs treatment. usually before they call the student for the second time students are required to get consent from their guardians. the involved personnels are generally divided to two teams:

teams for primary school consists of
- 2-3 dental nurses
- 2 attendants
- and occasionally a dentist will accompany them whenever needed
teams for secondary school
- 1-2 dentists
- 1-2 dental assisstants

their coverage for each area is quite thorough although for secondary schools its quite difficult for them to cover all schools; the reason being
1 they're almost always lacking in numbers of officers.
2 usually schools dont allow the program runs on exam period i.e pmr/spm/midterm exams

for example in bandar baru bangi the klinik kesihatan dental teams will cover
primary schools
- sek jalan 2 - sek jalan 4
- sek jalan 3 - sek chung hwa in kajang
- sek jalan 6 - sek convent in kajang
- sek integrasi - those that have slipped my mind
secondary schools
- sek jalan 2 - sek maahaad hamidiah
- sek jalan 3 - sek jalan reko
- sek jalan 4 - sek al amin
so you see its pretty thorough, but i have to mention that schools with the best cooperation given during my working year in the government (2004-2007) (from the children as well as teachers) are sek men jalan 4 and maahad hamidiah.

i also do understand your concern.

i do always hear complaints from parents and students that the dental service given at school left much to be desired. that doesnt give you an excuse so that you can run away when the dentist starts calling your class. the first tier (the general check up) is the one which plays the most important role and also the simplest: to determine whether you need any treatment or not. if you dont, good for you. if you do....

actually you have 2 choices- 1. let the dentist do her job... its not bad actually. we usually try to do the best that we can. it just the time constraint. just imagine.. we are to do up to 100 dental fillings from 8.30 am to 12.30 pm.
move on to no.2. you can always decline treatment. tell your dentist that you want to have treatment at nearby clinic. or for parents, you can always inform the dentist that you dont want your child to have dental treatment at their school. the dentists are always glad when you tell them that. it will take a little bit off their shoulder, u know.

just dont run away when they call you the first time, okay. its nothing, they wont do the treatment right away. its just check ups, but an important one, so that you'll know whether you need a dental treatment or not.

Thursday, March 6, 2008

for parents and would-be s

fact 1 -

yes, milk tooth is rrreeeeeaaaaaallllyyyyy easy to have holes on it. its minuscule, plus the fact that our child almost all the times doesnt want to hear us...

no sweets!!
but i want it!!
go brush your teeth!
but i dont want to!!

they always seems to LOVE contradicting us!

fact 2 -

but they can also brush their teeth fine! yeah... they also can eat fine by themselves... but theres always mounts of nasik on the table and floor...

so lets fast forward to lesson number 2:

routine dental check up for your child (age 2-6 yrs)

as i mention earlier, milk tooth is too easy to become rotten, because
1. they take their milk often, and milk are like vitamins for bacterias.
2. their size is small, so however small the hole might be, it can straight away become big the next week.
3. their motor control (i.e their control of their toothbrushes) are still not very good (thus the nasik on the floor) so no matter how loong/short they take to brush their teeth its still not thoroughly clean..
4. not to mention the amount of sugar they take... (i do wonder whether mine can get juvenile diabetes with her granny/grandpa/aunties/uncles feeding her all sorts of tidbits every half hour or so...)
5. and because of no. 2, all in a sudden before you realize there's a hole in your child's tooth, he's already crying, not able to sleep, not able to eat, and worse- now you see his face is asymmetrical- because the swelling becomes so big, one of his cheek becomes extra ermm.. 'comel'....

so please bring your child to dental checkups as early as at the age of 2... the earlier the better.. so that anything can be detected early... early intervention also means less pain and less cost..
and if your child is below 6 yrs old please dont let him brush his teeth only on his own. of course you can encourage him, its better that way,but also make sure you yourselves help him brush everytime..

its just so sad to see children as young as 2 years old crying their hearts out because the pain is unbearable.. we ourselves cannot stand toothache, let alone a 2 year old... no wonder dental treatment is such a phobia..

so let your dentist help them. small lesions/holes can easily be filled, but large ones will be a completely different story altogether.

the reason behind

why this blog

the basis of this blog is my passion towards my work. i believe i have a lot to offer to my patients. first of all, of course, pain-free dental treatment. which, strangely, is like an alien subject in this part of the world. but being a human first and a dentist, much much later...

i am no stranger than us ordinary people. i used to be terrified whenever i have dental appointments. i will feel like cringing, my heart beats thousand times more, i'll be sweating like.. ermm.. the sound of the drill makes me want to run faster than you can say 'drill'..

when i become a dentist (only about 4 yrs ago..) i set myself a life long goal:

i want all my patients to feel comfortable when they are with me
- i want my patients to be able to tell me their fears and expectations
- i want to provide dental treatments with littlest pain possible
- i want my patients to be satisfied with the service i give, they feel that that is the best that they could get
- i want me to be satisfied with the service i give, i feel that that is the best that i can give

reality hits me like buckets of icy cold water. malaysians... their take on their dental health... i would estimate only about 20% keeps their biannual dental checkups, and about 95% of that 20% are in kuala lumpur. so for me, practicing in bandar baru bangi.... only 1 out of 10 patient i saw come for their routine check ups.



The last epidemiological survey of adults in Malaysia in year 2000 revealed that only 25.2% of adults (aged 15 years and above) had a dental check-up in the past year while 15.3% had one in the past 1 to 2 years.

its really frustrating. usually when they come to me... its too late for me to do any minimally invasive (= minimal pain) treatment anymore. instead we were left with either one of two: root canal treatment or extraction. in which.. both of course we can try and do it as pain-free as possible, but for sure both are really invasive procedure...

so lesson number 1:

try and keep your routine dental check up. it doesnt have to be biannually or annually, keep it at your own time but do it regularly. the advantages would be:
- small caries lesion can be detected early. you may not feel anything, just a stinging during eating sweets.. but its there. so if we can find it early, the restoration process (the treatment) would truly be pain-free.
- your calculus or staining or karang gigi is at minimal level so the removal will also be minimal and again, pain-free. try imagining removing a 5 years old calculus vs 1 year old calculus. or try this: imagine how hard we have to scrap 5 year old dirt vs 1 year old dirt. go figure.
- start your child's check up early. say around 2-3 yrs old. that way they will get used to the surrounding hence, eliminate the phobia.
- consider the cost, my friend!! routine check up will cost you about rm10-15, simple filling rm50-60. so at most, per visit you will pay.. say about rm120 for check up and 2 simple fillings with no pain.. IF u hv holes in your teeth.. only IF... compare it with.... when its too late.. your tooth already need root canal treatment... which will cost you more than rm200... and multiple visits.. with the toothache that you might have to endure before that because you left that hole in your tooth for much too long.. not to mention the meds you have to take... oh did i mention the hideous swelling that might accompany the pain??

think about it....

Wednesday, March 5, 2008

the newcomer

and that's me

truly a newcomer in everything; the internet, blogs, googles and yahoos.. the world that i conveniently ignored since my husband is in THIS world. i used to even ask him to .. set my mail, check my mail, compose my mail, search something or anything from the www, ... well you get the drift. not until i accidentally found out about HIS blog. how i did that? well i googled his name of course... i bet he is still knocking his head off that simplest mistake since i was not supposed to find out about it. sorry honey.
you would not believe how ignorant i am. i didnt even know the meaning of the word 'blog'.

blog (blŏg) Pronunciation Key
n. A weblog.

intr.v. blogged, blog·ging, blogs
To write entries in, add material to, or maintain a weblog.

thats from the american heritage dictionary. sorry i cannot help to look for it. its just so strange for me.

from blog history in blogstar:
Early 1999: Peter Merholz
coins the term blog after announcing he was going to pronouce web blogs as "wee-blog". This was then shortened to blog.

thats like almost 10 yrs ago. so .. i've been snubbed for the past 10 yrs.. no wonder all my younger sisters rolls their eyes. my husband complains i'm a slow writer (or is it typer? mmm not sure about that) and my friends look at me like i'm out from another world when i told them ' but i dont really know how to email..'

well here's the weird truth:
1. i've never had an online chatting (except for recently of course)
2. i've never manage my own email acc.
3. i dont have a friendster/facebook/whatever
(mb i'll hv it soon... i dont know.. )

what's lasting is not what resists time, but what wisely changes with it - peter muller

so i have not been wise for the past 10 yrs... its never too late isnt it??