Tuesday, May 20, 2008

in too deep

choices, choices, choices.

pumps: red? blue? purple?
football: man u? liverpool? chelsea?
cars: toyota? mazda? honda?

teeth: cabut? cabut? cabut? *huh?*

we do have choices when it comes to the health of our teeth. all the choices available is to eliminate whatever discomfort that we have. be it just a small hole, or major pain in the (ermm..) oral cavity... YES! we have!

a small to medium-sized hole on our tooth will present itself as a slight discomfort: during eating, drinking... especially hot or cold or sweet. its solution is simplest of all: filling! because the cavity is small, only involves the enamel and a little bit of dentin and very far away from the nerve, pain during this type of treatment is zilch!

a medium to large-sized cavity will cause a more apparent discomfort. added to that is the feeling that there's always some food stuck at that area whenever we eat, and it is becoming more and more difficult for us to take the food out. the other sign would be, whenever we floss, the floss gets stuck. the solution again, is filling. but apart from the normal filling material, we will also add a medication (a calcium hydroxide material) that will stop the caries from going deeper and nearer to the nerve by promoting the production of secondary dentin, which is a harder, stronger layer as compared to our primary dentin.

a large cavity may well has your pulp (the chamber housing our nerve) involved already. you will have: - hell of a pain, accompanied by swelling of gum, and the occasional facial asymmetry. Solution: root canal treatment. basically we will take out all the nerve and blood capillary that supplies that particular tooth; clean the canal area and fill it up with a type of rubber. it is almost the same process as mummification: we embalm the tooth so that the tooth is dead, no sense whatsoever, but still can remain in the mouth and still can be used to chew.

if all these fail, then you can consider extracting the tooth. but, you can also consider redoing the treatments.

choices, choices, choices. its all up to you. how much value do you put to your teeth? or should i say, how much value do you put in comfortably and without worry eating the satay kajang.. pizza... nasi dagang... soto ayam.. mee bandung muar... roti canai... lamb chop... strawberries and vanilla ice-cream... lobster thermidor... cupcakes....

choices, choices, choices.

euro: italia! italia! italia! :D

Thursday, May 15, 2008

the very first time

I hate horror movies. When i become a dental surgeon, that hate evolves to despise. I totally despise horror movies, one in particular. Why can’t they make gross movies about lawyers? Engineers? Accountants? Why can’t they produce ‘DrakuLawyer’ or ‘The Engineer of Death’ or ‘Ledger of Blood’? First impression always counts, doesn’t matter what anyone believe. And the first impression the world population got about a dentist is horror.


Enough babbling. Seriously, going to the dentist is NOT excruciating anymore. Pain during dental treatment is an outdated perception, an old story (just like the movie). Modern technologies, updated equipments, improved techniques; all with the same aim:- to lessen, if not eliminate, pain. Do you remember your first visit to the dentist? is it bad? do you want your child to have that same bad experience?

So, how are we going to wipe off the phobia? Especially to our children? When the whole world practically is against us?

  1. Make your child’s first visit a very comfortable one. Instead of scaring them away, we can always give the impression that a trip to the dentist is a joyful one; just like a trip to the zoo. Be positively enthusiastic; children can always sense if we are fearful.
  2. Bring them early in their life, and bring them often. They will easily get use to the clinic’s surrounding. Bring them as early as their first tooth erupted. Bring them whenever you yourself or your spouse or your sister has dental appointments.
  3. Bring all family members. Children always like to copy their siblings, and they always like to do things in groups. It is a family trip, after all.
  4. Do NOT mention the word ‘pain’, ‘needle’, ‘jab’ or anything similar before the trip. They will chicken out even before the war begins.

We will also try to make your child’s first visit be as comfortable as possible. We do not usually do any treatment right away; we will just introduce the instruments to them. We will usually show them that our tools are not going to cause any pain, that it is just water and air. We will also let them experience our ‘robotic’ chair- boys always love it.

Nowadays, dental clinics are designed to be very people-friendly and comfortable. We always have children’s section where they can play with toys and further ease their minds. Clinics are now devoid of that ‘hospital-ly’ smell, thanks to ambi pur and aromatherapy. We ourselves do not like pain. We certainly do not want our patients to experience pain.

Ease your minds, don't believe the propaganda. Dentists don’t bite. Seriously.

Monday, May 12, 2008

to be or not to be

I have been pondering on this subject for quite some time, trying to figure out the best way to subtly and carefully going through this sensitive issue without offending anyone, to no avail. Therefore, first and foremost, I am inexpressibly sorry if I offended any of you, but, seriously, there’s just no other way for me to directly confront the subject except for, well, being direct.

While we constantly being reminded everywhere: the television, the adverts, the billboards; about the effect of smoking to our general health, the little known and often ignored, but otherwise extremely important effect of smoking is to our oral health (or should I say oral pain?).

And me, being ever always an obsessively organized person, will list down all the effect of smoking to our mouth and teeth in one, two, three.


Do you always notice that some people have brownish teeth? Especially the lower ones. What happen was, the white plaque and food remnants that stick to our tooth surface and everybody has it, for smokers, is being ‘painted’ brown and yellow by the nicotine. Your dentist can remove the staining on the tooth surface (with backbreaking and neck-paining effort, seriously) but for staining in between the teeth, it is upmost difficult. Dentists have some special polishing material to remove it, but patients always complains of hypersensitivity afterwards, because those materials will actually also remove a little bit of our natural tooth surface, not to mention patients will have to do it regularly… unless if you quit.


The nicotine and the smoke will cause dry mouth. Lame effect, huh? Dry mouth, so what? So, the effect of dry mouth are:

- bad breath. Believe it or not, our saliva plays important role. Lack of saliva will cause bad breath. That is why we have bad breath in the morning because during sleep, our salivary production is also at ‘rest’. Add that to the smell of smoke, and here I wonder how your partner feels when you guys are smooching.

- hypersensitivity. Our saliva actually provides a protective layer on our tooth surface, giving extra protection to our tooth nerve from stimulation by extra cold, extra hot or extra sweet food.dry mouth sufferers will complain of teeth hypersensitivity. Clue: you feel sharp, stinging pain all over your teeth, and you cannot quite pinpoint exactly which tooth is the problem.

- gum and mucosa pain. If you have a minuscule ulcer for example, maybe because you poke yourself with your toothbrush or fishbone, dry condition will exaggerate the pain and prolong the healing. Usually it will take three days for an ulcer to heal, for smokers, about 10 days. And the symptoms are the same as hypersensitivity (the you cannot pinpoint part). And worse, sometimes there’s no wound whatsoever and yet you still have the gum pain. Worse still, if you have pus at your gum area, the pain will make you feel like you want to cabut all your teeth, even though there’s nothing wrong with them. Your teeth are innocent!! Why blame them?!

- difficulties in swallowing. Saliva provides lubrication while swallowing. Lack of lubrication equals to ‘burning sensation’ while you are eating.

.. and that’s just a small part of the effects of dry mouth. Lame, you say. If you do smoke and you have not experience any of these, you will. Soon. Unless if you quit.


Smoking, besides burning a hole through your pocket, can cost you your teeth. One of the reasons of loose teeth is loss of bone, and smoking can cause just that: periodontal destruction and loss of bone. Periodontal tissue is the tissue that is holding our teeth at its place, located inside our bone. Roughly 90% of patients with periodontal problem worldwide are smokers. You are interested in wearing dentures, is it? Of course, unless if you quit.


This will be under the heading - other effects of smoking:

- altered taste sensation, means that sweet lollipop is not so sweet anymore, and that yummy curry is not really that 'kick'. Unless if you quit.

- notice an ever growing dark space in between your two upper front teeth? That is caused by gum recession, which in turn, caused by smoking. That space will be ghastly darker, noticeably bigger, and will be at point of not returning to normal… unless if you quit.

- oral cancer. THE point of no return. Unless if you quit.