April 2021

WHAT EXACTLY ARE DENTAL SEALANTS?

Sealants are a form of preventive dentistry. We recommend sealants for both adults and children with deep grooves, pits and fissures on their teeth. Sealants are thin coatings that are placed on the chewing surfaces of back teeth to protect them from bacterial attack. They do this by keeping the germs and food particles out of the grooves. Permanent molars are the most likely to benefit from sealants. The first molars usually come into the mouth around 6 years. Second molars at around age 12. It is best to apply sealants immediately the teeth erupt before they have a chance to decay. Applying sealants does not involve drilling or removing tooth structure. The process is short and easy. After the tooth is cleaned, a special gel is applied on the teeth for a few seconds. The tooth is then washed off and dried and the sealant is painted onto the tooth surface. The dentist may shine a light on the sealant to make it harden. It takes about a minute for the sealant to form a protective covering. As with anything new, the child may feel the sealant with his tongue. The sealant though is very thin and can only fill the pits, fissures and grooves. A sealant can last 5 to 10 years. Still, there is need for regular dental appointments so that the dentist can replace the sealant if it is wearing away. Dr Biren Yajnik Dental Surgeon, Sterling Dental The writer is the Vice President of the Uganda Dental Association.

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WHEN YOUR BREATH SMELLS AS BAD AS YOUR SOCKS!

Bad breath is one of the commonest dental conditions. Almost every one, at some point in their lives will suffer from some kind of bad breath. Bad breath can be thought of as either a normal type, an abnormal type, or a “weird” type (which we call pseudo halitosis). Normal halitosis is experienced in the morning when we wake up and it fades away relatively quickly after that. The weird type is when someone thinks they have bad breath but the dentist fails to detect it at all. The abnormal/disease related/ pathological type is the one that causes most concern.  It can be related to any of the organs below; i.e. nose, mouth, throat, chest and stomach.  Here is how! Nose– Chronic nasal diseases (chronic sinusitis) and this can be a big cause of bad breath… Mouth– Cavities in teeth, calculus (kaboole), gum disease, oral cancer. Throat– Enlarged tonsils that trap food, throat infections, tonsil stones, etc. Chest– Lung diseases such as bronchitis, pneumonia, asthma, lung cancer. Stomach– Acid reflux (Gastroesophageal reflux disease), ulcers Others– Liver diseases, kidney diseases. Habits– Smoking, drinking excessive alcohol, diets high in garlic, forgetting to floss, poor toothbrushing technique. Take Home: the first stage in understanding how to manage bad breath is by taking note of what the possible causes are. The above list is not exhaustive, so feel free to read up some more on it. Dr Trevor Kwagala Dental Surgeon The writer is the General Secretary of the Uganda Dental Association.

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image credit; https://houseofdentistry.co.ke/service/braces/

WHY DO I HAVE CROOKED TEETH?

Everyone loves a beautiful smile. Unfortunately, teeth often appear crooked, affecting one’s appearance and self-confidence. Teeth become crooked usually because they don’t have enough space in the mouth. This could be due to; A small jaw size. Too many teeth in the jaws. (excess teeth i.e., supplemental teeth) Retained baby teeth that refuse to give way for adult teeth. Early loss of baby teeth which causes the space for future teeth to close. Age related changes in the jaws (in adolescents and adults). Many of these conditions can arise due to genetic reasons; i.e., passed on from parents to the child, or due to certain habits that we engage in as children, such as thumb sucking, using a pacifier, etc. Additionally, most people will experience crowding and malalignment in the lower front teeth as they grow older. How can we align them? Teeth can be aligned depending on many factors such as: Age Type of malocclusion Degree of malocclusion General health of the person (Malocclusion basically means a type of malalignment) These factors will usually determine what procedure can be done and which one cannot.  Some of the treatment options available for correction of wrongly aligned teeth include; Metallic braces Ceramic braces Invisalign Removable appliances Dr Biren Yajnik Sterling Dental The writer is the Vice President of the Uganda Dental Association.

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WHAT YOU NEED TO KNOW ABOUT SALIVARY GLAND STONES!

If you are getting sudden pain inside your mouth when meal times reach or have a lump under your tongue that is very painful; then you may have an obstruction in the “pipe” running from the salivary gland to the mouth (salivary duct) caused by a stone. This condition is called Sialolithiasis (salivary gland stones). Salivary glands are structures that produce saliva. In the human being, we have 3 major salivary glands; namely They may get obstructed by stones that form within the glands. The submandibular glands are the commonest site for stone deposition, followed by the parotid and finally the sublingual glands. Risk Factors Salivary gland stones can occur at any age; however, most cases occur in patients in their third to sixth decade of life (20 – 60 years of age), with the risk increasing as one gets older. Males seem to be more commonly affected than women. This condition rarely occurs in children. While the cause is not yet generally accepted upon, certain risk factors for developing stones include dehydration, medications that reduce saliva production such as antihistamines and blood pressure drugs, kidney diseases, radiation therapy to the head and neck region, age, mouth injuries, gout, Sjogrens syndrome, etc. الصيدلية على الانترنت لديها مجموعة متنوعة من المنتجات الصحية للرجال المتاحة وتعمل باستمرار على تحسين العملاء خدمة. أيضا على موقع الصيدلية هناك مقالات مفيدة حول الأدوية التي يستخدمها الأطباء في علاج ضعف الانتصاب Appearance. The stones are formed from calcium, carbonate and phosphate ions as well as other organic substances found within the salivary glands. They usually appear white / cream colored and are hard. Their size varies from less than 1 mm to a few cm in largest diameter. Symptoms The stones obstruct salivary outflow through the salivary duct, causing saliva to flow backwards and eventually stagnate, leading to swelling, pain and infection in the gland. Sometimes pus may develop within the gland and if the infection spreads to the rest of the body, one may develop a fever. Management The dentist may take an x-ray to see the location of the stone better and plan for management. Small stones may resolve on their own spontaneously, or they may be “milked” out in the clinic by the dentist. You may be advised to take a painkiller such as acetaminophen (Panadol™) to moderate the pain as well as antibiotics if the infection has spread to the rest of the body. Prevention of salivary gland stones involves drinking a lot of water, eating healthy and having regular dental checkups to aid early detection. Dr Biren Yajnik Sterling Dental The writer is the Vice President of the Uganda Dental Association.

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MOUTH; MIRROR OF THE BODY

The mouth is a reflection of what is taking place inside your body. Most of the times we forget this or better still we are ignorant about this. So many illnesses taking place inside your body can be seen in the mouth. Therefore, the dentist might be the first person to give you a key to an ongoing hazard in your body. You may be wondering how this is so. It is so because the mouth is part of the body. It is the mirror of the body. Whenever you visit your dentist, you are asked a number of questions that you may think are not pertinent to oral health so you don’t disclose important medical facts! Each time you hide something from your dentist, you are hurting yourself because there is a reason why you are asked particular questions. There are common diseases that your dentist can notice from the mouth e.g. HIV/AIDS, Diabetes Mellitus, Syphilis, Tuberculosis, oral cancer, etc. Special considerations are undertaken by your dentist when you are pregnant, when you’re taking certain medications and even when you have certain allergies. It is important that you disclose all medical information to your dentist! Dr.Nakyonyi Maria Gorretti Dental Surgeon Uganda Dental Association- Projects Secretary

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SHOULD I BE KEEN ON THE TOOTHBRUSH I USE?

The answer is yes! You should. It is important to brush a minimum of twice a day with fluoridated toothpaste and a good toothbrush. You may be wondering what a good toothbrush really is. Here’s what it is. QUALITIES OF A GOOD TOOTHBRUSH: SIZE Size of the head of the toothbrush often makes no difference. However smaller heads are able to reach the most posterior teeth (wisdom teeth) much easier than toothbrushes with bigger heads. Select a toothbrush with a head size that can easily fit into the mouth and can brush one to two teeth at a time. You should be able to reach all teeth easily. HANDLE A good toothbrush should have a handle long enough to provide comfort in the hand as one is brushing. BRISTLES: If you think that hard bristled toothbrushes are the ones to use, then you are wrong. Any toothbrush you choose should have soft bristles enough for effective cleaning and safe for the gums. Hard bristles wear away the teeth causing hypersensitivity. POWERED VERSUS MANUAL: Powered toothbrushes don’t clean any better than manual toothbrushes. If you are able to brush, i.e. you are not physically and mentally handicapped, then better you use the manual toothbrush since you will be in full control of the brushing. Powered toothbrushes are equally good although they are much better for people who are physically and mentally handicapped. However heavy hand electric toothbrushes cause risks of enamel (outer layer of the tooth) wear. NB: Don’t forget to change your toothbrush every 3 months. DR. MARIA GORRETTI NAKYONYI           DENTAL SURGEON                                                                                                                                                                                                                                                                                                                                 

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WHY DO I NEED A GOOD TOOTHPASTE?

Why do I need a good toothpaste? I understand how disappointing and frustrating it can be when you think you are doing everything right i.e. brushing well, avoiding confectionaries name it but you still feel your oral health is not getting any better. While the problem might be coming from many other areas,  have you thought of the type of toothpaste you are using? Here are a few hints on the choice of a good quality toothpaste for routine oral health; Fluoride; This is a component essential for remineralizing your teeth in the earliest phase of tooth decay, replacing minerals that have become lost and might lead to cavity formation. Fluoride strengthens teeth and even provides protection against tooth decay. Look at the package when you are choosing toothpaste and make sure it contains FLUORIDE. You may see the words sodium monofluorophosphate or sodium fluoride in the ingredients section. These are forms of fluoride and both are okay. For adults, fluoride concentration should be at least 1.1% w/w (1450ppm as it appears on the toothpaste packaging) Smooth, not gritty. You will never want to choose abrasive toothpaste because it is going to damage the outermost layer of your teeth (enamel). Nonabrasive products are always the way to go. ADA seal and authenticity American products have the ADA (American Dental Association) seal of acceptance that proves authenticity. For context, Colgate is an American Brand; so look out for the seal. Other brands have different authenticity seals or marks, so make sure to check out those on their websites. NB: These qualities may be different for special needs like sensitivity. Your dentist usually prescribes a desensitizing toothpaste for that particular purpose. DR. NAKYONYI MARIA GORRETTI DENTAL SURGEON

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NEVER FORGET THE TONGUE!

Wow you should be asking what about the tongue? It will really be shocking if one said they didn’t know the tongue. The tongue is a muscular organ found in the mouth along with the teeth, gums, tonsils, name it and serves important functions namely; Eating Swallowing Speaking Tasting i.e. bitter, sweet, cold, hot etc. The tongue forms the floor of the mouth of all mammals where humans belong. It harbors a lot of bacteria and food remains, hence playing a big role in bad breath. Unfortunately, most of the times we concentrate on teeth and forget to brush the tongue. This allows accumulation of food within the rough surface of the tongue, which when acted on by bacteria, produce plenty of foul-smelling compounds from the retained food residues.  Each time you brush your teeth never forget to brush the tongue too to clear the dirt that accumulates as it does on our teeth. You can brush your tongue using a tongue scrapper specifically made for that, or the back of the toothbrush that has also be designed for the same purpose and if all these are unreachable then your toothbrush can serve the purpose. NB: Never forget to brush the tongue! DR. NAKYONYI MARIA GORRETTI DENTAL SURGEON Uganda Dental Association- projects secretary

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TOOTHPICKS: THE GUM NIGHTMARE!

Toothpicks have been around for centuries. They are commonly made out of wood and a few from plastic. You’ll find them well placed at the table of your local favorite restaurant, in the supermarket, the neighborhood shop, everywhere. It’s common to see people using them to remove meat remnants from in between their teeth after a sumptuous meal.   Dangers of toothpicks As you use a toothpick, you often poke downwards towards the gum. This causes gum irritation and bleeding. In the long run, you get gingivitis (a disease in which the gums are swollen, red, painful and bleed easily) Aggressively using the toothpick risks its breakage in between the teeth, inside the gum or in the mouth where you could accidentally swallow it. Wedging the toothpick in between the little space that naturally exists between teeth creates a widened space called a “black triangle”. This forms because the toothpick destroys the gum, eventually resulting in reduced bone height in between the teeth. Aggressive use of toothpicks may wear down the enamel (outer layer of the tooth) leaving your tooth at risk of getting interproximal dental caries (holes found in between teeth). It is important that you clean the area in between your teeth to avoid food getting trapped there, as this can predispose you to getting cavities, bone loss and gingivitis. Exchange the toothpick for dental floss for an effective clean! You can visit your dentist to show you how to clean in between your teeth using dental floss. DR. NAKYONYI MARIA GORRETTI DENTAL SURGEON BDS(MUK)

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DID YOU KNOW THAT JUICE CAN WEAR DOWN YOUR TEETH?

FACT: LEMONADE IS MORE ACIDIC THAN COCACOLA. Our teeth can be worn down by acidic drinks. This kind of tooth wear is called dental erosion. These acids can come from within the body (intrinsic) and from outside the body (extrinsic). From inside the body, acids may come from excessive vomiting or acid reflux common in people with heart burn. From outside the body, acids mainly come from our diet in the form of soft drinks i.e. carbonated sodas (coca cola is top of the list here) and energy drinks, lemonade, orange juice, etc. So how can you control this kind of tooth wear? Avoid drinking acidic beverages i.e. swishing or holding the liquid in the mouth. Use a straw when drinking may be of help. Position the straw to aim at the back of the mouth so that the acids don’t bathe the teeth. NB: Avoid aiming the straw towards the front of the teeth. Take copious amounts of water or better, milk while eating. Milk has high levels of calcium that neutralize the acids and remineralize the tooth. Rinse the mouth following meals, vomiting and after consuming acidic drinks. Chew sugar free gum often to stimulate saliva production. Saliva helps to neutralize acids in the mouth. Avoid brushing teeth immediately after eating or drinking acidic beverages. Wait at least 1 hour after eating, drinking or vomiting. Always brush teeth using a soft bristled toothbrush and fluoride toothpaste. DR. NAKYONYI MARIA GORRETTI BDS(MUK) PROJECTS SECRETARY UGANDA DENTAL ASSOCIATION

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