HOW TO CURB AWAY PERIODONTAL PAIN

It’s that time of the year where you haven’t really got over with the spirits of Eidul Fitr, one of my two favourite occasions- the other being my Birthday, and waiting for the grand Eid to strike; Eidul Adha, that is. The latter is known mainly for the food that is practically eaten thrice a day. So it’s, indeed, a MEATY affair, as the only item on the menu is MEAT!

Meat, as we studied back in our biology class, consumed more than required is hazardous to one’s health. Well, so is protein and carbohydrate. So, why is meat the only macro nutrient that is the much talked about?

This article is not based on to what amount meat should be consumed or which meat of the two; the red or the white meat, is good for one’s health but it is basically a warning for everyone to restrict on your meat consumption during the festivities so that you can enjoy eating just about anything and not turn up at the dental clinic right after the holidays.

Here is a relatable story. You go in a ‘dawat’(a gathering), a grand feast is presented before you and you can’t really help but start hogging on it until you realize that a small piece of it has stuck between your teeth. If the teeth happens to be the ones in the anterior then this small mishap really doesn’t stop you from indulging in the delicious saucy meat. But, if the calamity has struck your posterior teeth then your tongue will act as a natural cleanser in your mouth and try to floss subliminally.

Tongue, toothpick and finally floss or whatever comes in hand that is sharp yet slender, is the tool you’d like to grab to banish the villain that’s coming in your way from enjoying the most amazing meal you had in ages! But your arch nemesis won’t go away easily. So you leave it where it is and retire to bed. The first thing you notice when you wake up is the swollen area around the teeth where the small meat was stuck. That area is basically numb (not entirely anesthetized) yet tender. Immediately, not realizing what time it is, you call your dentist, asking for a medication that can curb away the pain.

The most painful condition associated with oral cavity, after dental pain, is the pain of gingiva. The more the gingiva is aggressively handled, the more relax you feel. Yes, blanching gingiva stops the blood supply, which, in turn, halts the painful stimuli reaching the affected site. So, let us look at the regime that can act as an analgesic.

The infamous clove or clove oil gives a soothing effect to the gingiva while the tannin present in tea leaves, too, seems to work by temporarily stopping the blood supply. Tea leaves from the Camellia sinensis plant, such as black, green and oolong tea, contain a variety of compounds like minerals, vitamins and caffeine. What is very often referred to as tea tannins are in actuality called polyphenols. Polyphenols, which include flavonoids, give tea a boost of health benefits that help to prevent cancer, heart disease and stroke.

So what exactly are polyphenols? Basically, they are natural chemical based compounds found in tea leaves that have antioxidant qualities. These antioxidants help prevent damage to the cells in our bodies and strengthen our immune system. A subgroup of polyphenols in tea is called catechins and one of the most powerful catechins in tea, especially green tea, is called EGCG (epigallocatechin gallate) which is said to be a particularly strong antioxidant. Because green tea goes through a minimal fermentation process, and white tea goes through none at all, these two have the highest amounts of antioxidants.

Other natural pain relievers are the amino acid, tryptophan (found in avocados, bananas, grapefruit, nuts, seeds, papayas, peaches, and tomatoes) encourages production of the calming neurotransmitter, serotonin. Particularly beneficial foods for pain include broccoli, cauliflower, winter squashes, sesame and flax seeds. Strawberries contain natural salicylates, and are cooling and anti-inflammatory. Enzymes, present in unheated foods, reduce inflammation, which is often a factor in pain.

The natural pain relievers among herbs are the Cayenne pepper which stimulates endorphin production and is an anti-inflammatory agent. Topically it is used diluted in salves, as it blocks transmission of substance P, which transports pain messages to brain.

Corydalis root, a relative of Poppy helps relieve pain from traumatic injury. Corydalis binds with opium receptors in the body and slows down the breakdown of choline. It is analgesic, antispasmodic and sedative.

Cramp Bark is an analgesic, anti-inflammatory, antispasmodic, and sedative. It can calm menstrual cramps, rheumatism and spasms of legs and lower back.

Feverfew herb inhibits certain inflammatory type hormones known as prostaglandins and prevents blood platelet aggregation (clumping together). Used on a regular basis it helps prevent migraines, relieve arthritis and menstrual cramps. Feverfew is anti-inflammatory and antispasmodic.

Ginger root is warming and improves circulation. It can improve the pain of arthritis, backache, and menstrual cramps. Chew a piece of fresh root for sore throat. Ginger is analgesic and anti-inflammatory.

Hops strobiles, a relative of Marijuana, are sedating to the nervous system. They calm cramps, insomnia, restlessness, stomachache and stress. Hops are an anodyne, antispasmodic, and sedative.

Kava kava root, enjoyed by many tropical island natives is a skeletal and muscle relaxant. It improves anxiety, cramps, gout, insomnia, neuralgia, pain and rheumatism. It is an analgesic, antispasmodic, and sedative.

Passionflower, doesn’t make you more passionate, but slows the breakdown of neurotransmitters serotonin and norepinephrine. Try it for cramps, headache, insomnia, muscle spasms, neuralgia, shingles and stress. It is anodyne, anti-inflammatory, antispasmodic and sedative.

So, next time, when you get a call from your patient, you can advise these natural pain relievers instead of the medications like paracetamol or aspirin, which, in the long run, has addictive effect, not to mention, are not safe for one’s body.
 Hope these remedies help you guys !

DO DENTISTS PRACTICE WHAT THEY PREACH ?

Dentists around the world preach like a cleric/priest. We ask patients to clean their teeth with a proper brushing technique, floss and rinse their mouth after every meal. Ask them to avoid chocolates, especially the yummy caramel ones, keep the snacks to minimum and say no to fizzy drinks. Clearly, our patients need not have a life while we eat back our words- and chocolates of course, and hog on just about anything.

My question here is, do we- the dentists, practice what we preach? I don’t. 

With the help of my principal, Dr. Navid Rashid Qureshi of LCMD and the supervision of my two favourite teachers, Dr. Naheed Najmi, the vice principal of LCMD and Dr. Tahera Ayub, the administrator and an assistant professor of Oral and Maxillofacial Surgery department, I set out on a journey of research. A survey which comprised of questionnaires and an examination I had to do on the dentists’ oral cavity.

A research, which, initially, became a crucial task for me as I had examine my doctors’ oral cavity to grade their DMF (decayed, missing, filled teeth) score. Out of a few dentists, nobody let me do the deed. It was a tough task but, nonetheless, a challenge which I was happy to be a part of.

Questionnaire comprising of questions like the number of times brushing should be done in a day, the time it should be done for, the brands of toothpaste and toothbrush used, if the toothpaste they used contained fluoride, if other method(s) were used for cleaning the teeth, use of mouth, eating habits, any oral treatment done etc. In total there were seventeen questions asked from the dentists and the patients (control group). At the end of the form, there was a Silness-Loe Index printed to score the dentists and the patients’ oral hygiene.

50 dentists were questioned and examined and the same numbers of patients were used as a control. Once the details were collected, information was compiled in the computer to sum up the result. MS Excel was used for it. Chi tests were performed.

First, an ‘observed’ data was entered in MS Excel for questionnaire. Then, an ‘expected’ data was used to get the chi test performed by the computer.

The result deduced by this survey was that dentists, indeed, practice what they preach. As this research was done entirely in LCMD, survey on this topic should be done in other colleges too so that majority of dentists can be evaluated.

This research was then made into a poster and presented in Pakistan Dental Association 10^th international 30^th National Dental Congress, where I won a special prize for the poster competition.