Proper brushing makes teeth healthy
Dr H.S. Chawla

“A tooth in socket is worth a diamond in pocket”

In fact, a healthy tooth in the mouth is worth even more than a diamond: a diamond can be bought with money but a tooth, once lost, can never be got again. There is nothing like a natural tooth; this realisation in fact comes only when one starts losing them. A clean neat tooth will stay healthy in the mouth, whereas a dirty tooth will develop dental cavities and gum (periodontal) disease, leading ultimately to its loss. The most important measure to keep teeth healthy is to clean them every day; a tooth brush, dental floss and inter-dental brush are required.

First of all, why do we brush? The main concept behind brushing is to reduce the number of bacteria (micro-organisms) in the mouth. Are bacteria really present in our mouth? The answer is “yes”. Bacteria stick on the teeth in large numbers and their collection on the teeth is called dental plaque. Using a colouring dye, the dental plaque on the teeth can be seen with the naked eye.

If the number of bacteria is less in the mouth, most of these would be oxygen loving bacteria (i.e. aerobic), which are not harmful. However, as they multiply and the total number of bacteria increases, they pile on one another. There is resultant depletion of oxygen and not enough for all. With the result, facultative and anaerobic organisms — the bacteria that can live and multiply in limited or in the absence of oxygen — take birth. These bacteria are harmful for the teeth and gums and produce cavities and gum/periodontal disease.

Brushing reduces the population of bacteria to low levels and then the environment in the mouth and around teeth remains aerobic and anaerobic bacteria do not get favourable conditions to arise and grow. Half-hearted and insufficient brushing does not make sense as the bacteria will get dislodged from one surface and deposited at another surface. So, for that reason even repeated brushing, five to six times or even more, cannot keep the bacterial population low.

In the normal brushing routine, if one is using tooth paste, one cannot brush for more than one or two minutes as the mouth becomes filled with foam and one gets a feeling that one has brushed thoroughly well. The minimum time required for brushing is five minutes: dry your brush first without tooth paste and as the mouth becomes filled with spit, it can be spat out; this is continued. This way the bacteria are dislodged slowly and thrown out of the mouth along with each spit.

After this, apply tooth paste and brush again for 20 to 40 seconds. One can also use the toothpaste twice to get a good effect. It is like greasy hands get cleaner after second scrub with soap.

A question that is often asked is: would over-brushing lead to wearing out of enamel? The answer is “no”. Enamel is the hardest substance in the human body with a mineral content of 96 per cent, and brushing will not erode it. The recommendation is to use a soft brush and repeated movements. Just remember to brush all the sides of teeth — outer that face the cheeks and lips and inner facing the tongue.

The time of brushing is very important, after dinner and breakfast are the best times. Of these two timings, at least once a day thorough brushing of a five-minute duration should be done, and the ideal time for this is after dinner.

Thorough brushing at night time is important because the mouth remains closed at night during sleep, the salivary secretions lessen and the mouth acts as an ideal incubator for multiplication of bacteria. So, if their number is reduced to the minimum at bed time before sleep, the bacterial counts in the mouth in the morning will not be large enough to cause dental disease. If one has skipped thorough brushing at night, it may be performed any time of the day. It also helps to keep the mouth fresh.

The writer is Professor, Oral Health Sciences Centre, PGI, Chandigarh. Email: chawlahs@gmail.com

Taking the pill cuts risk of cancer
Jeremy Laurance

The contraceptive pill should be made available to women over the counter after the largest study of its link with ovarian cancer showed it has prevented 100,000 deaths from the disease worldwide.

Fifty years after the pill was launched, The Lancet medical journal says it is time to remove the requirement for a doctor’s prescription and offer it directly to women on demand.

Its call is prompted by “dramatic” findings from a huge study of ovarian cancer, published simultaneously in The Lancet, which combined results from 45 smaller studies in 21 countries. The findings show that taking the pill sharply reduces the risk of developing ovarian cancer and the protective effect increases with length of use.

For individual women, the reduction in risk is small – ovarian cancer is a rare disease – but because an estimated three million women take the pill in Britain and 100 million round the world, it has a large effect.

Researchers led by Professor Valerie Beral, head of the Cancer Research UK epidemiology unit at Oxford University, found that in Western countries, including the UK, 10 years of taking the pill reduced the incidence of ovarian cancer before age 75 from 12 cases per 1,000 women to eight. Deaths were cut from seven women per 1,000 to five.

The most remarkable finding, the researchers say, is that the protection lasted for more than 30 years after pill use was stopped. This is important because ovarian cancer is commoner in older women who have passed the menopause. Professor Beral said: “Worldwide, the pill has already prevented 200,000 women from developing cancer of the ovary and has prevented 100,000 deaths from the disease. More than 100 million women are now taking the pill, so the number of ovarian cancers prevented will rise over the next few decades to about 30,000 per year.”

For decades after the pill was launched, it was almost constantly under a cloud of suspicion, fuelled by concerns about the social and sexual revolution that it ushered in. A stream of reports suggested the harm it caused by increasing the risk of blood clots and of certain cancers might outweigh its benefits.

Now the tide has turned. Last September, one of the longest studies of the pill, spanning 36 years and run by the Royal College of General Practitioners, showed that it reduced the risk of three cancers – ovarian, womb and bowel – in women who took it, for up to eight years. It neither increased nor reduced the risk of breast cancer but the study did show a small increase in cervical cancer. This was outweighed by the reduction in the other cancers.

That finding, published in the BMJ, has now been confirmed and deepened by the latest study in the Lancet. The co-author, Sir Richard Peto, professor of epidemiology at Oxford University, said: “Young women don’t have to worry about cancer from taking the pill because the eventual reduction in ovarian cancer is bigger than any increase in other types of cancer caused by the pill.”

— The Independent

Do’s and don’ts for low-back pain
Dr Ravinder Chadha

Proper treatment of low -back pain entails finding out the cause. Preventing further agony and discomfort also requires undergoing appropriate treatment and rehabilitation. Inadequate rehabilitation leads to the recurrence of back-pain, resulting in physical limitations. Even slight improvements in day- to-day life — posture, etc — also helps a lot. Using a different chair, supporting the back while sitting can also bring relief. Rehabilitation in the form of physical exercises can improve circulation, lead to stronger muscles and thereby functional ability of the back muscles. Certain do’s and don’ts also help:

DO’S
l Your bed need not necessarily be hard but the mattress should be firm. A soft/sagging bed causes strain on the muscles and ligaments of the back. If possible, a plywood piece as big as the mattress should be placed between the mattress and the bed.
l While sitting, the lower back should touch the backrest of the chair, enabling the spine to remain straight. Using a lumbar roll above the belt line (i.e. in the hollow of the back) facilitates a correct posture.
l During long drives, using a pillow or a rolled-up towel behind the small of the back also relieves strain off the back muscles. stop often and walk around for a few minutes to relieve muscle stiffness.
l While sleeping on the back, it is advisable to place a pillow under the knees or sleep on the side with a pillow placed between the bent knees.
l Wear comfortable low -heeled flat shoes to avoid back pain.
l Obesity during pregnancy makes an individual vulnerable to back pain. In such cases, excessive weight pulls the pelvis forwards, straining the lower back. Ideally, remaining slim and active is the key.
l Individuals afflicted with lower-back pain should continue to exercise all through their lives as they are four times more prone to recurring back pain as compared to others.
l While doing a desk job, standing, stretching and walking at least for a minute or two every half an hour relaxes the ligaments/muscles and joints.
l Ideally, while picking up an object from down below, one should bend the knees keeping the back upright. This transfers the load from the back muscles to the hip and knee.

DON’TS
l Avoid lifting heavy loads like a TV set, a child or a large dog by a quick stooping movement.
l Do not keep a wallet full of currency notes and credit cards in the hip pocket to avoid sciatica pain.
l Individuals suffering from low-back pain should avoid wearing high heels.
l Avoid slouching while sitting to remain free from back-related pain.
l Wrong abdominal and back exercises put an undue load on the low back. Hence exercises which suit the specific problem should be done, and not routine exercises.
l Prolonged bed rest should be avoided as it results in deconditioning and bone mineral loss.
l Avoid prolonged standing to relieve strain on the back. Rest one foot on a low stool to rectify the problem.
l While carrying weights, divide the load into two equal halves, close to the body to avoid straining the back.
l Avoid performing certain activities for a long duration if this causes strain on the joints. Among such activities are gardening, kneeling, squatting, etc.

The writer is a former doctor/physiotherapist, Indian cricket team.