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Can dark gums be made natural pink?
Conservative treatment to avoid disc surgery
Advancement in knee replacement surgery
Health Notes
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Can dark gums be made natural pink?
The colour of the gums around the teeth generally matches with the skin colour of the person. People in western countries (Caucasians) have a naturally fair complexion and pink gums. Populations with dark skin have dark/blackish gums. In India, we have a variety of complexions, more so on the brownish side, and our gums are of different hues and colours, varying from light pink to dark brown. Some gums may also show dark patches. The degree of discolouration and saturation varies between individuals.
Darker or pigmented gums are not an indication of disease. Gum hyper-pigmentation is seen as a genetic trait in some populations and is medically known as racial or physiological gingival pigmentation. A number of times, pigmentation of the gums are more marked and noticeable in certain individuals and a cause of worry because of bad looks. How does it happen? The culprit responsible for the dark colour of the gums is the black pigment — melanin — the production of which dramatically increases with exposure to sunlight. Melanin formation is more pronounced in the case of individuals with a complexion towards the dark side. Also, when the skin becomes dark or “tanned” in individuals indulging in outdoor activities, so do the gums. As children are more active outdoors, their gums tend to be darker particularly in children with high smile line. This is especially true in those who are dark-complexioned to begin with. Once the gums become dark during childhood, they, more or less, tend to stay that way. This pigmentation/hyper pigmentation of the gingiva (gum tissue) is generally present near the teeth, while the upper portion, which is all the times hidden under the lips, is relatively pink. Melanin hyper-pigmentation — dark gums — usually does not present a medical problem, but it is annoying, bothersome and may lead to hidden inferiority complex due to unaesthetic appearance. This problem is aggravated in people with an excessive gingival display while smiling, also known as “gummy smile”. De-pigmentation of dark gums is possible. The blackness of gums is merely superficial. When the outer dark coloured layer of the gum is removed, pink gums emerge. Various de-pigmentation techniques can be employed with similar results. One of the most popular, simple and effective methods is the surgical removal of undesirable pigmentation. The procedure is a painless outdoor procedure carried out under local anesthesia. It essentially involves removal of only the outer layer of gum epithelium together with a layer of the underlying connective tissue, and then allowing the denuded connective tissue to heal by secondary intention. The new epithelium that forms is devoid of melanin i.e., dark pigmentation. Immediate results are seen, evident on the day after the procedure. Twenty to 30 per cent of the pigmentation returns after a period of five-six months, and then stays as such. If the simple precaution of not exposing oneself for long hours to direct sunlight is observed, de-pigmented/treated gums are likely to stay pink. The aesthetics, on the whole, are reasonably improved. The surgical procedure can be revised in the case of return of pigmentation. The writer is a former Head, Oral Health Sciences Centre, PGI, Chandigarh Email:
chawlahs@gmail.com
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Conservative treatment to avoid disc surgery
Prolapsed disc is a very common problem. Patients are commonly prescribed bed rest and medication (in the form of analgesics/anti-inflammatory drugs).On persistence of symptoms or failure of treatment, surgical intervention is advised. This suggestion makes an individual sit up and think whether surgery is the best course.
Ideally second opinion should be sought. The common causes are an incorrect posture, sudden bending, etc. Usual symptoms are back pain which radiates to the outer side of the leg to heel/foot; pain often associated with numbness or tingling; increase in pain on bending forward/sitting/as opposed to standing/walking. MRI is diagnostic. This gives an insight into the extent of the tear and degenerative changes in the disc. Conservative treatment
Exercise: The programme of exercises should be specifically designed to provide the maximum benefit, taking into consideration the patient’s limitation. Extension and isometric exercises are advised for pain relief. Flexion exercises in the early stages should be avoided as they exert a greater load on the disc.
The writer is a former doctor/physiotherapist, Indian cricket team
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Advancement in knee replacement surgery
Due to modern medical advances, more than 25 per cent of the population is older than 60
years but still looks forward to many decades of active life. Painful joints as a result of wear and tear or inflammatory arthritis can be a serious impediment to normal life.
Osteoarthritis of the knee is one of the most common disorders mostly affecting those above 40. It affects more women than men and risk factors include obesity, heredity, knee injury and occupational loading. Symptoms Many people experience aching in and around the knee, persistent pain or attacks of acute stabbing sensation, morning stiffness and stiffness associated with pain. The disease is also associated with swollen knee joints, buckling or giving way due to weak knee muscles and tenderness in the knee area. In severe cases, the pain may confine a person to the house. Loss of mobility and dependence on others can be psychologically devastating. This is especially so in elderly people. Fortunately, recent advances in joint replacement surgery can help. The symptoms depend on the severity of the disease. In mild cases, pain may be felt only at the end of the day or during strenuous activities. With increasing severity, the walking distance gradually decreases and it may be associated with swelling and warmth over the joint even during moderate activities. In advanced cases, walking without support becomes impossible and pain may be present even during rest. Many patients spend sleepless nights for fear of pain even with the slight movement. Surgical options Knee replacement may be unicompartmental or involving total replacement of the knee. The surgeon will decide what is best after studying the severity of the pain, the degree of functional impairment and evidence of structural joint damage. Arthroscopy is the simplest surgery. Carried out under local anaesthesia, the patient can be discharged in a day or two It is minimally invasive and involves cleaning/debridement of joint, repair of damaged cartilage, removal of damaged bone and loose fragments of cartilage. It helps preserve the remaining healthy part and stimulates the regeneration of a new cartilaginous load-bearing surface. However, this is useful only in very early stages and is not applicable for patients who have very severe pain, instability or deformity of the joint. Osteotomy or “bone cutting” helps prevent deterioration of joints with arthritis. It helps realign the loading axis of the knee to redistribute the static and dynamic loads on articular surfaces. This reduces pain and delays progression of the disease, but is rarely performed, as it is useful only in a few cases and does not eliminate the symptoms totally. When pain is very severe, joint replacements can offer a dramatic cure with restoration of normal activities. Here, the superficial layers of the bone are removed and replaced with new gliding and load-bearing surfaces made of plastic, metal or ceramic. Deformities can be corrected and the joint becomes stable allowing the patient to regain mobility. Unicompartmental knee replacement is recommended for patients with partial knee damage. It involves insertion of small implants in place of the damaged tissue of the knee joint. It helps relieve pain and preserves function for as long as possible. It is usually recommended for patients less than 60 years of age. Total knee replacement is recommended for patients with moderate to severe symptomatic knee arthritis affecting both the medial and lateral compartments. It involves resurfacing the worn out parts of the knee surface with implants made of metal and plastic, placed on the joint surface of each bone. Most ligaments and tendons remain intact with this process. It allows the smooth gliding of bones over each other, enabling the knee to bend and move. Latest advance Computer Navigation is the latest advance in orthopedic surgery. The anatomy of the operating area is assessed and displayed accurately and three-dimensionally. The benefits to the patient are better alignment, early mobilisation and most importantly decreased wear and tear of the prosthesis. As a result, the longevity of the joint replacements may be extended up to 25 years, which means that many patients may never need a revision surgery in their life. The writer is Director and Chief Surgeon, Max Devki Devi Institute of Orthopaedics & Joint Replacement, New Delhi.
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Health Notes
Washington: It is considered an effective path to good health, but a new study has shown that exercise may lead to faster prostate tumour growth, and thus hasten the decline of some cancer patients.
Researchers at the Duke Comprehensive Cancer Center (DCCC) and the Duke Prostate Center, who looked at prostate tumours in mice, found that cancerous cells multiplied twice as quickly when the animals were active.
— ANI
Genetic link between autism and muscle-weakening disease
Washington: Researchers in the US have found a genetic link between autism and a muscle-weakening disorder known as mitochondrial disease. The study, which looked at 37 children, found that some kids with autism might have a genetic defect that affects the muscles. According to the researchers, their findings may open new avenues of research into the causes of autism.
— ANI
Mouth may tell the extent of smoking-related lung damage
Washington: A University of Texas M. D. Anderson Cancer Centre team, led by an Indian researcher, has revealed that mouth can convey the extent of damage caused to lungs by smoking. The researchers said that cells lining the mouth could reflect the molecular damage that smoking does to the lining of the lungs. “We are talking about just a brushing inside of the cheek to get the same information we would from lung brushings obtained through bronchoscopy,” said Manisha Bhutani, study presenter, first author and a post-doctoral fellow in Thoracic/Head and Neck Medical Oncology.— ANI
Three drinks a day doubles women’s breast cancer risk Washington: A new study has found that alcohol, consumed even in small amounts, boosts the risk of breast cancer, particularly estrogen-receptor and progesterone-receptor positive breast cancer. The study led by Jasmine Lew from the National Cancer Institute (NCI) in America has revealed that alcohol is the substantial risk factor for development of the most common type of breast cancer.
— ANI
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The colour of the gums around the teeth generally matches with the skin colour of the person. People in western countries (Caucasians) have a naturally fair complexion and pink gums. Populations with dark skin have dark/blackish gums. In India, we have a variety of complexions, more so on the brownish side, and our gums are of different hues and colours, varying from light pink to dark brown. Some gums may also show dark patches.
