Taking care of your teeth: best time for braces
Dr H.S. Chawla

Crowded, unduly spaced, protruded, retruded, irregularly placed teeth are bothersome to the owners and their parents alike. It may be a source of psychological trauma to a growing child and affect his/her overall development and tell on the academics.

It is well known these days that “irregularly placed teeth” can be corrected. It would be relevant to put across that nearly all types of “irregular teeth”, even worse jaw positions, can be placed into a remarkably pleasing alignment and profile.

“Irregular” teeth can be the result of environmental effects of adverse oral habits like finger or thumb sucking, mouth breathing and lip sucking. Mouth breathing, which may result in the front teeth projecting outwards, can be corrected with a simple appliance worn in the mouth by the child at night. Its regular use will correct the habit of breathing from the mouth.

Mild deformities of teeth caused by mouth breathing have been known to self-correct once the habit stops. Similarly, for other habits, the dentist gives anti-finger/thumb/lip sucking appliances to be worn in the mouth. Their use effectively checks the habits and averts bad effects.

When milk teeth do not shed on time, the underlying permanent teeth tend to emerge away from their natural location, leading to the crooked placement of teeth. Another reason for the “irregular teeth” is when there is less jaw space available for the number of teeth to be adjusted in that area. It is like four people trying to adjust on the rear seat of a small car. Hence overcrowding results.

Many anomalies of “irregular” teeth can be averted if appropriate interceptive/preventive action is taken as the teeth are cutting into the mouth. In these early intervention cases, only minor teeth alignment may be needed using either removable or fixed braces.

Another advantage of early orthodontic treatment is that in case a few permanent teeth are missing --- which is not that uncommon - and this fact is discovered early with x-rays, the dentition can be so adjusted that the empty space(s) are covered with the remaining teeth. As the child grows, he does not have to wear a denture for the missing teeth. This can only be achieved by early orthodontic treatment.

Similarly, retruded or protruded jaw positions can be intercepted and corrected at a young age when these are developing.

There are a few irregularities of teeth which appear to be anomalies requiring treatment, but actually are harmless passing phases that correct themselves with the passage of time. An example: the “size” of most teeth is established at a very young age. They do not enlarge with age. The face as such grows bigger along with increase in the body length and size. So, when the front teeth cut into the mouth at the age of 6 to 8 years, these do look bigger in dimensions relative to the face. The face, however, will grow over the years. A tooth that looked oversized earlier would look perfectly proportionate with the adult face.

All these examples emphasise that the dentist should be consulted as soon as the permanent teeth start emerging in your child’s mouth. Most people - and even some dentists -- think that orthodontic treatment should begin or be considered when all permanent teeth erupt. Early intervention is essential and helpful many a time.

Orthodontic treatment can commence even when a few of the primary teeth are still standing and are estimated to fall in a year’s time. The major advantage of early orthodontic treatment is that the correction of the teeth carried out with braces at a younger age is more stable compared to those carried out at a later stage.

The writer, Head of the Dental Department, The Apollo Clinic, Chandigarh, is a former Head, Oral Health Sciences Centre, PGI,  Chandigarh. Email: chawlahs@gmail.com

Evolution of anaesthesia
Dr Tej K. Kaul

Every year certain dates are dedicated to various events as a remembrance and resolve for improvements. One such important date in medicine is October 16. On this date, called World Anaesthesia Day, the first successful administration of ether as an anaesthetic was demonstrated publicly by William Morton in 1846.

Prior to this date surgery used to be a nightmare. Musclemen were an essential part of the operation theatre, to hold the patient and his limbs, gag him to immobilize him for the surgery to be performed. Only the procedures to save a person’s life were performed. Thus, it was the speed more than the skill that mattered.

A monument erected by the citizens of Boston over the grave of Dr Morton bears the following inscription: “Inventor and revealer of anaesthetic inhalation — Before Whom, in All Time, Surgery Was Agony. By Whom Pain in Surgery Was Averted and Annulled, Since Whom Science Has Control of Pain ”.

Since October 16,1846, anaesthesiology has come a long way. The techniques of anaesthesiology have become sophisticated, The instruments for drug delivery and the monitoring equipment have been infinitely refined. Even those opting for anaesthesiology as a subject and profession have multiplied many times.

There is tremendous dedication and toiling, leading to the progress this discipline has made. The overall progress made by surgery is because of the advances in anaesthesiology. The complex neurosurgical, beating heart cardiac surgery, vascular, transplant and foetal surgical procedures are possible only because of anaesthsiology.

The present day anaesthesiologist has started even working outside the parameters of the O.T. and his expertise and knowledge are being appreciated by the colleagues in other branches of medicine. He does not work only inside the boundary walls of an operation theatre but is being recognised even outside. It was an anaesthesiologist who during the great epidemic of Polio in 1948 started ventilating the patients who suffered from acute poliomyelitis affecting the respiratoty muscles.

Thus the concept of an “Intensive Care Unit” was born. Naturally, the responsibility of managing an ICU fell on the anaesthesiologist. The present-day intensive care units are managed mainly by an anaesthetist.

The other areas where an anaesthetist is involved are pain management, respiratory therapy, management of trauma, resuscitation and disaster management. It is the anaesthetist who is the leader or in-charge of disaster management teams or critical care ambulances or even air ambulances. With the involvement of anaesthetist in these areas, the results in patient care have tremendously improved.

The writer is a former Professor and Head Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana.

Health Notes
Drug holds promise for reducing coronary artery plaque

WASHINGTON: A commonly used drug for treating high blood pressure, olmesartan, has been found to play an effective role in reducing coronary plaque in a trial.

Titled “Impact of OLmesartan on progression of coronary atherosclerosis”, the trial was conducted on 247 angina patients with native coronary artery lesions.

The scientists randomly assigned patients, to receive 20-40mg/day of olmesartan or control.

The participants were then treated with a combination of ß-blockers, calcium channel blockers, diuretics, nitrates, glycemic control agents and/or statins per physician’s guidance. — ANI

Green algae extract may offer short bowel syndrome treatment

WASHINGTON: In a first of its kind study, scientists have found that an extract from green algae Chlorella may turn out to be an effective treatment for short bowel syndrome (SBS).

SBS is a clinical condition characterised by diarrhoea, dehydration, electrolyte imbalance, malabsorption, and progressive malnutrition related to a wide resection of the small intestine.

One of the most important therapeutic objectives in the management of SBS is to maintain the patient’s calorie intake and nutritional status.

But some enteral nutrition (EN) products use for energy supports in order to reduce total parenteral nutrition (TPN) demand. — ANI

Repossession could pose serious ‘mental threat’

LONDON: The stress of the global economic downturn can pose serious threat to mental health, according to a new survey.

The survey of 2,000 people, which was released to mark World Mental Health Day, showed house repossession as the event most likely to cause mental health problems, ahead of redundancy, or finding out about infertility.

Charity Rethink has called for action to prevent a “mental health disaster”.

The survey, which was published as a UN report, found that England spends more of its health budget on mental health care than any other European country. — ANI

How staying in office can help you stay fit

LONDON: Moving photocopiers, water coolers and other office equipment further away from workers’ desks are some of the guidelines suggested by the Scottish Government’s health experts to tackle obesity.

Issued by NHS Health Scotland, the guidance also suggests businesses organise health checks for employees and help them set personal goals on how far they walk or cycle to work each day.

Dr Andrew Tannahill, head of evidence for action at NHS Health Scotland, said the objective of the guidance is to urge workers to move around during office hours rather than “sitting on the spot”. — ANI

Traditional family dinners ‘the best bet to fight childhood obesity’

MELBOURNE: Forget exercise and cutting on calories, for a traditional family dinner is more than enough to fight obesity, at least in the case of kids, says a leading expert.

In a recent Brisbane health conference, child health experts have said that family that eats together has better nutrition levels than those who miss out on the lovely experience.

Based on a two-year health survey, University of Newcastle health school associate professor Clare Collins said that parents and children who start a healthy food programme lose more weight than those who focused solely on exercise.

Her survey of 165 obese children aged five to nine underlined the fact that parents were still the biggest influence on child nutritional health. — ANI