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| Sunday, 15 May 2005 |
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Features |  |
| News Business Features Editorial
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For a beautiful smile
What is orthodontics (Dentofacial Orthopaedics)? Orthodontics means in simple terms straightening or correction of maligned or irregular teeth. But now, orthodontics is formally defined as the area of dentistry concerned with the supervision, guidance and correction of the growing and mature dental and facial structures. Braces are appliances used to make these corrections. The professional who has specialised in orthodontics is called an orthodontist. Who needs Orthodontic treatment Not everyone's teeth are perfectly aligned. In fact, many people have crooked or overcrowded or protruding teeth. You should look at your child's smile or your smile in a mirror. If you see the warning signs of an abnormal bite, you should seek advice from an orthodontis. The following are the warning signs of an abnormal bite: * Upper front teeth stick out, protrude or are 'bucked'. * Upper front teeth growing behind the lower front teeth. * Upper front teeth cover more than 25 per cent of the lower front teeth when the back teeth are biting together. * Excessive spaces between teeth * A space exists between the upper and lower front teeth with the back teeth biting together * Crowded, overlapped, misplaced teeth or extra teeth * Some teeth don't meet at all. * Baby teeth falling out or got extracted too early or are retaining till very late * The centres of the upper and lower front teeth don't line up * Often biting the cheek or roof of the mouth * Finger sucking or tongue sucking habit continuing after 6 years of age. * Difficulty in chewing or biting with teeth that don't meet evenly on both sides * Teeth wearing unevenly * Jaws that shift off centre when the teeth bite together * A weak chin or a prominent chin * Embarrassing teeth or smile often hidden by hands What causes an abnormal bite? There are several causes. Heredity is one. Local factors such as finger sucking, high cavity rate, gum disease, trauma and premature loss of baby teeth can also contribute to an abnormal bite. What are the benefits of Orthodontic treatment? Orthodontics plays an important role in improving overall oral health to achieve balance and harmony between the face and the teeth for a beautiful smile, which may enhance one's self esteem. Properly aligned teeth are easier to brush and so the tendency to decay may be decreased as may the likelihood of developing disease of the gum and supporting bone. Properly aligned teeth also make it easier to chew all types of food and eliminate the headaches and pain caused by uneven chewing. In addition, well aligned teeth are less likely to experience abnormal wearing down of teeth; prevent extra stress on your teeth, gums and jaw which can lead to problems later on. One main benefit of orthodontic treatment particularly in adults is to move teeth prior to crown and bridge work. Because of the individual conditions present and the limitations of treatment imposed by nature, each specific benefit may not be attainable for every patient. What types of appliances (braces) are there? There are braces which can be removed for cleaning, known as removable braces. The second type of brace is fixed to the teeth and cannot be removed for cleaning. The contemporary uses of removable appliances (except the functional appliances used for growth modification treatment and retainers used for retention of treatment results after the active orthodontic treatment) are considerably more limited than in the past. Although apparently simple to use, removable appliances are no longer the appliances of choice for comprehensive orthodontic treatment. Generally, high quality orthodontic treatment is best carried out using fixed appliances as this has been shown to achieve a better occlusal result than the removable appliances alone. When is the best time to schedule an initial consultation ? Every child who has the warning signs of an abnormal bite should see an orthodontist at an early age. This could be as young as 3 or 4, but the American Association of Orthodontists recommends an initial consultation no later than age 7. By age 7, some permanent teeth have erupted and developing orthodontic problems can be identified. Early consultation allows the orthodontist to determine the optimum time for treatment to begin. Many parents assume that they must wait until a child has all of his or her permanent teeth, only to find out that treatment would have been much easier if started earlier. Early treatment provides an opportunity to guide the growth of the jaws, guide incoming teeth into optimal positions, regulate the width of the jaws, lower the risk of trauma to prominent front teeth, correct harmful sucking habits, reduce the likelihood of teeth becoming stuck or impacted under the gums and preserve or gain space for arriving permanent teeth. As a result, it can eliminate the need for more drastic measures later. In some cases, satisfactory results are unattainable once the face and jaws have finished growing with orthodontic treatment alone. With early treatment, children may not have to endure years of embarrassment. Adults can be treated at any age as long as the gums and bone holding the teeth are healthy. An increasing number of adults today are seeking orthodontic treatment. How long do you have to wear braces? It varies, but it may take from 9 to 36 months depending on how bad the bite is to begin with, pattern of jaw's growth and cooperation of the patient. For adults, treatment may take a little longer because the facial bones have stopped growing. But whatever your age, keeping your teeth and gums healthy during orthodontic treatment will help keep treatment time on track. Will the braces be painful? Having the brace fitted is not painful. However, it is likely to be sore for about 3-5 days after each fitting and adjustment appointment. If necessary, painkillers such as the ones you would normally take for a headache may help. How often will you need an appointment? Once your braces have been fitted, you will need regular appointments every 4-8 weeks for it to be adjusted. Do you still need to see your regular dentist? Yes. It is important to have a check-up every 4-6 months with your regular dentist throughout orthodontic treatment, so that your teeth can be checked for decay and gum condition can be evaluated. Do you have to undergo any other types of treatment to complement dental and facial aesthetics? If you have difference in the number, size or shape of the teeth, achievement of the ideal result may require dental restorative treatment. The most common types of complementary treatment are cosmetic bonding, crown and bridge restorative dental care and periodontal therapy. If you have already finished most of your growth and have moderate or severe discrepancies in sizes of upper and / or lower jaw bones, you will require a surgical orthodontic treatment (combination of orthodontic treatment and jaw / orthognatic surgery). Having orthodontic treatment requires patience and discipline involving orthodontist, patients and parents. However, the result of treatment can be more than just a healthy smile. Often, your orthodontic treatment prevents bigger problems developing later. Proper oral care at home is important because it will help keep treatment time on track and might even help to be reduced. Furthermore, it will contribute to the long-term health of your teeth and gums. Nutrition for the Elderly by Dr. D. P. Atukorale The nutritional status in the elderly is often wanting compared to that of young and middle aged people, usually due to unfavourable conditions relating to food, social conditions (especially those living in isolation and loneliness) and, lack of help in the home and inadequate facilities for cooking. Old people may also have a lack of appetite associated with constitutional disease, mental disturbance, malabsorption, effect of drugs and (infrequently) alcoholism. The vulnerable are those living alone and they may have low haemoglobin, low plasma albumin, low red cell folate (Vitamins from leaves), in comparison with those living among relatives. Nutritional deficiencies and protein calorie malnutrition are also common among elderly people living in homes for elders and those hospitalised for long periods. A reduction in food intake contributes to sub-optimal intake of essential minerals and nutrients, and low energy (food) intake increases the risk of under-nutrition needing hospitalisation. On the other hand, excess of intake of vitamins and minerals can occur in some old people. Those taking diets high in milk and cereals and fruits have the highest intake of micronutrients. Factors affecting Psychological and socio-economic factors, chronic diseases, use of medication and nutritional knowledge interact to influence the food intake and nutritional status. Age related psychological changes, which affect nutrition include decline in smell, taste, hearing, vision and poor dentition, and ill-fitting dentures can affect food selection, chewing efficiency and ability to swallow. Increase in adipose tissue along with decrease in physical activity results in the need for less calories and more proteins (1g per Kg body weight) by old persons. Regular moderate physical activity including aerobic exercises such as walking can minimise age-related body composition changes. Also physical activity enables older adults to consume the required energy (food) and essential nutrients. Other important changes in old people include reduction in salivary function, skin synthesis of vitamin D and calcium absorption. In addition bone loss; changes in glucose tolerances, insulin secretion, lipid metabolism and protein synthesis and decline in total body water are common in the elderly. Socio-economic factors such as lack of support from children, isolation and poverty can influence the nutritional status of the ageing population. Loneliness in ageing adults of 60 years and over is often associated with low intake of energy and calcium. Diseases such as coronary heart disease, cancer, alcoholism and cognitive impairment, and use of medication, can also influence the nutritional status of the elderly. In addition lack of understanding of nutrition can increase the ageing population's vulnerability to nutritional deficiencies. Vitamin and Mineral In 1989, the recommended Dietary Allowance (RDA) for adults for vitamin A was 1000ug for males and 800ug for females. There is an age related delay in the clearance of vitamin A absorbed by the liver and other tissues, and vitamin A absorption increases with age. Carotinoids, due to their anti-oxidant properties, may reduce the risk of cardiovascular disease, cataract and cancer. Therefore reduction in the RDA for vitamin A for older adults may be unwise. Vitamin D In contrast to vitamin A there is growing support for an increase in the requirement of vitamin D with age. Vitamin D is obtained from diet as well as from skin synthesis upon exposure to sunlight. The vitamin D3 thus formed is the metabolically active from vitamin D, which stimulates intestinal absorption of calcium. Important food sources of vitamin D include vitamin D enriched milk, fish oil and liver. Currently the RDA for vitamin D for older adults is 5ug (200 1U) for both men and women. Older people are at risk of vitamin D deficiency because of inadequate dietary intake and limited exposure to sunlight. Adequate intake of Vitamin D reduces osteoporosis, a disease characterised by reduced bone mass, and osteoporosis related bone fractures. Water soluble vitamins Old people need more vitamin B6 and B12 than the young Old adults who limit the intake of milk and dairy products, which are the best dietary sources of riboflavin, may be at risk of riboflavin deficiency. The elderly may show changes in the mouth, lips due to deficiency of B vitamins such as, riboflavin, macra and pyridoxine. Minerals Scientific evidence shows that the RDA of calcium of 800mg per day is not adequate to meet the needs of ageing people. Increased calcium intake reduces the risk of osteoporosis. There is evidence to show that increasing calcium intake with vitamin D reduces age related bone loss and the risk of osteoporotic fractures. Elderly persons are advised to take 1500mg of calcium per day. Milk and other dairy products are a good source of potassium, which may be deficient for ageing people. Other Consideration Constipation is common in the elderly due to reduced intake of fibre such as red rice, pulses, green leaves, and fruits. Many older people do not drink sufficient fluids. They should drink six large glasses of fluid per day. To meet the nutritional needs healthy ageing people are encouraged to consume nutritionally balanced, nutritionally dense diet containing a variety of food in moderation. Adequate intake of fluids, and regular moderate physical activity e.g. aerobic exercise will maintain healthy active life for several more years. Anaemia is common among the elderly due to deficiency of folic acid and vitamin B12 and iron. It is advisable to give supplements of thiamine, niacin, riboflavin, pyridoxine, folate and vitamin B12 to the elderly to counteract the effects of malabsorption, and, vitamin, C to aid absorption of dietary and medicinal iron. Holistic healing : Fundamentals of Ayurveda Positive health by Dr. Danister Fernando Health is a global issue and the ultimate measure of a nation. This can be evaluated in quantitative as well as the qualitative measures to project people's capability of contributing to the nation's productivity. There is increasing evidence that both individual and family lifestyles and society profoundly influence the levels of health performance. According to the Buddha, Health is the greatest gain (Arogya parama labha). On the other hand it is the real wealth of a person. It is apparently a foundation of happy life. Healthiness causes happiness and happiness generates the health benefits. Therefore healthiness is a universal basic need of every human being. It expresses the urge of comfort and harmony. Everybody seeks to be free from mental distress and physical suffering. But the popular misconception is that health is a commodity, which can be purchased from the market. Certainly that is not factual. People think that one can be healthy with medicines and physicians. One can buy medicine but not the health. One can pay for a consultation with a medical doctor but not for the health. That is why all the industrialised countries with the highest health budgets are still suffering from severe and chronic health problems. Medicines or physicians are not capable of providing health to a nation or a country or a person. Good health cannot be given or donated. It should be earned or gained. Certainly it is a goal to achieve. Medicines can only help you to relieve your discomfort and pain. But it is rather a temporary solution for being happy and steady with your day-to-day life. In present day society none can be found as non-users of medicines. It has become an obsession that for every problem, people are medicated. Even simple health problems are treated as medical conditions. The ultimate result is we are all over-medicated. Therefore society is drugged for nothing but killed by prescriptions. The main cause of this tragedy is that health is defined in terms of medicine. Health is one's own responsibility and accountability to promote the natural capacity of the system. You must take care of yourself as much as you are concerned about your vehicle or house. You take pains to maintain these properties at the optimum level because they are yours and you have paid for them. As far as your property is concerned, you are proud to have a good quality car or house or estate. But why not bother about yourself. You don't put any type of fuel into your car. But you may put any junk food into your mouth. That is the difference. |
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| Produced by Lake House |
The demand for Orthodontic treatment among Sri Lankans has increased
significantly in the recent past. This is because people all over the world
including Sri Lanka have become more concerned about facial and dental
aesthetics. The demand is high among the urban population since awareness
about the orthodontic problem is related in some extent to socio-economic
status and in educational levels of the society. But what is orthodontic and
who needs it. Dr. D.K. Paranthamalingam explains. 
