90 percent of adults in the 35 - 44 age group have dental caries:

Take care of your teeth

By Nilma DOLE

We wait until the last minute to check our teeth often delaying a toothache until something causes excruciating pain. We go frantically to the dentist and then a tooth has to be extracted or filled. Dental caries is a condition of bad teeth that is also known as tooth decay. It can arise from an infection of a tooth or a cavity that dissolves the enamel (hard part) of the tooth.

This is why dental caries is a ‘silent epidemic’ which is one of the most prevalent diseases affecting the world, and Sri Lanka is no exception.

Dental caries is also one of the primary reasons why people lose their teeth and have bad teeth. Even if a child is born with bad teeth, parents shouldn't think it is superstitious to take the child to the dentist.

Later in life, the child might be prone to dental problems if parents ignore them and let their children mature into adulthood. Not only the child but also adults too should check their teeth at least once every year. It would help solve the dental caries problem and also combat the bad teeth problem.

People will have sensitive teeth that causes pain whenever acidic drinks, carbonated beverages, fruit juices and other food high in salts and acids are consumed.

You might not even know that you have dental caries until it hits the nerve of the tooth and you wince in agony. By this time, it will be so painful that you have to go and see a doctor. Nevertheless, having dental caries is not a good thing for if one tooth is affected, it has the potential to spread to the other teeth.

The hard tissues of the teeth encompassing the enamel, dentin and cementum are easily destroyed by acidic food and are often caused by an unhealthy diet or eating too much junk food.

Nowadays, children are prone to get juvenile diabetes, obesity and tooth decay as a result of the shift from traditional food to more convenient fast food which is ridden with salt and sugar.

This causes the destruction of the organic matter of the tooth which is normally caused by production of acid by hydrolysis of the food debris accumulated on the tooth surface.

Bristles

You should brush your teeth day and night with a good toothbrush with soft bristles. Dentists recommend that soft brushing is good for the teeth or else the gums are prone to bleed. Also, brushing the right way is important to ensure that your teeth are in good condition. Brushing with a fluoride toothpaste should be sufficient after eating acidic food and drinks. The root cause of dental caries is by two bacteria, Streptococcus mutants and Lactobacillus. If left untreated it can lead to pain, tooth loss and infection.

Today, caries remain one of the most common diseases throughout the world and if left untreated, can lead to teeth problems.

In Sri Lanka, the National Oral Health Survey conducted by the Ministry of Health and Nutrition revealed that 63.51 percent of children over the age of five have dental caries in their deciduous teeth and nearly 40 percent of those in the 12 to 15 year age group also had dental caries in their deciduous teeth.

In addition, it was found that nearly 90 percent of adults in the 35 to 44 year age group have dental caries and 71 percent of those over the age of 75 had the condition.

According to the proportion of untreated (active) dental caries dominated the caries experience among all age groups with regard to all socio-demographic attributes.

In children, less than five percent have been comprehensively treated for dental caries while in adults, it was nearly 16 percent. Moreover, only 24 percent of elderly people had received treatment for dental caries.

According to socio-demographic aspects, there have been more female children, male adults and the elderly who had comprehensive treatment for dental caries.

Urban residents in all age groups except five-year-olds and 12 year-olds with permanent teeth had more comprehensive treatment for caries than their rural counterparts. Overall, in the 35 to 44 age group, about 74 percent have not been treated for dental caries but they have the condition. This shows how adults are not bothered about their teeth unless they have a severe pain and go at the last minute to the dentist.

However, dental caries affect individuals differently. While some may experience severe pain for a small cavity, others go on living without pain but they have dental caries. At first, the tooth may appear as a small smooth surface caries, which may eventually develop into a large cavity over time if regular brushing is not done. In other cases, caries may be visible but it can't be seen through ordinary methods of teeth analysis by a dental explorer, which is used for caries diagnosis.

Lactating

Women who are lactating might be at risk if they do not take calcium supplements. Those who smoke can get it as tobacco smoke dissolves the enamel and those who do not take care of their teeth are liable to get dental caries.

Tooth decay is caused by certain bacteria that produce acid in the presence of fermentable carbohydrates. The mineral content of teeth is sensitive to increases in acidity from the production of lactic acid. Your teeth are prone to food and substances that can damage the teeth.

It has been recently reported that failing to brush your teeth properly could increase the risk of dying prematurely from cancer. They found a link between high levels of dental plaque, or bacteria, and dying from cancer up to 13 years earlier than expected. In a study done in Stockholm, about 2,000 patients were surveyed for 24 years and those with the most bacteria on the surface of their teeth and gums had an 80 percent increased risk of premature death.

It is best to check your teeth early which is less painful and less expensive than the actual treatment of a severe bout of dental caries.

A dental hand-piece can accurately check if a person is suffering from dental caries and the extent of the spread of caries.

It is used to remove large portions of decayed material from a tooth. There are a range of restorative materials which can help restore the build of teeth and when the decay is too complicated, it might be difficult to restore the tooth back to its original lustre so a crown may be needed.

The restoration appears similar to a cap and is fitted over the remainder of the natural crown of the tooth.

Crowns are often made of gold, porcelain or porcelain fused to metal.

An extraction is the best way to solve dental caries, especially in a severely affected tooth.

The removal of the decayed tooth is performed if the tooth is too far destroyed from the decay process to effectively restore the tooth.

Extractions are sometimes considered if the tooth lacks an opposing tooth or will probably cause further problems in the future, as may be the case for wisdom teeth.However, if we take care of our teeth and ensure that we brush it twice daily, in the morning and before going to sleep, then we will have a million dollar smile sans dental caries!

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[ How to brush your teeth properly]

1. Use a good toothbrush.
2. Replace your toothbrush every month.
3. Wet your toothbrush only slightly.
4. Squeeze a small amount of fluoride toothpaste onto your toothbrush.
5. Concentrate on one tooth at a time.
6. Start with the front of your teeth.
7. Hold the brush so that it's parallel to your lips, then tilt it upward by about 45 degrees.
8. Start with your top front teeth, and work around each side of your mouth in a back-and-forth circular motion, brushing the outer side of each top tooth.
9. Move to the bottom row of teeth, and tilt the toothbrush up by about 45 degrees.
10.Work around each side of your mouth with a circular motion, brushing the outer side of each bottom tooth.
11. Gently run the bristles of your toothbrush along the gum line.
12. Brush your molar teeth and the inside of your teeth.
13. Gently brush your tongue.
14. Rinse out your mouth.
15. Check for any missed places in your mouth.
16. Rinse your toothbrush.

If you want, use mouthwash.

Courtesy : National Oral Health Survey, Ministry of Healthcare and Nutrition

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Brain development and criminal law

The legal system needs to take greater account of new discoveries in neuroscience that show how a difficult childhood can affect the development of a young person's brain which can increase the risk of adolescent crimes, according to researchers. The research will be presented as part of an Economic and Social Research Council seminar series in conjunction with the Parliamentary Office of Science and Technology.

Neuroscientists have recently shown that early adversity - such as a very chaotic and frightening home life - can result in a young child becoming hyper vigilant to potential threats in their environment.

This appears to influence the development of brain connectivity and functions.

Such children may come to adolescence with brain systems that are set differently, and this may increase their likelihood of taking impulsive risks.

For many young offenders such early adversity is a common experience, and it may increase both their vulnerability to mental health problems and also their risk of problem behaviours.

These insights, from a team led by Dr Eamon McCrory, University College London, are part of a wave of neuroscientific research questions that have potential implications for the legal system.

Other research by Dr Seena Fazel of Oxford University has shown that while social disadvantage is a major risk factor for offending, a Traumatic Brain Injury (TBI) - from an accident or assault - significantly increases the risk of involvement in violent crime.

Prof Huw Williams, at University of Exeter, has similarly shown that around 45 per cent of young offenders have TBI histories, and more injuries are associated with greater violence.

Prof Williams said: “The latest message from neuroscience is that young people who suffer troubled childhoods may experience a kind of ‘triple whammy'.

A difficult social background may put them at greater risk of offending and influence their brain development early on in childhood in a way that increases risky behaviour.

This can then increase their chances of experiencing an injury to their brains that would compromise their ability to stay in school or contribute to society still further.”

Prof Williams wants to see better communication between neuroscientists, clinicians and lawyers so that research findings like these lead to changes in the legal system.

“There is a big gap between research conducted by neuroscientists and the realities of the day to day work of the justice system,” he said. “Although criminal behaviour results from a complex interplay of a host of factors, neuroscientists and clinicians are identifying key risk factors that - if addressed-could reduce crime.

Investment in earlier, focussed interventions may offset the costs of years of custody and social violence”.

Dr Eileen Vizard, a prominent adolescent forensic psychiatrist, will talk at the event Neuroscience, Children and the Law, about how the criminal justice system needs to be changed to age appropriate sentencing for children as young as ten, whilst also providing for the welfare needs of these deprived children.

Laura Hoyano - a leading expert on vulnerable people in criminal courts will discuss the problems children face when testifying in criminal courts.

- MNT

The weight of the world: the obesity threat

The battle for our bulging waistlines is no longer just a health concern.

A new report says we also need to consider the ecological effects of fat. Larger people require more food and energy, and with the United Nations projecting that there will be nine billion humans by 2050, bigger bodies will gobble up even more resources.

Researchers calculated the weight, or biomass, of the planet's adult population from data collected in 2005 by the United Nations, the World Health Organisation, and the US Agency for International Development.

Measures included population size; a person's fat content, also known as body mass index; and height.

Scientists found that the world's adult human population weighed 287 million tonnes.

About 15 million tonnes was due to overweight people, and about one-third of that was due to the obese in North America, despite the fact that it contains only about 6 per cent of the global population.

Asia accounts for 61 percent of the global population but only 13 percent of the world's overweight biomass, the team reported online in BMC Public Health.

If populations in other countries began to take after the United States, where 36 percent of the population is obese, the amount of energy required to support all that extra weight would increase by 481 percent.

- Nature

Loneliness tied to shorter lifespan

People with heart disease who live alone tend to die sooner than those sharing their home with others, according to an international study that looked at more than 44,000 people.

Previous studies have linked social isolation to everything from heart attacks to weakened immune systems, but the current study, published in the Archives of Internal Medicine, focused specifically on people with known heart disease or at very high risk for it.

Reasons for the difference remain unclear, but lead researcher Deepak Bhatt said access to regular medical care might be involved.

“Patients living alone may have more difficulty getting their medications refilled and taking them regularly,” Bhatt, at Harvard Medical School in Boston, said.

“They also don't have anyone at home to call the doctor's office or emergency room if they are not looking well.”

The study included more than 44,000 people, all aged 45 or older, from multiple countries across the globe.

Over the four years the study lasted, 7.7 percent of participants younger than 65 who lived on their own died, compared to just 5.7 percent of those who didn't live alone. The gap was smaller for people aged 66 to 80, but it remained statistically reliable even after accounting for age, sex, employment, ethnicity and country.

The living situation of those over 80, however, wasn't tied to death rates. Bhatt and his team speculated that in people under 80, living alone could signal psychological and social problems like job strain or loneliness.

In contrast, very old people who live on their own may be healthier and more independent than those who don't.

Whatever the explanation, Bhatt said cardiologists should routinely ask their patients if they live alone.

“If the answer is yes, that might be a red flag and they should make sure the patients have a way to get their medicine regularly,” he said.

Patients who live alone should think twice before ignoring changes that might be a sign of health problems.“Many times people just adapt to their circumstances.

Perhaps just lower your threshold a little bit and realise it's better to call (the doctor) than not to call.”

But that might not be the whole story, he acknowledged. “Other mechanisms by which living alone could increase cardiac risk have to do with possible social isolation and loneliness, and these are more challenging to fix,” he said.

Indeed, another report published along with Bhatt's shows that older people who felt lonely had more difficulty performing basic tasks of daily living and died younger than those who didn't feel alone.

- Reuters