when to vist a dentist ?

EPILEPSY

EPILEPSY

·         Epilepsy is a group of neurological diseases characterized by unpredictable seizures and can cause other health problems.

Epileptic seizures are episodes that can vary from brief and nearly undetectable to long periods of vigorous shaking.

·         Epilepsy is the fourth most common neurological disorder and affects people of all ages.

·         Epilepsy means the same thing as "seizure disorders"

SEIZURE Vs EPILEPSY

A single epileptic attack is described as seizure.

The term epilepsy is coined when seizures are recurrent and long standing.

CAUSES

·         The cause of most cases of epilepsy is unknown.

·          Brain injury, Stroke, Brain tumor.

·         Birth trauma, Prolonged and difficult labor.

·         Meningitis, Encephalitis.

·         Cysticercosis.

·         Hereditary - a small percentage of cases.

DIAGNOSIS

A person is diagnosed with epilepsy if they have had at least two seizures occurring greater than 24 hours apart that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.

CLASSIFICATION

Based on manifestations,

1. Grand mal

2. Petit mal

3. Complex Partial

4. special verities like Reflex Epilepsy

The layman is aware of Grand mal seizure which is characterized by generalized convulsive 

movements with rolling up of eyes, heralded by the epileptic cry along with falling and later frothing 

from the mouth. This lasts for 3-4 minutes during which the patient is unconscious. He may injure 

himself during the episode and at times may bite his tongue.

Petit mal affects young children between 5-10 years and is noticed as brief spells of unconsciousness 

during which the child does not fall but may blink or stare vacantly. He will not respond if he is

called by name at the time of the episode. The whole episode may lasts less than a count of ten. 

Many such episodes 25-100, can occur daily. It may be the teacher in the class who notices this first, 

through inattentiveness shown by the student.

Complex Partial Seizure as the name itself suggests has complex symptomatology. It may manifest 

as repetitive motor acts like opening and shutting the door, crushing of whatever the person see by

hand, inappropriate uttering of meaningless words etc for short periods during which he is unaware of the surroundings.

Unlike petit mal, this can occur during any age groups but the number of attacks per day is one or two

only. The complex seizure may be followed by grand mal seizure at times.

Reflex Epilepsy is a rare type precipitated by extraneous stimuli like sunlight, some music etc. A 

type of reflex epilepsy called Hot Water Epilepsy is seen in south India. It occurs when a person takes hot water bath.

WHAT A BYSTANDER SHOULD DO WHEN A PERSON DEVELOPS SEIZURE?

Remove all the hard objects that can harm himself around the patient.

People should not crowd around as it will affect the oxygenation.

Put the patient on his side to avoid aspiration.

Do not feed the patient, as he may vomit.

Admit the patient if more than one seizure occurs.

INSTRUCTIONS TO PATIENT

Take medicine regularly. A doctor may attempt to reduce the dose if the person doesn’t develop for a minimum of 2 years or more.

Avoid sleep deprivation as well as not take alcohol.

Occupation involving tackling of machinery is best avoided, except for these guides he can lead a normal life.

Driving is possible on specific instructions of the doctor only.

Care of epileptic patient during dental treatment

Expert opinion from doctor treating him is needed.

He should not stop or miss the anti-epileptic drug

Should be accompanied by a bystander.

Future developments in epilepsy

Research is in the offing for the development of the software to be implanted in the brain that can detect the excitation stimulus as it originates which can lead to production of seizure and to nullify it, before it spreads in the brain.

Brain stimulation in particular parts of brain by putting a permanent electrode may help in abolishing the epileptic attacks.

Thus, the future prospects for an epileptic holds good.

BY,

DR.RENJU T GEORGE,

INDIA.

TURMERIC

TURMERIC

Turmeric is a perennial herbaceous plant that reaches up to 1 m tall which is a part of ginger family of herbs, the Zingiberaceae.

The root and rhizome stem of the Curcuma longa plant is crushed and powdered into ground Turmeric spice.

This gives curry an yellow color. Its used in almost all Indian dishes , this

spice has almost no calories  and zero cholesterol.

  It is rich in dietary fiber, iron, potassium, magnesium and vitamin B6.

Biochemical composition

·         The most important chemical components of turmeric are a group of compounds called

curcuminoids, which include curcumin (diferuloylmethane), demethoxycurcumin, and

 bisdemethoxycurcumin.

·         The best-studied compound is curcumin, which constitutes 3.14%

(on average) of powdered turmeric.

·         In addition, other important volatile oils include

turmerone, atlantone, and zingiberene. Some general constituents are sugars, proteins, and

resins.

USES of Turmeric

THERAPEUTIC USES

The wide range of turmeric health benefits come mainly from its main ingredient, curcumin.

This widely researched component of turmeric is highly therapeutic and is used in various

drugs and pharmaceutics mainly because of its immunity boosting and anti-oxidant properties.

·         Anti- Inflammatory and Anti-oxidant Property – Free radical causing oxidative damage of DNA and proteins are associated with a variety of chronic diseases such as cancer, atherosclerosis, and neurodegenerative diseases. Curcumin plays an important role in curbing these conditions. Curcumin down-regulates certain inflammatory transcription factors such as kappaB, enzymes such as cyclooxygenase 2 and 5 lipoxygenase, and cytokines such as tumor necrosis factor (TNF), interleukin-1 (IL-1) and interleukin 6 (IL-6) and hinders the development of these disease.

·         Enhances Immunity

Certain studies reveals that curcumin is 5 to 8 times stronger than vitamin E and stronger than vitamin C, this antioxidant breakthrough may help boost your immunity, maintain normal cholesterol levels, and put the brakes on aging.

·         Curcumin Helps Promote Weight Loss and reduce the incidence of obesity-related diseases. The inflammation associated with obesity is due to macrophages in fat tissues throughout the body.  Scientists believe that turmeric suppresses the number and activity of these cells, and help reduce some of the adverse consequences of obesity.

·         Turmeric Improves Rheumatoid Arthritis :The researchers also found that curcumin treatment was safe and did not relate with any adverse events.

·         Curcumin in turmeric has a potential role in the prevention and treatment of Alzheimer’s disease

Various effects of curcumin, such as decreased Beta-amyloid plaques, delayed degradation of neurons, metal-chelation, anti-inflammatory, and antioxidant property, improve overall memory in Alzheimer’s patients.

·         Curcumin Protects Against Certain Liver Diseases

·         Curcumin Prevents the Development of Type 2 Diabetes in people who have prediabetes

 Researchers from Cancer Biology Research Center, South Dakota, claim that curcumin may be an

effective chemopreventive and therapeutic agent for cervical cancer prevention and treatment. 

They found that curcumin treatment suppresses cervical cancer cell growth by altering the HPV-

associated molecular pathways in cervical cancer cells.

OTHER USES

Apart from therapeutic uses, turmeric is also used as an important spice, in beauty products and in spiritual ceremonies.

• In India, turmeric is used in almost all curries and gravy dishes. It gives a rich color and a unique flavor to the food.

• Turmeric is a well-known preservative.

• Turmeric is a great pesticide. Sprinkle turmeric (powder) water near all the entry points of your house to ward of insects, ants, and termites.

• Women in India use turmeric in skin products such as creams and body scrubs to boost the glow factor.

• Can be used as a dye.

• Drinking turmeric with milk is good for health.

Dental Application of Turmeric

Turmeric can be used in following ways offer relief from dental problems:

1. Rinsing the mouth with turmeric water (boil 5 g of turmeric powder, two cloves, and two dried leaves of guava in 200 g water) gives instant relief. Massaging the aching teeth with roasted, ground turmeric eliminates pain and swelling.

2. Applying the powder of burnt turmeric pieces and bishop's weed seed on teeth and cleaning them makes the gums and teeth strong.

3. Applying a paste made from 1 tsp of turmeric with ½ tsp of salt and ½ tsp of mustard oil provides relief from gingivitis and periodontitis. Rub the teeth and gums with this paste twice daily.

4. Dental-plaque detection system

 A yellow pigment of beni-koji and turmeric are known as staining agents also used for other purposes.

The dental-plaque detection system includes a dental-plaque staining agent, which contains at least one selected from the yellow pigment of beni-koji, turmeric extracts, and curcumin; and a light-emitting apparatus, which outputs light having a wavelength within a range of 250 to 500 nm to an object in the oral cavity where the dental-plaque staining agent is attached.

5. Curcumin available in gel form can be used in apthous ulcer cases.

The benefits of turmeric include: analgesic, antibacterial, anti-inflammatory, anti-tumor, anti-allergic, antioxidant, antiseptic, antispasmodic, appetizer, astringent, cardiovascular, carminative, cholagogue, digestive, and diuretic.

Side Effects of Turmeric

Turmeric is safe and without side effects when used optimally.

1.People with turmeric sensitivity can have mild stomach upset or diarrhea.

2.Use turmeric with caution if you are pregnant.

3.Turmeric can make gall bladder problems and GERD (Gastro Esophageal Reflux Disorder) worse.

4.Turmeric can slow blood clotting and might cause extra bleeding during and after surgery.

AVAILABLE FORMS

Turmeric is available as 

• powder ,extracts,as rhizome itself,
• Creams
• oral gel
• ORGANIC Capsule form -1 - 2 capsules with water,after food, twice a day, or as directed by your health care practitioner
• Pastilles - modern drug delivery system,by keeping it in the mouth for 20minutes.

by,DR.RENJU T GEORGE,

INDIA.

Coconut Oil

COCONUT OIL

Coconut oil, or copra oil, is an edible oil extracted from the kernel or meat of mature

coconuts harvested from the coconut palm .It has various applications as food or in cosmetics.

Coconut oil is one of the few foods that can be classified as a “superfood.”

COMPOSITION OF COCONUT OIL AND ITS NUTRITIONAL VALUES

Nutritional value is as  per 100g

Energy =3,607 kJ (862 kcal)

Fat

100

Saturated            = 86.5

Monounsaturated=        5.8

Polyunsaturated=1.8

Vitamins

Vitamin E- (1%) 0.09 mg

Vitamin K- (0%) 0.5 μg

Minerals

Iron        - (0%) 0.04 mg

Proteins

Saturated Fats : Predominantly these saturated fats are medium chain fatty acids or

triglycerides. When applied on the skin, they keep it smooth to the touch. Due to the

presence of these fats, coconut oil also retains the moisture content of the skin, as the fats

eliminate moisture loss through the pores on skin.

Capric /Caprylic/Lauric acid: These are not very different from the medium chain fatty acids,

but it is still important to mention them separately here, since they have their own

contributions. These three fatty acids have strong disinfectant and antimicrobial properties.

As a result, when applied on the skin, coconut oil protects from microbial infections that can

get into open wounds or even enter the body through the pores. This microbial action can be

experienced even if coconut oil is taken internally, as the fatty acids boost the immunity

when converted to monocaprins and monolaurins.

Vitamin-E: The contributions of vitamin-E towards skin care are well known. It is essential for

healthy skin growth, repair of wear & tear on the skin, keeping skin smooth and protecting

against cracking. Above all, it prevents premature aging and wrinkling of the skin, since it has

good antioxidant properties.

It can be used for dry skin treatment.

Proteins: Like coconuts themselves, coconut oil is rich in many proteins. These proteins keep

skin healthy and rejuvenated, both internally and externally. Proteins also contribute to

cellular health and tissue repair, along with a wide range of other essential activities within

the body.As a result useful to treat dry and damaged hair . 

BIOCHEMISTRY AND ITS DENTAL VIEW

 While coconut oil is one of the few known natural sources of lauric acid, it’s also found in mother’s milk, increasing immune strength of infants.

Coconut oil is easily digested orally by salivary amylase enzyme.Hence it is best used for cooking baby foods.

USES OF COCONUT OIL

Cardiovascular Health: Research has indicated that not all saturated fats increase the risk of heart disease.  Studies show that virgin coconut oil can improve cholesterol levels by decreasing low-density cholesterol and increasing high-density cholesterol in serum and tissues.

• Immune Health: Research shows that lauric acid can increase our body’s production of monolaurin, enhancing anti-bacterial protection.
  • Studies also suggest that virgin coconut oil has anti-inflammatory and analgesic and properties.
  • Skin Health :
  •  Studies show that coconut oil can improve atopic dermatitis, an inflammatory itchy skin condition, by acting as an effective moisturizer.
  • Virgin coconut oil can also be used as a moisturizer to provide relief for mild to moderate xerosis.
  • Virgin coconut oil when topically applied to wounds, promotes speedy healing.
  • • Hair Health: Coconut oil treats damaged hair by penetrating into hair fibers and acting as a moisturizer.   When coconut oil is used as a pre-wash and post-wash grooming product, it can reduce protein loss for both damaged and healthy hair.  The lauric acid present in coconut oil has an affinity for hair proteins and because of its low molecular weight it can penetrate the hair fibers and prevent hair damage.
    •  Weight Management: A study conducted on women revealed that coconut oil promotes reduction in abdominal obesity.
    • Consuming medium chain triglycerides can increases diet-induced thermogenesis, which can contribute to preventing weight gain or regain, and in some cases may induce weight loss.
    • When compared to most vegetable oils that contain long-chain triglycerides (LCTs), medium-chain triglycerides (MCTs) found in coconut oil are used for energy production and are not stored as fat.  Partial replacement of LCTs with MCTs can reduce accumulation of fat.
    • Performance Enhancement: Studies show that MCTs are easily digested and rapidly absorbed into the blood stream from the GI tract upon consumption, and are efficiently utilized by the body for energy production, improving performance of athletes.

       Health Benefits of Coconut Oil

·         Coconut Oil Contains a Unique Combination of Fatty Acids With Powerful Medicinal properties.

·         Coconut Oil Can Increase Your Energy Expenditure, Helping You Burn More Fat.

·         The Lauric Acid in Coconut Oil Can Kill Bacteria, Viruses and Fungi, Helping to Stave Off Infections.

·         Coconut Oil Can Kill Your Hunger, Making You Eat Less Without Even Trying.

·         The Fatty Acids in Coconut Oil Are Turned into Ketones, Which Can Reduce Seizures.

·         Coconut Oil Can Improve Blood Cholesterol Levels and May Lower Your Risk of Heart Disease.

·         Protect Hair Against Damage, Moisturize Skin and Function as Sunscreen.

·         The Fatty Acids in Coconut Oil Can Boost Brain Function in Alzheimer’s Patients.

·         Help You Lose Fat, Especially The Dangerous Fat in Your Abdominal Cavity.

dry skin treatment .

DISADVANTAGES

·         No Effect on Common Cold

 = Excess may be harmful -

Many health organizations advise against regular consumption of coconut oil due to

its high levels of saturated fat having potential to increase risk of cardiovascular

disease

Because of its high saturated fat content, it is slow to oxidize and, thus, resistant to

rancidification, lasting up to six months at 24 °C (75 °F) without spoiling.

BY,

DR.RENJU T GEORGE,

INDIA.

DIET FOR DIABETIC PATIENTS / DIET IN DIABETES

DIET IN DIABETES

Diabetes  is the most common endocrine disorder characterized by hyperglycemia, absolute or 

relative insulin  deficiency or resistance to the action of insulin.

Diabetes = siphon  or  running through

Large urine volume.

Mellitus = sweet

 Glucose in urine.

In diabetes the blood glucose levels are too high , as a result the body being unable to utilize the glucose completely or partially. Glucose comes from food we eat. Insulin is a hormone that helps the glucosegets in to your cells to provide energy. It is produced by beta cells of the Islets of Langerhans in the pancreas.

Diabetes is either due to the pancreas not producing insulin or the cells of the body not responding

properly to the insulin produced

TREATMENT OF DIABETES

1.        Diet

2.       Drugs

3.       Exercise

4.       Education

5.       Monitoring

DIABETIC DIET  is a low calorie low carbohydrate medium protein high fiber low fat diet.

It is also the best weight reduction diet.

 In diabetes the blood sugar levels fluctuates either it becomes high or low unlike the popular

belief that it refers to just high blood sugars.

It is the fluctuation that damages the internal organs and systems. This can be controlled by a

small frequent meal pattern or snacking with high fiber.

Always make sure that all meals and snacks contain fiber in some form or other. It can be from

the whole grains and flours, skin from pulses, vegetables in form of curries or salads etc.

A meal once eaten takes approximately two hours to digest, for the glucose to be absorbed by

body and used .As the body utilizes glucose, the sugar level decreases ie hypoglycemia.

Healthy snacking is required to prevent this.

Low carb snacks like low calorie biscuits like fiber biscuits, oats biscuits, butter milk,

Smoothies (curd blended with half a fruit), low calorie fruits such as apple, orange, guava,

pomegranate etc.

Sand wiches or Chapatti rolls with vegetable stuffing or a mix of vegetables and egg or chicken or paneer or soya sprouted wheat, pulses ragi flakes with milk.

Fruits need to be restricted as fruit sugar i.e. fructose increases blood sugar. One low calorie fruit a  day is allowed per day for a diabetic patient provided sugars are under controlled.

High calorie fruits such as mangoes, grapes, pineapple are a temptation to many. One can

reduce the amount of the fruit when it is a high calorie one.

Dried fruits have a high concentration of sugar so reduce the quantity by two dates or apricots etc.

Fruit juice other than  lime juice (with dash of salt or plain) has to be avoided.

Green salads include mixture of onions, tomatoes, cabbage, cucumber, carrots, capsicum, bell peppers, celery and other salad greens etc.

Apple cider Vinegar, Curd etc can be used to enhance the taste .Avoid salad dressings or oils.

TO CONCLUDE,

• Fire foods have a high GI, and are low in fiber and protein. They include “white foods” (white rice, white pasta, white bread, potatoes, most baked goods), sweets, chips, and many processed foods. They should be limited in your diet.
• 
  
• Water foods are free foods—meaning you can eat as many as you like. They include all vegetables and most types of fruit (fruit juice, dried fruit, and canned fruit packed in syrup spike blood sugar quickly and are not considered water foods)
•  
• Coal foods have a low GI and are high in fiber and protein. They include nuts and seeds, lean meats, seafood, whole grains, and beans. They also include “white food” replacements such as brown rice, whole-wheat bread, and whole-wheat pasta.

by,

DR.RENJU T GEORGE

INDIA

BAD BREATH/HALITOSIS

BAD BREATH/HALITOSIS

HALITOSIS colloquially called bad breath, feter oris,fege bosta, is  a symptom in which a noticeably unpleasant odor  is present on the exhaled breath. 

CAUSES

- The most common cause is of  the odor is caused by bacteria present below the gum line and on the back of the tongue.
- Of those who feel they have halitosis, significant percentages 5-72% have been reported to have no genuine halitosis when professionally examined. 
- The remaining 10% is accounted for by many different conditions, including disorders in the nasal cavity,sinus,lungs,throat, esophagus,stomach or elsewhere.


Other causes are

• Deep carious lesions (dental decay) – which cause localized food impaction and stagnation
• Recent dental extraction sockets – fill with blood clot, and provide an ideal habitat for bacterial proliferation
• Inter dental food packing – (food getting pushed down between teeth) - this can be caused by missing teeth, tilted, spaced or crowded teeth, or poorly contoured approximal dental fillings. Food debris becomes trapped, undergoes slow bacterial putrefaction and release of malodorous volatiles. Food packing can also cause a localized periodontal reaction, characterized by dental pain that is relieved by cleaning the area of food packing with inter dental brush or floss.
• Acrylic dentures (plastic false teeth) – inadequate denture hygiene practises such as failing to clean and remove the prosthesis each night, may cause a malodour from the plastic itself or from the mouth as microbiota responds to the altered environment. The plastic is actually porous, and the fitting surface is usually irregular, sculpted to fit the edentulous oral anatomy. These factors predispose to bacterial and yeast retention, which is accompanied by a typical smell.
• Oral infections
• Oral ulcerations
• Fasting
• Stress/anxiety
• Menstrual cycle – at mid cycle and during menstruation, increased breathvolatile sulfur compounds were reported in women.
• Smoking – Smoking is linked with periodontal disease, which is the second most common cause of oral malodor. Smoking also has many other negative effects on the mouth, from increased rates of dental decay to premalignant lesions and even oral cancer
• Alcohol
• Volatile foodstuffs – e.g. onion, garlic, cabbage, cauliflower and radish. Volatile foodstuffs may leave malodorous residues in the mouth, which are the subject to bacterial putrefaction and VSC release. However, volatile foodstuffs may also cause halitosis via the blood borne halitosis mechanism.
• Medication – often medications can cause xerostomia (dry mouth) which results in increased microbial growth in the mouth.

MANAGMENT

The following strategies may be suggested:

1. CLEANING OF TONGUE SURFACE twice daily is the most effective way to keep bad breath in control; that can be achieved using a tooth brush, tongue cleaner or tongue scraper to wipe off the bacterial biofilim, debris, and mucus. Brushing a small amount of mouth rinse or tongue gel onto the tongue surface will further inhibit bacterial action.
2. EATING HEALTHY FOODS with rough foods helps clean the very back of the tongue.
3. CHEWING GUM Since dry-mouth can increase bacterial buildup and cause or worsen bad breath, chewing sugarless gum can help with the production of saliva, and thereby help to reduce bad breath. 
4. GARGLING right before bedtime with an effective mouthwash .  
5. MAINTAINING ORAL HYGIENE, including daily tongue cleaning,brushing,flossing and periodic visits to dentist. . 
6. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by one's dentist).
7. PROBIOTIC TREATMENTS specifically Streptococcus salivarius K12 has been claimed to suppress malodorous bacteria growth, however well designed randomised control clinical trails are needed to assess this.

by,

DR.RENJU T GEORGE,
SIGNAL DENTAL SPECIALITY CLINIC,
KALAVATHU ROAD ,
PALARIVATTOM,
COCHIN-25,
KERALA,INDIA.