Is scaling good or bad?

If you can see white flecks on your tooth surface, or any white deposits just above the gingival line you may be suffering from periodontitis and need a dental treatment. The problem is not as less serious as it appears to be.

Periodontitis commonly known as pyorrhea, constitutes the inflammation of gums and the bone surrounding the teeth ie the alveolar bone.

Scaling is the advised treatment for periodontitis, it is a prophylactic treatment.

It is a wrong perception that scaling makes your teeth weak or it removes a layer of your teeth. Scaling does not remove the tooth layer, but just the plaque and calculus from your tooth.

During scaling, there may be mild bleeding. This bleeding is not the result of any harm to your oral health but due to the infection in your gums and bones.

You may have slight sensitivity after the scaling procedure, it is because earlier you were carrying chunks of calculus over your teeth and after it is removed your teeth is exposed to the oral fluids again. Like you feel sensitive to the area when a bandage has been removed after a long period.

If you had grade 3 periodontitis, after scaling you may feel slight mobility in your tooth. It is because, earlier the calculus was eating your bone and replacing the eaten bone, calculus (dirt) was actually holding your tooth. Now once that calculus is removed, you may feel mobility of tooth, but the bone and the gingiva would heal now after the scaling procedure. If you do not remove that calculus, it may eat the complete layer of bone holding the tooth and the tooth will shed off automatically. Apart from that, calculus will also spread to the other teeth.

When you have caries, it may affect a single or multiple tooth, but if you have periodontitis your complete oral cavity is effected and at risk. You should definitely go for the treatment.

All these symptoms will gradually go off within 7-15 days of the treatment. You do not need to worry. If you are still concerned about the treatment, you can discuss with your doctor. He will explain the issues to you.

Be patient and relaxed if you are in the hands of a doctor. But you actually need to worry in case you are treated by a quack…

 - Dr. Richa Singhania Agrawal

What is Reservation????

On a hot summer day, after two long hours of nagging lecture we had a short refreshment break. To overcome the exhaustion by the lecture, I clicked on the news section of my country in my laptop to be informed of the situations there. News flashing that day was about the demand for caste-based reservation for Patel community, raised by Hardik Patel. Clips of his provoking speech addressing a huge crowd were displayed. I wondered how a face from the crowd emerged overnight, and was greatly eminent in some few days, who could now confront Prime Minister.

                                                                                                                 Deeply engaged in the thinking process, I didn’t notice a fellow American student, sitting next to me was watching the videos. Suddenly he asked curiously breaking my thought processes - “Is this person a celebrity or politician?”

Surprised, not expecting a question at that moment, I flummoxed. Gathering my wit, I passed him a smile and replied “He is none of these”.

The answer wasn’t sufficing to quench his curiosity, he questioned again - “How is he followed by a colossal crowd?”

Confused how to explain as he would never have encountered any such situation, I tried explaining “The person on the screen is an agitator, demanding reservation for his Patel community”.

The guy was able to figure out the two acquainted words, one was ‘reservation’, and other was ‘Patel’ which he related with few of his Indian-origin friends in US, studying in Universities, employed or businessmen. He asked hesitantly with an insinuation- “Is this for any Reservation in a Hotel or a Flight for Mr. Patel?”

Poor fellow was yet unaware of the mighty ‘reservation’. I tried appeasing his curiosity with some explanation- “Socially oppressed communities in India are provided reservation in Government institutions for their amelioration.”

He exclaimed “What kind of reservation are they provided?”

With mixed views on the reservation, whether actually progressive or deteriorating for my country, I hesitantly said “They have reservation against merits of general category people”.

No efforts of hiding his consternation expressed by his wide open eyes, he grinned- “What is the reason behind such partiality?”

I was really having sympathy with him. Through his spectacles it was a partiality. He was unable to accept the ‘reservation’ our Government has always welcomed warmly. Considering his puzzled condition, I provided him with a reason “Reservation protects the oppressed people from social injustice and exploitation.”

Not agreeing with my statement, fiercely he replied “Let me cite you an honest example of upheaval of oppressed communities in America. Earlier, Africans were imported as slaves. In late 19^th century, after a series of protests for their rights, importing them for slavery was banned by the law. But even after this, those who were already in the country remained greatly oppressed. They suffered great humiliation and discrimination. They escalated to their present conditions led by Jr. Martin Luther King, who followed non-violent civil disobedience movement who was a follower of Gandhi, he compared the African-Americans with the untouchables of India. Most of all, he also demanded for the upgradation of the other oppressed communities who were not blacks. He never demanded for any partisan reservation. Now they are not among oppressed any more, have the voting rights and are as equal as others.”

Defending my country’s opinion, I proudly stated “In India, voting right is basic fundamental right of every citizen, none can be devoid of. But the oppressed ones are also human beings and indistinguishable from other Indians, there is no reason they should be humiliated. There are special provisions for them to cope with their oppression, so they may gain social reputation”.

Somewhat carelessly, belittling my words he answered “If they look like you then actually you have no grounds to incorporate an unfair law in your Constitution. African-Americans were clearly distinguishable and actually this was the reason for discrimination. They were even devoid of voting rights and were humiliated. But lawfully they overcame their oppression themselves. They still appear distinct from white Americans, but are nowhere lagging behind and that too ‘without any reservation’. Even we have an African Origin American now as our President.”

I tried defending the reservation vaguely by explaining “We have reserved seats for oppressed even in constituent assembly, but these communities have suffered greatly for hundreds of years”.

Giving an ironical surprise look with his dancing eyes, he crudely stated- “Oh, does it really matters? What actually matter is the present situation and what can be done to get the people out of oppressed state. You are even tagging them as oppressed with such reservation. This would not serve any fair consequences, but will be regressing. Also, you will lose the eligible candidates by your so called ‘reservation’.”

Break was over, our debate ended up fragmentarily. Even after his lengthy stand, how can I neglect the mightiness of reservation which covers 49.5% of quota? Which exceeded 55% in Andhra Pradesh, Rajasthan and some states, but restricted by the High court in 2005. Tamil Nadu still is debatable on its reservation policies, continuing their 69% quota. In 1951, court provided a judgement that caste-based reservations were violating the constitution. To make the judgement inoperative, there was amendment in the constitution. Having the cover of constitution, some states catapulted to 69% of reservation. This unconstrained leap was checked by implementing the cap of 50% on reservation in 1963.

Proposed reservations for economically poor people among the forward castes was held illegitimate by the court in 1992, while there are still discussions on excluding or including the creamy layer. In the same year, court disregarded ‘promotions’ to be considered under reservation. As expected, in response again amendment was made in constitution to make the judgement void, which even mentions that the backlog vacancies are considered as special category and would not be under any cap of 50%.

Again and again court delivered judgement against reservation, repeatedly amendments were made in the constitution as an answer to overrule the court. Legacy of Judicial powers was challenged, politicians were mending it their own ways. This reservation sought for the politicians as a tool of politics is not justified anyhow.

Returning to the scene of classroom. The lecture was over with an end to classes that day. My friend and I were leaving the class together. Looking at me, he sarcastically questioned “By the way, is there any positive outcome of your so called ‘reservation’?”

Joyed, feeling my side weigh, I immediately answered “Yes, these oppressed people are studying and working with us in Government institutions.”

He clarified offhandedly “I meant to ask that are they oppressed yet, or had they overcome the situation in such a long period of reservation?”

The question left me with a deep silence, to delve into the thoughts with a direction. “Oh yes, if they are still oppressed, proves that reservation is no good. And if they gained a social reputation, then what is the need of continuing meaningless reservation”. My eyes sparkled with brilliance even after losing the debate.

My friend smiled and added a humor- “Nobody wants to lose their special provisions. It would be better if India proceeds in reverse direction and gradually covers all the castes categorized as reserved. Ultimately it will extract the roots of reservation- Everyone being under that 50%.”  Saying this he winked at me. Both of us smiled and he departed.

There was a great sense in his humor. Considering the present situation, it is ironically a great solution. Many castes are presenting forward to be categorized under reserved categories proving their oppressed conditions. This would actually help in getting out of this nettle of reservation. One may wonder why. It is actually not possible to step back in the policy of reservation, or every reserved category would be on the verge of revolting heavily. Gradually all the castes should demand reservation and finally complete population will be covered in this 50%. Indirectly, reservation will come to a happy ending with no more amendments in constitution giving chances to the politicians to deep root their seats over the foundation of this policy. This will eventually free us from the evil claws of reservation.



- Dr. Richa Singhania Agrawal

Subsequent stages of a small dental cavity

When you have a small cavity extended on the outer surface of tooth (enamel) it can be treated by a filling (with dental cement), but if you ignore that cavity it grows deep/wide and penetrates the next layer (dentin), still it can be treated by filling [the difference is that more of your natural tooth is lost].

Even if you ignore at that level, it may or may not be accompanied with pain and/or swelling. the infection reaches pulp. And pulp is the vital part of tooth. To save the tooth it is necessary to remove the pulp, clean the pulp chamber and fill it with an inert material and cover it. This procedure is called a root canal treatment.

During root canal treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. Afterwards, the tooth is restored with a crown or filling for protection

After the RCT, it is necessary to have a cap/ crown over the treated tooth, as treated tooth is not as strong as the natural tooth, it subsequently gets brittle. To prevent the chipping off of the restored material or the remaining tooth, we place a crown which distributes the stress the pressure of the tooth uniformly over the cap.

Even if you ignored the tooth in this stage, either you will loose your tooth(even better) or you will land with some serious infection or cyst or any other oral problems depending on your condition.

Dr. Richa Singhania

Why does mouth smells bad after waking up?

When we sleep, our saliva flow rate is quite less than as we are awake. For this reason the bacteria in our oral cavity becomes more active.
They grow and multiply easily with less saliva flow.

Due to these bacterial actions, added up with the increased realease of toxins while sleeping, contribute to the bad smell after we wake up.

It can be reduced by brushing twice daily (morning after we wake up, and before going to sleep), cleaning tongue with a tongue scraper/ brush daily, regular flossing and rinsing every time you eat/ drink something, using mouth rinses intermittently as prescribed by the dentist.

Dr. Richa Singhania

HALITOSIS- How to stay away from bad breath

Bad breath is not uncommon, but it is also not an untreatable problem. We can get rid of bad breath using a number of remedies. One should not be under-confident or ignore the problem due to the shame factor. Rather, should seek immediate medical attention. As soon as you try to solve any health problem, better are the chances of treating the problem without any negative effects.

Chronic halitosis is the result of not maintaining proper oral hygiene. These days individuals are quite aware and are concerned about their oral and physical health.
A patient with halitosis, when aware of his/her bad breath, may get conscious and as a result may appear under-confident, which can hamper the social behavior and response of the individual.

Secondly, if patient somehow manages to maintain confidence, he cannot control the response of others he is standing in front of, in his work places or the social gatherings.

Thirdly, if there is chronic halitosis, it will surely be accompanied with periodontitis (pyorrhoea), which according to the oral conditions, may be visibly identified from a distance. Of course your first impression would not be good.

Periodontitis slowly loosens the roots of all teeth. It is even worse than having a cavity as a cavity affects single tooth but periodontitis affects the complete oral cavity. If you are suffering from periodontitis (pyorrhoea), schedule an appointment with your Dentist, and have the treatment as soon as possible. The longer you ignore it, worsely it will affect your oral health.

Important tips for alleviating Bad breath/ Halitosis -
1. Brushing twice daily (morning after you wake up, and before going to sleep) using proper brushing techniques. Simply brushing won't help if you are unaware of the brushing technique.

2. Avoid food that imparts strong smell to the oral cavity like onion and garlic.

3. Cessation of any form of tobacco, smoking habbit or alcohol, as neither of them are good for our health but surely contribute in causing oral cancer and also physical deterioration.

4. Drink ample water to maintain water balance and also regulate the flow in oral cavity. Water cleanses the oral cavity by flushing away the fermenting food particles.

5. Maintain your salivary flow- Notice if you feel your mouth dry, ie less amount of salivary flow (Xerostomia). Reduced salivary flow is also one of the main contributing factor for halitosis as saliva cleanses the oral cavity and has anti-bacterial properties. If that is the case, there are chances that it may be an emergency, immediately consult your dentist.

Chewing sugarless gums may prove to be of great help as they increase the salivary flow rate.

6. Regular flossing- To avoid the deposits between the tooth which may further result in bacterial action on the remnant of food particles. Many people do not consider flossing as essential as brushing. Try flossing out between some of teeth, you can smell the stinking foul smell from the floss. You’ll never want that putrid smelling thing in the oral cavity from where you ingest your food and drinks. Floss regularly!!

7. Regularly clean your tongue using tongue scraper/ Brush- as tongue is a hairy structure and tends to trap the remnants of food particles, which after fermentation by microorganisms present in oral cavity imparts bad smell.

8. Use mouth rinses as prescribed by the dentist. But not regularly, like other medicines/drugs it has its side effects.

9.Rinsing everytime after you eat /drink something.

10. Have a balanced diet- Eat a low carbohydrate, protein rich diet with good amount of seasonal fruits and vegetables included. This will favor you in multiple ways- keep you healthy, keep your teeth healthy due to cleansing action of fiber-rich diet and thirdly maintain a healthy gut. Gastrointestinal problems also result in bad breath.

11. If you already have dental prostheses, either fixed or removable, take special care for the hygiene of your oral cavity including the prostheses. Many a times prostheses serves as the creep for collection and fermentation of particles.

Keeping these points in mind, you will definitely get rid of bad breath. Of course it's not good to be over-concerned, but it’s really good to be aware and vigilant :).

In short I would like to conclude- Maintain proper oral hygiene, not ignoring it to the extent, that others start ignoring and avoiding you. Morover, ignoring the problem catapults you to the path of developing serious oral health problems.

Hope that this information helps you.

Dr. Richa Singhania