Life Vs Corona !! A doctors tale !

I remember very vividly it was on a Saturday evening in late December that we talked about a notorious viral disease going around in China. “Oh! This won’t come here, stop watching those sad videos, they are doctored” was my casual response.

In the first week of February my sister who works for Amazon, got a message that her official tour to France, which was scheduled for 1 March for 10 days stands postponed in the wake of this Wuhan virus from China. I remember asking her if they were expecting some Chinese delegates and she replied, “this disease is very contagious and these are the precautions taken by Amazon” and I was amused like a virus in China and meetings are cancelled in France! Boy we really are living in a small world!!

In the next few days when we experienced many cancellations close to home as well, including kid’s birthday parties, exams, annual functions, conferences that’s when the severity of this infection dawned upon me.

Now kids were home and we were advising everyone to stay home as few positive cases were reported in Delhi and around. We were trying to fully equip all our clinics and train our team of doctors and staff to take all precautions and help people calm down amidst the rising panic. My husband who works as a MD specialist with Delhi government was regularly going to hospital, everyday getting new information on this virus called CORONA or COVID19.

By mid-March there were suggestions pouring in from all sides, why are your clinics still on? Why is Arun still going to hospital? You please close your clinics and ask Arun to call off sick and take a leave maybe unpaid, life is everything!

Arun & I would hear all this yet never discuss between us. Then on the day of junta curfew, Sunday, 22 March, Mint Leaf Dental clinics were closed for the first time in 6 years.

That day I felt the panic rising in me, not for myself, I can always close my clinics as per my will, business can be rebuilt, not for my parents or kids as they were anyhow staying in and managing well but for Arun as he had to join back from next day!!

Confused and irritated, I passed a statement, “this is one of the reasons I would never want my kids to be doctors, disease or war we have to be there always. While everyone can work from home, doctors cannot and what are we getting out of all these long years of hard work and toiling for others, we are expected to be in the middle of disease always”.

I just kept on blabbering, panicky for good 10 minutes when finally, Arun asked me a question

“If we will not then who will? And mind you even if your kids will not be doctors there will always be someone else’s”!!

These words brought me back in reality and I could fully comprehend my responsibility as a doctor, as a wife of a doctor and a mother of two daughters who must respect doctors. Thereafter I took it upon myself to give my best to my nation and make it easier for my family and all others whom I can.

Regular OPDs in all hospitals and clinics, elective surgeries and all non-urgent treatment were suspended by the order of Govt. of India from 25th March and rightly so for someone else needs hospital care more.

Hence, I decided to opt for online and video consultations totally free of cost, got registered with GMDA to provide telephonic consultations to the needy and scared.

This is the least I can do to help my people and contribute as a doctor in the times of crisis. I keep myself busy in these consults and make the situation comfortable and happy for our kids, till date none of them have expressed a desire to go out. They discuss every small instruction regarding Covid and follow all protective routine religiously, they talk about future, about hope, their friends and their own birthdays in October nearly every day till late in the evening when it’s time for Arun to get back home and then another routine starts, his deep cleaning!! 🙂

Initially ,kids used to run to hug him after a long day trapped in house but he could not touch them and now they also know that papa must clean himself off the virus before touching anything and anybody. The whole thing starts from the gate and takes another 45-60 minutes till he is ready to embrace normal life for few hours until he goes back into the world of the virus next morning.

I must tell you here that even after taking all precautions and all protective gear, doctors are getting this deadly disease, because the virus overload is too much per doctor depending on the number of patients they examine each day. This is the reason for the deaths of young and healthy doctors when in general mortality rate is higher for age group above 60 years.

Till date globally more than 5000 young doctors have lost their lives while on duty till their last breath.

The whole world is going through unprecedented times. It’s a war against an invisible enemy and like all wars this war will also be won by being stronger than our opponent.

Do not think about any doctor, healthcare worker, policeman or anyone, they are doing their duty for the nation. You do yours and do not go out unnecessarily, please think about your kids, their future and their right to run in streets, jump on swings and explore the beautiful world. They deserve to live healthy and happy lives with their parents and friends around.

Please stay indoors, take all precautions and contribute to the future of your children and many others who look forward to seeing their parents every evening.

We are hopeful for our future generation…Lets make it a beautiful and bright one !!help doctors … so they can help you !!

Love always !!

Dr VT

Are your teeth Summer ready ??

So, summers are here! And so are the vacations! No early mornings, no school, no boring routine and yes just chilling out in the home or maybe in the hills or a beach vacation. This is a good time to spend quality time with children but to fully enjoy this time are we fully prepared?

Like we checked the swimming costume, football, cricket gear, skates, kitchen full of snacks because children at home would need something to munch on the whole day and of course the first aid box, you never know when do they get that scratch while playing! Did you prepare for your teeth during summers? You might think what special to do about teeth? Well not much, just a few things on your check list and you are good to enjoy these summers without any dental setbacks.

First of all make sure that the brushing routine, morning and evening is well taken care of by you and your children. You shall be enjoying your morning sleep, maybe keeping awake till late in night watching your favourite show and forget brushing your teeth. Do not let this routine get disturbed at any cost. Why? You will know soon.

Secondly, its summer time and we love swimming, sometimes hours at a stretch. The water in a pool contains chemicals which are harmful to our skin, hair and teeth. Yes, the chlorine can affect our enamel and can lead to yellowing or brown spots on teeth especially front one. So avoid the pool water to get in the mouth and same old brushing twice daily with fluoridated toothpaste.

Third, you as well as kids need munching whole day, so why not keep healthy options stocked in kitchen like fruits and salads. Keep those candies, chocolates, chips and fries as far from reach as you can and you will see that kids will prefer handy things! Fruits will keep teeth clean of plaque and gums healthy and do I need to tell you the effect sugary candies has on teeth? Brushing twice daily will surely help!

Fourth, while at home or on an outstation trip encourage drinking water instead of carbonated drinks to keep yourself hydrated. All colas, sodas and other carbonated drinks are full of sugar and acids and will harm the enamel on teeth leading to sensitive teeth and will make your mouth dry. So keep bottles of water more than cans of soda and even if you want to sip one you can use a straw!!

Fifth very important thing is kids indulging in contact sports during vacations and there can be injuries to face, mostly to teeth and jaws. Get the mouth guard or teeth guard customized by your dentist to avoid any dental injury.

Last but not the least, during vacations adults and kids have enough time to get detailed dental checkup done and get any treatment you need at your leisure. Try to get one checkup done before you travel outstation because there should not be any spoilers in terms of toothaches on a fun trip. Last thing you want is a child suffering from toothache while on vacation. Take your prescription and your dentist’s phone number with you so you have help at the click of your phone in case the need arise.

Wishing you all a very happy and smiling summers and a healthy, fun filled rocking vacation! Keep brushing twice daily!

Do share your experiences and those shining teeth pictures!!

Till next time

Dr V Thakran

When will permanent teeth come in my child’s mouth ?

Yes!! This is the most frequent question I have from all parents these days. If we go theoretically than the shedding of milk teeth and emergence of permanent teeth usually starts around 6 years and continue till 12-13 yrs. But now a days this schedule is disturbed in most kids, and the problem is not with eruption of permanent teeth rather it is shedding of milk teeth, which is delayed in most kids due eating habits. Today all children usually eat soft and processed food rather than raw and hard food which acts as one of the triggers for resorption of roots of milk teeth hence leading to shedding.

These retained milk teeth force permanent teeth to come out from unnatural spots hence leading to crowding or malaligned teeth which further needs braces treatment to align them in teenage.

So now what can we do as a parent.

First thing is encourage your child to eat salads like cucumber, raw, un sliced fruits like apple & guava and also raw vegetables like carrot, radish, beetroot, etc.

Secondly, after six years of age ask your child for any mobility in any front tooth and if there is any than encourage them to move it and take it out as soon as possible.

Third and last thing is if ever you see any permanent teeth coming out inside or outside of milk tooth than report to the pediatric dentist and get the milk tooth removed as soon as possible.

All these measures will ensure timely and right eruption of permanent teeth and reducing the chances of braces for your child.

A child is the future of nation and a smiling child is bright future… !!!

Till next time

Dr V Thakran

Smile versus Joy !!

While working in my clinics I often wonder that as a dentist are we working on the smile on his/her face or the joy in his/her eyes ?This is really a challenging thing to consider and I always ask my team of doctors to reconsider this for each of their patients, because smile and joy are very subjective !!

While we are passionate about creating good smiles we should be sensitive to the kind of joy it would bring to the patient. Of course good skills are the first and foremost requirement but this joy factor includes few things more than skill!! Whether a patient is joyous depends on the amalgamation of your response to his/her presence in your clinic. If staff is courteous, patient is made comfortable, explained the treatment options in detail, mentioned the cost and discount too will decide if he/she is joyous or not. Your kindness, skill, followup and truthfulness regarding the longevity of treatment done by you will add to the joy of patient. If as a clinician and a doctor one fails to provide this than the smile which you have worked on will lack the joy it should have !!!

Happy working !!

Till next time

Dr V Thakran !!

Answer to the big WHY ?

 Hello !

While we were contemplating on our decision to start working for our social initiative for under privileged, we decided to have another shot at our plans and decided to take a survey. For 3 months me and my team asked everyone we met which included our regular patients, relatives, friends and neighbours only one question.

What are the chances of them hiring any house help, driver, office boys, nannies,cleaners or washers who are toothless, have bad smelling breaths or gutka /pan stained teeth? 

And the unanimous answer gave us a green signal to our project Karma.

 Why is dental health so important? What difference would it make in a poor person’s life if it is made affordable? Some would argue that instead one should contribute towards more serious problems like maternal health, cancer, AIDS and other life threatening diseases.

Teeth in our heads seems very natural and mostly taken for granted but the location of these small teeth in our body is a Critical. Yes,Critical!! Because if not taken proper care than the infection spreads to the nerves inside the teeth, to the bone around the teeth and here pus accumulates and a dental abscess is formed. But this can happen to any other body part as well than why it’s dangerous around teeth? Because it’s not good to have all this infection so close to your brain and chest, that is why it’s critical !

An untreated dental abscess can invade the tissues of the head and chest. It can infect and clot the veins of the neck, and spread between the skull’s many sinuses. If it reaches the brain, it can result in a brain abscess or meningitis. This is now a rare event, but it wasn’t always. In the seventeenth century, “‘teeth’ were continually listed as the fifth or sixth leading cause of death.”

Mary Otto’s heartrending and incisive book, Teeth, writes about a twelve-year-old who “died of a toothache” in 2007. His life could have been saved, if his family had money and an adequate access to dentists. “By the time his aching tooth got any attention,” “the bacteria from the abscess had spread to his brain.” Surgeries and no doubt much suffering followed, but it was too late.

This death and many other like that especially in a developing country like India where majority of population falls under low income group is direct result of a system of privatized dental care. 

With a limited number of government dental institutions in our country the dental care is mostly a “carefully guarded largely private system,” one that is “enormously difficult to reach for those without money.” 

The state of our teeth, reveals—and reinforces—deep inequalities in society. Though the betterment of healthcare system and an increase in  the number of dental professional is totally a matter of government planning but I doubt anything like dental health care would be given any immediate priority in developingsetup where basic education and daily meals is a major issue.

The victims are exactly who you would expect: the poor.

And while economic inequality—whether through poor diet or           lack of access to dental services—can result in dental inequality, bad teeth also reinforce economic disadvantage. The workforce or daily wages worker of today increasingly needs a healthy smile. We would not want our drivers, house helps, nannies, office boys who all are the first point of contact with us or with our children to have an infected mouth at any point of time leave apart hiring a toothless driver or living with a house help who is continuously on leave due to toothache. These jobs are termed “emotional labour” as their job is transmitting happiness and service to the consumer—a task that demands a degree of oral health. Bad breath and missing teeth make it harder to get hired.

Toothlessness spells joblessness, which means lack of access to dental care, which in turn leads to more suffering. Vicious circle!!

Although there are some programmes wherein preventive services or dental awareness is implicated but no amount of prevention—not even the reduction of socioeconomic inequality itself—would eliminate the need for dental care, any more than it would eliminate the need for the care of cancer or heart disease.

We should implement a system of universal coverage that would make treatment available based on health needs, not means. This is the idea behind our project Karma. Basic oral health is the right of every human being, and many lives can be changed by empowering those with greatest needs. With KARMA, we envision provision of basic healthcare to one and all !!

 

If our work force is healthy than only we can be sure of our wellbeing and can work towards building a healthier society and nation too !!

 

Till next time,

 

Dr V. Thakran

 

 

 

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SPECIALISATION IN DENTISTRY – ALL YOU WANT TO KNOW !!

We live in an ever-changing world, where the only constant is change. We like it or not but change is inevitable. In this fast paced world the change that we witnessed is the advancements at all levels. Whether it is technology or human resource, every thing and every job has become very specific.

The more we got into certain job the more efficiency it needs which further needs a larger and more equipped work force.

So, we can say that the era of SPECIALISATION HAS BEGUN. Like some 25 years back a single doctor (MBBS) would check all patients and give medications as well!! But as different kinds of diseases surfaced, specialist doctors were in demand because general people have understood that each part of body works differently and there is a doctor for all of them who just treats that part and the treatment given by that specialist doctor will be specific, correct and advanced.

Same goes for dentistry. Few years back even dentistry was considered a specialized branch but not anymore. Dental surgery further has nine different specialties to deal with many different diseases in different parts of oral cavity.

Presently the market practice goes like

one mouth—one dentist—choose one —get treatment

What if I tell you a different equation

one mouth—two jaws—32 teeth—9 specialities—right diagnosis—specialist treatment.

Yes after working more than 12 years in India’s best government dental institutions when I happened to visit private dental sector, I found that the connect of dentistry with specialization was completely missing.

People were unaware of any such thing. Any person would never visit  an orthopedician for a cardiac surgery but would happily get a Root Canal Treatment(RCT) done by a braces specialist (ORTHODONTIST) or tooth extraction by a RCT Specialist (ENDODONTIST).

Actually, when it comes to teeth we do not mind taking chances because there are 32. But let me tell you that each one has its own purpose and we cannot emphasize enough on the importance of teeth and oral health.

After BDS (equivalent to MBBS IN MEDICAL) MDS (equivalent to MD) can be done only in one of the nine specialties and that dentist is allowed to practice extensively only that. Any MDS dentist  is a specialist for one field only. They can diagnose the problem but treatment out of their specialization is not their forte. If any doctor(medical or dental) works out of their specialization it would be a hit and trial method and can lead to long & painful treatment or even failed treatment.

Any doctor who does masters for 3 years in a particular field and has exclusively practiced this field since many years knows the best about his/her field and he/she can do the justice while treating a disease particularly related to their field only. This way the treatment rendered will be painless, correct and quick as well.

Just to explain you in simple terms if a patient visits a dental clinic with tooth pain and he has been diagnosed by the attending doctor that he needs a couple of extractions and RCTs. On this patient extraction should be done by a maxillofacial surgeon, RCT should be done by an endodontist and crowns or caps after RCT should be given by a prosthodontist. Only a certified implantologist can put implants after the extraction.This would mean many doctors working on your teeth according to your dental needs.

 As a patient, we do not mind visiting many different medical specialists in a hospital for ENT, EYE OR GYANECOLOGICAL issue. Same way we should not mind, rather demand the treatment by dental specialists only and should respect all institutions who are providing you that comfort and facility.

 

After such evolution if we would still want to light a fire by hitting rocks rather than using a lighter which might cost you a few bucks more than a rock but will make your life very easy, comfortable and secure.

 

Decision is yours, health is and should be the priority. The specialized dental or medical services may cost you a bit but this expenditure would be far less than the loss you could bear due to treatment by the wrong doctor.

                   

IT IS YOUR FUNDAMENTAL RIGHT TO THE RIGHT TREATMENT!!

until next time

Dr. V. Thakran

 

BRACES..TILL WHAT AGE ?

A 42 year old mother of two teen kids asked me the other day, “one can wear braces till which age”? She wanted to improve her smile line and was exploring permanent yet less invasive options.

Wow! what a question. And that too, a very relevant in today’s time. So, let us first talk about

what are dental braces and why do we need them?

As everybody knows dental braces is the metal wiring in teeth to straighten them out. Yes, this can be accepted as a basic definition. But we would be able to define it more clearly once we know

why any individual would need braces?

So, we can say that due to heredity or local regions, anyone can have maligned or poorly aligned teeth. Like for example if the jaw size comes from one parent and tooth size comes from other parent than there can be a mismatch and it can result in unwanted spacing or crowding of teeth.

Second reason could be over retention or early extraction of milk teeth. This will also create space challenges for the permanent tooth while erupting in the oral cavity.

Now this improper alignment can result in trauma to tongue and other oral tissues, improper chewing of food, harmful and unbalanced forces to the jaw joints, improper cleaning between teeth resulting in gum problems and yes the main reason which people choose is esthetics. Teeth can definitely make or mar a beautiful smile, hence leading to confidence issues and social incompatibility.

These days parents are more conscious or we can say that it’s a small world and children are super informed and more conscious of their general presentation hence more children are reporting for the orthodontic treatment.

But another truth is that I have personally seen lots of TemporoMandibular Joint(TMJ) problems in young adults and more often than not it is because of the faulty teeth alignment in upper and lower jaws. So this TMJ problem is definitely going to worsen with age. To solve this permanently and to avoid any further damage to the oral tissues and joints is the proper alignment of teeth which can only be done by dental braces.

I want to mention once and for all that braces can be worn by any individual irrespective of the age and gender, if the bone support is good (which can be analysed by an x ray).

These days due to advancement in technology there are many kinds of options available apart from the classical metal ones. Now we have a range of white or ceramic braces, lingual i.e. on the inner side of teeth and invisible braces. These provide the flexibility to straighten your teeth without it being noticed and then after few months flaunting a beautiful smile and experiencing a better life.

So, braces can be worn at any age, even moms and dads can wear them and as far as the beginning age is concerned it should preferably be done after the age of 12 years as after that there is a minimal growth in jaws and most of the permanent teeth have erupted in jaws.

At any age braces can be the best investment for a healthy and confident future!!

feel free to post your questions!!!

Till next time

Dr V Thakran

 

 

IS ROOT CANAL PAIN FULL?

 

IS ROOT CANAL PAIN FULL?

 So, this is the question people ask me whenever they get to know that I am running a chain of dental clinics. My answer always is – Depends who does it!!

Because if this procedure is done by an endodontist, who is a root canal specialist then it is not only painless, but is also accurate, quick and long lasting!!

Let’s talk why do we need RCT?

Simple answer is when the nerves inside (center of) the tooth is hurt by decay/ trauma or attrition than they swell up and because the tooth is a closed cavity, the expansion in nerves will cause pressure that is perceived as pain.

Except in situations of sudden trauma(fall/hit) tooth gives you many signals that decay is proceeding towards the nerves. These are mainly sensitivity to sugars, cold, hot and finally pain which increases on lying down.

In all the situations of sensitivity, we can always fill in the cavity/ decay as this suggests defect only in dentin or enamel. If this sensitivity is overlooked than further damage will reach the core of tooth where the nerves and blood vessels are present and then it will be irreversible damage and the nerves are sacrificed for ever to save the tooth in the oral cavity.

Now WHAT IS DONE IN RCT procedure?

In this process, we remove the dead nerves of the affected tooth from the center of tooth, enlarge that space which contains nerve (c/a root canal) and then fill it up with an inert material. Now this tooth will never be sensitive to hot and cold but you will feel pressure due to the nerves present around the tooth in bone.

So basically, RCT is very much avoidable in most cases and is totally painless and efficient if done by an experienced root canal specialist!!

Till next time !!

Dr V Thakran

Dental Implants – Are they worth it ?

It is like asking ,”Human teeth —are they worth it?

One thing I am sure of and I tell all my patients is that,”nothing in this world can replace original”. Very relevant for teeth also. They are really 32 pearls which we take for granted, but understand their importance once we loose them.

If there is anything that is physically, physiologically and mechanically most similar to human tooth than that is a dental implant.

So if you need an extraction than the best rehabilitation of that space would be with an implant.

Are you a suitable candidate for an implant?

Any healthy human can get an implant. Any medical condition like uncontrolled diabetes, radiotherapy or chemotherapy and any other immunocompromised condition will not allow implant to stay in bone as it will be rejected as a foreign body. Further the quality of bone has to be assessed by an X ray and CT scan. This helps us to know exactly which size and shape of implant would be needed.

Implant can be placed immediately after extraction, if there is no infection in bone. Or delayed usually 3-4 weeks after the extraction.

Crown on implant is fixed after 3 months as that gives time to the implant to fix in the bone, without any disturbance from direct chewing forces, but in certain cases like front tooth rehabilitation, an immediate loading (crown) is also done for esthetic reasons.

 Which implant to go for?

As technologically improves every new day, we have better things coming up. But they definitely comes at a price!

So, one should never settle for the cheaper version, as most probably that would be deficient in quality which is measured by surface treatment, threads in screw and density of implant material.

Caution with implants

1.Rejection is prompt in case of any immunocompromised situation in body.

2.There will be scattering when going for local CT scan/ MRI after implant placement.

3.You have to keep it clean likewise or even more than the natural teeth.

So it needs care with love.

So preserve your natural teeth by loving and caring for them. In case of loss of teeth dental Implants are totally worth

the money and time spent to get them !!

Till next time,

Dr V. Thakran 

Eid Mubarak to all !!

Being a doctor is considered to one of the noblest professions and we always aim to keep up the spirit of humanity over every other emotion.

While any disease or clinical symptom or the incidence may vary from region of stay or age or food habits or may differ from male to female but never on the basis of religion. So we never have this option in our patient information forms to mention your caste or religion.

To tell you the truth I feel religion is not something related to how we pray, which God we pray and how we address Him, rather I believe that religion is what we practice ! Yes and may vary from person to person even in one family. Like military was my grandfathers religion for he was an army man, cleanliness is my mother’s religion, simplicity is my father’s religion, staying playful and constant demands are my children’s religion and doing justice to our jobs by giving the most ethical and very specialized treatment to everyone who seeks our help is our religion.

We should always celebrate diversity because personal and national progress depends in happiness, celebrations and integrity.

My every blog is inspired by some real incidence and this time since last nearly 25 days we have noticed that at our practice many people request for change of their dental appointments to either early mornings or late in evenings and due to no questions asked policy at Mint Leaf Dental we always oblige them but during our monthly survey when we examined the pattern it was mainly due to the ongoing holy month of Ramadan and those patients wanted an appointment so that it may not disturb their faith and very intense fasting routine. We very much respected that and after knowing the reason behind this rescheduling, our team of doctors and staff even worked beyond their daily hours of work. Helping other person keeping their faith and religion intact is in turn helping us practice our religion faithfully.

I have a team of doctors and staff from all region, religion and faiths. I cannot feel prouder when they all celebrated and wished EID MUBARAK to their colleague and after much googling, presented gifts to her. 

Diwali , Eid, Christmas and Gurupurab are just different occasions to celebrate our happiness and togetherness by the people of a great country who still celebrate 15^th August as one National festival.

When I tried to thank my team to keep up the spirit of their profession one witty fellow mentioned that, “Madam, each part of the mouth we treat has different religion, teeth bite, while tongue tastes all flavours, sometimes bitter as well, palate gives us an indication of hot and cold, while gums hold the teeth but the best part is they all are dependent on each other for their functions and if even one part is not taken care of well than whole mouth will stink!!!”

So, the message is very well taken and we should be thankful for all the diversity, we should celebrate the oneness and integrity and do not let any one get affected otherwise whole humanity will stink.

We are celebrating, at all our clinics in Delhi and Gurgaon. Are you?

                                 

Dr V. Thakran & Team

Mint Leaf Dental