Online Consultation

Ismail Munir

Sensitivity is often regarded as a good attribute, as sensitive people are more emotional. However, it is good to maintain balance and not always be sensitive.

Is Being Sensitive Always Good?

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Iqra Mazhar

Everyone Needs Their Hesy-Ra

Introduction

Ancient Egypt was way ahead of its time; its people practiced oral health care as early as 2000 B.C. Hesy-Ra was the first dentist they had, and he was called &ldquo;Great one of the Dentists&rdquo;.&nbsp;

&nbsp;

Considering that the diet at the time consisted mainly of fruits, vegetables, and starchy items, it can be assumed that their teeth were always under quite some pressure. Maybe that is the reason Egyptian dentists came up with a herbal mixture of honey and barley to treat teeth that had been loosened. They were the first ones to introduce dental bridges to the world! So, if the people in the past could focus on their oral care despite having such little resources, why can&rsquo;t you<a href="#accordion">[4]</a>?

&nbsp;

It doesn&rsquo;t seem fair that the only time you ever mention a root canal is when we have to ensure that someone perfectly understands how much pain you are in. &ldquo;You think root canal hurts?&rdquo; is not how we should mock an extremely helpful procedure. 
&nbsp;

Understanding Root Canal

Root canal treatment (RCT) is an endodontic treatment (or endodontic therapy). It is the removal of diseased pulpal tissue to prevent pulpal pathosis.&nbsp;

&nbsp;

Pulpal pathosis is essentially the colonisation of bacteria in the pulp, which is the innermost layer of the tooth carrying the neurovascular structures and the lymphatics.&nbsp;

&nbsp;

RCT also aims to provide some degree of protection to the disinfected tooth from any future foreign organism attacks.&nbsp;Moreover, RCT helps prevent extraction of an infected tooth. Delaying a RCT can lead to the tooth getting extensively destroyed due to the progressive decay, and make it impossible to save it. The only way out then would be extraction.&nbsp;

&nbsp;

Extraction should not be taken lightly. For one, removal of a naturally existing part of the body can be traumatic. Second, it can cause a series of unfortunate events as well like shifting of teeth and collapsed occlusion, which would affect your ability to chew (mastication).

&nbsp;

According to the American Association of Endodontists, more than 41,000 root canals are performed every day in the United States only. This amounts to more than 15 million root canals each year<a href="#accordion">[2]</a>.&nbsp;

&nbsp;

Although RCT presents with high prevalence in some regions, it is still feared. Studies show that people avoid RCT due to a lack of faith in the procedure itself. The major reason behind it is the lack of awareness about RCT:

<ul>
	<li>24.4% of patients in a study&nbsp;reported that it was the first time they heard about RCT, whereas 52.2% of patients were seen to lack proper knowledge about the procedure<a href="#accordion">[3]</a>.&nbsp;</li>
	<li>66.6% of patients in that study, who had previous RCT exposure, reported having to go through pain at some point during or after a root canal treatment.&nbsp;</li>
</ul>

&nbsp;

For the common man, the myth about the pain linked to RCT really creates a biased stance. Evidently, some teeth need RCT, but stay painless as well. Patients who present with a history of trauma, have non-functioning teeth over time, but they stay asymptomatic. Therefore, in cases like these, a radiographic routine is set.&nbsp;

&nbsp;

It is worth mentioning here that 76% of patients assume that the tooth has to be producing pain for a RCT to be recommended. Whereas, 91.5% patients found it much more convenient to self-medicate for their dental problems<a href="#accordion">[3]</a>.

&nbsp;

The procedure begins with your doctor applying a local anesthetic to save you from any procedural pain. Nitric oxide or oral sedatives may be used for this purpose.&nbsp;

&nbsp;

After the anaesthesia, a dental dam is placed to protect your tooth, and keep it dry as well.

&nbsp;

Next, a hole is made in the dental crown to reach the pulp where the infection has infiltrated. Delicate instruments are used to remove the neurovascular contents of the tooth, and the canals are cleared of any infective material.&nbsp;Finally, the canals are filled with a rubbery material called the gutta-percha. A temporary filling is made till your custom-made crown is ready.&nbsp;&nbsp;

&nbsp;

Ideally, you shouldn&rsquo;t have uncontrollable pain after a root canal treatment. However, you might notice mild sensitivity. These symptoms are successfully managed with pain relievers like NSAIDs (ibuprofen, naproxen). If side effects do show up, they subside within 1-2 weeks<a href="#accordion">[1]</a>.

&nbsp;

Please note your endodontist/dentist is the right person to decide whether you need an RCT or not after they&rsquo;ve required radiographs and relevant history<a href="#accordion">[1]</a>:

<ul>
	<li>Persistent Toothache: If pain persists due to dental origin, it may be an indication that you have a deeply rooted pathology, which definitely needs root canal treatment. If you allow it to progress, the pain might radiate to your jaw, face or adjacent teeth as well.</li>
	<li>Sensitivity: Sensitivity refers to the sharp discomforting sensation you may feel, while consuming something hot or cold. If you face sensitivity when you drink hot coffee or eat ice cream, it may warrant root canal treatment. This becomes crucial if your pain lasts for more than a few seconds.</li>
	<li>Swollen Gums: Swollen gums are an indication that you have an infection in your oral cavity, and collection of pus is inevitable. This can cause puffy, swollen, or even tender gums.</li>
	<li>Pimple On The Gums: Due to the infection, a pimple or boil may develop on the gums. The collected pus from the infected tooth may drain from the pimple, leading to bad taste and foul smell.</li>
	<li>Swollen Jaw: If the pus is unable to drain from the site, it may cause your jaw to appear swollen.</li>
	<li>Discoloration&nbsp;Of The Teeth: Infection of the dental pulp causes your tooth to look darker than the original shade. This happens because of the compromised blood supply to the tooth.</li>
	<li>Tenderness:&nbsp;Pain while eating or while touching your tooth means that the nerves around the pulp are damaged.</li>
	<li>A Cracked Tooth: Accidents or trauma may cause a crack in your teeth leaving it exposed to bacteria, which can make its way to the dental pulp.</li>
	<li>Loose Tooth: Another indication of an infected tooth is that it can feel looser. The reason behind is that the pus from the infected dental pulp can soften the bone that supports the tooth.</li>
</ul>

&nbsp;

Like any other treatment, RCT is an excellent treatment modality for a pulpal infection<a href="#accordion">[1]</a>:

<ul>
	<li>It prevents infection from spreading to adjacent teeth.</li>
	<li>Relieves you of the symptoms presenting due to the infected tooth.</li>
	<li>Reduces the chance of damage to the jawbone.</li>
	<li>Reduces the chance of an extraction.</li>
</ul>

&nbsp;

Conclusion

Root canal treatment is one of those diseases which are frowned upon just because of the hearsay of people, which, again, is based upon misconceptions. An infected tooth can lead to serious systemic complications like coronary artery disease and even <a href="https://merisehat.pk/disease/arthritis">arthritis</a>. Hence, it is essential to get a specialised treatment, which in this case is RCT, like you would do for any other serious disease. After all, everyone needs their Hesy-Ra.

&nbsp;

Key Points

<ul>
	<li>Root canal treatment (RCT) is an endodontic treatment, also known as endodontic therapy, and is the removal of diseased pulpal tissue to prevent pulpal pathosis.</li>
	<li>Pulpal pathosis is essentially the colonisation of bacteria in the pulp, which is the innermost layer of the tooth.</li>
	<li>Root canal treatment also aims to provide some degree of protection to the disinfected tooth.</li>
	<li>RCT can also help prevent extraction of an infected tooth.</li>
	<li>Avoiding RCT can lead to extraction that can, in turn, cause shifting of teeth and collapsed occlusion, which affects your ability to chew (mastication).</li>
	<li>According to the American Association of Endodontists, more than 41,000 root canals are performed every day in the United States alone.</li>
	<li>Studies show that people avoid RCT due to the lack of faith in procedure itself in particular. The major reason behind it is the lack of awareness about RCT.</li>
	<li>According to present studies, 24.4% of the patients reported that it was the first time they heard about RCT.</li>
	<li>52.2% of patients were seen to lack proper knowledge about the procedure.</li>
	<li>66.6% of patients who had previous RCT exposure reported having to go through pain at some point during or after root canal treatment.</li>
	<li>Patients who present a history of trauma, have non-functioning teeth over time, but they can stay asymptomatic.</li>
	<li>91.5% of patients found it much more convenient to self-medicate for their dental problems.</li>
	<li>You should get an RCT if you have sensitivity, loosened teeth, swollen gums or jaw, a cracked tooth or a pimple on your gums.</li>
	<li>The procedure begins with your doctor applying a local anesthetic to save you from any procedural pain.&nbsp;</li>
	<li>A dental dam is placed to protect your tooth and keep it dry as well.</li>
	<li>A hole is made in the dental crown to reach the pulp where the infection has infiltrated in.</li>
	<li>Delicate instruments are used to remove the neurovascular contents of the tooth, following which gutta-percha is filled in the canals.</li>
	<li>A temporary filling is done to enclose the new access till your custom crown is not ready.</li>
	<li>Post procedure symptoms are successfully managed with pain relievers like NSAIDs (ibuprofen, naproxen).</li>
	<li>Its benefits include prevention of the spread of infection, reduced risk of extraction, and damage to the jawbone.</li>
</ul>

[1] Root canal: What is it, diagnosis, treatment, Side Effects &amp; Recovery. Cleveland Clinic.

[2] Mdobrow. New study shows Root Canal treatment's bad rap may become a thing of the past. American Association of Endodontists.

[3] Bansal, Ramta, and Aditya Jain. “An insight into patient's perceptions regarding root canal treatment: A questionnaire-based survey.” Journal of family medicine and primary care vol. 9,2 1020-1027. 28 Feb. 2020, doi:10.4103/jfmpc.jfmpc_880_19

[4] Did the ancient Egyptians have dentists? Dr. John Bazos.

Arbaz Ansari

A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Braces: From the Nerdy Clique To The IT Crowd

So you have watched every single teen movie of the late 90s/early 2000s. And this is probably why when someone asks you to visualize a nerd, you imagine a person with the biggest and Harry Potter inspired&nbsp;frame<a href="#accordion">[1]</a>, with pulled-up socks, a turtleneck, and a heavy stack of books clutched tightly to their chests.

&nbsp;

But what is another cinematic and stereotypical accessory that completes the nerdy and geeky vibe? Classic braces, of course!<a href="#accordion">[2]</a>

&nbsp;

Those who have been victims of the orthodontically administered metal devices&nbsp;would not even fathom calling them or remotely associating them with fashion<a href="#accordion">[3]</a>. But the world is a mysteriously unique place where the most bizarre trends sprout the fastest. In a world of fantasy-influenced vampire facials<a href="#accordion">[4]</a>, a reboot of the controversial low-rise jeans<a href="#accordion">[5]</a>, and the questionable consumption and promotion of tide pods<a href="#accordion">[6]</a>, we have been puzzled by the rekindled spirits for the nostalgic torture devices.

&nbsp;

It caused an uproar due to the conventionally high standards of Asian teenagers; nevertheless, the industry for braces skyrocketed exponentially in countries such as Indonesia, Malaysia, and Thailand<a href="#accordion">[7]</a>.

&nbsp;

Similar to most fad trends, braces are having quite a celebrity moment: their prices have skyrocketed; they&#39;ve received multiple endorsements from prominent Eastern celebrities and influencers; and they have all our attention. An all-out metal mouth is currently viewed as a paragon of opulence, wealth, luxury, and style. It can easily be compared to possessing a coveted Birkin bag or adorning a vintage Prada dress. A few teenagers have been so beguiled by the trend that they are purchasing metal-and-plastic mouthpieces with cutesy animated cartoons and designs to enhance the vibe of the previously distasteful braces. 
&nbsp;

Understanding Dental Braces

The renewed popularity of braces allows people who suffer from irregular teeth alignment to rejoice. What seems puzzling is how a certain demographic has taken a liking to braces &ndash; a historically detested instrument &ndash; and made it something trendy.&nbsp;

&nbsp;

Several people who have not been diagnosed with any oral problems, such as receding gums, loose teeth, crooked teeth, or weak teeth have persuaded their guardians or even paid from their own pockets to get fashion braces<a href="#accordion">[10]</a>.&nbsp;

&nbsp;

To answer the question whether these decorative and perfunctory braces are worth the hype &ndash; they are not. Not only do they force their recipient to tolerate and numb their senses to unbearable (and otherwise avoidable) physical pain<a href="#accordion">[10]</a>, but they have, as expected, been linked to several other problems.&nbsp;

&nbsp;

Enthusiastic and socially-driven adolescents who were desperate to jump on the bandwagon and try these luxury items, have reported difficulties in pronouncing certain syllables and words. Some expressed how the braces affected their sense of taste, and others reduced the number of meals they had because the braces were a hindrance<a href="#accordion">[10]</a>.

<div>&nbsp;</div>

If TikTok can be credited for something, it is its influence and sheer dynamics that compel millennials to participate in all the trends that have been promoted by Gen Z<a href="#accordion">[8]</a>. Perhaps, it&rsquo;s an attempt to remain more relevant. Anyways, orthodontics, especially in Pakistan, have observed a shift in their client demographics. A majority of dentists, orthodontics, and dental clinics claim that the introduction of invisible aligners or clear braces is a plausible reason for the sudden interest exhibited by adults opting for this trend<a href="#accordion">[9]</a>.&nbsp;

&nbsp;

Very much like dental aesthetics internationally, this orthodontic choice is outwardly invisible or transparent and is an adult&#39;s first preference in Pakistan to get a perfectly aligned smile.&nbsp; 
&nbsp;

Popular as invisible aligners but vernacularly known as invisible braces, these new and trendy orthodontic supports are becoming a cult favorite. They are transparent, plastic plate-like figures that are arranged cozily over your teeth. The idea relies on the concept of pressure to tenderly move your teeth into the correct positions and set your smile<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

The orthodontist may likewise put connections that resemble the shade of your teeth onto your teeth to hold the aligners in their original positions<a href="#accordion">[3]</a>. In this manner, they are camouflaged and remain invisible.

&nbsp;

You have the luxury to detach the aligners when you want to carry out necessary routine activities. For instance, the presence of aligners may hinder consumption of food or maintaining oral hygiene and can now be easily removed to avoid hindrances<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

However, you should not remove them for prolonged periods or without purpose as they need to be applied for at least 22 hours every day in order to function effectively.&nbsp; 
&nbsp;

While the resurgence of braces, in general, has been welcomed and appreciated, there is no denying it is because of invisible aligners that their popularity is gaining momentum.&nbsp;

&nbsp;

The triumph of the successor to the millennial torture device can be attributed to 2 reasons<a href="#accordion">[9]</a>:

&nbsp;

1. Lowered Insecurity Scale

What prevented a great many people from getting the run-of-the-mill metal braces is that they were loud and noticeable from afar. They brought uncalled attention from other people. So, even though they were &ndash; and still are &ndash; extremely helpful at drawing out the adjusted grins, individuals try not to get them due to their appearance, because at the end of the day, beauty triumphs over health.&nbsp;

&nbsp;

However, with the societal acceptance of invisible aligners, individuals who were once afraid to highlight their insecurities find no hesitance scheduling an appointment with an orthodontist to get these aids.&nbsp;

&nbsp;

Moreover, some individuals are expected to abide by a specific clothing handbook and dress code in their corporate or professional environment. Wearing braces, to them, is a casual disregard for workplace rules. While some teenagers these days might even do it intentionally for a bit of mischief or to act rebellious, adults prefer to remain neutral. Enter the invisible aligners, and even the adults will not fret about the tediousness of wearing them and taking them off as a constant issue.&nbsp;

&nbsp;

Many patients who mustered the courage to settle for invisible aligners swear by their transparency, claiming that they can go anyplace without any individual noticing that they are wearing textured medical equipment on their teeth. 
&nbsp;

2. Health Trends&nbsp;

And while looking your best matters and is prioritized by many, at the end of the day people look for convenience and ease. Till date, one of the most common objections raised by patients is that metal braces are irritating because food particles frequently get stuck between them.

&nbsp;

And, even though there are specific braces that are not as robust and can be adjusted appropriately around wires, cleaning teeth with metal braces is hard and tedious. All the food particles that remain stuck are bound to disintegrate and cause bad breath in&nbsp; individuals with braces.&nbsp;

&nbsp;

But that is not the only displeasure people with braces face. While their sense of smell is irked due to the overpowering odor, their appearance is also affected as white spots materialize around the accumulation and build-up.&nbsp;

&nbsp;

With the magical invisible aligners, this ceases to be an issue. They can be taken out without any problem. Without any orthodontic dissidents, individuals find it easier to brush and floss effortlessly. There&rsquo;s no odor, no particles stuck in braces, and, most importantly, no hideous metal thing sticking out of their mouths; the person not only looks good, they feel good as well. The flexibility to remove the invisible aligners have made it so practical for day-to-day&nbsp;activities. 
&nbsp;

Have you caught yourself occasionally contemplating this trend? Have invisible braces charmed you with their secretive nature? Do you question the opposition you once put forward as a child towards braces? Well, then you are in luck. Because, like all other millennials spread across the globe, you too can be a part of this trend with the help of professional dental practitioners to achieve the best outcomes<a href="#accordion">[9]</a>.&nbsp;

&nbsp;

This might be a dream come true. However, before you commit to this decision, make sure you know what is in store during the teeth-fixing process<a href="#accordion">[9]</a>:

<ul>
	<li>Most licensed practitioners will invest their time and due diligence by completing an underlying dental test.&nbsp;</li>
	<li>Your dental specialist would decide whether or not these trendy braces are the proper dental treatment for oral health and designing a perfect smile. If it is, they will guide you about the length of the treatment. In addition, they would respond to any queries you have.&nbsp;</li>
	<li>The primary examination is followed by a consultation with one of the dental specialists who will take the advanced impression of your teeth to visualize a more accurate picture and assess the situation accordingly. Moreover, photos and X-rays could be taken. After careful deliberation, they will make a preferential model of your teeth structure. The model will be then shipped off to the designated lab where your invisible aligners will be planned.&nbsp;</li>
	<li>After the lab transports the customized and personal set of aligners to the dentist&#39;s office, you will be notified and called in for the placement of braces.&nbsp;</li>
	<li>The changes are carried out methodically like clockwork. As you complete the treatment, your teeth move into a more adjusted shape.&nbsp;</li>
	<li>Occasionally, your orthodontist would request that you visit them to guarantee that your therapy is on time and as expected. Toward the end of the course, if no complications arise, you can expect to boast a perfectly adjusted grin. The dental specialist would plan a modified clear retainer guaranteed to last forever. 
	&nbsp;</li>
</ul>

With all said and done, there is no reason as to why anyone should deprive themselves of oral <a href="https://merisehat.pk/article/baby-hygiene">hygiene</a>, prioritization of safe practices, and a healthy desire to align their teeth with braces. If Angelina Jolie can dazzle and charm swarms of crowds at the Golden Globes<a href="#accordion">[7]</a>&nbsp;with a pair of the oh-so horrible braces then these orthodontically supported instruments should be adequate for everybody.&nbsp;

&nbsp;

The braces would easily assist with turning a flawed grin into a wonderful smile by reducing unnecessary crowding, fixing teeth, or altering an asymmetrical bite. The best part of this new trend is the individual gets the opportunity to personalize and own their style. Braces are currently a mutually beneficial and socially approved arrangement for everybody.

<div>&nbsp;</div>

[1] Kirsty. THE TRUTH BEHIND HARRY POTTER’S GLASSES. Select Specs.  Published 2015.

[2] Khanna A. The Best Braces Moments in Pop-Culture History. Fresh Orthodontics. Published 2016.

[3] Cassoobhoy A. Braces. WebMD. Published 2020.

[4] Abelman D. What Exactly Is a Vampire Facial?. Allure. Published 2021.

[5] Besser R. How Low Can These Low-Rise Jeans Go?. Vogue. Published 2022.

[6] Bever L. Teens are daring each other to eat Tide pods. We don’t need to tell you that’s a bad idea. The Washington Post.

[7] Trilivas R. Fashion Braces: A Cool, New Trend? We Think Not. Allure. Published 2013.

[8] Chen S. Up close and personal with the Millennials on TikTok. QuickTok.

[9] Altaf A. Why More Adults in Pakistan Are Seeking Braces?. Dental Aesthetics.  Published 2020.

[10] Puiu T. Fashion braces are the new trend, but what is their impact on oral health?. ZME Science. Published 2022.

Zarlish Kazmi

Humza Khizer

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

Should We Floss?

Every now and then we all get something stuck in our teeth after a good meal. And when we&rsquo;re successful in dislodging the little pieces of food, we experience a feeling of satisfaction. This process of cleaning the spaces within our teeth is known as flossing and it is an important step in maintaining oral hygiene. 
&nbsp;

The American Dental Association recommends that we floss at least once a day and brush twice a day for good oral hygiene<a href="#accordion">[1]</a>. 
&nbsp;

However, we all have come across individuals who would debate why flossing is so important, if it really is. The science behind flossing is that when we do not floss, plaque builds up between our teeth and covers the gum lines. When we start to skip flossing on a regular basis, we put ourselves at risk of periodontal disease (gum diseases) and tooth decay, which is second only to cavities<a href="#accordion">[1]</a>. 
&nbsp;

Understanding the Advantages of Flossing

Here we will discuss the benefits of flossing in detail. 
&nbsp;

<ul>
	<li>
	<h5>Gets Rid Of Plaque&nbsp;</h5>
	</li>
</ul>

Plaque is a thin, colorless film that accumulates around the teeth and gums. It is sticky and difficult to appreciate in the beginning, however, your dentist can catch it. Regular flossing prevents plaque formation and tooth decay<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

<h5>How Does Plaque Form?</h5>

Plaque develops when we do not brush for a long time. After consuming a rich carbohydrate meal, the starch in the food along with the bacteria, and the acid that the bacteria produce, all combine together to form a thin, sticky layer that forms a film around the teeth and gums<a href="#accordion">[1]</a>. 
&nbsp;

The acid produced by the bacteria can erode the enamel, which is the bone of the teeth. When plaque keeps building up for long, it soon hardens into a substance called tartar. Once tartar develops, there is increased risk of developing gum diseases.&nbsp; 
&nbsp;

When we floss regularly, we&rsquo;re basically removing the food particles and plaque that accumulate between our teeth.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Prevents Tooth Decay</h5>
	</li>
</ul>

Tooth decay occurs when cavity forms within the teeth and it is simply the formation of holes within the enamel. Although tooth decay is a gradual process, it largely depends on the amount of plaque deposited between and over the teeth<a href="#accordion">[1]</a>. Flossing once in a day reduces the chances of tooth decay by preventing plaque formation. 
&nbsp;

<ul>
	<li>
	<h5>Protects The Gums</h5>
	</li>
</ul>

The early stage of gum disease is known as gingivitis, which is basically the inflammation of gums. Gingivitis causes bleeding from gums while brushing<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

When gingivitis is not controlled, it results in periodontitis &ndash; a severe form of gum disease that results in gums pulling away from the teeth. The teeth soon lose bone support and this can result in widespread inflammation in the entire body<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

Regularly flossing and brushing the teeth keeps the gums strong and protects them from gingivitis or periodontitis. Every 6 months, professional cleaning by a dentist is also recommended.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Prevents Bad Breath&nbsp;</h5>
	</li>
</ul>

Halitosis, also known as bad breath, develops when food particles stay stuck between the teeth for too long. When these food particles are not removed, it can cause foul-smelling breaths that can be very embarrassing in public. Flossing regularly as part of the oral hygiene helps prevent halitosis&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Improves Heart Health&nbsp;</h5>
	</li>
</ul>

That&rsquo;s right! Flossing does have an indirect effect on heart health. It not only benefits the gums and teeth, but also causes an improvement in overall health by benefiting our heart<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

A 2019 study concluded that individuals who flossed regularly and maintained good oral hygiene had lower risk of heart failure and atrial fibrillation<a href="#accordion">[1]</a>.

Additionally, according to the American Heart Association, there is a strong link between our oral health and the general health of our body<a href="#accordion">[1]</a>. 
&nbsp;

It is recommended that we floss once a day and brush twice a day to maintain optimal oral health.&nbsp; 
&nbsp;

However, a common query is whether we should floss before or after brushing our teeth. Ideally, we should floss before brushing so that the particles are dislodged from between the teeth because if you brush first, then the food particles will remain stuck.&nbsp; 
&nbsp;

Remember, there&#39;s no need to floss too harshly as this will harm the gums and cause them to bleed<a href="#accordion">[2]</a>. 
&nbsp;

Here&#39;s a step-by-step guide on how to floss<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

1. Take 18-24 inches of dental floss and wrap it around both the middle fingers while leaving 1-2 inches of the floss unwrapped.&nbsp;

2. Hold the dental floss tightly between the thumb and index finger. Place it in the space between the two teeth.

3. Glide the dental floss gently up and down, and rub it against both sides of the teeth. Do not push the dental floss into the gums as it can cause injury and bleeding in the gums.

4. Move the floss in a C-shape to enter the space between the gums and teeth.&nbsp;

5. Use a clean piece of dental floss for each tooth.&nbsp; 
&nbsp;

Now that we&rsquo;re familiar with the benefits of flossing, let&rsquo;s convince the skeptics to try it as well so that their teeth can stay healthy. It takes less than a minute, there are no downsides to it, and their oral health will be at the top of its game!&nbsp; 
&nbsp;

<ul>
	<li>Flossing is a method of cleaning the spaces between our teeth.&nbsp;</li>
	<li>It is recommended that everyone should floss at least once a day.&nbsp;</li>
	<li>Flossing regularly prevents tooth decay and plaque formation.</li>
	<li>It also keeps the gums healthy and prevents bad breath.&nbsp;</li>
	<li>Flossing also improves heart health.&nbsp;</li>
	<li>Flossing should be done before brushing the teeth.&nbsp;</li>
</ul>

[1] Lindberg S. Benefits of Flossing Your Teeth: 5 Reasons to Floss Regularly. Healthline.

[2] Why should I use dental floss?. nhs.uk.

[3] How to Floss Properly: Step-by-Step Guide to Flossing Teeth. Healthline.

Nawal Adnan

&ldquo;She says I&rsquo;m not sensitive enough, Canny! Tell me what to do?&rdquo; shrieked Molar.

&nbsp;

&ldquo;It&rsquo;s not your job to become anything for her, let alone sensitive Mol&rsquo;, because if you change for her, there is something wrong with your roots,&rdquo; assured Canine.

&nbsp;

Canny was not so wrong. While being reasonably sensitive as a person is a basic human requirement, it&rsquo;s not the same with your teeth. They are hard structures and not built for weaknesses. Hence, if they cause any degree of discomfort, it must be addressed as soon as possible.&nbsp;

&nbsp;

Sensitivity of the teeth, also known as dentin hypersensitivity, is essentially a brief, sharp sensation of pain you feel because of exposed dentin in response to an external stimulus.&nbsp;

&nbsp;

Dentin is defined as the hard dense bony tissue which forms the bulk of a tooth lying under the enamel. The stimulus can be heat or cold, and even chemical in some occasions. Sensitivity of teeth can cause excruciating pain and become a hindrance in the daily routine. Hence, treating it becomes immensely important.

&nbsp;

Understanding Sensitive Teeth And Their Management

According to a dedicated study, the prevalence of dentin hypersensitivity was 12.3%, and each patient had an average of 3.5 hypersensitive teeth. This hypersensitivity was higher in the age group 18-44 years compared with the participants who were of 65 years or older. The results also showed that sensitivity was higher in women than in men.&nbsp;

&nbsp;

Overall, it is safe to say that dentin hypersensitivity is a fairly common condition, with a reported prevalence between 4% - 69% in adults.&nbsp;Another research showed that the prevalence actually varied. However, an average of about 57% was reported. There are 40 million people in the U.S. that are affected with dentin hypersensitivity, 14.3% of which were dental patients. Around 8%-57% were from the adult dentate population, and up to 30% were adults who had sensitivity at some point during their lifetime.&nbsp;

&nbsp;

Research indicates that among the periodontal patients, the prevalence is much higher, between 60% - 98%.&nbsp;

&nbsp;

To conclude, it is fair to state that dentin hypersensitivity occurs in two peaks - the 1st one reporting at 20-30 years of age, and then the 2nd peak later in the 50s<a href="#accordion">[1]</a>.

&nbsp;

Dentin hypersensitivity is not always because of some underlying pathology; some people quite naturally and easily develop more sensitive teeth than the rest because of a thinner enamel. Enamel is basically the outer layer of your tooth which protects the dental integrity.&nbsp;

&nbsp;

There are a number of reasons as to why the tooth&rsquo;s enamel could be torn down<a href="#accordion">[2]</a>:

<ul>
	<li>Brushing your teeth extremely hard and with great force.</li>
	<li>Brushes come in a variety. Hence, using a hard variant of toothbrush might harm the enamel.</li>
	<li>Grinding your teeth.</li>
	<li>Eating or drinking foods that are high in acidic content.</li>
</ul>

&nbsp;

Other medical conditions which cause tooth sensitivity include <a href="https://merisehat.pk/disease/gerd-56">gastroesophageal reflux disease (GERD)</a>. The pathology is that when acid comes up from the stomach and oesophagus, it might splash on the teeth as well, causing them to wear down progressively.&nbsp;Conditions that induce frequent vomiting, like gastroparesis and bulimia nervosa, can also cause acid to wear down the enamel<a href="#accordion">[2]</a>.

&nbsp;

Nothing is a better diagnostic modality for all your dental problems other than a checkup with your dentist. Two visits in a year are recommended. Your dentist can have a look at the sensitivity during your routine dental cleaning, and do a visual exam as well. The use of dental instruments might bring up any undiscovered sensitivity. For example, an X-ray of your teeth helps rule out other causes like cavities.

&nbsp;

It is very important to treat sensitivity and relieve the patient of the immense pain they are in. Sensitivity has the potential to take away the joy you feel when you eat your favorite ice cream, or start your day with a hot cup of coffee.&nbsp;

&nbsp;

Even though it is a sharp pain sensation, there are some ways you can tackle sensitivity<a href="#accordion">[3]</a>:&nbsp;&nbsp;

<ul>
	<li>Desensitising&nbsp;Toothpaste: Desensitising toothpaste can help block the pain caused by sensitive teeth. You can see the result after several applications. The most active component of a desensitising toothpaste is potassium nitrate, which is a compound that blocks pain signals going all the way from your nerve in your tooth to your brain.</li>
	<li>Fluoride: Your dentist may recommend you to apply fluoride to the sensitive areas of your teeth. Fluoride helps to strengthen the worn down tooth enamel, and consequently reduce the pain.</li>
	<li>Desensitising&nbsp;Or Bonding: Exposed root surfaces are what essentially cause sensitivity. However, it is treatable by applying bonding resin to the sensitive root surfaces. Your dentist might need to apply a local anaesthesia&nbsp;for this procedure.</li>
	<li>Surgical Gum Graft: Sensitivity can also occur if you somehow lose a part of your gum tissue. As a fix, a small amount of gum tissue can be taken from any other place in your mouth and attached to the affected site. This can help protect exposed roots, which in turn reduces sensitivity.</li>
	<li>Root Canal: Root canal is the definitive treatment, if no other modalities are proving beneficial for your sensitive teeth. Root canal, also known as RCT, is a procedure which is used to treat problems in the dental pulp. RCT is titled as the most successful technique for treating tooth sensitivity.</li>
</ul>

&nbsp;

Researchers have now found definitive proof that the temperature sensor called the TRCP5 is responsible for transmitting cold sensations, and triggers the nerves. This creates pain and cold hypersensitivity. This sharp pain is considered as a warning alarm to protect a damaged tooth from further injury.&nbsp;

&nbsp;

It was explained in the research that as a response to the cold stimulus, the TRCP5 protein enables other molecules like calcium to interact with the cells. In a diseased state, the dental pulp is inflamed and the TRCP5 is overabundant, causing an increased electrical signalling.&nbsp;

&nbsp;

While the research team had a pharmacological target to minimise tooth sensitivity against the cold stimulus, it should be noted that clove oil has been used as a remedy for tooth pain for a very long time. Surprisingly, the active agent in clove oil was found to be eugenol, which is a chemical that has the potential to block TRCP5<a href="#accordion">[4]</a>.

&nbsp;

Aren’t you done with giving a mere pain such control of your life? How long before you actually have had enough? Passing down the sugary joy a chocolate molten lava cake brings? Avoiding the rush of a cup full of caffeine pumping through your body, energising the day? Ignoring the satisfaction of a blueberry slush on a sunny day? Why renounce the beauty of life when all you can do is visit your dentist and most likely get a prescribed toothpaste? It’s time you got back control of your food choices. And obviously, get rid of the pain.

<ul>
	<li>Dentin hypersensitivity is essentially a brief, sharp sensation of pain you feel because of exposed dentin in response to an external stimulus.</li>
	<li>Dentin is defined as the hard dense bony tissue which forms the bulk of a tooth lying under the enamel.</li>
	<li>According to a dedicated study, the prevalence of dentin hypersensitivity was 12.3% and each patient had an average of 3.5 hypersensitive teeth.</li>
	<li>Dentin hypersensitivity is much more prevalent in women compared to men.</li>
	<li>Dentin hypersensitivity is a fairly common condition with a reported prevalence between 4% and 69% in adults. However, another study showed the prevalence to be at an average of about 57%.</li>
	<li>Research shows that among the periodontal patients, the prevalence is much higher, that is 60% &ndash; 98%.</li>
	<li>Dentin hypersensitivity occurs in 2 peaks - the 1st one reporting at 20 to 30 years of age, and then the 2nd peak later in the 50s.</li>
	<li>Enamel is basically the outer layer of your tooth which protects the dental integrity, and thinning of this structure can cause sensitivity.</li>
	<li>Brushing really hard, using a hard toothbrush, or grinding your teeth excessively causes sensitivity to occur.</li>
	<li>Other medical conditions which cause tooth sensitivity include gastroesophageal reflux disease (GERD).</li>
	<li>Two visits annually are recommended so that your dentist can have a look at the sensitivity during your routine dental cleaning.</li>
	<li>They might also order an X-ray of your teeth to rule out other causes like cavities.</li>
	<li>Options like desensitising toothpaste, application of fluoride, desensitising, surgical gum graft, and root canal can help treat the sensitivity.</li>
	<li>RCT is titled as the most successful technique for treating tooth sensitivity.</li>
	<li>Researchers have now found definitive proof that the temperature sensor called the TRCP5 is responsible for transmitting cold sensation and triggers the nerves to fire.</li>
	<li>In a diseased state, the dental pulp is inflamed and the TRCP5 is overabundant, causing an increased electrical signalling.</li>
	<li>Pharmacological approaches are being designed to efficiently target TRCP5.</li>
	<li>Surprisingly, it has been discovered that the active agent in clove oil is eugenol, which is a chemical that has the potential to block TRCP5. Cloves have been used for a really long time without the knowledge of the interaction of eugenol with TRCP5.</li>
</ul>

[1] Kanehira, M., Ishihata, H., Saito, M. (2015). Dentin Hypersensitivity: Etiology, Prevalence and Treatment Modalities. In: Sasaki, K., Suzuki, O., Takahashi, N. (eds) Interface Oral Health Science 2014. Springer, Tokyo.