Dr. M.K Singh

We all got together to indulge into our favourite foods this holiday season, where platter overflowed with sweet, spicy and acidic foods. However, when it comes to teeth, sugar isn’t the only culprit that cause tooth decay. High levels of acid in everyday foods and drinks are equally harmful. Lemons to wine, high-acid foods and drinks erode your teeth, causing decay, sensitivity and discoloration. But that doesn’t mean you have to strike all acidic foods and drinks from your diet. The way you consume these items can lessen their damage on your teeth.

Tooth erosion:

It is a type of tooth wear where, the protective surface of your teeth or the enamel wears away exposing the underlying material, called dentin. This leaves your tooth vulnerable to tartar, plaque and bacteria, which cause decay.

Causes of tooth erosion:

Calcium is a key ingredient in building strong teeth. Unfortunately, exposing your teeth to acid can leach calcium from your enamel, causing this protective surface to break down. Foods which have Ph. below 5.0 to 5.7 are acidic. This acid can come from many sources, including the following:

· Carbonated drinks. All soft drinks, including “diet” options, contain high levels of acid that can easily dissolve your enamel.

· Wine. Whether you choose red, white or rosé, drinking wine will soften your enamel.

· Pickles. Which are traditionally seen in an Indian platter

· Fruit juice. The most acidic options include lemon, cranberry, orange and apple.

· Citric fruits. Snacking or sucking on lemons, oranges and limes can wear down your teeth.

· Candy. No sugary sweets are good for your teeth, but you should pay extra attention to avoid sour gummies and candies.

· Sugar. Even though sugar itself does not contain high levels of acidity, it promotes the growth of acid-creating bacteria in your mouth, creating an acidic environment.

· Stomach acid. Vomiting and reflux also can cause serious tooth damage when stomach acid comes into contact with your teeth. If you suffer from an eating disorder, acid reflux or a related condition, seek professional help.

Signs of tooth erosion

Acid wear may lead to serious dental problems. It is important to notice the signs of tooth erosion in its early stages (sensitivity and discoloration) before more severe damage occur, such as cracks, pain and decay.

· Sensitivity. As your teeth’s protective enamel wears away, you may feel a twinge of pain when you consume hot, cold or sweet food and drink. As more enamel is worn away, teeth become increasingly sensitive.

· Discoloration. Teeth can become increasingly yellow as the thinning enamel layer exposes the underlying dentin.

· Rounded teeth. Your teeth may have a rounded or “sand-blasted” look.

· Sharp edges. You might notice thinning of teeth with sharp edges which might cut your tongue and cheeks.

· Transparency. Your front teeth may appear slightly translucent near the edges.

· Cracks. Small cracks and roughness may appear at the edges of teeth.

· Cupping. Small dents may appear on the chewing surface of the teeth, and fillings may appear to be rising up out of the tooth.

What you can do to prevent tooth erosion

Follow these tips to reduce the effects of acid on your teeth.

· Eating higher pH. Food alongside. This helps in lowering the acidity. Includes food like nuts, cheese, oatmeal, mangoes, melons, banana, apples, eggs, vegetables, brown rice and whole grains.

· Eat with meals. Instead of snacking throughout the day, save acidic foods for mealtimes. This will reduce their contact with your teeth and help neutralize the acid by eating it with other foods.

· Wash down with water. Sip water alongside or after the acidic food or drink to wash it out of your mouth.

· Use a straw. While having acidic beverages, reduce their contact with your teeth by using a straw and finishing the drink quickly, instead of sipping over a long period of time.

· Say no to bubbles. Swap out carbonated drinks with water, milk or tea.

· Wait before brushing. Acid softens your enamel, so brushing immediately after eating or drinking high-acid foods or drinks can actually cause damage. Wait at least half an hour and then start brushing. In the meantime, you can always rinse your mouth with tap water.

· Quit smoking. Studies have showed that smokers are more prone to acidity leading to acid reflux and teeth erosion

· Professional help. See your dentist twice a year for dental cleaning and oral screening.

· Sugar free gums. Chewing on sugar free gums increase the saliva flow which, neutralise the acid and help the teeth to stay strong.

Epilepsy is an abnormal medical condition due to abnormal electrical discharge from the brain, which could be due to genetic defects, brain injury,brain infection,brain tumor etc.

Recent study shows, patients with awareness, knowledge and attitude towards the disease had better health related quality of life.

Do’s

• Do take your medicines at the prescribed times.
• Do make it known to your family members, friends and people who work with you that you are seizure-prone. Tell them what should be done in case you get an attack in their presence. This is nothing to be ashamed of as epilepsy is a medical condition just like high blood pressure. If your child has epilepsy, do inform the teacher and the school authorities about it.
• Do tell your child's teacher what to do if your child has a seizure.
• Do keep an accurate record of your seizures and their frequency. Preferably, maintain a seizure diary.
• Do ask your doctor about medicines for other conditions before taking them.
• Do follow a balanced diet.
• Do exercise regularly but avoid over-exertion.
• Do have good lighting in the room where you watch TV. TV picture flashes can trigger seizures. Good lighting can prevent such attacks.
• Do tell someone if you are going for a swim; swim only if your seizures are under control. Moreover, whenever possible, go swimming with a friend.
• Do talk to your doctor about the pros and cons of using contraceptive pills (medicines used by women to avoid unwanted pregnancy) along with your epilepsy medicines.
• Do wear protective headgear when cycling.
• Do tell your doctor about any ill effects that you experience.
• Do get a good night's sleep daily.
• Do make sure you have enough medicine so that you don't run short, even when you are travelling.
• Do check-in with your doctor regularly.

Don’ts

• Don't stop your treatment unless your doctor tells you to.
• Don't consume caffeine or alcohol excessively.
• Don't take other medicines without checking with your doctor.
• Don't lock the bathroom/toilet door, if possible.
• Don't smoke.
• Don't give others your medicines and don't take anyone else's medicines.

Myths and facts about epilepsy

Is epilepsy a very rare disorder?

No. Epilepsy is not a very rare disorder. Epilepsy affects 50 million people worldwide. In India, epilepsy has been identified as a public health problem.

Epilepsy is a mental illness?

It is not a mental illness but disorder of the brain.

Are people with epilepsy violent or crazy?

No. The belief that people with epilepsy are violent is an unfortunate image that is both wrong and destructive. People with epilepsy have no greater tendency toward severe irritability and aggressive behaviours than other people. However, once the attack is over, they return to normalcy and usually display normal behaviour in between attacks.

Are children with epilepsy dull?

Except for children who are born with obvious mental handicaps, children with epilepsy have normal intelligence and should be encouraged by parents and teachers to attend school and complete their education.

Is epilepsy a curse or wrath of God?

No. Epilepsy has nothing to do with curses, possession or other supernatural processes, such as punishment for past sins.

Does epilepsy spread through touching or coughing?

No, epilepsy does not spread through touching or coughing.

Does the use of an onion, metal, etc., help in terminating an ongoing epileptic attack?

No. Some people think that an epileptic attack can be terminated by making the person smell onions or dirty shoes, or by placing a metal key in the person's hand. These are irrational beliefs.

Are epilepsy medications ineffective?

No. Epilepsy medicines are very essential for the control of epileptic attacks and should not be neglected.

Is marriage a cure for epilepsy?

No. Marriage is an important aspect of life but not a cure for epilepsy.

Epilepsy is hereditary hence unfit to get married?

Epilepsy is not a hereditary disorder, and the tendency of epilepsy being passed is only about 3 %, therefore no bar for marriage.

Women suffering from epilepsy cannot have children?

Epilepsy or anti-epileptic drugs cannot affect fertility, even during pregnancy, women can take their medicines under their doctor’s supervision.

Is life of a person with epilepsy miserable?

No. Life of a person with epilepsy can be very manageable and very similar to life of people without epilepsy provided you have a positive approach towards life.

Is epilepsy a hindrance in leading a happy and successful life?

No. People with epilepsy can live a happy and successful life. With the advent of newer medicines, availability of medical care and increased awareness of the condition, it has become possible for a person with epilepsy to lead a good life. There are many famous poets, writers and sportsmen with epilepsy who have excelled in their respective fields.

Special Precautions in Children with Epilepsy

Computerized and Lights:
Up to 5% of children with epilepsy have photosensitive epilepsy. Computers and TVs with a flat screen do not flicker and, so, are less likely to trigger seizures than screens that flicker. However, flashing lights/ flickering screen can act as trigger in photosensitive epilepsy patients.

Exams and Tests:
For Children who are likely to have seizures in stressful situations or at certain times of the day, this may affect how they perform in exams or tests. Tiredness, memory or concentration problems may also affect exams or tests. Tiredness, memory or concentration problems may also affect exams.

Physical Activities and Lessons:
Safety is important for all children, especially during physical activities and lessons, such as when studying science. Epilepsy does not need to stop a child from doing an activity as long as he or she is safe.

During Swimming:
This must be allowed only in the presence of trusted lifeguards. It is essential that the swimming coach and the lifeguards fully understand a child’s epilepsy so they can quickly see if the child is having a seizure in the water.

If you are experiencing a wheezing sound while you breathe or having difficulty in breathing, you are suffering from asthma. It is a medical condition characterized by paroxysmal wheezing respiration dyspnoea. There is no definite way to prevent asthma, but by following a step-by-step daily plan, you can prevent asthma attacks or keep them in check.

Symptoms of Asthma or Asthma Attack 

1. Wheezing 
2. Chest tightness or chest discomfort 
3. Breathing discomfort with or without cough

Here are some important measures to follow to prevent asthma:

1. You need to strictly follow your asthma action plan. The plan should be laid down after a detailed discussion with your doctor or healthcare team. All the medicines you require to prevent the asthma attacks will be written down for you.
2. You should get vaccinated for pneumonia and influenza. This will prevent these conditions from triggering asthma attacks or flare-ups.
3. You need to identify the asthma triggers and stay away from them. Several outdoors irritants and allergens from pollen to cold air can trigger asthma attacks.
4. You have to monitor your breathing. By recognising the warning signs of an attack like wheezing, slight coughing or shortness of breath, you can prevent an asthma attack. You need to measure and record your peak airflow regularly using a home peak flow meter.
5. By acting quickly, you can identify a fatal attack and prevent it from occurring. When the peak flow measurement decreases, you need to take your medicines immediately and abstain from any activity which may have triggered the attack.
6. You need to keep taking your prescribed medicines, even if your asthma symptoms have improved. You should not change your medication schedule without consulting a doctor. It is recommended that you to bring along the medicines you take at your doctor’s appointment as he will be able to tell whether you are taking them right.
7. If you use your quick relief inhaler a lot, the asthma is not under control. You need to visit your doctor as soon as possible and he/she will make some modifications to your treatment.
8. For prevention of asthma, you should use allergy proof pillow covers and mattresses. You must wash your bedding every week in hot water to eliminate dust mites. You may use a dehumidifier for reducing excess moisture to prevent mold.
9. Do not allow your pets in the bedroom and on the furniture. Pet dander is a common trigger of asthma and it cannot be avoided by people who own pets.
10. You can also fit an air filtration system in your home. It will help in the elimination of asthma triggers such as pollen, dust mites and other allergens.

Doctor suggests immunotherapy for asthma prevention in the form of allergy shots. Immunotherapy aims at altering a person’s immune response by making it less sensitive to asthma triggers. If you wish to discuss about any specific problem, you can consult a Pulmonologist.