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No one likes to visit the dentist.
And while most people grit their teeth and get a check-up done at least once a year, here in India people are known to take pride in the fact that they have never visited the dentist before.
...until their problem becomes too big to ignore any longer.
That's why we decided to interview Dr. Srivats Bharadwaj, MDS (Pediatric and Preventive Dentistry) to learn more about the 3 commonest oral health problems that people face in India.
The problem of bad breath, recurring mouth ulcers, and oral cancer.
Interview Highlights You Should Not Miss:-
1. Why 90% of the time bad breath has got nothing to do with the mouth.
2. The surprisingly simple solution to getting rid of recurring mouth ulcers.
3. A portable torch-like device that can detect oral cancer even before the symptoms start to show in the mouth.
So stay tuned because it's going to get interesting now.
Ria: What is halitosis? And what are its major causes?
Dr. Srivats Bharadwaj: In lay man's terms, halitosis is also called bad breath.
And most people think it is the mouth from where it comes, which is why people come and visit us. But the actual cause of bad breath, 90% of the time, is never the mouth.
The mouth is just a window.
For example, if you have shut the doors of your house for 15 days, and suddenly you open the door, there will be a bad smell because of lack of air circulation. For this, you cannot blame the door.
These are all the major causes of halitosis.
The other 10% of the time, the cause is because the person is maintaining really bad oral hygiene.
Ria: So sir, you told us how halitosis is mainly caused by medical conditions, like lung infections, etc. Can you tell us a little bit more about them and why they cause bad breath?
Dr. Srivats Bharadwaj: It's because of nasal secretions.
All of us have bad breath when we get up in the morning. So it's not a condition. It's just that when we sleep at night there are digestive and nasal secretions.
All these activities that are happening when you are asleep with your mouth closed. So all the acids that are released will give a pungent smell.
Next is, if you have compromised immunity.
Let's talk about simple gastritis. Undigested food will cause bad breath.
So if you have bad breath, don't simply check your oral cavity. It is an indication of bad general health.
Ria: What is halitophobia? And how common is it?
Dr. Srivats Bharadwaj: It is very common.
In fact, that is one of the main reasons why the toothpaste companies have encashed on it. So if you see any advertisement of any toothpaste, all of them only talk about it. Fresh breath. Energy. And they also relate it to relationships.
It's just that the mouth serves as a window. But simply brushing your teeth nicely does not completely eliminate halitosis.
Ria: So basically it is a marketing tactic to put fear in people's heads.
Dr. Srivats Bharadwaj: Yes. [laughs]
But halitosis is present in many individuals. Many people suffer from it. But the problem is not eliminated by brushing your teeth.
Ria: What can people do to cure halitosis?
Dr. Srivats Bharadwaj: Please drink enough water. Do the adequate amount of exercise. Eat on time. Sleep on time. Don't snack at odd hours.
Ria: As well as visit the physician to check if there is any medical condition.
Dr. Srivats Bharadwaj: Yes. Exactly.
And also visit the dentist to rule out any dental cause of halitosis.
Ria: Now let's talk about recurring mouth ulcers.
What causes them?
Dr. Srivats Bharadwaj: Recurring mouth ulcers, the major causes are, as simple as, vitamin deficiency and stress.
Recurrent mouth ulcers are also called recurrent aphthous ulcers. And it's very common in people who have stress, those going through hormonal changes, or who have food allergies.
These are the major causes.
Fortunately, it's a benign condition. And an indication of something underlying.
Unfortunately, the only treatment for aphthous ulcers is symptomatic, like pain relief and mouth washes.
Of late, we also have laser therapy for healing the ulcers. But it does not attend to the root cause.
Ria: Because these ulcers are recurrent, why use lasers at all?
Dr. Srivats Bharadwaj: Because if you don't treat it, it will take somewhere between 7 - 14 days for this ulcer to heal, during which you won't be able to eat properly, or talk properly.
Ria: What are the different types of recurrent aphthous ulcers? And how common are they?
Dr. Srivats Bharadwaj: One is Major, and the other is Minor.
The Minor is very common. More than 60% of the population suffers from it.
But once people make lifestyle changes and identify the cause, it can be completely eliminated.
Ria: What about Major Aphthous Stomatitis?
Dr. Srivats Bharadwaj: The only difference is size and location.
The Major is bigger and causes more discomfort and has a longer healing time. They can take up to 21 days [to heal].
Ria: Sometimes local anesthetics can be applied over the ulcer for pain relief. Do you recommend buying it over-the-counter from drug stores?
Dr. Srivats Bharadwaj: I will not recommend buying anything over-the-counter.
It is always better to get it checked professionally. And only then medicate yourself.
Ria: Why do they tend to occur in the same location?
Dr. Srivats Bharadwaj: No, it is not always in the same location.
It's just that the Major occurs in the posterior aspect of your tongue. Whereas the looser, soft mucosa, like the inner margins of your lips, the cheek, the tongue, those places have Minor.
It just depends on the texture of the mucosa.
Ria: Let's talk about oral cancer now.
In India, oral cancer makes up 40% of all cancer cases. Why is that?
Dr. Srivats Bharadwaj: One of the major reasons is tobacco and its different forms.
We also eat a lot of spices.
And to top it off, we are not aware of sharp teeth margins.
In India, we don't have the habit of regularly visiting the dentist and getting ourselves checked. So the chronic irritation of your tongue or cheek muscles against any sharp tooth in the mouth can lead to cancer.
Ria: How common is this?
Dr. Srivats Bharadwaj: It is very common.
And the other reason is the use of alcohol-based mouthwashes. It is strongly recommended not to use any alcohol-based mouthwashes as they can irritate your cheek muscles, tongue, and the oral mucosa and lead to cancer.
And also ignorance.
Most people do not visit the dentist at all. And most oral cancer can be easily screened and treated at an early stage.
Ria: What are some of the early signs of oral cancer?
Dr. Srivats Bharadwaj: Early signs of oral cancer can be, you could have bleeding gums, chronic ulcers in your mouth, discomfort and pain in swallowing and chewing your food and any of the regular habits.
And today with the advancements of technologies, we don't need to look at biopsies.
Especially at Vatsalya, we are one of the first people in the country to have something called a VELscope.
It is an oral cancer screening device. And it is a small handheld torch and it can throw the light in the mouth and immediately detect oral cancer in a very, very early stage.
Ria: Is it 100% accurate?
Dr. Srivats Bharadwaj: It is 99% accurate. Nothing can be 100%.
The advantage is it is non-invasive. It catches the lesion when it is not even seen in the mouth.
So it is non-invasive. It is cheap. It is simple. It is safe. It's quick. And the treatment options will be very, very non-aggressive.
Ria: So sir, is this VELscope used is treatment camps in India? Or is it too expensive to be taken around?
Dr. Srivats Bharadwaj: Nothing at all. It is a portable handheld device and we take it to our free clinic and use it regularly every Sunday.
We do screening programs with it.
Ria: How does oral cancer progress through its various stages?
Dr. Srivats Bharadwaj: If you ignore it, it just grows and keeps eating away at the adjacent structures of the teeth and then the jaw bone, which will automatically be an aggressive one.
And it can sink into the lymph nodes and start percolating down. It can migrate to any part that's what's called metastasis.
But having said this, as long as you can detect it early, you can have an early intervention and minimal intervention on that.
Ria: What is the treatment for oral cancer?
Dr. Srivats Bharadwaj: It can range from surgical excision to radiation therapy and prosthesis.
In advanced cases they lose their whole jaw or part of the jaw, then just removing it won't be enough. They have to replace it also.
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And if you are a parent (and reside in Bangalore), then you should definitely take your kid to Dr. Bharadwaj's Vatsalya Dental Clinic and check out the jungle-themed park they have created in their Bannerghatta road branch to prevent children from developing a fear of the dentist.