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Man, Know Thy Teeth ….By Peju Adeniran

Life as a medical student was hard; there were books to read, lecturers to impress, patients to attend to, and a social life to try and fit into the mix.

The perks were therefore few and far between, but I’ll let you in n a little secret; one of the advantages was that as a young doctor, you could get access to free diagnosis, consultation, and even free medication when possible.

It was under one of these of F-O-C arrangements a few years ago, that I had a colleague take a professional look at my teeth.

Like most people, I consider myself to posses a good enough set of teeth; there were no obvious cases of tooth decay, I had not had any tooth pain or bad breath, so I figured I had nothing to worry about.

As I sat draped in the dental chair, I was handed a dental mirror that would allow me take a look at the back and sides of my teeth, I took it confidently and looked in, but to my horror, I discovered something shocking.

At the back and sides of my mouth were unsettling evidence of plaque and tartar that had left dark marks all round on the areas close to the gum line.

I was mightily appalled. “How had I let this happen?” I thought to myself.

Teeth are normally very resistant; they are often preserved even in skeletons and you can tell someone’s diet, even when they have been long dead, just by looking at the state of their teeth.

The top layer, called the enamel is whiter, like milk in primary teeth in children, and darker and stronger by the time the secondary teeth appear in adults. Enamel is very strong and can usually withstand a lot of pressure in order to protect the living tissue it encases.

But, enamel is not foolproof.

It can be worn down by eating too-hard foods for those who chew on hard bone frequently. It can be broken, if you use your teeth to open bottle tops for example or bite into a stone in your food or chip it against a hard object like the floor if you fall.

Enamel is also quickly decalcified (the calcium, which makes it hard, is removed) by acids, and these acids come from the sugars that we eat which are broken down into acid by the normal bacteria in our mouths.

Brushing twice daily, or at least about eight hours apart, or even rinsing the mouth by swishing water around after eating sweets for instance will help to reverse this reaction.

Brush for at least two minutes; recite the alphabet thrice while you brush to help you keep time.

Don’t forget to brush the tongue, in about 20 firm strokes, to remove bacteria.

After three months, your brush is full of the recommended limit of bacteria, and should be replaced.

What about getting the perfect, white smile?

Even though the teeth may look clean and perfect, like I thought mine were, not taking the time to clean the hard-to-reach spots at the back and sides can lead to plaque formation.

Dental Plaque is present in just about everybody’s mouths. If not gotten rid of, plaque will harden to form calculus, which leads to other problems such as gum/periodontal disease, which manifest as bleeding gums and bad breath.

Habits and daily routine such as cigarette smoking, coffee drinking and tea will leave stains on your teeth. Also taking too long between brushing sessions will allow food remnants leave permanent stains on the teeth.

Flossing is easy, and essential. Bits of food stuck between teeth, especially left for a long time can contribute to gum disease and decay.

With the right brushing and flossing technique Dental Plaque may be easily removed.

Calculus and Stains require a visit to your dentist’s office to be professionally cleaned off  nevertheless prevention is always better than cure.

Some long – term medications, like some anti-depressants, could contribute to gum disease; ask your doctor for help if you are taking any of them.

It is important not to ignore any sign or symptom of gum disease, as this can progress to irreversible stages of advanced gum disease (periodontitis).

When you know you have the perfect, healthy teeth smiling comes a whole lot easier!

Sugar and Kids Behaving Badly ….by Ehgosa Imasuen

If there is one thing readers have noticed about my blog, it is that I thrive in being counter-intuitive. Today’s post will not be any different.

This article is for any parent who has sat through the aftermath of a birthday party, the cakes, the sugary drinks, the candy, and the children. The children turn hell raisers; noisy, disruptive, inattentive, hyperactive.

When my kids started school a year ago—it is a quaint little place, ten in a class, strict, nice—the proprietor gave us a list of foods she frowned upon in the school. We were to cut down on these: refined sugars, processed fruit juices, sugary drinks, and candy. This was great advice. Too much refined sugar is bad for you; it puts a strain on your ability to digest and metabolise it, and has been shown to be risk factor for the future development of diabetes, obesity, and associated problems. She did give these reasons but the primary one was that it affected the children’s behaviour. Now this is something I know to be wrong.

Experts say the notion that sugar causes children to become hyperactive is by far the most popular example of how people believe food can affect behaviour, especially among young children. But the fact is that sugar may actually be an innocent victim of guilt by association. Studies have shown that parents who feel that their children have had sugar automatically perceive their behaviour as hyperactive, and disruptive, even when no real change in behaviour could be measured scientifically. If the parent was left blind to what the child had had, they could not predict or associate the child’s behaviour with sugar intake.

What psychiatrists now assume is that the context of the sugar intake; parties, friends, excitement, may be the real reason for the perceived change in behaviour. Humans are very good at equating association with causality. Because two things happen together doesn’t mean that one causes the other. And this is where intuition can go awry. Every single fibre of your being tells you that when your child has had refined sugar he goes hyper. But the studies do not back this up. But where did the history come from? The idea that food might have an effect on children’s behaviour first became popularized in the 1970s by Benjamin Feingold, MD, an allergist who published the Feingold diet. He advocated a diet free of more than 300 food additives and naturally occurring salicylates found in plants and many fruits and vegetables to treat hyperactivity.

Since then, many studies have looked at the issue of food additives and hyperactivity. Most of these studies have failed to substantiate Feingold’s claims or have shown only a mild benefit in a small number of children with ADHD. And Feingold’s diet would have been helpful, if it was practicable; it banned the very foods that children like. And any parent who has had to fight off a three-year-old’s temper tantrum knows this simple truth: the little tykes always win.

There is a real condition called Attention Deficit Hyperactivity Disorder (ADHD). If you perceive that your child’s behaviour is disrupting family life or affecting their performance in school, it may be a symptom of a bigger problem, such as a conduct disorder or attention deficit-hyperactivity disorder (ADHD), and should be evaluated by a mental health professional.

But know this today; limiting your child’s sugar intake will not hurt, but it will not AFFECT the child’s behavior either.

Water No Get Enemy ….Peju Adeniran

To improve my health, I started an exercise program a few months ago. Before now, in conjunction with eating healthy, all I did for exercise was to take long, power walks in the evenings at least twice a week.

But as I grow older, it is has become apparent that this is not going to be enough; metabolism slows down the older one gets, and I need more than my usual to maintain my weight and health.

So, I joined a gym and met brutal Chioma, my gym instructor. While I will save my adventures with Chioma for another day, I will talk about working out and water.

More than half of our bodies and our entire planet is made up of water, so Fela knew what he was saying when he sang ‘Water No Get Enemy.”

But many of us are ignorant of the ways in which water can be useful to us aside from just drinking, cooking and washing.

In the spirit of World Water day, let us share some tips on how water can help keep us stay healthy and well in and out of the gym.

  • Water is an excellent detoxifier. Our bodies need water for the huge amount of the chemical processes that go on in our body especially in the digestive system.
  • When it comes to digestion the question is “to drink or not to drink?” Well, it depends. The stomach uses a natural acid, Hydrochloric acid, to digest food. Over-dilution of this acid by drinking too much water WHILE eating could hamper the digestion. But drinking water 30 minutes BEFORE and two hours AFTER eating will help in rinsing out your stomach of food debris and keeping it ready for the next meal.
  • Muscle-building is a useful tool in the gym to tone up the body and increase your metabolism rate. However, when you first start weight-lifting, you will experience minute muscle tears and re-building. Myoglobins (the cellular protein unit in your muscle) will be released into your blood stream for disposal. These proteins, because they are heavy could damage your kidneys, especially if you have some degree of prior kidney damage. So, when body-building ensure to increase your water intake to flush the proteins.
  • Do not limit your imagination to the fact that water is only available in the liquid form and in your glass. Many of the popular fruits and vegetables have a high amount of water, and are more interesting ways to hydrate your body.
  • Water is a great friend of your skin. Drink water and sweat your way to clearer skin by eliminating toxins through your skin pores during your cardio work out. Increase the rate of toxin removal by drinking water.
  • Water is also useful for practical weight loss purposes. If you are doing weight training for instance and have no dumbbells, no problem. Take a look at this; a litre of water is approximately 1kg of weight. Therefore if you are training with 1kg dumbbells, just take a litre container of water, fill it up and you have one kilogram to work with. You want two kilograms, use two litres etc. Note that different liquids have unique weights and this only holds for water.
  • Water your hair and nails from the inside! Challenge your hair to grow by drinking 8 cups or 2 litres daily, and watch your hair and nails sprout like plants!
  • Water is the first medication with most domestic accidents. Chemical splashes on/in the skin, eyes, ears and nose? Flush vigorously with water, then rush to hospital. Same with accidental ingestion of MOST poisons
  • Water is recommended in copious amounts for all people, except for those that are suffering from certain chronic kidney ailments. Everyone else should keep drinking up!

I Feel Pain When I Laugh….by Peju Adeniran

When Sylvia* came to the hospital for the first time, it was on Sunday morning, when most people were in church. Infact, she came in straight from church, dressed in her Sunday best, bent over in pain and holding a note from her pastor.

The note read: “Please doctors, attend to Miss Sylvia* X, she is a worker who had to be excused from the church service because of ill-health.”

Well, she didn’t need a note to see a doctor in a public hospital, Anyway, alone with the female doctors, Sylvia undressed shyly, and proceeded to show us one of the most painful-looking inflamed hemorrhoids I had ever seen.

I wondered to myself how she had managed to walk, sit and stand properly, with that kind of swelling coming from her intestines.

While on her side and undressed, Sylvia told me that the pain from the piles was so bad especially when she was making a bowel movement, that she had trained her body to stop using the toilet all together.
“I got tired of seeing blood whenever I went in there, and sometimes I avoid going to where people crack jokes, because my bum bum pains me when I laugh hard.”

A hemorrhoid or “pile” occurs when a vein in the anus becomes swollen with blood, which has become trapped in it. Blood normally passes unhindered through the veins in the anus, back into the body and then returns back unhindered. But some conditions occur, when this blood flow is obstructed because of unusual pressure on them.

When the veins are blocked, it can also cause some degree of irritation to the skin above the veins, thereby causing the pain the people who suffer from hemorrhoids experience.

Hemorrhoids are one of the most popular illnesses in our society today. Not because they are most common in incidence, but because amongst those that practice and advertise “traditional medicine cures” they are frequently advertised as one of the conditions that people should come to them for.
 Sylvia had been consulting at a “traditional medicine” place for about two years with no relief before she eventually sought treatment from the hospital that Sunday morning.

She had been asked to drink various herbs; some of which were even inserted up into her, where the piles were, all to no relief.

As she wept on the table that day, I thought of how much easier her life could have been if only she knew a few things.

One, there are many possible treatments for piles, but by far the best, would be to not have gotten the piles in the first place. It is definitely a case of prevention being the best medicine.

How is this possible, you ask? By taking better care of our insides and intestines we can prevent this condition.

Sylvia, like most people who suffer from this condition, consumes a lot of processed carbohydrate foods, without including fiber; which she could have gotten from raw fruits and vegetables

She also confessed to me that since she went to a boarding school she had trained herself to not use the toilet regularly, which means she was often constipated.

Her daily water intake, from the consumption chart we drew up was also not impressive, meaning she didn’t also hydrate her intestines properly.

Eventually these bad habits caught up with Sylvia, and she ended up in pain, on the Doctor’s examination bed and being prescribed corrective surgery.

So, to prevent the condition above, it is wise to take care of your intestines by avoiding Sylvia’s unhealthy habits. It is also important to exercise often; weight gain, especially in the abdomen has been known to contribute to piles.

Pregnant women, because of their growing abdomen are, unfortunately, susceptible to piles, but thankfully, it is only temporary.

Here’s a fun fact to consider: people who sit for long on the toilet bowl, because of the pressure on the anal veins, with no support from under, could be increasing their risk for piles as well.

So, if you think that the toilet is the best place to read that newspaper or your new novel, you could be inviting PILES.

*she is well now, and allowed me share this story with you all.

The Curious Case Of The Everlasting Cough (2)….by Peju Adeniran.

Whenever I think of drug addiction in the young, Bariga comes to mind.

And even though I had lived in Lagos all my life, I did not think much of Bariga as a place, until one day, during a psychiatry rotation in school, a patient who was fighting drug addiction revealed that he was hooked on crack cocaine, a commodity that he easily bought off his friends who lived on the streets in Bariga. He said, he regularly bought wraps, for a mere 50 naira a hit.

The cheap price was going to be the first of my many surprises with drug addiction, as, for instance, I would later learn that in Northern Nigeria for example, a popular narcotic concoction of choice was made by boiling laundry blue, herbs and lizard droppings. ( ).

Another lesson, was realizing that many drug addicts did not necessarily use the narcotics or hard drugs that we have come to know and expect. In spite of available street drugs, most young addicts, (young in age and young in addiction) prefer to lean towards “softer” drugs at first, than to start at the top.

They like to use drugs, which they believe are cleaner, drugs they can “pull back from” believing that those ones are less addictive, and that they can stop them anytime they want.

That’s where Codeine falls into. If you recall, Codeine which has now become a ‘popular,’ ‘clean,’ and ‘soft’ drug came to my attention when a patient mentioned that her son had been on cough syrup for a very long time with no apparent relief from his symptoms, and also from the case of a woman who had seen children buy this cough syrup from a pharmacy with the help of an adult.

Weeks later, another case came up where a male senior secondary school student in a prestigious Nigerian school was found not only to have been abusing Codeine but had set up a lucrative business buying the bottles of cough syrup in bulk and selling in school to his classmates.

Matters came to a head when he was reported to the school by the parents of one of his customers who had had confessed his source. A search was carried out and hundreds of empty bottles of cough syrup were found under his bed.

His business had been going on for a long time, and everyone was amazed by how much money he had amassed by the time his business went bust. (The money was enough to amaze even his rich parents).

A codeine-high in a young person looks like this; a blunt, happy or dreamy expression all the time, with a reluctance to have an emotional response to anything; it is hard for people like this to get angry or anxious, some are immune to most physical pain.

It’s the classic prescription-drug addiction effect that has been described in movie and music stars; Michael Jackson being a famous example.

Now you can ask me; how could the parents have missed it in their children? Quite easy; they must have thought they had happy, easy going children.

Unfortunately, I was not privy to how the story ended. In spite of my efforts to follow up on how treatment for the addicted patient was sought and effected, not much was heard of how the case ended.

I still think of that case from time to time, and I am now deeply suspicious of people who come to me for cough medication especially those that recommend what medication I should prescribe for them especially when it involves codeine. In my head, I wonder if they planned on having an “everlasting cough” so I usually write a prescription for: “lots of rest, multivitamins and honey, then get back to me.”

We need to fight this everlasting cough epidemic!

Ice Cream Is Good And Bad For You….Eghosa Imasuen

I remember the anecdotes associated with these words of wisdom, after a period of enjoyment comes a bout of payback. Valentine’s Day was just some weeks ago and I know that some of my readers had ice cream, or at least bought ice cream. How many of those who swallowed the creamy stuff, luxuriating in the coolness, the ease with which it went down the throat, the taste of cow’s milk percolated into fatty cream, and then frozen, ended up in the toilet within hours? If you were one of them, you have Lactose Intolerance.

Lactose intolerance is a condition—completely misnamed, since contrary to what the title suggests, it is actually the normal state for adult mammals—in which the ability to digest the sugar, lactose, is impaired because of a lack of the enzyme lactase. The etymology of the words lactose and lactase are self-explanatory. Lactose is the predominant sugar found in milk. And in adults, the frequency of absence of the enzyme lactase in populations ranges from 5% in Northern Europe, and some pastoral communities in Africa, to 71% in Sicily and up to 90% in Africa and Asia.

What happens is this: lactose is a disaccharide, a sugar made of two smaller units. Disaccharides cannot be absorbed directly through the intestine’s walls. So when a lactase-deficient individual ingests milk, the sugar remains in the lumen of the gut where it is immediately acted upon by bacteria. This fermentation produces by-products, gas: hydrogen, carbon dioxide and methane. These in turn produce the intestinal symptoms some of you remember from the 15th of February: cramps, bloating, heartburn, and flatulence, and of course, diarrhoea. Although to be pedantic, the way Lactose Intolerance produces diarrhoea is through the direct action of the undigested sugar itself, not through the action of bacteria. The sugar draws water into the lumen of the gut leading to the watery stools.

But what is the real-world relevance of Lactose Intolerance, you ask. You see, in the northern-hemisphere-dominated world we live in, assumptions can lead to, and have led to, death. During the Nigerian Civil War, Caritas, the Catholic aid agency, and others pushed large shipments of aid to help the protein-energy-malnourished children in the Biafran enclave. They came with egg yolk, with dried fish, with milk. And doctors, including the pair who would go on to found Médecins san Frontières, noticed that older children were dying from consuming milk. From consuming milk? Yes. The Red Cross initially ascribed these deaths to spoilage, to contamination, to even outright poisoning by the opposing forces. They said Biafrans were preparing the milk wrongly. But it was Lactose Intolerance. Even the brilliant can be slow to latch onto the obvious.

Lactase is an enzyme that every child is born with, an important trait because the infant’s entire diet consists of mother’s milk. The mammalian production of lactase drops off as infants approach the weaning period but some populations—because of a mutation in the genes that code for this trait—have retained the ability to process lactose into adulthood. Unsurprisingly this recent agriculturally associated trait confers an advantage in pastoral communities, so lactose intolerance is rare in societies where dairy products have a long, almost prehistoric, history of being consumed, i.e., the Fulani, the Tutsis, and Northern Europeans. However, most other humans lose this ability. And it is not modifiable, although new research seems to suggest that retaining Lactase activity into adulthood is on the rise worldwide, a sign, some say, of evolution in action.

So those who stole to mommy’s kitchen cupboard to binge on powered milk; those who add coffee to their milk instead of vice versa; those who quaffed Valentine’s Day ice cream as if there was no tomorrow, now you know why you ended up in the loo hours later.

Are you taking care of your teeth?

EwellAfrica talked to Moyo Ajaja DDS, a dentist practicing in America about caring for our teeth.

Please tell us about yourself?
I am Christian and believe the human body is sacred and that neglecting our health is akin to desecrating a holy place. I fill many roles, I am a wife, mother, sister, daughter, friend, and a dentist. I am passionate about living a full life, using all my talents and encouraging all those around me to dream bigger!

A lot of people don’t consider dental health important until they have pain, can you give us a brief overview about dental health? Why are dental check-ups important?
The condition of the mouth is an indicator of a person’s overall wellbeing. Periodic (at least every 6 months) dental check-ups are important to protect, preserve, and restore oral health with early intervention in a disease process. Usually a dental check-up entails radiographic imaging, professional cleaning and examination of the teeth, gums, cheeks, palate, head, and neck. This exam includes the lymph nodes, muscles, joints and bones. From the state of a patient’s mouth a dentist can tell if that patient smokes, chews tobacco, uses recreational drugs, has uncontrolled diabetes, leukemia, or a compromised immune system.

How early should we start having check ups?
The American Academy of Pediatric Dentist recommends dental visits start as soon as a baby’s first tooth shows up and no later than the first birthday. Usually these appointments are to introduce the child and family to the dental environment (children this young are usually seen by a pediatric dentist) and provide the parents with milestones to expect with the child’s teeth and the way the child’s jaws fit together. Another purpose of these early visit is to educate parents on how to care for the teeth, diet, and what to do if the child has an injury to the mouth/jaw areas.
Does every dental check up include oral cancer screening or should we be asking our dentist about it? – Yes, every dental exam includes a visual oral cancer screening. You may ask your dentist about the findings. If there are any signs of abnormal tissue additional testing is usually the first step and the dentist will discuss those options with you when necessary.

What is the best way to clean our teeth?
Brush and floss! This is the best way to remove the bacteria layer (plaque) that accumulates on the gums and teeth. Brushing cleans about 80% of the tooth and gums and flossing cleans the remaining 20% surfaces that the brush bristles cannot reach. I recommend that patients use a soft bristled brush morning and before bedtime for at least 2 minutes and floss before bedtime. Most people underestimate the 2 minutes therefore I recommend using a timer or if you listen to the radio then brush for the length of a song.

How often should we change our toothbrushes?
Every 3-4months or as soon as the brush bristle start to fray. Remember that soft bristles are the gentlest on the gums. A medium or firm bristled brush can cause the gums to recessed and also damage the surface of teeth.

Toothbrushes/chewing stick? Can you compare and contrast the two?
The toothbrush is a relatively modern invention while chewing sticks have been used in many cultures for centuries. Some religions even promote the use of chewing sticks. Both of these instruments are useful for the mechanical removal of plaque from teeth and gums. Some studies have shown that when used properly, chewing twigs, stems, or root can be as effective as using a toothbrush because it cleans the surfaces of the oral cavity and increases saliva flow. Additional studies also indicate an antimicrobial agent in the plants chewed may reduce the bacteria known to cause dental decay and gum disease. The World Health Organization also recognizes chewing sticks as a valid instrument to maintain good oral hygiene. I want to emphasize that whatever method used to keep the mouth clean the key is to do this frequently, at least twice a day, clean in-between teeth with floss or similar interdental cleaner, and limit frequency of dietary exposures.

What is Gum disease?
Also called periodontal disease is an infection of the tooth supporting structures (gums and bones).
What are warning signs of gum disease? – The initial signs of periodontal disease is bleeding, swollen and red gums. This initial stage, called Gingivitis, is completely reversible with dental treatment and good home care practices. Without treatment gingivitis can progress to infect the jaw bones (Periodontitis) and cause bone loss. Tooth loss occurs once there is inadequate support from the gums and adjacent bones.

What can we do if we can’t afford dental treatment, are there options?
Yes there are many options. Start by dialing “2-1-1” a toll-free telephone service that connects people with local community organizations and government agencies. They will guide you through the resources available in your area.

What causes bad breath? How can it be treated?
Halitosis (bad breath) can originate from several areas. The lungs – a diet of onions and garlic can cause bad breath once digested and absorbed into the bloodstream some of its byproducts are expelled via the lungs. The mouth – inadequate hygiene or salivary flow allows bacteria to flourish and aids the decomposition of food particles. The rest of the body – a disorder elsewhere in the body such as respiratory infections, diabetes, gastrointestinal, kidney, or liver disease. Treatment is targeted at the cause of the bad breath dietary changes where necessary, dental treatment and good oral hygiene, and medical intervention if a systemic disorder is suspected. Alcohol and tobacco use also exacerbates halitosis.

What if anything is a key take home point you would like to leave us with?
Brush for two minutes at least twice a day, floss daily and schedule your next dental appointment today!

Challenge countdown.

We are almost at the end of our 21 day challenge, but we still want you to finish strong!

Today your challenge is simply this.
Review the past challenges and figure out how to incorporate them into your new healthier lifestyle.
Create an action plan that includes tangible changes to your dietary and workout routines.
Get your family and friends on board!

See…simple and easy and worth it all!

Be well!

New day, new challenge

Your challenge today is…

Spirit challenge: Disconnect and connect.
Between BBpins, facebook, twitter and more, we are spending more time communicating online and less offline. There are even spouses who do more discussing through status updates. Today we would like you to stop tapping the key board so much and connect to the people and life that are really in front of you. Surprise your spouse with lunch plans, put the Wii down and tell your kids a story, stop stalking random photos on facebook and get out there and make your own memories. Life cannot be lived solely through a computer, it has to be lived by being part of it, mind, body and soul.

Body challenge: Drink water.
How much water are you drinking? Not liquid, but water? Pure simple water. This is the best thing you can do for yourself today, drink clean water. Current recommendations suggest that we should get around 2 litres of a day, more if you are losing a lot, through sweating and exertion. So please put down the soft drinks, put down the juices and drink simple water.

Dear diary…What did I eat?

So many people say, I hardly eat but I still gain weight, I think it’s just my body type, it just gains weight on its own.
Studies have shown that most people think they eat less than they do. When asked to list what they had eaten that day, most people left out close to a significant portion of their total daily caloric intake unintentionally.

Dietitians and health professionals agree that a food diary can help you keep better track of your eating and as such can help you lose weight because you know exactly what you put in your body at any given time.

A study published in the American journal of preventive medicine showed that participants who kept a food diary or journal lost twice as much weight as those who didn’t.

A food diary doesn’t have to be sophisticated, a small notebook will do, it just helps you get information about your eating habits. It helps you figure out what exactly is sabotaging your weight loss efforts. Those two bags on plantain chips? That meatpie and then the donut that you forgot about? Everything adds up.

Furthermore you can make it a food and exercise journal and really get going.

So write it down and keep it real!
Be well and be healthy!