A MIDDLE aged male hailing from a rural setting of Mwananyamala, having confirmed his appointment with the chair side dental assistant over the phone earlier, opened the door of the Dental Clinic.
He had a cigarette in his mouth. He took a final puff and threw the butt out of the door as he stepped in. The nicotine around his person smelled awfully. A patient who was already sitting in the waiting lounge for his turn with the Dental Surgeon (DS) expressed his disgruntlement, “You are not supposed to smoke here.
Your entry into this clinic has brought in a puff of smell of nicotine. This is supposed to be a sanitized place. The smell of cigarette here is most revolting. Surely you could have restrained yourself from having a cigarette for a little while before you came in.”
The DS in the dental surgery heard every word. He came out. He politely told the patient who had vented his disgust, “Thank you gentleman for pointing out the need to maintain the hygiene in place” and then turning to the person still standing at the entrance, “If you do not mind, Sir, I would request you to remain outside for about five minutes until the wind blowing across the corridor removes the smell of nicotine from your shirt. I can see the packet of cigarettes jutting out of your pocket. Please leave that in your car”.
The plea on the part of DS had the desired results. The incomer nodded his assent. He carried out the instructions of the DS without displaying any vexation on his part.
The patient (P) in the waiting lounge was made to come in. As he alighted in the dental chair the DS readied himself by putting on the gloves and taking hold of a probe and mouth mirror ready to carry out the inspection of the patient’s mouth.
To the instructions, “Open please,” from the DS the patient opened wide. The DS was on the verge of introducing the instruments when he was awestruck to see the mouth trimmed with bits and pieces of ‘Karanga’. The P while in the lounge had been silently and quietly munching groundnuts. He had not even given a thought to rinsing and cleaning his mouth and ridding it of the debris. It was a nutty and a daft thing to do just when the DS was to undertake a dental check-up.
The DS trying to compose himself could not help saying, “Good God, aren’t you supposed to present a cleaner mouth to a dentist when you need a dental treatment? I have a mind to send you off to your home for you to carry out a thorough toileting of your oral cavity. You must realise that I cannot see a single tooth clearly as their surfaces are all covered by ‘Karanga’.
” The patient probably sensing the ‘cussedness’ of his action that had not gone down with the DS lifted the tumbler of water with the intention of swishing his mouth to remove the crumbs. The DS stopped him outright. He said, “You will choke the spittoon that way. It would be in the fitness of things to carry out your cleansing act there in the water basin.
The large drain pipe will easily flush it away with free flowing water from the tap”. The P ultimately had his mouth cleared. Upon completing his check-up the DS said, “It is remarkable that you do not have a single tooth which has carries/decay.
You have two ceramic crowns which are partly chipped off. What is it that has drawn you to the dental clinic? The P Replied, “As such I have no specific complaint. My appointment with you is mostly to gauge the advantages and disadvantages of inserting small ice cubes in my mouth and crushing these with my teeth. I have developed this fancy for the past three months or so. The DS was momentarily taken aback.
He asked, “However, there must be an explanation for such a whim. How did it all start?” P: “I was with my friends. We were enjoying our soft drinks viz. fanta, sprite, pepsi, etc. Most of us had ice pieces in our drinks.
Some of my pals, at least three of them, opened the corks with the help of their teeth-literally wrenching them out of the bottle tops. To me this held a tremendous appeal. I did not possess the verve or skill to carry it out. Instead I started biting and crushing my teeth into the ice into bits.
I discovered that three of my friends who could uncork the bottles with their teeth did not fancy crushing ice in the mouth. I therefore cultivated the habit of eating ice pieces. The fad has stayed so far. Somebody had cautioned me that the ice-crushing habit could cause harm to my teeth.
I wanted a professional opinion”. Six years back the DS in his clinical dental practice had encountered a lady patient with the ‘Ice-breaking craze’. She had placed four silver amalgam fillings in her lower first and second molars. She had replaced these on four occasions.
Nonplussed, the DS carried out a diligent fact-finding. The patient’s mother had finally given the game of her daughter away disclosing the weird habit of her daughter.
The DS had finally told her, “If you reappear with the same complaint, make sure you make arrangements to see another dentist”. The patient did not show up again hopefully with her peculiar ‘ice works’ finally held in check. DS: “You are 28 years old and you have all upper 16 and lower 16 teeth.
The anterior teeth have incisal edges while the posterior teeth have cusps. The incisal ends of anterior teeth help to tear the food while the cusps grind the food and mash it. The repeated crushing of ice will ultimately flatten the teeth and bring about gradual wear and tear of teeth.
Flattened cusps would mean inefficient grinding of food in the long run. With the frictional scrapping away of the enamel, the dentine which is the layer of the tooth with nerve endings will be directly exposed to hot and cold foods and drinks. This could bring about sensitivity, which will eventually force you to avoid foods you love.
The two ceramic crowns in your mouth show their occlusal surfaces which are worn out exposing the metal base. With time with daily usage of ice there will be complete denudation of the ceramic covering. This will mean preparing and fixing new crowns. It is good to see you enjoying your ‘karanga’.
With flattening of teeth and hypersensitivity induced, this enjoyment could come to a sudden halt”. P: “Currently is there need for me to replace the two crowns?” DS: “Not really. They could last you for almost 6 to 10 years.
However their longevity cannot be assured in view of your habit. At the rate you are crunching ice, the crowns could become bear with just the metal cover left behind in 6 to 12 months from now. It is entirely up to you to keep your ‘exhibitionist streak’ with regard to icecracking contained.
P: “Doctor, before I go out of the dental clinic I wish to asserverate that henceforth I will discontinue with the ‘ice crumpling’ act. I also know I was rude to the patient with addiction for the cigarette. I do not know if my ‘crush’ for ice could be equated with that of the cigarette.
DS: “Both habits are addictive.The patient, who finally decides to do away with his, will be the greater for it!”
Dr K. S. Gupta, B.D.S.; is a Private Clinical Dental Practitioner. He is also the former President of Tanzania Dental Association Email: kgupta52@hotmail. com