Dental Hygiene | Brushing Techniques | Dental Decay and Gum Diseases

Hello, hi, namaste. Almost everyone has some of the other dental problems, so that's why today I invited Dr. Hemant. He's one of the famous dentist in Pune, and he's going to explain us what are some of the pressing questions of the people, like how to really like brush our teeth, how to maintain the dental hygiene. He's going to explain us about how to maintain the dental hygiene. This is one of the important aspects. Instead of like directly going and getting treated, if we take small, small precautions, that can avoid major risks of your dental health, right? So thank you, thank you, Dr. Hemant, for coming here and accepting our invitation. I would like you to explain us about like— and Dr. Hemant has treated almost 20,000+ patients 20,000+ patients. So he has lot of qualifications. I would like him to explain us like what, what, what is his expertise, where, where did he did his dentistry and all. And, uh, yeah, please go ahead, Dr. Hemant.

Yes, so yes, myself Dr. Hemant here. Uh, I'm myself is a prosthodontist. Prosthodontist means the one who replaces the teeth with implants. I have done my graduation and post-graduation from a prestigious Government Dental College and Hospital, Mumbai. In, uh, Mumbai, Maharashtra. Also, I've done my fellowship in one year as a fellowship in mastering the implants from USA, which is State University of New York, which is Stony Brook University. After that, I started my practice in Pune, particularly in Pimples or Dagar area. So when I started with— obviously I was also having these things that the patient used to ask me that how can we avoid decay and all that, right? So I made us exactly the blueprint how patients can start day-by-day process so that they can avoid their decay. And lot of our patients at this moment have almost zero down on their decay. Obviously, because of the neglect, sometimes patients do come with decay, and that is the reason we motivate enough them so that they should not come across with the decay, right?

Thank you, thank you, Dr. Hemant, and thank you for coming here. So yes, I have prepared some of the questions to ask him, some of the questions which I received from many people. Like, uh, to talk to him. And by end of this video, I'm telling you, like, you'll be more empowered, like, how to take care of your dental health so that you will not go through that expensive treatment, uh, by at the age of 30s, 40s, 50s, whenever you are, right? So let me go with the first question I would like to ask you, Dr. Haimanth. So you, before I go to the any questions, you, you said, like, you have created a blueprint on decay. Could you please elaborate about that, like, what exactly it is and how to take care of this, like overcome these decay issues?

Yes, great. So first of all, when I ask patients, so they say, Doctor, this tooth was paining since almost 6 months or maybe 4 months or whatever. And then before that, I was feeling that there was some black dot, but initially that black dot was something I was not having pain, and that's why I didn't thought of that I should come to you. And that's why I give them a sequential plan, which is very easy. There's nothing as such difficult in that. What they have to do is every 6 months they have to do checkups. And a lot of times I encourage patients to do even follow-up checkups, which we keep free when we have some patients who are already coming to us since long. Also, along with that, we encourage them to do yearly cleanings, which is scaling. That's a professional scaling. This is from a doctor side. But yes, not only the doctors is enough, enough for you to save your teeth, but also you need to take actions. And how to take that actions? That means we have to have follow some basic criteria. So first is all you know that brushing. So how exactly I'll— in the maybe in the brushing, uh, if at all in the brushing question, we may— I'll explain you how exactly you should do brushing. But yeah, you start with at least start with a 2 times brushing properly. One time flossing. Flossing, if you don't know, flossing is something like a thread-like thing which you put it in between your two teeth, move up and down so that in between your tooth the whole area gets cleaned, right? And if you're not comfortable by doing that thread while flossing, then you can use nowadays electrical flossers like water flossers also. They are very easy to use and they are very easy to get also in the market. So if you do flossing in the night and brush twice a day along with gargles frequently after every food, And try to eat little less refined food, obviously. Try to reduce your— some of the intakes which are more acidic, like cold drinks or more of sticky products and all those. Then even this also can reduce your decay. Obviously, along with this, I have a separate altogether ready-made plan for the food also, which we will be covering in the next questions.

Yeah, great, great. So my next question to you, Doctor, is like, that's great, like some of the inputs, like I think we have to integrate. So now the question is like, why and how and all those, right? So like, so now first question I would like to ask you, what are the ideal brushing techniques? Proper way to brush and floss my— floss the teeth?

Oh, great question. I would like to explain this through a video maybe. So I'll just share how— what exactly I show it to my patient even. Okay, so what ideally you need to keep is, first of all, when people know that you should brush, people know that how you should brush, but they don't know the exact technique. And that is the reason, first of all, I say that I'll cover how exactly the— even exactly ideally you should do brushing, right? So first is you should keep your brush little 45-degree angles like this example what he has kept it in the video. So if you see this, this is oriented in a 45-degree at the level of gums and tooth. See, this is not perpendicular like 90 degrees what normal people does, right? But it is kept in a 45-degree like this. And now he's keeping at the junction of what? This, this area which is tooth and the gums, right? And now he's moving into a roundish movement, right? So after doing this for almost, for maybe say around, say around 8 to 10 times, what exactly we need to do is then we need to move on to the next movement. And the next movement is also similar to this, only thing after that movement Is it visible, right?

Yes.

Yeah, so I was explaining you how to keep the brush. So even in the back tooth, I specifically took this for another video for a back tooth because patient may find comfortable to do brush in the front teeth, but for the back teeth they are not very comfortable. So in the back teeth also you need to keep it for 3 teeth, like your brush covers around 3 teeth. So keep it in the 45° upwards for upper teeth, then move it in the round motion as what we were telling before. Now, once you do this roundward movements at least for 8 or 10 times, now you need to do the sweeping motion, right? Sweeping motion means what? See this, this is a— so this is a sweeping motion. So for upper teeth, this is sweeping downwards. Similarly, for the down teeth, you keep it 45° downwards at the junction of gums and teeth. Now move roundwards, same way what I told for the upper teeth. And now move it in the sweeping motion for the upwards, right? So this is how you should do the sideward surfaces of the teeth. When it comes to the upper surface of the teeth, you just move to— you just have to move it to and fro. That's it. You don't need to move it around or something. You just move it to and fro. So this is about the brushing. Another thing what you need to do is you need to start flossing. So are you Are you able to see the floss over here? Right, so this is a simple string of a floss which you can use. This is very easily affordable, hardly it comes at around ₹100 or something, a box of 50 flosses. So what has been shown in this picture, what you have to do is you just put between your two teeth and move up and down. So, and little right, left, that means towards the teeth, and then move little up and down. So this will clean out all the debris regularly each day, and that will keep your teeth more cleaner, right? So that is from the brushing side. Yeah, what's the other question?

The flossing can be— can we can only do only for the front teeth?

No, flossing can be done for the back teeth even. We feel that how can we do it for the back, but it's easy. With 2 or 3 days of practice, you can do it. Initially, you just try it Then after 2 to 3 days of practice, you can easily do it. It's very— a lot of my patients, they do on their own itself, and then they tell me that I've started flossing. So it's not that difficult.

Yeah. And also you said the sweeping, like after making some round sweeping. So how many times should we do? Like, it's just one time, like sweeping?

No, we need to do it 8-10 times. For a roundish movement also, 8-10 times. And for sweeping also, sweeping also. That will ensure all the food particles coming out of the And many people ask me this, like, how long should I brush? Yes, so either people brush for 30 seconds or some people brush for 5-10 minutes or even more than that also. It's not mandatory. I generally say 2 or 3 minutes is enough. That is enough to give you all these things. So properly you should do the— how exactly the brushing should be done, as I show you. If you do that, then there is no need to brush it about 3 minutes. So that is good enough. Only thing, the important part, which I'll— if at all you do ask this question, I'll cover this also. That, uh, so when it comes to toothbrush and toothpaste, people do ask me this question. I say toothpaste, I preferably don't give any preferentials because I feel except those close-ups or those who are very much foaming toothpaste, or rather than foaming, those who create a lot of, uh, uh, smell, particularly those toothpaste you should not use, or those who claim that we will whiten your tooth those toothpaste should not use because they are more abrasives. So you should not use those toothpaste or any toothpaste like Colgate, Pepsodent, Patanjali, whatever those regular toothpaste you can use it because they have a minimal content which is all required. Now the main important part is toothbrush. So for a toothbrush you need to select the ultra soft, that is on the wrapper we can see on the back side that is written as ultra soft, and then it should be little flexible so that it can move around in the back teeth also. Third thing, it should be little more, I would say, a little good to handle, means it has some grips. It is a very small point, but yeah, it is important because otherwise we cannot do in the back teeth. Okay, one of the very important point is for those people who don't have very high mouth opening or their mouth opening is less, I suggest them to use even along with your normal toothbrush, use even a kid toothbrush also, so that you can able to reach out to your wisdom teeth also. I see a lot of people have a very clean mouth, but they're all wisdom tooth are decayed, or the last teeth are decayed. Why this happen? Because their mouth is not opening that bigger, and then their brush doesn't go there, and obviously the teeth starts decaying. And that's why we need to clean those areas if you are not able to use kit brush. So whatever the way, we have to keep it clean. So if at all, I don't suggest as such any particular brand, but if you want to, I particularly use either Colgate Slim Soft or maybe Thermosil Ultra Soft. These are the regular ultra soft brands which I particularly use. Yeah, and I generally suggest the same. Yeah, now the next question was electrical toothbrush. Now, uh, I do suggest that you can use electrical toothbrush, but yes, if you are a person with good dexterity and your hands are quite good manipulative and you can able to follow the exact technique which I was telling you you don't need electrical toothbrush because electrical toothbrush are doing the same work what your normal toothbrush does. Only thing is they're, they're, they're little for the lazy people who, who cannot do too much of movement. So, so it's, it's a little easy for them. Nowadays electrical toothbrush with flosses are coming in. So they have a water floss along with the toothbrush. So in India they are just launching, uh, since some time. But yeah, flosses are there since long, but electrical toothbrush plus flosses If that is the case, you can use it, but else you are okay to do it with the brush itself also.

Got it, got it, perfect. So basically, like, the toothbrush, you recommend the soft one rather than the hard, ultra soft one, like not the hard, like rather than the hard. Great, great, perfect. And regarding the paste, it's not like we should not go for the which has lot of chemicals, we should like, and also nowadays like in the paste, they're, they're putting the marks black, green, and red or something. So is there anything important we have to consider in that?

No, actually, those are a little bit of marketing gimmicks. Like, I generally, I'm not too much brand specific, or rather I would not something like I have any stats with any of these things. So I generally suggest you can use any toothpaste and actually it doesn't matter much in particular toothpaste. Yeah, it should have that basic content which is nowadays in almost most of them. So that basic content, if as I said, like a simple plain Colgate maybe, or plain Pepsodent maybe, or if it's a Patanjali, even I have used Patanjali also. So it's also okay, you can use those little Ayurvedic toothpaste also, obviously in a one way. So there are some alternative, I would say, apart from brushing, there are some alternative home remedies also that we will discuss in another topic whenever we are discussing. So yeah, but at least for toothpaste you can use anyone, that's not at all— unless until they are too abrasives like whitening, claiming they are claiming whitening or something which are claiming like a very too high mouth freshness. So like, so some— I'm not against any brand or something, but they, they, they promote, right? They promote that we will give you smell which will attract girls or something, right? So All those smell comes because of the more abrasiveness, and that is not good. Even the brush abrasiveness also is not good. People feel that if I use hard brush, my teeth will more be clean, but that's not the case. I use ultra soft, and, and since long I don't have any decay, or not only me but a lot of my other patients also.

So my next question to you, uh, Dr. Hemant, is like, how does diet affect on dental health?

Yeah, so, uh, very nice question because that is what most of us are messed with. So particularly in terms of dental, I would say, yeah, we should have more of a raw diet, or rather I would say we rather more focus on the dones. So we should not have too much of refined foods. Like, it's okay sometime in between if, like, specifically, uh, related to kids, we cannot just always and always avoid them from eating chocolates or something, but try to make them as less as possible, okay? Because the more the refined food is, the more it will get stuck, and more it will get stuck, it will create a decay, right? It's a very easy format, right? So the more the food is, that is a party for the bacteria to grow. Obviously they'll grow more and they'll create more of a decay. That is why it is very important that you should more of fruits, vegetables, more raw foods. And I don't suggest— that's why nowadays the people say more of a juice and all those things. I even suggest people for dental purpose, uh, specifically eat raw fruits. And specifically, uh, if you're buying a good quality fruits, or rather sometimes if it's possible, eat without cutting them. That is in terms of a dental saying, I'm saying it. Yeah, obviously you need to see that they are good quality, otherwise if at all they do have any, uh, infected or something, that's another issue. But if at all you're getting good quality fruits, it's always better to eat directly without cutting into the pieces. The important benefit of that is your gums get stimulation, and that's why fruits— and even fruits have fibers, right? So in a way, nutrition-wise also it's important for gums even. And at the same time, as in massaging-wise also, it's very important. That's why I suggest people— very important, this thing is cold drink. Because of the westernization, people have started using cold drink with everything, not only pizza, burgers, but even for other foods also people started eating, drinking cold drinks and all those, whatever those liquors, soft liquors, everything. But I generally suggest, I personally don't eat any, don't drink any aerated drinks, and that's why I suggest people even to avoid them because they create a lot of acidity in the mouth and acidity erodes the teeth. I see a lot of patients with having something like big, big patches or big, big holes in their teeth because of the acidity content either from their stomach or maybe because of overuse of cold drinks. That's why cold drink is one of the biggest no for dental problems. Refined food, even too much of sweet foods also, right? Too much of sweet, obviously that also creates a lot of decay because sweet is also sugary products, right? That attracts the decay. Even I say This is something may not find comfortable for some people, but even I would say that drinking too much of a tea, coffee is also not good. Yeah, because India is a very full tea country, that's why people drink tea so much. So it's okay once in a while, but, or maybe once in a day, provided you gargle and all that. But then taking too much of tea and coffee during the day, that also, because that's one way is it's acidic also, another it's a sugary also. That attracts more decay.

Okay, got it, got it. And, uh, how about the cool and hot, like, things? When we are consuming the cool things and hot things, that's— do they affect our teeth?

Uh, if at all you do have a good set of teeth, which after checking your dentist also, if you don't find any decay in them and everything is good, there's no problem as such for you to take any cold or hot. You can take it, there's nothing wrong in doing that. Yeah, you should not use two extremes, like particularly people use very highly chilled products or something, or very hot tea. They like to eat, they like to drink coffee or tea very hot or something. So I generally suggest don't go into the extremes, but there is no problem in the cold and hot unless you have some dental problems. Yeah, if you have some dental sensitivity or dental problems, then you can avoid more of a hot or cold because they will initiate that problem. But sometimes this is a little irony that sometimes I tell my patients that it is better to have little pain or sensitivity sometimes because it tells you that there is a problem behind. Otherwise people would do is people take medicines, push their problems down, and they don't go to the doctor, any doctor, dentist, or any doctor, and then the problems get aggravated inside.

That's why generally sometimes having a small pain in the initial level is better than having a big pain at the later level where we cannot manage that Right, so basically, like, for example, one student asked that, like, when they are eating sugary foods, something like sweet or anything, they feel pain in their frontal teeth.

Yes.

So why that— why does that happen?

Sugar or the sweet products, if they are inducing a pain, most probably there is a dental problem. Means either it can be a decay, okay, or it can be something like sensitivity issues because of recession of gums, or maybe because of acidity, your tooth got a little hollowed out, and that's why this sweet is creating issue. But mainly the decay is one of the common reason because of which the sweet is creating a problem. And sometimes sweet and the hot rather than cold, rather than cold, because cold can initiate sensitivity in any situation, sometimes even without problems also. But sweet and hot is more indicating that there is a little more aggressive dental problem than a smaller one, because those are little— happen only on those situations where there is a little bit of a decay and hollowing already started happening.

Okay, so what do— what should they do when they have the— when they experience this kind of pain?

Uh, if at all, if it's a sensitivity pain, they can obviously— they should once visit the dentist, because sometimes you don't know whether it's a real sensitivity or whether it's a decay. So you should visit and check out if at all there is any decay or not. If there is no decay, dentist said yes, it's good to go, there's no much issues and there is no problem, then obviously he or he will prescribe. Or else you can also start with some anti-sensitivity toothpaste also, provided— the biggest myth behind the anti-sensitivity toothpaste is people use it for a lifetime. It should not be. See, do you, do you take paracetamol for a life? No, right? So similarly, anti-sensitivity toothpaste should not be used for a lifetime. That's it.

Okay, okay. So like, how, like, how long they should take? Like, how will they know that they have overcome this pain? Is it possible? Is it reversible?

Uh, yes. So if at all it's just a sensitivity pain, it can be easily reversible. If it is a dental decay or dental infection or gum infection related pain, we have to cure it by either any treatments or maybe cleaning or filling, or maybe sometimes if at all it's too much, then the root canal also. Okay, so maybe I would like to show this example in a one video format, which will, I think, will cover one of your question also. If I, so now from this area, if you see here, there is something known as a white, which is enamel, right? Then there is something known as a dentin, which is yellowish color. And then there is third layer, which is a blue and red one. This is pulp or the root canal part. In simple Hindi, we say nas, under ki nas, right? So this is how these 3 layers are there in a tooth. There is a 4th layer of cementum also, but that is something not visible by the patient, so I'm not explaining the cementum and the other things right now. This is the enamel. If you have a small decay which is in the enamel, which is a very small dot, then it can be easily cleaned and even filled also, if at all it's not bigger level. But now if, if you allow this decay, if you can see this decay is growing, right? So if you allow this decay to reach to the second level, right? So then in this situation, now the decay can be filled, but we have to put some anti-sensitivity layers below and then we can fill it. This is a little deeper filling, but yes, this is still can be filled very easily. Till this level, it is easily manageable without anesthesia most of the time and without much of a discomfort. Without much of even a cost. So most of the patients say that the dental treatments are costly, but actually, oh, that is a one sentence which I regularly say to the patients. Rather than a dental treatment, the neglect is more costly. So if you come with this small level of decay, it will not cost you much. But now I'll go to the third stage. Now if you don't pay attention, now see, this decay has reached to what level? It has reached to the third level, right? It's a nerve, right? It's a root canal which has got touch now. At this situation, if you don't treat anything, then obviously it will create pain, or at least it will start creating pain after some time. Now, at this level, we have to do root canal so that the tooth can be cleaned. And what we do in a root canal is we clean this whole nerves, which are the colored ones you can see. But if you still don't do this root canal on a time, if you don't visit the doctor even after such a big decay also, which most of the time happens in India regularly, And that's why what happens is, if you can see now, the decay is spreading more and more and more. And now in the one of the last pictures, if I can show you, can you see the whiteness going around into the beyond the tooth, right? So yeah, yes. So in this last picture, can you see the whiteness going around the tooth? That is something infection spreading from the roots in around the bone also. And it gets spread to the other teeth, it gets spread to the bone, it gets spread to the around tissues even. Means I do have patients who have got infected with the eyes, or you get infected with the sinus, you are infected with the jaws, and the, uh, even the spaces around also. That's because of the too much neglect. This is something not common with the general office-going people, this bigger infections like aspirate. But those are very uncommon with the uneducated people. But yeah, even with educated people also, the infection do spreads till bone level also. I regularly see that.

Wow.

And that is the reason I tell people that you should have frequent checkups, whoever the dentist you are visiting, so that there are more chances. Means one of the slogan which I keep it is, come to a doctor or dentist before you have a disease. If you do that, like similarly you does the same, right? You're asking people to reverse— rather than reversing, you asking people to keep your health better so you don't attract disease, right?

Yes.

That is what the best mantra is. But then people feel doctor as what? He will take care of it. Me, whatever I'll do, whatever I'll put in my stomach, he will take care of it, right? And even whatever I'll do with my teeth, and he'll take care of it. So that's how they get a problem, and that's why I ask patients to come on a time for a follow-ups.

Got it. So how often they should visit, uh, a dentist?

6 months is the ideal protocol, because, uh, once a year I do advise them to go for a clinic And yes, a little myth about the cleaning. People say that when we do cleaning, there is a lot of tooth structure get removed, but nothing like that. I do cleaning for myself, so I generally suggest around once a year cleaning to be done, and there's no problem in that. With the advanced treatments nowadays, there's no problem with doing a cleaning. There's no abrasion, there's no tooth reduction, so there's no issue about that.

Oh wow, that's That's great, but it's mind-blowing information. Like, we got some great clarity on like how this infection forms and all those things. So especially people who are watching this, if you have any sensitivity issues or if any smaller issues, just go and visit a doctor and understand the problem before it becomes worse. Otherwise, like as he said, like it's, uh, like it's your delays creating more, like making more expensive. Delay in treatment is creating more, making it more expensive. Uh, so okay, like, next, moving to the next, uh, question, Doctor. Like, is there any link between oral health and overall health?

Yeah, very nice question. So, uh, so oral health and the general health is very much dependent. Why am I saying this? Is because this is the first thing that would your food or the breathe or whatever you are taking in, right? And then it goes to the stomach, it goes to, and then it get assimilated or get digested and then it comes out or whatever get absorbed, right? So first of all, the very important part which I see to most of the older patients, or nowadays some of the young patients also who has a lot of missing teeth, that if you have missing teeth, what happens is our 32 teeth, if you have one or two less, wisdom tooth less, then that's okay. But at least apart from wisdom tooth, 28 teeth should be there. So if you don't have those number of teeth And if you have some teeth extracted because of decay or something, what happens is that much amount of, I would say, inefficiency of chewing happens. And that creates what? That creates an improperly chewed food or improperly mashed food. That is something the stomach has to work. Now my stomach, if you are not chewing that properly— see, I have a patient who says, doctor, because of the right-sided pain, I'm eating from left side since last 3 years, 5 years, and all that. So now he's chewing only from one side. He feels that I'm chewing it, but his stomach is not feeling that. So what happens is that improperly mashed food gets into his stomach, and now his stomach has to secrete more acidic. So he has to secrete more hydrochloric acid or those acids which are getting created there, and those acids break down that food because the food is not broken down by your teeth, right? And that's what they have to work upon. And if you have more acid in your stomach, what happens? You know already, right? More acidity, more pep. Dyspepsia, more of those all stomach-related problems may happen, right? And that is the reason it is very, very, very important in terms of digestion. And as a traditional general health prevention, even Badri can also explain us that about how exactly the general health affects, right? So similarly, oral health is very first point, and I would say it's a gateway. It's a gateway to health. The one thing is this. Second part is in terms of confidence even. So suppose example, if you have too much yellow teeth, if you have a bad breath, you cannot go to a social meetings, right? That is another thing, right? So that is the second point. Apart from that, even there are some other issues also which a lot of things we will discuss in the further this thing. But obviously the 4 most important what point you have to consider is, and the Very important part is start doing the regular follow-ups because you may not know that how exactly your oral condition is. Sometimes people say I have a very perfect mouth because I'm not going to dentist, I don't have any pain. But when I ask them to open the mouth, lot of times I see lot of teeth broken. Just because they are not paining, that doesn't mean— and they have to be extracted now or later, right? And that is the reason I ask people that at least till the age of 50 you should not have any one tooth out. Ideal is to have lifetime teeth if it's possible. But yeah, at least till the age of 50, it should not have anyone to go out of your mouth. But I do see patients now— have a recently have extracted a patient's teeth with just 8 years. So his tooth comes at 7 and he got extracted that at the age of 8. That is actually a little— I would say I was feeling, uh, a little harm. I rather, I was feeling little unhappy that I'm extracting his teeth, but there was no option. We have to extract because the tooth was completely decayed.

But sometimes what happens is due to the tension and anxiety or anything, like they put a lot of pressure on their teeth, on jaw. So all the tensions accumulated here and they, they eat the teeth also. Like they, they— I don't know how to, uh, like explain that, but yeah. So like, uh, like do you think like that will really affect on dental Dental issue. Yeah, yeah.

So it's a very vast topic, and even we have, uh, some of the covered also, I think, in one of the, the single. So, but then, uh, to be in a precise, what I can tell you is this is something known as MPDS, that's myofunctional pain disorders, and all those big terminology. Rather, in a simple way, I would say because of either stress, because of improperly treated teeth, because of a patient's habit, maybe a gutka, tobacco, or something habits, or maybe because of any other habit, because of some chewing or something, he got a habit that he starts chewing his teeth with each other. Sometime it's possible for him to recognize, sometime it's not. But this stress-induced or any habit-induced chewing, what happens, or the clenching, what happens is this create a lot of teeth attrition. So There are 3 things here. First, if it just created teeth attrition, that is still okay in one way that you will hardly have a tooth problem. That is still not very much okay, but if at all. But if you don't pay attention, that will sometimes transfer to your muscles, that's your cheeks. Then your muscles of the cheeks got little tight, and now you will not have too much of a mouth opening. If this continues, you will have problems in your joints also. Like I have a lot of patients come with TMJ pain, that's a joint here, right? So Now that is an aggravated situation where we cannot do much things because we cannot treat this surgically very easily. Yeah, there is a surgery for that, but it's too difficult. And that is the reason I ask patients and I ask people also that this chipping part, and particularly the clenching part, should be detected. And even we do provide night guards for that, and that's specifically customized night guard, not the ones which are online available, because a patient-ready-made night— sorry, the patient-customized night guards are necessary because they will give them more results than the ready-made night guards.

Okay, yeah.

So this is just in a brief— I explain, otherwise is a quite whole topic.

Yes, yes, yes, yes, I understand. So, but are there any natural remedies for bad breath?

Yes. So one of the, uh, natural remedy is already you teach, that's pranayama and, uh all other forms of breathing techniques because it keeps your gums healthy. And that is also one of the very common, they say. One of the, one of the part is treatment. Yeah, so this is the only one thing which I keep as a treatment, which is cleaning. Cleaning your teeth is very necessary from the doctor point of view. That's only one part which is I am seeing, which is from the doctor side. Now I'll come to the natural remedy part. From the natural remedy part, there are chances that either you not cleaning your tongue, so that is how the smell may happen, either because of the teeth deposits. So for that, I already suggested you that you should do cleaning, or if at all there is too much of infected tooth, you should remove or treat that tooth also. That is also another treatment option if at all the mouth breathing, because mouth breathing does have some treatment-related remedies also and some home remedies. So in a home remedy, tongue cleaning, brushing, flossing, And as I suggested you that we have electrical water flossers. So with this electrical water flossers, what facility available is with that water what you put into that flosser, you can put some mouthwash drops also. Now your interdental cleaning can happen with water which is impregnated with the mouthwash. Now, now it creates a more of a better smell in your teeth also because now it's properly cleansing out your teeth. So that is also one way of doing it. Along with this, you can use some of the natural remedies like eating fruits and all those. And even along with this, for those patients or those people who have long hours of fasting, even that is also sometimes create a— so if it's your fast, that's a different thing. But if it's a regular day, she should not keep very high long hours of this. At least you can have some little bit of this because that sometimes create a lot of smell, because obviously when you are not giving fruits or not giving a food or maybe water or something, saliva formation doesn't happen. Your mouth gets dry and that also create a smell, right? So that's another thing that if at all you do have a dry mouth, that also create a smell issues.

Yeah, my next question is that only, like, what is the role of saliva in keeping your dental health?

Yes, so saliva has a very high role. Some things which are in your control, some things which are not in your control. Like there are people who have a very thicky and the sticky saliva. So now they don't have too much control because the saliva is like that, but at least they can rinse again and again so that that will not allow. See, if your saliva is too sticky and if it's too thick, then what happens is whatever you eat will get stuck there easily, right? Because the saliva is allowing it. So, you know, otherwise, the more the fluidy and the more the thinner the saliva is, it is more easy for us to keep it clean because saliva is necessary for keeping it clean. Keeping the teeth clean. Else, if you're seeing some cancer patients, they get more decay. Why? Because in most of the cancer treatments like radiotherapy or chemotherapy, they have less saliva formation because of those treatments. And that's why even with some medical medicines also, so that's why sometimes they get more decay. And that is why it is necessary to have a good saliva. So you can— a good amount of drinking water itself is also one of the alternative for that. But yeah, it's innate saliva flow which you can at least have a with the supplements of water, you can increase it. If at all someone has a very dry mouth, then that becomes something like a consulting issue that you have to consult a doctor, see why exactly. Is there any stone formation? Like we have a kidney stone. So similarly, there are stones formation in a salivary glands also. So by going to a dentist, you can show them, and maybe if at all it's the thing, we need to do something, a diagnostic test, whether it's really that problem. And if it is so, we may have to remove it also. If that is at all the case, that is a rare condition, but it do happens.

Got it, got it. So yes, why did I ask this question, dear friends, is like breathing techniques improve the production of your saliva. And also like especially people who are mouth breathing, they, they are more tend to have dry, dry mouth. And also if you're like, it's very, very important to drink the water, be hydrated. So dehydration also reduces the production of saliva. So that's why I have asked this question and very, very important for like, like, because we don't even give any attention to that. We just taken it for granted. There is saliva is forming inside that. And as a saliva is important for your digestion as well, it's not only for your teeth, it's also important for your digestion. It is something, uh, Vagrasana or something which actually induced that, uh, like there are many breathing, all most of the breathing techniques like improve the production of saliva because it calms down and it improves the production. Of saliva, especially Nadi Shodhana or Iqbal breathing or anything. So my next question is like, again, like you mentioned about tongue cleaning, like is there anything like people has to know, people miss out when they're cleaning their tongue?

Just so either you can use the tongue cleaner which you get as a metallic ones, provided you should not use it very roughly because otherwise your tongue may get aggravated. But yeah, if not, you're not comfortable with that, you can use even those brushes which has the tongue cleaner, that those dot dot dots options are available on the brush, that's a tongue cleaner. So you can use that also, and with that also you can clean it. You don't need to clean it too much, like you should not have too much of over-cleaning it, right? So just on a simple cleaning so that there should not be too much of deposits and allowing that tongue to get sore. Your regular tongue should more look like a pinkish white or whatever the color accordingly. It should not be more of uh, like aloes and all that, that's, that decides that it's more of deposits which are happening because of the food, right?

Got it. So, uh, can certain medications affect dental health?

Uh, yes. So example, uh, this is a quite vast topic, but if, if I tell you for those very common disorders, like example, uh, hypertension the blood pressure. Blood pressure has some medicines known as clonidine or something in the form of -dipine, those having last terminologies as a -dipine. So all those, see, there are physicians who do advise this. So we discuss with physicians sometimes. It's, it's not about they don't know, but because of the problem of the patient, they have to give it, right? So we discuss sometimes with, for our patients who have these problems, and we stop them to, ask them to stop this medicine. So sometimes with the medicine specifically having that dipine as a content, those are clonipine, all those medicines, those create some sort of gum swellings. And I do have a patient who has a gum swelling as big as that they are visible from, like, whenever he smiles, also all gums are visible as in boogie forms, like they are swollen, right? So that do happen. So sometimes a medicine can create a problems in related to teeth and gum. So maybe I suggest, like, not for the gents, but sometimes for the ladies, sometimes for the kids, they take iron medications most of the time. Even nowadays, gents also sometimes take, but generally ladies do require that. So those iron preparations, if at all they're in syrup forms, they also create a lot of staining on the teeth. So it's okay, you can still take it, provided you need to see that they directly taken into the— directly into the inside mouth rather than on a teeth, one thing. And second thing, you can rinse afterwards so that the staining should not form, right? So that is iron preparation. Also, one of the very common medicine-related issues nowadays, a lot big issues which can create problems have been stopped. They have been banned already. But yeah, there are some medications which can reduce salivary flow, which can even affect the gums also. Some of them are already a little out of the practice because the physicians are also more and more discussing with dentists and they're finding common solutions. But one of the common is hypertension, which is generally being used regularly in a lot of rural areas where there is a lot of synergy is not happening with the dentist and the physicians that have seen that a lot of patients come with these medicines issues.

Wow, wow, it's very, very important to know. Like, otherwise, like, hypertension has become like a big issue, huge issue in India, across the world. So that's great, like, good to know. Like, especially whenever you're taking any medications, be aware of the side effects of it. And it's not just for like, yes, you're taking medication for one thing and you get another problem.

By the way, by the way, I'm sorry if I said only stop. You should not stop the medication, you have to replace it. So the doctor will replace, the physician will replace it with the other hypertension medicine.

Exactly, exactly. Great. So, uh, like if we have to know what are the signs and symptoms of gum diseases?

Yes, so first, uh, very common signs of gum disease is getting it red. That's the first sign which generally easily sees. Second is it gets swollen up. It gets swollen up, and that is one of the very common signs— color change and then the swollen up. The pain sometimes may come after that, because sometimes not necessary every time the pain may come. Sometimes the pain may come depending on the, what is the situation. And that's why look out for the color change also. Look out for the swelling also, because you may not know sometimes that there is pain or not, but then at least if at all there is a color of the swelling then there are chances that you do have some gum inflammation or gum swelling happening in your mouth. Or even, uh, this is not exactly related to gums. This can be exactly related to the oral cavity also. So sometimes people feel like, uh, uh, ulcers, like ulcers. There are ulcers, right? And the ulcers go within 2 to 3 days. But sometimes the ulcers cannot be always ulcer because there are gum inflammation, gum swellings, or even tooth infection which create ulcer-like wound created into the mouth. So sometime, if at all your ulcer is not going for 1 or 2 days, and if at all that ulcer is emitting some fluid like a liquid, is pus-like fluid, then you need to visit doctor because it's not something a simple ulcer. It may be an infection of a gum or tooth which can be easily solved.

Okay, got it. But what is the impact of smoking and alcohol on oral health? Oral health?

Ideally, you should not do that. That's, that's for sure, because obviously smoking has a bigger impact than the alcohol in a way. Because what happens with the smoking is when you do smoking, smoking has an effect on you directly on your gums. So it has a less effect on your teeth. Only on the teeth, they generally have more of a staining. They generally don't create too much of problems in terms of teeth per se, but they have a major problem related to gums. So what happens when we— when the people smoke, the gums started getting dissociating, they start getting more swell, they start getting more inflamed. And I do have patients, I have smoking and those even the tobacco chewing, if at all you want to cover that also. So I do have patients who have smoking along with tobacco chewing or smoking along with gutka chewing. I have a I would say most severe case, if I can explain. One of the case I have who has a 32 teeth removal needed, so that means all. So, and he's just 33. So, and that was the biggest shock. Not only for me, it was— it's okay because I, I do see patients like that, but for that patient it was the biggest shock because he were thinking 6 or 8 of my teeth are moving, but all other were also moving. Only thing they were not moving that dominantly that he could feel. But they were on the 1 or 2 years, they'll go for a toss. That is why you should stop smoking if at all it is possible. Yeah, I do advise, I do sessions for how to smoke, uh, how to cease your smoking, and that's a smoking cessation program. We do almost 5-6 visit, uh, virtual or maybe online, virtual online, or maybe physical programs where we actually guide people how they can stop smoking. And I have a specialization in that also, how to stop your smoking. Wow.

I think then, uh, like, it's very, very important. Like, for them, it's not only affecting their lungs, it's also affect their teeth, right? So now I think it affects whole body. Like, it's one of the, like, uh, uh, like, one of the, like, even on the packet of cigarette, it's, it has been written, right? Great. So it's, uh, it's again, it's your choice. If you have a lot of money to take care, replace everything in your body, so it's up to you.

So then, yeah, all those are plastic or other materials which cannot always replace. So even I say to my patients that even if you're going for an implant treatment, which is the biggest treatment in dentistry per se for a normal patient, even if you're going for an implant also, that's not 100% substitute for— and that is why I promote even, even along with Uh, I have another friends who are like a naturopath and all that. So I always talk with these people because that is more necessary to keep yourself preventive rather than treating the things, because treatment cannot be always as best as what prevention could be.

As I said, that is also one thing I say, Hemant, like, uh, this is created by God. Nobody can create the same like how he created. Yes, we use plastic material. We cannot use the same material which he has used to make this. We use some alternative materials and we create this, but still it's not the same what he has created. Nobody knows, yeah, like how this has been created.

Actually, even scientists have come to know about that, how it is— sorry, what exactly are the materials from which it has been created, but they cannot replicate it as of now. So the tooth regeneration is still in the process. See, the scientists may be able to find that formula maybe in the coming time because nowadays we are so progressing. So it's good that if at all it comes. But till this time, I do replace a tooth which looks exactly like a tooth in look-wise or even function-wise also. They are able to chew anything with that teeth. But I cannot say that it will last for 100 years like what your teeth last, right? So they will exactly function, exactly look like if at all you are doing it very premium quality like a US-made or something, those products sometimes we use. But yeah, we cannot still have a warranty or something like that, that it will stay for as long as what a natural tooth can stay.

So what are the other options for replacing missing teeth?

Yeah, so for a missing teeth replacement, if at all I can show you this also with video, is it okay? Yes. So this is one of the way of replacement which is known as implant supported prosthesis or implant supported teeth, in which what we do is we remove this tooth. You put this implant, this implant gets buried into the bone. We allow it to get healed completely. Then we put something known as abutment, which is like a screw-like attachment which can bind the implant with the artificial cap. And now we put a cap on that. And now this is how the implant and the cap gets fitted with the hole with the bone. And now with this technique, you can replace your tooth even if you don't have any tooth or even if you don't have any support. So this is how the patient is having a missing tooth. Now the patient don't want to go for an implant. Patient says, doctor, I'm not comfortable with the implant process, maybe because of cost, time, or discomfort, or any other parameter. Then we can go for a bridging where we need to, uh, a bit reduce the tooth. That's how we are doing it. We are reducing the tooth bit. Then we took a measurement. Nowadays, uh, since some years, we have equipped ourselves with the most advanced scanners. Which can scan your mouth. And then with those scans, we send it to the labs. The lab made a 3D print. They confirm with us that this is how you want the teeth. Then we say yes, we proceed with it. Then the lab makes a crown like this. In the third picture, we can see the bridge, which is known as a bridge. And now the bridge is being cemented into the mouth. Wow. So this is a bridging. So this is second technique. The third one is a denture, which most of the people know. That's a removable denture. But they are not very comfortable. So nowadays almost 90% of the people are, you can say more than that, are not comfortable with the denture. So patients generally go for either a bridge or an implant. That depends on a person's perspectation, how they are comfortable. But yeah, implant is more ideal replacement options.

Hmm, got it, got it. Great. And what are some of the childhood mistakes we make that impact us during the, when we become adult?

Yeah, so I would explain this as a kid, I would explain this as a parental, so both. So first of all, uh, mainly as a parent, because as a parent we have more control rather than— because the kid doesn't have that much capacity to know the things. So as a parent, uh, the first checkup, which is not for the kid obviously, the first checkup for the lady should be done before the pregnancy because there are a lot of conditions which we cannot treat when the patient gets pregnant because we cannot take X-rays and all, right? So that's the first thing. Second thing is, once the delivery is done, once the baby is coming out of the mother's body, then after that, the mother should take care of their oral health very nicely. They cannot come to a dentist very soon, but they should keep it clean because what happens is, in that period, she neglects herself too much. So that's a very important period. And along with that, I suggest people either use mouthwash, or if you are not, then you can use even a warm saltwater gargle But start doing that because that is necessary. Pregnancy is a time where the most of the gum inflammation happens because of just a hormonal change, right? And even sometimes that lead to problems also. Now when the baby comes out, so for first 6-8 year or something, you don't need to worry if at all there are no— so there is some, uh, table how the teeth generally should come by that time. If the teeth isn't coming accordingly, the parents also do know by their own kids or maybe by their someone else's kid, they know that by 6, 7 months or 8 months they should have a teeth. If that is not happening, then you can visit dentist, else the first visit should be at around 3 years. So I generally suggest 3, 6, 9, 12— these 4 times you should have a minimal compulsory visits where you do a very minimal cleaning and a fluoridation. Fluoridation is something like some preventive treatments which avoids the dental problems and dental decay formations. Along with that, it checks you on that, uh, that whether the decay is happening or not, right? Because sometimes parents don't know because the kids doesn't show, right? And the one of the very important part is about that checking on the food what you are giving it to the kids. Because like even if I can say even my daughter, so there's always a chocolate because my, uh, lot of my friends whenever they come they bring a chocolate because I have two kids. So it's very common nowadays to have a chocolate in home, but see to it that they should not eat on a so regular level. Either you can give out to those other people, or maybe at least not very regularly, frequently to your kids. And if at all they are eating it, see to it that they should at least gargle or brush so that they, they get cleaned, right? That is a very important thing. As I say, the raw fruits, more of fruits, vegetables, they are very necessary. Because if the kid eat too much of refined food nowadays, people like— even sometimes I see a lot of kids ask for only pizza, burgers, and all those things. So my home, there's no pizza. Somehow I don't eat it. I don't eat pizza, and that's why my family also avoid eating pizza because I don't like it. So the thing is, it's a good thing that they don't have exposure to pizza, but this is not something which can assure— I can assure it when they got old, right? And that is the reason if we train them from the initially, there's more chances that the food control can happen, right? And along with that, obviously training them for brushing is very important first. You can start with a finger brush, then you can start with toothpaste and all that also. But the more important part along with— because this is something every parent does, right? But the more important part is in between checkups, because almost 99% of the parents don't know that they have a— that their kids have a decay. I do have my friends who come with root canals or even swollen cheeks. I do have one of my schoolmates, so he came with such a— so his, his son came with such a big swelling in his face. That is because the root canal was not addressed, because the, the person was not knowing that his kid has a root canal problem. So the chick got so much swell, and that's why the situation come. And another thing which I generally suggest, which is nowadays very important because people want to get their teeth look good, so I generally suggest kids to have an 8 and 9 years orthodontic or a simple dental checkup for alignment. Why it is necessary? Because there are some dental alignment problems which can be treated as early as 8 or 9 years, like myofunctional appliances and all those appliances which can be used so that we should not have bigger problems in that. Even the use of braces can also be avoided with these appliances, but they should get checked at a very early age, right? And even a lot of surgeries can be avoided. Like, see, if I give you an example, Suppose Hrithik Roshan, you all know Hrithik Roshan, right? So Hrithik Roshan has gone through surgeries to get his chin back, right? And lot of, lot of patients I have seen that they have gone for this surgery because they want to look good. Either the upper jaw or the lower jaw was outward, and then they have to do the surgery to go it inwards. Now this can be avoided if that patient gets a checkup, ortho checkups done at the age of 8 or 9. So we do give some appliances which like a place from the head to chin or sometimes in the mouth only, which can manipulate the jaw positions. So these are little advanced treatments, but they are not that difficult, not much costly, not very even discomfortful. Yeah, just the kid has to be aware, they have to wear it every night and all that. But with that, they can avoid a lot of trauma in the future. And that's why this is one way, orthodontic way is a very important way. But apart from that, decay, which is the most common reason, And that's why for that, the food, the cleaning, and all that is also necessary.

Wow, wow, great. So perfect, Dr. Hemant. Thank you, thank you so much for this wisdom. And I hope many of them got like great points which you can integrate and implement into your lifestyle. And so if you have more questions, please comment in below this video so that we'll speak to Dr. Hemant again. We'll make another video, like a video 2 of this. And for again, thank you so much for your time, and it was very insightful and helpful. And I myself like need to— now I understood that need to implement many things whichever you have said. So I'll also implement, and I'll also make sure my students also implementing whatever you have told. Thank you so much, Dr. Hema.

Yeah, thank you, thank you for the opportunity. And yes, Badri is doing a great work, do follow him regularly. And also we'll coming up with some videos if at all it is required.

Sure, sure, sure, sure. Thank you so much. And also, I want you to do like, like do one audit for my students. So we'll plan that.

Yes, yes, sure.