Emmanuel Kapininga’s 30 Days Writing Challenge

This is a guest blog post with a difference. During the Flying Faculty visit in February this year I had an interesting conversation with one of the BDS 5 students, Emmanuel Kapininga. He explained that he had recently participated in a writing competition and had chosen oral health as his theme. This guest blog, written by Emmanuel, incorporates a selection of the pieces that he wrote daily.

My name is Emmanuel Kapininga, 23 years of age, pursuing a bachelor’s degree in dental surgery at Kamuzu University of Health Sciences. I am in my final year. Earlier this year 2024, the student publications director organised a 30 day writing challenge. The aim of the challenge was to entertain, raise awareness and help students to develop a habit of writing. The pieces of the writing were posted on Facebook each day for 30 days. I joined to develop my writing skills.

Luckily, at the end of the competition, I was announced a winner on the third position and got away with a 5,000 kwacha which is roughly 2USD.

In the competition, I decide to write about oral health and I got positive feedback from people on social media and those from my neighbourhood. I am glad that I participated in this challenge and wish I could have more opportunities to sharpen my skills and increase interest in writing. Most of all I was happy to know that I educated a good number of people through this. The main challenge that I faced was to translate some of the medical terms to plain English or local language for many people to understand.  The following are some of the pieces that I wrote during the competition. 

𝐖𝐇𝐀𝐓 𝐈𝐒 𝐎𝐑𝐀𝐋 𝐇𝐄𝐀𝐋𝐓𝐇?

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment (WHO, n.d.). As any aspect of the body it changes with age, physiological and environmental state.

𝑾𝒉𝒚 𝒐𝒓𝒂𝒍 𝒉𝒆𝒂𝒍𝒕𝒉

It is necessary to have knowledge about the oral health of one self. It helps know what is normal and what is not and seek assistance from professionals, it also helps recognise some systemic pathologies or diseases which have oral manifestations. 

𝑶𝒓𝒂𝒍 𝒉𝒆𝒂𝒍𝒕𝒉

As stated in the definition, oral health is the state of the mouth and the orofacial structures. That is to say good oral health will mean, having normal function and good aesthetics that will not negatively affect an individual in the social environment.

On the other hand, bad or poor oral health means a deviation from comfortability and function on the mouth and related structures. Having a bad breath, bleeding gums, dental caries, mobile teeth are examples of states of poor oral health.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

As any aspect of health, oral health must be taken seriously. Selfcare, prevention and seeking dental assistance from dental professionals are the best ways that will help each one of you to achieve good oral health. Join me in the 30 day writing challenge as I tackle some of the frequent oral health conditions, how to recognise the abnormal, how to provide oral health care and when to seek assistance.

𝑩𝒊𝒃𝒍𝒊𝒐𝒈𝒓𝒂𝒑𝒉𝒚

WHO. (n.d.). world oral health organisation. Retrieved from https://www.who.int/health-topics/oral-health#tab=tab_1

𝐖𝐇𝐘 𝐃𝐎 𝐖𝐄 𝐁𝐑𝐔𝐒𝐇 𝐎𝐔𝐑 𝐓𝐄𝐄𝐓𝐇 𝐖𝐈𝐓𝐇 𝐅𝐋𝐔𝐎𝐑𝐈𝐃𝐀𝐓𝐄𝐃 𝐓𝐎𝐎𝐓𝐇𝐏𝐀𝐒𝐓𝐄?

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

Have you ever wondered why you brush teeth? List three reasons why you brush your teeth. I bet some of you will say; to whiten teeth, avoid bad breath or have the sweet smell from the toothpaste. Well, you are not very far from the truth but those are secondary benefits of brushing your teeth with toothpaste. I will explain the scientific reasons for toothbrushing and what is needed to achieve this.

𝑾𝒉𝒚 𝒘𝒆 𝒃𝒓𝒖𝒔𝒉 𝒕𝒆𝒆𝒕𝒉

The main reasons for brushing are; to remove food debris (remains) from the oral cavity, to remove plaque, and to sufficiently apply fluoride to the teeth. If this is done properly, you can not have a bad breath unless there are other causes than poor oral hygiene. It also helps avoid the initiation and progression of dental caries.

For these goals for cleaning to be achieved there is a need to follow the principles of timing and technique for brushing as well as the right brushes and tooth paste.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

Knowing the reasons why we brush teeth will help you understand the importance of brushing and the right way of brushing. In my next article, I will explain the principles for effective tooth brushing. This will deepen your knowledge on how and why we brush. Therefore, I urge you to keep on reading my posts throughout this journey.

𝑴𝒆𝒂𝒏𝒊𝒏𝒈𝒔 𝒐𝒇 𝒘𝒐𝒓𝒅𝒔

1. Plaque: a sticky film that coats the teeth and contains bacteria

2. Dental caries: in simple terms, it is tooth decay

3. Fluoridated toothpaste: this the tooth paste that has fluoride as one of its components. Most of the commercially available tooth pastes have fluoride. It is written on the tooth paste tube and it is necessary to check before you buy.

𝐏𝐑𝐈𝐍𝐂𝐈𝐏𝐋𝐄𝐒 𝐎𝐅 𝐓𝐎𝐎𝐓𝐇 𝐁𝐑𝐔𝐒𝐇𝐈𝐍𝐆

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

As discussed earlier, toothbrushing has goals. There are a couple of principles that help make sure that we are effectively brushing our teeth. There are principles of timing, technique, type of tooth brush and toothpaste.

𝑷𝒓𝒊𝒏𝒄𝒊𝒑𝒍𝒆𝒔 𝒐𝒇 𝒕𝒐𝒐𝒕𝒉 𝒃𝒓𝒖𝒔𝒉𝒊𝒏𝒈

The first principle is timing. This discusses how long and when to brush teeth. The ideal time to brush teeth is after meals. This can be after breakfast in the morning, after lunch and after supper at night. The essence is to remove all food that remains in the mouth after eating. When brushing, it is recommended that you spend at least two minutes. Brushing has to be done every day, at least two times a day with at night being the most important.

On the technique, you have to place the tooth brush bristles 45° to the gums, this helps to clean the gum pockets. Scrub the teeth gently (not violently as most people do)

The type of tooth brush has to be medium. This is to avoid hurting your gums and destroying tooth structure. Soft brushes can be used in people who experience pain when brushing. You can check the pack in stores before you buy any tooth brush, it is written whether its medium, hard or soft. Alternatively, you can dip the brush in warm water and the bristles will become soft.

The toothpaste has to have fluoride as this will help strengthen the tooth and prevent it from initiating decay

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

Brushing without following these rules, is as good as not brushing and sometimes it can cause more harm than good. 

𝐖𝐇𝐘 𝐃𝐎 𝐘𝐎𝐔𝐑 𝐆𝐔𝐌𝐒 𝐁𝐋𝐄𝐄𝐃?

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

A good number of people have ever been victim to bleeding gums. It could be either during toothbrushing, spontaneous (on its own) or when chewing. This can come with or without pain. I will discuss why it occurs and how to deal with it.

𝑾𝒉𝒚 𝒈𝒖𝒎𝒔 𝒃𝒍𝒆𝒆𝒅

Gums could bleed from traumatic tooth brushing. This happens because of using heavy forces when brushing or using toothbrushes with hard bristles.

It could happen due to inflammation of the gums. This is the most common cause. This happens due to poor brushing technique which leaves food remains in the gingival pockets (space between the gums and the tooth). The food that remains creates a favourable environment for micro-organisms including bacteria. This causes irritation to the gums causing inflammation. Inflammation causes the gums to bleed after a light touch like when brushing.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

Consistent toothbrushing and following the principles for tooth brushing is the best way to prevent bleeding gums. If your gums bleed while brushing, try and use a softer brush and read my next content on how to brush and the bleeding will stop within seven days.

𝐇𝐎𝐖 𝐓𝐎 𝐁𝐑𝐔𝐒𝐇 𝐘𝐎𝐔𝐑 𝐓𝐄𝐄𝐓𝐇

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

As obvious it may seem, toothbrushing has to be done with care and gentleness. I discussed the principles for tooth brushing, and technique is one of the crucial principles. In this piece, I will discuss the technique for brushing in depth.

𝑯𝒐𝒘 𝒕𝒐 𝒃𝒓𝒖𝒔𝒉

First of all, you need to have a medium or soft tooth brush to avoid hurting your gums. The brush has to have straight bristles, not flared up due to overuse.

Apply the toothpaste and position the brush 45^o to the tooth. Move the brush in circular motion, gently on each tooth and on all sides of the tooth. Most people are fond of cleaning the front surfaces only.

Shake the foam from the paste and spit out. DO NOT RINSE. Yes, you read it right, do not wash your mouth with water. Just spit the toothpaste. This will give the toothpaste time to effectively perform its function.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

As uncomfortable as you may feel not rinsing your mouth, keep on. You will get used in a few days. You are not supposed to eat or drink anything within 30 minutes after brushing.

𝐃𝐄𝐍𝐓𝐀𝐋 𝐂𝐀𝐑𝐈𝐄𝐒 (𝐓𝐎𝐎𝐓𝐇 𝐃𝐄𝐂𝐀𝐘) 

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

Tooth decay is one of the common causes of dental pain. It leads to cavitation (ku bowooka) of the tooth which leads to inflammation of the pulp (pain of the tooth). It may also cause swelling, headaches and sleepless nights, depending on severity of destruction. This essay will discuss the causes of tooth decay.

𝑫𝒆𝒏𝒕𝒂𝒍 𝒄𝒂𝒓𝒊𝒆𝒔

It is influenced by both familial and environmental factors. Familial factors means that it can be inherited (taken) from parents. It is not necessarily inherited as tooth decay, but rather a high risk to caries. That is to say other people are likely to develop dental caries than others.

Environmental factors include diet and oral health hygiene. Sugary food like chocolates, sweets, tea and sweet beverages can increase chances of one to develop caries. It is advised that if you cannot resist taking sweet food, it is better to eat them in one setting within a short period of time than continuously eat them over a long duration. This gives time for your teeth to be cleaned by saliva.

Poor oral hygiene (poor tooth brushing) is another influencing factor for caries development.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

There is a more scientific explanation to the development of caries, but that is the basic idea that will help you prevent tooth decay. I will explain the characteristics of tooth decay and how to prevent dental caries in my next pieces. Stay with me.

𝑵𝑩

I was requested, by some people, to put the words in plain language. That is why I have some words in brackets. Some in Chichewa and some in a closest relative word.

𝐍𝐔𝐑𝐒𝐈𝐍𝐆 𝐁𝐎𝐓𝐓𝐋𝐄 𝐂𝐀𝐑𝐈𝐄𝐒

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

A nursing bottle 🍼 is a bottle which is used to feed children, especially just after their breastfeeding period. Nursing bottle caries, in simple terms, is a pattern of tooth decay where the upper baby teeth are more disrupted. They are also known as ‘bottle mouth caries’. The lower teeth are spared in the sense that they can be mildly affected or completely healthy.

𝑩𝒐𝒕𝒕𝒍𝒆 𝒎𝒐𝒖𝒕𝒉 𝒄𝒂𝒓𝒊𝒆𝒔

These are caused by excessive drinking of sweet beverages from bottles. It could be squash, fanta, tea and all that you can name. Try to drink from a bottle. You will observe that your tongue covers the lower teeth and you pour the drink on the upper teeth. This is why the upper teeth are the highly affected. This is common in babies because parents give them drinks to make them sleep while they work. It can be given to the children when going to school as well. After a long time of this habit, you will observe that the upper teeth are getting dark spots. That is decay.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

This can also happen in adults with the habit but it is not as common because the teeth are somewhat resistant. It can happen to anyone! The best way to prevent this is to reduce frequency of drinking sweet beverages. Instead, you can be taking water. Most of all, clean your teeth.

𝐈𝐍𝐒𝐓𝐑𝐔𝐂𝐓𝐈𝐎𝐍𝐒 𝐀𝐅𝐓𝐄𝐑 𝐓𝐎𝐎𝐓𝐇 𝐄𝐗𝐓𝐑𝐀𝐂𝐓𝐈𝐎𝐍

𝑰𝒏𝒕𝒓𝒐𝒅𝒖𝒄𝒕𝒊𝒐𝒏

It is very important to understand and adhere to the instructions that are given after we have had our tooth removed at the hospital. I will discuss the instructions and reasons behind.

𝑷𝒐𝒔𝒕 𝒆𝒙𝒕𝒓𝒂𝒄𝒕𝒊𝒐𝒏 𝒊𝒏𝒔𝒕𝒓𝒖𝒄𝒕𝒊𝒐𝒏𝒔

First of all, you are given a cotton gauze to bite on. You are supposed to bite on it for not less than 30 minutes. You should not chew on it; limit talking and swallow your saliva. This is to stop bleeding. 

You should take the pain killer given just after removing the cotton and continue as prescribed. You take the painkiller to reduce pain before the anaesthesia (Dzanzi lokupha msempha) wears out. If given antibiotics, take them as told.

You should not do any physical exercise or work like farming, carrying goods. This is to avoid raising blood pressure which may lead to bleeding.

You can use ice packs to reduce the size of swelling. Use two pillows when sleeping to allow venous return (magazi aziyenda) and reduce swelling.

You are supposed to start rinsing your mouth with warm salty water, at least four times a day. Rinsing should start the next day after tooth removal 𝗡𝗢𝗧 𝗧𝗛𝗘 𝗦𝗔𝗠𝗘 𝗗𝗔𝗬!

 If you start the same day, the wound does not heal.

Do not brush or eat using the side that has been extracted until it heals.

𝑪𝒐𝒏𝒄𝒍𝒖𝒔𝒊𝒐𝒏

Following the instructions will make the healing less painful and it will prevent other complications that may arise due to poor adherence.

DIABETES MELLITUS AND PERIODONTAL DISEASE

Diabetes Mellitus [DM] is a condition where the body fails to regulate blood sugar levels due to low insulin production, or ineffective insulin usage. (Insulin is a hormone responsible for blood sugar regulation).

Periodontal (gum) Disease [PD] simply means infection of tissues that surround the teeth.

There is a bidirectional relationship between the two, in that they’re both risk factors for each other. Chronic inflammation of the gums, as in PD, is associated with ineffective usage of insulin by the body, worsening DM.

On the other hand, poorly controlled diabetes provides a favorable environment for bacteria in the gums.

It is for this reason that gum disease is more common in those with diabetes mellitus. Having periodontal disease treatment does not improve diabetes mellitus. Proper medical treatment is needed for glycemic control.

𝐂𝐎𝐍𝐂𝐋𝐔𝐒𝐈𝐎𝐍

Much as periodontal disease can be prevented through good oral hygiene, in those with risk factors such as diabetes, good blood sugar control is just as important in preventing gum disease.

This can be achieved through adhering to lifestyle modifications, blood sugar control medications and not forgetting practicing good oral hygiene.

𝐁𝐑𝐀𝐂𝐄𝐒

This is a famous word in modern society. This is an appliance that is used to move teeth in different directions. It could be rotation, pulling, forward or backward movement.

Many people have taken this to be a fashion trend. Since it is expensive to have braces, people have started to think this a sign of wealth. 

Well, they are expensive, but this is a treatment for a problem. 

This needs to be made clear because many people wish to have braces but they do not know what they are for. 

Just like any other treatment, having braces has its own risks. There might be worsening of one’s condition of teeth by over rotating teeth. Having braces on, increases the difficulty of toothbrushing.

Use, importance and risks of wearing braces should be known. It is rather a treatment not a sign of being rich

𝐇𝐎𝐖 𝐓𝐄𝐄𝐓𝐇 𝐁𝐄𝐂𝐎𝐌𝐄 𝐌𝐎𝐁𝐈𝐋𝐄

Tooth mobility is the movement of the tooth that happens due to loosening of its attachment to the tooth socket.

Many people have experienced or have this problem.

Tooth mobility can be caused by several reasons. The first reason is trauma. This is caused by a physical blow to the teeth. The other reason is periodontal disease. This causes destruction to the fibers that hold the teeth in place. Periodontal disease can be caused by poor oral health and its progress is enhanced by extreme age or systemic diseases like diabetes.

The other reason for tooth mobility is normal exfoliation. This happens in children when they are about to have adult teeth. 

Whenever you feel like your tooth is mobile, visit a dentist. You will be told the cause and helped accordingly.

𝐒𝐌𝐎𝐊𝐈𝐍𝐆 𝐕𝐒 𝐎𝐑𝐀𝐋 𝐇𝐄𝐀𝐋𝐓𝐇

Smoking is one of the pleasures of the world. Cigarette smoking has a big impact on one’s oral health status. 

It reduces the amount of oxygen in the oral cavity. This creates a favorable condition for harmful microorganisms. Smoking also constricts the blood vessels in the oral cavity. This reduces the ability to fight harmful microorganisms in the mouth. All these effects lead to rapid progression of periodontal disease and destruction (destruction of the gums and fibers that hold teeth). This leads to persistent bad breath and may lead to loss of teeth. In addition to that, smoking stains teeth. The particles from the smoke stick on teeth and they alter the appearance of the teeth, making them appear darker than normal.

Smoking is bad and should be avoided at all costs. Not only is it bad for oral health but also for social and general health as well.

𝐃𝐄𝐍𝐓𝐀𝐋 𝐓𝐑𝐄𝐀𝐓𝐌𝐄𝐍𝐓 𝐀𝐍𝐃 𝐀𝐍𝐗𝐈𝐄𝐓𝐘 𝐃𝐈𝐒𝐎𝐑𝐃𝐄𝐑𝐒

For most people who might have undergone dental treatment, pain is a common complaint. This has been known to cause fear in a lot of people which is normal. Whenever this fear becomes persistent, unrealistic and causes avoidance of dental care at all costs, it becomes known as dental phobia (dental anxiety).

Dental phobia is usually provoked by past experiences, observing other people’s reactions to treatment and largely because of rumors. Patients with dental phobia may develop typical signs of other anxiety disorders such as panic attacks, generalized anxiety, agoraphobia or just specific phobias when going through dental treatment.

Dental phobia is not easily recognizable since most patients react differently to fear. Some go through vegetative reactions which include sweating, blood pressure changes and increased heart rate. Psychomotor reactions include stiff positions on the dental chair, nervous body movements and anxious facial expressions. Others have emotional reactions.

The problem concerns not only oral health, but also the general condition of the body: difficulty chewing and digesting food can cause serious digestive disorders, dental problems affect speech, bad breath and smile affect self-esteem when communicating with others.

Like all anxiety disorders, dentophobia requires special treatment that is offered through psychiatric services.

𝐂𝐎𝐍𝐂𝐋𝐔𝐒𝐈𝐎𝐍

Panic disorders warrant special attention during dental encounters. This is because of the extensive prevalence of antidepressant-induced dry mouth and periodontal disease. Some dental prescriptions may react badly with the psychiatric therapy the patient may be receiving. Always let your dentist know this regarding your general health condition so that they administer medications with caution.

DENTAL HEALTH AND SOCIAL-ECONOMIC STATUS

Dental health like every aspect of health is determined by several factors in a person’s life. These range from genetics and luck, lifestyle and environment, social and economic factors.

Dental treatment has made remarkable improvements in the quality of services that it provides. However, most of these treatments are quite expensive for the average Malawian.

It is for this reason that discrepancies exist between social classes when it comes to choosing dental treatment options. Those better off economically have an upper hand than their less affluent counterparts. Lack of knowledge on good oral hygiene, poor nutrition, lack of dental insurance also brings about differences in the quality of oral health.

The good news is: several efforts have been put in place to ensure equity in our health care system here in Malawi. Primary dental care is free in our health system. This means that everyone can access basic dental therapy for free.

Home oral care expenses are cheaper in most of our settings. Almost everyone can afford a toothbrush.

The addition of fluoride to drinking water has also improved oral health in those with a lower socioeconomic status.

Other interventions such as wearing helmets on bikes and mouth guards during sports to prevent facial injuries also improve oral health.

𝐂𝐨𝐧𝐜𝐥𝐮𝐬𝐢𝐨𝐧

In spite of one’s socioeconomic status, everyone can play a conscious role in as far as improving their oral health is concerned. We can all protect our teeth from physical injury, go for free dental checkups and practice regular oral hygiene.

DENTAL HEALTH IN THE ELDERLY

Most of us have an elderly person in our lives who is dear to us. As lifespan continues to increase, dental health is important in ensuring quality of life than quantity.

Dental conditions tend to worsen with increased time progression. In the elderly, this is commonly seen. Most of our elderly may have missing teeth, or many gum diseases.

Several factors play a role in the development of such. As discussed earlier, some chronic diseases such as diabetes, osteoporosis, and heart disease, which are very common in the elderly, worsen gum diseases. Immunity is also known to decrease as age increases, affecting healing in the gums.

Diet also plays an important role as most of the elderly prefer refined sugars in their diets. In some cases, memory loss may hinder routine care in as much as oral hygiene is concerned.

The best way to prevent dental disease is through proper oral care throughout one’s life. This however, may be difficult in the elderly experiencing problems with mobility, memory and material support. 

Caregivers ought to take into consideration these factors and plan how to adapt to individual disabilities while maintaining oral health.

In addition, early detection and treatment of systemic diseases is important.

Limiting the consumption of refined sugar, may be an effective way for the elderly to prevent the onset and progression of gum disease.

𝐂𝐨𝐧𝐜𝐥𝐮𝐬𝐢𝐨𝐧

Much as most dental conditions are treatable, preventing proves to be much better than cure for the elderly. This reduces the stress of going to the hospital and improves their quality of life by being disease free.

ARE YOU CHEWING ON YOUR OWN TEETH?

Bruxism a condition where a person grinds or clenches or gnaws their own teeth. This can happen during both day time and at night. Over time, this can wear down the enamel (hard part covering the tooth), making the teeth sensitive. It can also lead to jaw muscle pain and chipping of teeth.

You will usually know when you have bruxism if you produce a grinding sound at night time, which can sometimes be detected by a partner, headache upon waking up, pain or tightness with jaw muscles.

Bruxism is often caused by stress and anxiety, alcohol and caffeine consumption, smoking or as a side effect of some medications. Sometimes, bruxism is just present because of the person’s genes.

When you get a dental checkup, bruxism is diagnosed and different treatment options are provided depending on the cause. These include: stress management, mouth guards, improving sleep posture, and repair of the worn-out teeth with crowns and other procedures.

𝐂𝐨𝐧𝐜𝐥𝐮𝐬𝐢𝐨𝐧

While this condition might be common, those who have it may suffer social discrimination. It’s important to have this checked out for the benefit of your oral health as well as your mental health.

WHY YOU SHOULD GO TO THE HOSPITAL WHEN YOU HAVE A TOOTHACHE INSTEAD OF TAKING PAIN KILLERS

A lot of people have had a painful tooth before. Although it is advised to go to the hospital as soon as possible, some people take painkillers.

The truth of the matter is that the pain killers will only stop the pain but will not heal the tooth. This may lead to serious complications. 

There is a complication called Ludwig’s angina. Ludwig’s angina is a type of bacterial infection that occurs in the floor of the mouth, under the tongue. It often develops after an infection of the roots of the teeth (such as tooth abscess) or a mouth injury. This comes about when a decaying lower tooth has not been removed or treated. This is not always the case but it is a possibility in some individuals. It is recognized by a swelling that is painful and it crosses the neck. 

In extreme cases, it may lead to death due to airway obstruction (blocking of the path of breathing)

Whenever you have a toothache, it is necessary to visit a dental clinic and be treated accordingly. 

𝐃𝐑𝐘 𝐒𝐎𝐂𝐊𝐄𝐓

Dry socket is a painful condition that sometimes may happen after tooth removal. It happens when a blood clot at the site where the tooth was removed does not form, comes out or dissolves before the wound has healed. 

A blood clot forms at the site where the tooth has been removed. This protects the underlying bone and nerves. When it is removed before the wound heals, it causes severe pain which may start a few days after tooth removal. A bone may be visible in the socket and there is bad taste in your mouth. 

In most cases, people who present with dry socket are those who did not adhere to instructions after tooth removal. They start rinsing their mouth with warm salty water on the same day of extraction. This removes the blood clot. Rinsing with warm salty water should be done after 24 hours from the time of tooth removal.

𝐎𝐑𝐀𝐋 𝐓𝐇𝐑𝐔𝐒𝐇/𝐂𝐀𝐍𝐃𝐈𝐃𝐈𝐀𝐒𝐈𝐒

This is an infection in which a fungus called Candida albicans accumulates in the mouth. It is common in babies, people with poor body immunity and those who use steroid sprays for asthma. 

Other factors like, diabetes (shuga) dentures, poor nutrition and recent use of antibiotics may lead to the disease.

This disease can be recognized by white patches in the mouth that can be wiped off, leaving behind red areas that might bleed slightly. There is a loss of taste or unpleasant taste in the mouth. It may also create cracks at the corners of the mouth. 

This disease is not cancer and it is not a sexually transmitted infection (STI) but you should visit a dental professional whenever you suspect it. 

OPEN BITE

An open bite is a dental condition where the upper and lower front teeth don’t touch when the jaw is closed. This leaves a gap between them. 

In addition to genetic factors, environmental factors such as thumb sucking, pacifier overuse and tongue thrusting can cause an open bite.

If you leave your open bite untreated, it can lead to overall oral and health problems such as difficulty in chewing, speech impediments and breathing disorders.

When open bites happen in children who still have their baby teeth, it may get fixed on its own so long they stop the habits like thumb sucking.

Open bites make people uncomfortable and should be dealt with as early as possible.

DENTAL PLAQUE AND CALCULUS 

Plaque is a sticky, whitish film that forms naturally on teeth. You can remove and prevent plaque by practicing proper hygiene. Calculus is a hard, solidified plaque with a yellowish, darker appearance. The only proven way of removing calculus is through professional cleaning.

You’re more likely to develop plaque and calculus if you don’t brush or floss as often as you should (at a minimum of two times a day).

Generally, it takes about 24 to 72 hours for the plaque to start hardening to calculus.  The process can be accelerated by certain factors. Dry mouth and tobacco are some of the examples. 

The best way to avoid and prevent this whole process is to intercept it by applying proper tooth brushing methods.

ORAL/MOUTH CANCERS

Mouth cancer, also known as oral cancer or cancer of the oral cavity, is often used to describe a number of cancers that start in the region of the mouth. These most commonly occur on the lips, tongue and floor of the mouth but can also start in the cheeks, gums, roof of the mouth, tonsils and salivary glands.

You can suspect mouth cancer when you develop a lump in your neck, loose teeth, swelling or a sore on your lip that won’t heal, difficult or painful swallowing, bleeding or numbness in the mouth, white or red patches on the mouth, tongue or gums and unexplained weight loss.

There are so many causes of mouth cancer, infections, poor oral hygiene and gum disease, and exposure to the sun. The main risk factors for mouth cancers are tobacco and alcohol consumption. The risk is even higher in those whose close family member had a certain type of cancer before.

Cancer diagnosis can be made by your doctor or dentist during regular checkups. Treatment for mouth cancer depends on the type of cancer, where it is located and how far it has spread. Options available include surgery, chemotherapy and radiotherapy in some settings.

Conclusion

While mouth cancers can be treated once diagnosed, the best way to prevent them is to avoid smoking and alcohol consumption. Regular dental checkups and practicing proper oral hygiene go a long way in preventing these cancers.

CLEFT LIP AND PALATE

A cleft lip is an opening or split in the upper lip that occurs when developing facial structures in an unborn baby don’t close completely. A cleft lip may be on one side or both sides of the mouth. A baby with a cleft lip may also experience a cleft in the roof of the mouth (cleft palate). 

There are a lot of misconceptions about the cleft lip and palate. Some say it happens when the mother is a cheater or she provoked “Gule wamkulu” when she was pregnant. 

Deficiency of B vitamins and folic acid in maternal diet is the commonly associated cause of cleft lip and palate in the new born. Parents who are older than usual at the time of birth of their baby are at higher risk of having children with cleft lip and or palate.

Having a baby born with congenital anomalies like cleft lip or cleft palate is unpreventable. However, you can do things to reduce your risk, like avoiding using cigarettes, alcohol, and certain medications. Talk to your healthcare provider if you are concerned about cleft lip or cleft palate.

Many congratulations to Emmanuel for showing the initiative to participate in this competition. He is one of the pioneer group of BDS students who are poised to graduate in a few month’s time as Malawi’s first ever home-trained dentists. The knowledge demonstrated in Emmanuel’s writings above reflect the contribution that these young dentists will make to improving the oral health of the people of Malawi.