Meet The Team: Dr. Marwan Al-Obeidi

Dr. Marwan Al-Obeidi

Clinical Head & General Dentist, UK

BDS (London), MFDS RCS (England)
Member of the Royal College of Surgeons of England
Umm Suqeim Clinic, Dubai

Dr. Marwan Al-Obeidi received his Doctorate in Medical Dentistry from Guy's Hospital, London in 2003. Following his professional qualification, he practiced maxillofacial surgery at Queen Alexandra Hospital and the Royal Military Hospital in Haslar, UK. Dr. Marwan gained membership of the Royal College of Surgeons of England in 2007. He has over 10 years of experience working as a general dental practitioner in both Surrey and central London. Dr. Marwan enjoys all aspects of his field especially cosmetic dentistry and prosthetics. Passionate in learning languages, he is fluent in both English and Arabic, and also speaks French and some Italian. His interests include sports and history.

Member of the Royal College of Surgeons of England

Member of the General Dental Council (UK)

Receding Gums: Causes, Dangers and Treatments

By Dr. Omar Aldaoudi, Specialist Prosthodontist

Gum recession or receding gums refers to the loss of gingival (gum) tissue causing the exposure of the roots of the teeth.

Receding gums is a common dental problem in adults over the age of 40, but it can occur in younger ages. It can be generalized or localized and it is progressive in most cases. Usually, the first sign is hypersensitivity to cold and hot drinks. Also, the affected teeth appear longer and the roots are visible, a notch could be felt near the gum line, and spaces between teeth seem larger.

CAUSES

Gum recession has many causes and risk factors:

• periodontal or gum disease
• poor oral hygiene
• aggressive brushing
• hormonal factors
• gingival trauma
• poorly-fitted restorations
• teeth grinding or clenching
• malposition of the teeth
• smoking and chewing tobacco
• genetic predisposition

DANGERS

When gums pull away from your teeth, the roots of your teeth are left exposed and this puts you at risk for tooth and root decay. Left untreated, receding gums can also lead to functional and aesthetic complications.

TREATMENTS

The treatment of the gum recession depends on the cause, your dentist can help you to identify the problem and determine the best treatment plan.

If the recession is caused by periodontal disease, scaling and roots planning, stabilization treatments and perfect oral hygiene are extremely important to avoid further gingival and bone loss.

When the condition is a result of overaggressive brushing, your dentist and hygienist can assist you by demonstrating the proper brushing technique and recommending the best oral hygiene tools adapted to your case.

Also, you can prevent gingival recession by eating healthy food, maintaining a balanced diet, smoking cessation and regular use of night guard if you grind your teeth.

In some advanced cases, gum tissue regeneration and gingival grafting could be performed by a periodontist or oral surgeon.

Visit your dentist and hygienist regularly and inform them in case of family history of gum or periodontal disease.

If you are experiencing hypersensitivity, your dentist may apply desensitizing agents, varnishes and dentine bonding agents, he may also recommend specific toothpaste and mouthwash to reduce and treat the sensitivity.

About Dr. Omar Aldaoudi

Dr. Omar Aldaoudi DU, CES, DIU received his Doctorate in Medical Dentistry in 2003. He then completed advanced specializations and earned his certificate in Fixed and Removable Prosthodontics from the University of Paul Sabatier in Toulouse, France in 2007. Dr. Omar comes to Dr. Michael’s Dental Clinic with vast experience in cosmetic and restorative dentistry, esthetic, functional and prosthetic rehabilitation.

"Parents, don't let your children brush their teeth on their own"

Interview with Dr. Chantal Kengo, Specialist Pediatric Dentist

One of the main causes of tooth decay in children is poor oral hygiene, more specifically inefficient brushing of teeth. What happens when we let our children do the brushing on their own? Find out from Dr.  Chantal today.

You see a lot of children and parents every day. What do most parents say when it comes to brushing their children's teeth?

During consultation, parents would often say "My child knows how to do it", "My child does not want me to brush his/her teeth" or "I want my child to be independent." Most parents allow their children to brush their teeth by themselves. What happens then? The child does a very poor job of cleaning his teeth, and ultimately, the end result is cavities.

What do you recommend parents when it comes to their children's oral hygiene?

Every child is different but in general parents should brush their child's teeth until they are about 5 to 8 years old. Remember that it is very important that parents continue to supervise their children's brushing until the age 10 to 12. This is to make sure that they're doing it thoroughly. Brushing should be done for two minutes minimum twice a day.

What if the child insists on brushing on his own?

Brushing is a skill. Like many skills, it take years to learn it and be good at it. Young children usually do not have the manual dexterity to brush or floss properly. If your child wants to do it by himself, let him! It's a great way for him to practice but ALWAYS make sure that you brush his teeth before or after he's done it for himself. For older children aged 10 to 12 years, make sure that you supervise them. Be there when your child brushes his teeth and make sure that your child is doing it well. Reinforce whenever necessary.

Do you still see many cases of tooth decay in children?

I see a lot of cases. In fact, although tooth decay is preventable, the World Health Organization reports that around 60 – 90% of children around the world have tooth decay.

What other advice can you give parents?

Aside from proper oral hygiene and regular checkups, one other main thing that parents should focus on is their children's diet. I suggest a diet with very minimal intake of sugar to help protect your child from cavities. If you must give your child some sweets, give a small serving along with a main meal, or have a “Sweet Day”, one day in the week where your child can enjoy some sweets. Parents should also be wary about juices. Juices, even those labelled fresh or sugar-free, are loaded with sugar and acids. Limit juices and encourage your child to drink more water instead.

Is a Root Canal Treated Tooth Susceptible to Decay?

By Dr. Kavita Tarale, Specialist Endodontist

The only difference between a normal tooth and a root canal treated tooth is the absence of nerve supply and blood supply to the root canal treated tooth. And hence, there is no sensation to hot and cold food.

However, teeth that have had root canal treatment are at a risk of formation of tooth decay and gum disease, just like any other tooth. And if allowed to advance, either of these conditions can ultimately lead to tooth loss.

I have noticed that some of my patients think that since when a crown is done, very little or no original tooth structure is visible above the gum line, there is no chance of tooth decay on that tooth. A crown is connected to a natural tooth underneath it and because of this, decay can form around the edges of a crown.

Dr. Kavita Tarale, BDS, MDSSpecialist Endodontist

With proper care, root canal treated teeth can last life time. Root canal treated teeth tend to dry out, become brittle and can break. With a filling and crown, the tooth can be protected against breakage but not against decay. Proper brushing and flossing along with regular dental checkups can help prevent decay as well as any gum problems.

Dental decay or caries is an infectious disease caused by specific bacteria. But just having the bacteria present in your mouth does not mean you will develop decay. Other factors must be present. What are those other factors?

The most important other factor is sugar. When you ingest a meal with lots of simple sugars (this includes candy and sugary sweets, but also food with large amounts of sucrose), the bacteria consume those sugars. Upon consumption of those sugars, they release acid. That acid goes on to attack the mineralized part of teeth and weaken them. Over time, the hard enamel shell of the tooth is dissolved which leads to cavitation.

This decay process can occur on any surface of the tooth regardless of whether the tooth is vital (tooth with nerves and blood supply) or non vital (tooth that no longer has access to nutrients and blood flow). Hence, good oral hygiene practice at home along with a regular dental checkup is mandatory to maintain a healthy oral cavity.

Ramadan and Oral Health: What You Need to Know

By Dr. Omar Aldaoudi

Ramadan, the ninth month of the Islamic lunar calendar, is the month of fasting for Muslims.

Fasting is one of the five pillars of Islam, and all throughout the Holy month of Ramadan, Muslims fast every day from early dawn to sunset. All physically, mentally healthy and mature Muslims around the world abstain from eating, drinking, smoking and all other physical needs.

When it comes to oral hygiene and dental treatments, what should dental providers and fasting patients know about Ramadan?

Our specialist prosthodontist Dr. Omar Aldaoudi gives us insight on oral health and dental procedures during the Holy Month. In terms of dentistry, which acts are permissible and which ones would nullify the fast? Find out below.

What do people gain from fasting?

Fasting allows learning self-restraint from indulgence in everyday pleasures, developing self-control and self-discipline, purifying the mind and the body, and empathizing with the poor and hungry.

Health-wise, fasting involves powerful therapeutic processes that can help people recover from mild to severe health conditions. Fasting can lower blood sugar, cholesterol and (systolic) blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension.

What are your advice on oral hygiene for people who are fasting? Can they still brush, floss and use mouthwash as usual?

Toothpastes are allowed during the holy month of Ramadan, although some scholars of Islam consider the use of toothpaste to be highly undesirable because deliberate or accidental swallowing of them will nullify the fast.

You can always brush and floss thoroughly before sleeping at night and I recommend brushing after Suhoor (pre-dawn meal). Brushing twice daily is sufficient for oral disease prevention.

Mouthwashes are commonly prescribed by dentists as an adjunct to oral hygiene. Some patients may be reluctant to use mouth wash for fear of unintentionally swallowing some. If this is the case, you can use it outside fasting hours as advised by your dentist.

Will dental treatments/procedures and administration of an aesthetic (injections) nullify the fast?

Some patients think that actions that take place during dental procedures will nullify their fast but local anesthetics (injections) are permissible forms of treatments for those who are observing Ramadan. However, when patients are reluctant, it is best to re-schedule or delay treatments especially if there is no acute pain/discomfort.

Are there dental procedures that should be postponed by fasting patients if the treatment dates fall on Ramadan?

Dental treatments and preventative procedure (including restorations, scaling and extractions) do not invalidate the fast, but some patients are unwilling to have procedures done due to difference in their views.

Patients who require immediate or advanced treatment, like those who suffer from deteriorating chronic illness or those who face dental emergencies, could break the fast. If it is possible, the dentist can delay or re-schedule treatments for their patients.

What’s your advice on patients who are taking medications and who want to fast?

Oral medications are not permissible and invalidate the fast. If you fall ill and avoiding medication could result to harm and is life-threatening, it’s allowable to break the fast.

When a dental problem occur during the holy month of Ramadan and medications are needed, you can discuss with your dentist. He or she may be able to adapt your medications and/or the dosage.

What are your health tips for people who are fasting?

Don't skip Suhoor. Don't overeat during Iftar (dinner). Avoid eating fried foods, salty foods and high-sugar foods. Drink as much water as possible.

Keep your meals healthy. Whenever possible, opt for steaming, grilling or baking. If you use oil for cooking, settle for healthy options like canola oil.

Drink plenty of water (drink of choice), juices, milk and soups. Cut down on coffee, tea, soda and all other caffeinated drinks – they have diuretic effects and thus dehydrate the body.

   

In Focus: Mouth Breathing in Children

Do you often see your child breathing through his mouth? Our specialists at Dr. Michael’s Dental Clinic discuss the cause, dangers and treatment for young mouth breathers.

What are the signs and causes of mouth breathing?

“Mouth breathing is a very common problem that begins in childhood and can continue unnoticed till adulthood,” said Dr. Mai Kamar, our pediatric dentist.

“It has two major types - pathological or habitual. Pathological mouth breathing has an underlying cause such as enlarged adenoids, deviated nasal septum, asthma, allergic rhinitis, etc., where there is an actual obstruction to the nasal airway, hence the child resolves to breathing through the mouth to get the required amount of oxygen the body needs.”

“Habitual mouth breathing is where the child develops such habit after having a strong cold accompanied by nasal obstruction or allergy that caused him to breathe through the mouth during his illness. In this case, even after the cold subsides, the child continues to breathe through the mouth out of habit.”

“A parent can identify if his child has such a problem, by observing them from a distance while they are playing or watching TV,” said Dr. Mai. “If your child fails to keep his lips sealed during normal activity and keeps his mouth open for breathing, snores during sleep, has under eye circles, has crooked teeth, or has a chronic bad breath, then most probably your child is a mouth breather.”

How can mouth breathing affect children’s teeth?

“Mouth breathing can particularly affect the growing face,” said Dr. Argiro Kechagia, specialist orthodontist, “and these alterations will occur in the muscles associated with the face, tongue and the neck.”

“Untreated airway problems may so severely affect facial growth that orthodontics alone cannot correct the malocclusion. Corrective jaw surgery later in life, in addition to the necessary procedures to open the nasal airway, may be required.”

According to our Oral and Maxillofacial Surgeon Dr. Walter Goriwoda, mouth breathing throughout the growth stage can cause “specific craniofacial changes including narrow palate (due to missing pressure of tongue on palate), vertical increase (lengthening of lower face) and retruded jaw (1,5). Dental malocclusions are also observed, mainly posterior crossbite and anterior open bite, leading to absence of lip competence (1,3,5).”

Mouth breathing reduces the salivary flow and dries out the mouth. Without the protective functions of saliva, it can “potentially lead to demineralization of teeth with higher risk of decay chronic gingivitis, periodontitis (gum disease), candida infections and halitosis (bad breath) (4).”

Can mouth breathing potentially lead to more serious complications?

Our nose processes the air we breathe before it enters our lungs. Mouth breathing pulls all pollution and germs directly into the lungs; dry cold air in the lungs makes the secretions thick, slows the cleaning cilia, and slows down the passage of oxygen into the blood stream (AAO-HNS).

Dr. Walter also explains that “mouth breathing bypasses the protective function of the nose and sensitization to inhaled allergens is increased. This may increase asthma morbidity (2).”

It is very important to address mouth breathing at an early age where the treatment is much simpler and faster. Mouth breathing can affect the growth and development of your child. It may affect quality of sleep and lead to poor concentration during the day.

Who can diagnose and treat mouth breathing?

If your child is mouth breathing, take him/her to an ENT specialist. They are doctors who diagnose and manage diseases of the ears, nose, larynx, sinuses, throat, as well as structures of the neck and face.

Your child’s dentist can help prevent the habit by providing trainers and appliances that will progress the development of normal nasal breathing patterns and consequently help in developing proper alignment and occlusion of your child’s teeth.

---

1. Pacheco MCT et al. Craniofacial changes and symptoms of sleep-disordered breathing in healthy children). Dental Press J Orthod. 2015;20(3):80-7
2. Yumi I et al. Mouth breathing, another risk factor for asthma: the Nagahama Study. Allergy 2016; Mar 17 [Epub ahead of print]
3. Juliano ML et al. Mouth breathing children have cephalometric patterns similar to those of adult patients with obstructive sleep apnea syndrome. Arg Neuropsiquiatr 2009;67(3B):860-5
4. Surtel A et al. The influence of breathing mode on the oral cavity. Pol Merkur Lekarski 2015;39(234):405-7
5. Harari D et al. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope 2010;120(10):2089-93

3 Easy Tips to Turn Flossing Into a Habit

 By Hygienist Thana Al-Tahan

You just had your bi-annual dental cleaning with your hygienist, who thoroughly explained your case of gingivitis. “I swear I’ll floss every day,” you said and you meant it. You flossed your teeth every day for a week, and then like the diet you tried last summer, you gradually started to slack.

Most of us are aware just how essential flossing is in maintaining our oral health and preventing disease, we just have one problem – making a habit of it. We’re too busy. We’re too lazy. We forget. Six months later, we’re back in the hygienist’s chair being told we still have gingivitis. How do we overcome this obstacle and turn flossing into a daily habit?

Here are three tips to help you get started:

1. Set a visual reminder.

   Put your spool of floss on your nightstand. Next to your toothbrush. In the lunch bag you take to work. Heck, put it in the shower! Stick a red post-it note on your mirror. Seeing the floss or any type of visual cue will jolt a reminder for you.

2. Multitask.

   Among your busy work hours, your many social events, and your frequent travels… who has time to floss, right? Surely, you are doing something hands-free throughout your day however. Watching TV? Lying in bed? Stuck in terrible traffic? Multitask!

3. Attach the habit to an existing one.

   Convince yourself that you will absolutely not brush your teeth without flossing. They are not two activities, they are one. Eventually you will link the habits together and it will feel lacking to do one without the other.

Remember – it takes about three weeks to develop any habit so take the first step in this commitment and you will surely find the road towards becoming a habitual flosser with healthy gums.

What Is Oral Cancer And Are You at Risk?

April is Oral Cancer Awareness Month.

Regular dental checkup is the first line of defense in early detection of oral cancer.

According to the World Health Organization (WHO), oral cancer ranks eighth among the most common cancer worldwide. Globally, more than 300,000 new cases of lip and oral cavity cancer were estimated to have been diagnosed in 2012.

In the United States, oral and pharyngeal cancer (cancer of the mouth and upper throat) collectively kills nearly one person every hour.

In the Middle East, a multicenter, retrospective study on oral cancer finds that the death rate due to oral cancer in the Middle East is reported to be approximately 2 in 100,000.

Dr. Marwan Al-Obeidi, Clinical Head at Dr. Michael’s Dental Clinics talks about the disease and the role of dentists in its early detection.

What is oral cancer?

Oral Cancers are a part of a group of cancers commonly referred to as head and neck cancers. Oral cancer can affect any part of the oral cavity, particularly the tongue, floor of the mouth, the cheeks, bones, and lips. It is among the most prevalent cancers in the world and its incidence is increasing every year. The prevalence of this cancer is higher in males than females.

What are the causes of oral cancer?

There appears to be a direct link between oral cancer and well-defined predisposing factors. These factors are mainly tobacco smoking and smokeless tobacco (chewing) and alcohol. In fact, the WHO reports that tobacco use (smoking or chewing) and excessive alcohol consumption account for an estimated 90% of oral cancers worldwide.

Exposure of the lip to direct sunlight also accounts for a very high rate of lip cancers in countries with a population exposed to high amounts of direct sunlight such as Australia and indeed the Middle East.

Other risk factors include genetics and a certain group of viruses known as HPV (Human papillomavirus).

What is the role of dentists in oral cancer detection?

Our role as dentists is vital in early detection of oral cancers as early detection has been proven to dramatically increase the chances of successful treatment and survival rates for patients. We are also working very hard as a group of professionals to educate the population on the risks of predisposing factors and trying to raise awareness about this ever growing threat to our health.

It is very important that our patients are aware of any predisposing factors that can affect their health and we are continually trying to reduce the exposure to these factors.

Alongside health promotion, we also have a duty to carefully examine the whole oral cavity during each checkup appointment. As dentists, we are uniquely placed in a privileged position to be able to see most of our patients every 6 months for routine dental examinations. It is at these examinations that a general oral cancer screen is carried out where not only do we discuss any predisposing factors but we also actively screen for any abnormal lesions in the mouth.

How is oral cancer detection done during dental checkups?

As part of your routine dental exam, your dentist will feel for any lumps or irregular tissue changes in your neck, head, face, and oral cavity. When examining your mouth, your dentist will look for any sores or discolored tissue as well as check for any signs and symptoms mentioned above.

Your dentist may perform a biopsy if he or she sees tissue in your mouth that looks suspicious. This test is painless and involves taking a small sample of the tissue, and analyzing it for abnormal cells. Alternatively, if the tissue looks more suspicious, your dentist may recommend a referral to a more experienced specialist colleague who will carry out further tests if necessary. These tests are vital to detect oral cancer early, before it has had a chance to progress and spread.

What are the warning signs of oral cancer?

Oral cancer can present itself in many ways and is usually pain free at the early stages. It can present as simple swellings or lumps or even a patch on the oral mucosa (soft tissues) which can appear as just a redness or even a simple ulcer which doesn't heal. Other signs to look out for are a change in the hoarseness of the voice or difficulty in swallowing and movement of the tongue can be found to be constricted. All of the above can usually be accompanied by a dramatic decrease in weight over a relatively short period of time.

Importance of regular dental visits

It is very important to regularly visit your dentist even if you are not experiencing any symptoms as oral cancer often remains pain-free for several months and the patient is usually unaware of any abnormalities.

On your appointment, you should inform your dentist of all habits that could be predisposing to cancerous lesions such as tobacco use and alcohol consumption and any other medical conditions you may have. It is also important to inform your patient of any family history of cancer. The dentist will give you advice regarding these factors before carrying out a detailed examination of your oral cavity to ensure that no lesions or abnormalities are seen.

Remember, early detection is critical for successful treatment so if you haven't seen your dentist for a while, book a checkup appointment now and make sure that not only your teeth are healthy but your whole mouth is disease free!