Bohol Tribune
Opinion

The Medical Insiders

By Dr. Rhoda Entero

Getting Crowns for Children

(Part 1)

One thing good about dentistry is that it is a changing discipline and a field of science and art at the same time.

Many of us are familiar with crowns or jacket crowns placed on adult teeth.

However, crowns on children are usually placed there to badly carious teeth and something parents are not keen about.

More often the parents would decide to have the tooth extracted especially if the tooth is infected.

It is an option to wait for the teeth to exfoliate and be replaced by their succedaneous counterparts. 

Advanced studies in oral and dental health education lead to the idea of restoration treatment for children. 

Parents of kids with badly broken teeth most often had to contend with non-functional and non-attractive teeth until the succedaneous teeth replace them. 

It is not pleasant to look at children with bad teeth.  Oftentimes, kids with bad teeth get teased by older children.

The kids’ parents see their children as good looking despite having bad-looking teeth. 

More often, it is the anterior primary teeth that is most affected.

More often, too, big cavities on their kids’ teeth make chewing hard and leaving them out from enjoying a variety of food.

It is possible that in an early age, diet is limited to soft, sweet and chewable food, which may not have plenty of nutrients.

Crowns are the restoration method often chosen if the tooth is difficult to restore with amalgam, composite, GIC and other restorative materials.

It has become common for crowns to be used in kids’ teeth with plenty of benefits aside from aesthetics. Crowns can help preserve the teeth.

In this column, we are exploring the future of the use of crowns for kids.

Next week, we will go into full discussion about the use of crowns in kids’ teeth.

By Dr. Ria Maslog

The Full Growth Potential in this Global Pandemic

Even in this time of the pandemic, we are very privileged to be able to listen to lectures of experts to help us better address concerns of children.

In today’s issue, I will be sharing with you the inputs of Dr Joselyn Alonzo-Eusebio, Head of the Developmental and Behavioral Pediatrics of the National Children’s Hospital in Manila.

She said that while we are focused on safeguarding our lives and our livelihoods, children are at risk of being forgotten. And that, 99% of children live in 1 of 186 countries with some form of movement restrictions thus putting their health and nutrition at risk.

There are three factors that are closely linked to child growth. These are financial security, nurturing environment and immunity. If these three are being given utmost attention, then we will be able to keep children healthy and safe.

In this time of the pandemic, let us optimize the opportunity to educate parents on the relevance of sanitation and health and nutrition. Parents and responsible care givers should know by heart the ” Pinggang Pinoy”. This is a food guide using a food plate model to show the recommended proportion of food groups in every meal, intended specifically for healthy Filipinos. This food guide also promotes a physically active lifestyle and encourages Filipinos to eat less salty , fried, Fatty, and sugar – rich foods to prevent chronic diseases. Children should be offered flesh foods, legumes and nuts, grains, roots and tubers, eggs, dairy products, Vit A rich fruits and vegetables and other fruits and vegetables. In every meal, there must be a Go, Grow and Glow foods in the child’s plate.

In Pinggang Pinoy, 17% should consist of fish and its alternative, 17% fruits, 33% rice and alternatives and 33% vegetables. If this guide is being followed, then we can eliminate underweight, stunting and micronutrient deficiencies in children. When dietary counseling and food fortification are not sufficient to increase dietary intake and reach nutritional goals, then Oral Nutritional Supplements (ONS) may be used to meet the child’s needs. So what is an Oral Nutritional Supplements? These are sterile liquids , semi-solids or powders which provide macro and micro nutrients.

If there is undernutrition, this will result to compromised immunity leading to infection, then loss of appetite thus failure to grow. There are five ways to make sure the child’s immune system is strong to avoid an illness. These are:
1. Decrease junk food
2. Eat some bugs (probiotics)
3. Feed the bugs (probiotics)
4. Maximize food (getting creative with food)
5. Stay clean

Foods high in sugar, high fructose corn syrup, artificial trans fats, vegetable oils, refined carbohydrates and processed meats are pro inflammatory foods and they should be minimized. Instead, children should be offered probiotics, high fiber foods which include fruits, vegetables, legumes and whole grains.

Hand in hand with good nutrition, physical activity in children is associated with improved defense against infection and improved linear growth. Indoor physical activities are being encouraged.

Dr. Dionisio gave emphasis on the role of sleep to promote linear growth. Furthermore, she gave tips on how to help kids get better sleep. These are:
1. Set up a bedtime routine
2. Relax before bedtime
3. Keep a regular sleep and wake times
4. Keep older children’s naps early and short
5. Make sure the child feels safe at night
6. Check noise and light in the child’s bedroom
7. Avoid the clock
8. Eat the right amount at the right time
9. Get plenty of natural light in the day
10. Avoid caffeine

Besides, providing a well balanced nutrition and promoting exercise and good sleep, a nurturing environment should be provided most especially during this time of the pandemic. A nurturing environment shapes and calibrates the functioning of biological systems. A responsive caregiving to children is the key to a nurturing environment. Parents can reduce stress and support children during this covid19 outbreak by practicing the ” serve and return”, maintaining social connections and by taking a break with or without children. In serve and return, the parents or caregivers will interact socially and physically with children. Here, they will be able to feel that they are not alone and that their actions are being reciprocated by a responsible adult.

So it is our responsibility to protect the health and nutrition of every child. Even in this time of global pandemic, we should always remember that optimal growth occurs when the three conditions are met. These are adequate nutrition, absence of illness and reduced- stress nurturing environment.

By Dr. Cora Lim

Understanding Cirrhosis of the Liver

Scars happen. When scars replace healthy tissue, it can lead to health problems especially when it happens in the liver.

Cirrhosis of the liver happens when scar tissue replaces the healthy liver tissue. When this happens, the scar tissue blocks the flow of blood through the liver. This may lead to a reduced ability for the liver to process the nutrients, medicines, hormones, and to neutralize the toxins.

Before learning about cirrhosis, we need to know what the liver is.

The liver is an organ in our body. It is known as the largest internal organ in the human body. It is an important organ as it is responsible for many functions such as making blood proteins, transporting oxygen in the body, and also helping the immune system.

The liver is also responsible for storing excess nutrients and to return the excess nutrients back to the bloodstream.

Your liver is also the one producing bile which is important in digesting the food that you eat.

Moreover, the liver is also storing excess sugar in the blood in the form of glycogen.

The liver is also responsible for the elimination of toxic substances. It is also the one that eliminates excess drugs and alcohol in the body. 

The liver is an important organ as it is responsible for breaking down fat from the food that we eat and also producing cholesterol.

The liver is truly a vital organ that we need to take care of.

Now, cirrhosis of the liver is a slow developing disease where healthy liver cells are replaced by scar tissue. Eventually, cirrhosis of the liver will prevent the liver from functioning properly,

There are many possible causes why cirrhosis of the liver happens.One of the possible reasons people suffer from cirrhosis is due to Hepatitis B and C. Viral infection to the liver may end up causing cirrhosis. Another reason why people end up with cirrhosis is due to fatty liver disease. People who are obese or with diabetes may end up with fatty liver and eventually will have cirrhosis. Drug and alcohol abuse may also cause cirrhosis of the liver. The reality is that anything that can cause damage to the liver may lead to cirrhosis.

The symptoms of cirrhosis will depend on the stage of the disease. There will be no symptoms when the cirrhosis is at an early stage. As the disease progresses there could be symptoms that may arise. People with cirrhosis may lose appetite, lack of energy, weight loss or weight gain, jaundice or the yellowing of skin or eyes, itchy skin, edema, swelling in the ankles, legs, and abdomen, brownish color of the urine, confusion, personality change, blood in the stool, and fever are some symptoms related to cirrhosis.

If there are symptoms such as edema, a combination of diuretics and reduced salt intake are keys in reducing swelling due to edema. In extreme cases, the doctor may have to drain fluid from the abdomen. The fluid may lead to infection which is called peritonitis.This condition may be treated with the help of antibiotics.

People with cirrhosis may end up needing liver transplant as the liver can become badly damaged.

To prevent cirrhosis, it is important to know how to take care of the liver. Avoid alcohol and drugs and at the same time manage your blood sugar and to lose weight as needed. This way, one can help reduce the possibility of developing cirrhosis of the liver.

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