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Tackling teething troubles

It was a proud moment for Dr. V. Rangarajan to be recognised by the International Congress of Oral Implantologists, New York, for his work in implantology. An interview with the professor-consultant.

WHEN YOU got to know that this young dentist from Chennai was one of the four Indians whose work in the specialised area of tooth replacement had won him recognition from the International Congress of Oral Implantologists, New York, you had to know more.

"Dental Implantology as an area of specialisation in dentistry is a very recent science," begins Dr. V. Rangarajan, professor, Ragas Dental College and consultant, The Tooth Place and Sundaram Medical Foundation. But before he gets into the nitty-gritty, he explains what the `Diplomate' he had been awarded actually involves.

It is a carefully documented and diligently followed up record of 100 of his patients on whom he had fixed implants with success, that got him the title (that's how the Diplomate is referred to). The cases are reviewed by an expert committee at the international level before the doctor is deemed fit for the honour. Incidentally, Rangarajan had his training in Implantology in Germany and the U.S. "There are other dentists here who do implants but I am the first doctor in South India, to have been conferred this title — the other three are from Mumbai," says Dr. Rangarajan.

Undoubtedly, the awareness about proper care of teeth is much more these days, because we live at a time when everyone young, old, rich or poor, is conscious of his appearance and knows that if your well groomed looks create a favourable first impression, sparkling, clean teeth is a straight ticket to success. Also because nowadays you have so many other diseases being linked to teeth ailments, the need to have healthy teeth and gums is understood to be imperative.

"Yes ... fixing false teeth in the upper jaw is more effective but in the lower jaw as the grip is less, after some time they start moving when you eat or talk — that could be really embarrassing, and that's where implants come as a foolproof process. The false teeth look completely real and useful and also prove a tremendous confidence builder. So along with the treatment we also boost the patient's morale and self esteem. Also it is now being proved that those with periodontal gum diseases are prone to heart problems," the doctor explains.

So the primary step when you decide to go to a doctor for tooth replacement is to check out whether he is trained and experienced. "That way, half the problem is solved even at that stage itself," feels Dr. Rangarajan.

The implant is just a small cylindrical object that functions as the root. Once the implant is placed the patient can get back to his routine for the next three or four months before the artificial tooth is fixed to it. And most importantly it is a permanent. Dr. Rangarajan further explains: "Placing the implant is a minor 15 or 20-minute surgery, with just local anaesthesia. You wait for the spot to heal after which, the prosthodontist makes the mould, gets the tooth ready and fixes it with the help of biocompatible screws. Implantology is a part of prosthodontics."

Just as you have specialists in every area of medicine, among dentists you have orthodontists, prosthodontists, endodontists and so on. So, it's all about specifics and approaching a specialist accordingly.

Implants are ideal for those who have lost a tooth or two in a mishap. They can have artificial replacements that are as good as new. And a permanent set of false teeth held strongly with just two implants, are suitable for the elderly, who have lost all their teeth. So from 18 to 80 any one who needs an implant can go ahead and have it, provided their health is otherwise normal.

"Implants don't take too kindly to smokers. So the implants could be rejected," smiles the doctor. Uncontrolled Diabetes, those with bleeding disorders and those who have undergone radiation therapy in the jaw are the others for whom implants may not be possible. But for others it is a sure, safe and simple procedure.

Every case is a challenge, feels Rangarajan. The implant placed on a 77-year-old man and the few teeth fixed on the lower jaw of a middle-aged woman, are successful cases he is happy about. "Making and fixing such replacements are too tough a proposition. Added to it, due to constant paan chewing the woman had developed sub-mucus fibrosis and couldn't open her jaw fully. The teeth in the hind part of the jaw had to be replaced. With one implant and a little of the traditional method of grinding the healthy teeth, we could succeed."

In fact, that is another reason why implants are a boon. Till about two decades ago, the only way to fix dentures was by grinding the good teeth on either side and placing them tight in between. But in the case of implants the perfect teeth remain undisturbed. Treatment involves only the affected area.

Fixing false teeth to look different has always been a fad among many actors here and abroad. (Remember Kamal Hassan in "Kalyanaraman" and in the recent "Anbae Sivam" and Ajit in "Citizen"?) This is part of a prosthodontist's job. So is fixing artificial ears, nose, lips and so on.

"Years ago, some of our big actors who could not allow themselves to be seen with damaged dentures travelled all the way to Singapore to have implants and perfect teeth. Now such sophisticated treatment is available here in Chennai," assures Dr. Rangarajan.

And when the conversation returns to the recent recognition, "These things only goad one into working harder," his enthusiastic comment.


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