Ask the docor

Should I extract all my bad teeth?Dear Doctor;I am 32 but I have already lost three molars. For the last four years, I have been relying on amalgam in another of the infected molars, but the pain is now getting to me. Besides, a premolar is also getting similar problems. What is the best option for such a dilemma I am in? Should I just extract them all? Frank Nsengimana, Gikondo.Dear Frank, I can understand your suffering. Good dental hygiene is the best way to prevent dental infections. Drilling and filling teeth itself is controversial now. Because it is said that drilling and filling with amalgam does not prevent tooth decay. Rather the intervention can cause further damage to the affected tooth, making it more prone to infections. Whether affected teeth have to be extracted, would be best decided by a dentist after examining your tooth. But recurrent infections (as indicated by pain) affect the underlying gums and bones as well causing the root also to decay. Net result is that in most of the cases, the tooth falls off naturally.My eight-month-old baby doesn’t like sleeping, how do I help him?Dear Doctor;My eight-month-old baby does not want to sleep. I know I am equally into staying up late reading novels or watching movies but the baby worries me. He will even refuse to go to sleep when we have all decided to. Usually, he falls tired and sleepy toward or at 3am. Lullabies seem not to be helping. Could there be a problem with the child? How can we get him to sleep? James Niyitegeka, Kacyiru.Dear James, Children, particularly babies, do not have a fixed, sleep-wake up cycle, although they have longer hours of sleep. If he is sleeping by 3am, he definitely would be sleeping until late hours in the morning or in later part of the day. As a parent, you can organise his sleep pattern. First see that he is well-fed in the evening, because children if hungry tend to be cranky and do not sleep well. Check that he does not have any physical problem. Try to keep him awake throughout the day or do not let him sleep for long during daytime. This can be achieved by playing with him for long hours or taking him out of the house. The entire family should sleep by a fixed time and get up at a fixed time. Gradually, the baby will also fall in this pattern. Until then, bear with him.What really amountsto being ‘overweight’?Dear Doctor;I am 31 and I weigh 77 kilogrammes although my body mass appears bigger. My legs are big and my stomach is potty. Friends say I am overweight although I don’t feel anything like it. What really amounts to ‘overweight’? Is there a specific way by which health experts arrive at such a deduction? Muneza.Dear Muneza, The weight alone is not a criteria for being overweight, because weight varies as per the height, muscle mass and bone density of a person. The criteria used is BMI (body mass index) which is calculated using the formula; weight in kilogrammes over (divided by) height in metres square. If it is more than 25 it indicates obesity. Another criteria is WHR, ie, waist hip ratio. Here, the ratio of circumference of waist and hip is measured, more than 0. 9 in a man is obesity. Even if not obese by these criteria, if you are having a flabby stomach, it indicates that regular exercise is needed to prevent it from growing. Because someone may have a normal body weight but with central obesity, that is to say, a paunch coming out, the risk for heart diseases increases,Is it a must for expectant women to continue sex during their pregnancy?Dear Doctor;I am five months heavy with my first pregnancy. I had always thought that when a women conceives, she stops having sex until the baby comes. But friends have been telling me that I need a man by my side to be able to have a ‘normal’ delivery. Is this so? I still live with my parents because I am not married. Jessica, 21.Dear Jessica, Usually sex during pregnancy was discouraged in all communities to avoid risk of infection and possible damage to the intrauterine baby. But now research has revealed that it is perfectly safe to have sex during a normal, healthy pregnancy because baby rests well cushioned by the uterine cavity and amniotic fluid. But sex has to be avoided if there has been some vaginal bleeding, history of miscarriage in pregnancy before, twin pregnancy, abnormal placenta, among other risky pregnancy conditions. Regarding having a man, I think that is a romantic notion of your young friends. How can the presence of a man ensure normal delivery? That depends on how the labour pains progress and other medical conditions. Any loving and supporting person by the side, whether a family member or friend is good enough for physical and emotional support needed during the delivery.