Blog – AMARA MEDICARE | Dental, Eye & ENT Specialists


Teething baby with pacifier
Teething baby with pacifier



Teething is a natural process of infancy involving tooth eruption which commences from between 4  months to about 3 years of age. The child’s gum becomes sore as the new tooth pushes on the gum. The pressure of the tooth pushing against the gum can make baby’s mouth hurt.

Once the mouth hurts, discomfort is bothersome to the baby, thus tendency to not want to eat any food. Your baby may cry because of hunger pangs. During teething, baby gum is irritable and as a result may not feed well, thereby causing the child to cry often.


  • Swollen, tender gums
  • Fussiness and crying
  • A slightly raised temperature (less than 38°C)
  • Gnawing or wanting to chew on hard things
  • Lots of drool
  • Changes in eating or sleeping patterns
  • Mild chin rash due to constant saliva drooling on the chin


There are symptoms which you should not expect to see in your baby during teething. Such includes:

  • High fever (more than 38°C)
  • Diarrhea and watery stools,
  • Red eyes,
  • Coughing and vomiting.

These symptoms are not normal and not associated with teething. If you notice them, contact your doctor immediately.


  • Clean your baby’s teeth with a warm wet wool or soft brush. Do this in the morning and after every meal.
  • Babies love to chew or bite on anything they find when they are teething to ease their gums. To prevent picking things from the floor, cold teething rings or pacifier can be given to the child. Approved teething rings are made of plastic and do not choke. Ensure you clean the teething rings regularly.
  • During teething, make sure your baby eats well to remain healthy. Boiled carrots, dry biscuits and fruits such as apple are good foods that the baby can chew on. Foods that you give to your baby should be sugar free in order to prevent tooth decay.
  • Do not put a dummy or pacifier on a chain around baby’s neck to avoid strangulation. The baby’s gum should also not be cut for any reason as this would cause infection.
  • Visit the Dentist regularly for checkup of your baby. The doctor can tell you how to get approved teething rings and also other ways of caring for your baby and the teeth.







Image of teeth before and after scaling and polishing
Image of teeth before and after scaling and polishing


Most diseases of the mouth are caused by buildup of bacteria around the teeth. The bacteria build up are referred to as plaque and calculus (or tartar), and are formed when food particles are left behind on the tooth surfaces over a period of time. The food particles can be removed by rinsing with water after eating, flossing between teeth and brushing the teeth twice a day. However, no matter how well you clean your teeth there will always be areas within the mouth that are hard to reach and clean.

These areas tend to accumulate tiny food particles, which bacteria acts on and aggregate to form plaque. This plaque build-up, may then mineralize to form tough, hard deposits known as calculus (or tartar) which are sticky, hard & impossible to remove via regular tooth brushing. If these tartar are not removed, more plaque can build up around the tooth and below the gum line causing various gum and tooth diseases.

To reduce the risk of gum diseases and remove plaque and tartar, your dentist will recommend professional cleaning of the teeth called scaling and polishing, at least twice a year.


Dental Scaling and polishing are routine, non-surgical, non-invasive procedures done to remove plaque and tartar deposits built up on the teeth and the polishing of rough tooth surfaces to make them smoother.


There are two stages involved in scaling and polishing of the tooth.

  1. Scaling Stage: This is the first stage that involves removal of plaque and tartar deposits from the tooth surfaces. Often an ultrasonic scaler is used to scrape/remove heavy deposits of tartar and plaques, while other hand held instrument may be used to remove any stubborn deposits that remain.
  2. Polishing Stage: This is the second and final stage that involves smoothening of the teeth surfaces. Here, a polishing brush along with ‘special toothpaste’ is used to remove stains and to smoothen rough –like texture on the tooth surfaces. A stain removing chemical may be applied on the tooth surfaces to remove stubborn tooth stains. A smooth tooth surface helps to prevent easy buildup of plaques.


The procedure does not pose any direct risk to your teeth or gum. Instead it has great benefits in preventing various gum and teeth diseases in the mouth. In the course of the scraping stage, you might have minor sensitivity due to the vibrations from the instrument. However, this sensitivity can be managed by reducing the frequency of the ultrasonic scaler and use of desensitizing agent. Scaling & polishing is thus considered safe for all.


Scaling and polishing should be done at least twice a year. However, your dentist may recommend more frequent times depending on your oral health condition.


  1. It helps to prevent various gum and teeth diseases such as gingivitis, periodontitis, dental caries etc.
  2. It helps to prevent bad breath (halitosis).
  3. It keeps the gum healthy and less sensitive.
  4. It helps to maintain the natural tooth color, texture and brightness.
  5. It helps to improve your smile.


Yes. As long as there is at least a tooth in the mouth, then scaling & polishing can be done. It is beneficial for all age group.


Scaling and Polishing is very affordable as it is a routine dental treatment regularly prescribed by the dentist. In Nigeria, the price ranges from about ₦10,000 (Ten Thousand Naira) and above in most urban areas depending on the type of care provider and cost of living within the geographical area.




Image of pregnancy gingivitis
Image of pregnancy gingivitis

Pregnancy is defined as a state that includes fertilization, implantation, embryonic and fetal growth. Gingival enlargement begins with increasing Gonadotropin level (hormones responsible for reproduction) and is maintained through months 3 to 8 of pregnancy.

Pregnancy gingivitis is inflammation (swelling) of the gingival tissue caused by hormonal changes and progesterone. The prevalence of gingivitis during pregnancy has been studied in different population and it varies between 67 to 100%. The prevalence is circa 85.2% in Nigeria.


  • Erythema (redness)
  • Edema (swollen gum)
  • Hyperplasia (excess gum swelling)
  • Increased spaces between tooth and gum
  • Bleeding gum
  • Mobile tooth
  • Pain on gum while brushing or eating.
  • Mouth odor


  • Brush teeth twice a day (morning and the last thing at night before sleeping);
  • Dental floss use after eating;
  • Occasional use of mouthwashes as prescribed by the dentist;
  • Eat food with plenty of vitamin B12 and vitamin C. Common food that contains these vitamins include vegetables, fruits, soya beans, low fat milk, eggs, beef, kidney/liver, grains;
  • Visit a dentist for advice on preventing/controlling plaque and gingivitis and routine checkup (3monthly visit);
  • Dental cleaning (scaling and polishing) is necessary.


Bacteria (accumulated in plaques) from a mother’s mouth can be transmitted through the blood and amniotic fluid in the womb to her unborn child. This could contribute to the risk of a premature delivery, a low birth-weight baby, premature onset of contractions, or infection of the newborn child.


There is sufficient evidence that the lack of oral health care during pregnancy can have negative outcomes for both mothers and their newborns. Oral health needs should thus be emphasized in ante natal patients.

Eating Healthy, living healthy, regular visitation to the dentist & physician ensures delivery of a healthy baby that makes a happy family, happier”






Image of Mouthwash being poured into a cup

Mouthwash, also known as mouth rinse is a flavored, usually medicated solution used in rinsing the mouth and treating certain diseases of the mouth. It is an adjunct to regular oral hygiene practices. It is worth noting that use of mouthwash is not a substitute for daily tooth brushing and flossing. In Nigeria, mouthwashes can easily be bought on the counter and many tend to abuse its use and seldom use it as a substitute for tooth brushing. Generally, mouthwashes are useful for keeping the mouth healthy when used as an adjunct to regular brushing and flossing.


There are 2 broad types of mouthwashes based on there impact on germs. They are as follows:

  1. Cosmetic Mouthwashes: These work to temporarily mask bad breath. They are not formulated to directly kill germs instead they contain various flavors that help to contain bad odors. They do prevent gum diseases or tooth cavities.
  2. Therapeutic Mouthwashes: These works by controlling the germs in the mouth. They are formulated to kill germs or prevent buildup of germs in the mouth that can lead to various mouth diseases. How they work is determined by the active material used in formulating the mouthwash. Common active ingredients to look out for include the following; cetylpyridinium chloride, chlorhexidine, essential oils, fluoride; peroxide. Others can be formulated at home using doctor’s prescription e.g. salt and warm water etc.



  • They help to prevent or control tooth decay.
  • They help to reduce plaque & tartar.
  • They help to prevent or reduce gum diseases.
  • They help to freshen breath and control bad breath.
  • They can be prescribed to help treat various dental conditions such as mouth ulcer, dry sockets, periodontitis (a condition that makes the tooth mobile).
  • They are used as an adjunct to help the bone heal when a tooth is removed.
  • Fluoride containing mouthwashes can help to prevent tooth cavities.


Generally, mouthwashes should be used as prescribed by your dentist. It is worth noting that some mouthwashes contain some ingredient that tends to bind with fluoride and thus render the mouthwash (therapeutic ones) inactive. In order to prevent this, your doctor may advise you not to use mouthwash immediately before or after tooth brushing. You may also be advised to use them after eating as a mouth rinse to remove food particles that may lodge between the teeth.


Children below the age of 7 years are advised not to use mouthwash since their swallowing reflex (ability to control what is being swallowed) may not be well developed. Whenever mouthwash is recommended for children by the dentist, it is done under strict supervision and specific timeframe.


Some mouthwash contain alcohol and thus when consumed in large quantities may lead to nausea, vomiting and intoxication. Some mouthwash may stain the teeth when used for a long period, while some may also alter your taste. It is thus important to consult your dentist whenever you want to buy therapeutic mouthwash so as to guide you on the type, quantity, frequency and period of time to use the mouthwash and if it is safe for use as mouthwash may stain veneers, filling or crowns in the mouth.


Mouthwashes may offer additional benefit in terms of reducing the risk of bad breath, cavities, or gum disease; or for relief of dry mouth or pain from oral sores, however, they are not replacement for routine tooth brushing and flossing.





Before and after picture of Teeth whitened by AMARA MEDICARE LAGOS
Image of teeth before and after teeth whitening


We tend to be more self-conscious about the appearance of our tooth shape and color. The appearance of the tooth tends to affect how a person smiles and conduct himself in the public. Studies have shown that there is a direct relationship between low self-esteem and tooth discoloration. It is thus not surprising that people with discolored tooth tend to seek ways to make their teeth brighter. However, some are skeptical about the safety of teeth whitening.

Teeth whitening also referred to as teeth bleaching is a treatment modality that involves bleaching of your teeth to make them lighter. It lightens the existing color of teeth by several shades.  It is a procedure that should be done by a dentist or under the supervision or recommendation of a dentist.


Tooth discoloration refers to abnormal tooth color, hue or translucency. Normal tooth color varies according to race, gender and geographic region. Females generally have slightly whiter teeth than males, partly because females’ teeth are smaller. Baby teeth are generally whiter than the adult teeth. Tooth can become discolored due to the following reasons:

  1. Extrinsic Discoloration: These are tooth stains located on the outer surface of the tooth structure. These are common and it may be a result of various causes, such as;
    1. Poor oral hygiene
    2. Gingival bleeding
    3. Tobacco chewing habit
    4. Mouthwashes e.g. chlorhexidine
    5. Eating habit e.g. tea, coffee stains
  2. Intrinsic Discoloration: These are tooth stains which are located on internal surfaces of teeth. They occur due to defect within the tooth. Intrinsic discoloration may need to be professionally bleached to make the teeth whiter. They can be due to systemic or local causes such as;
    1. Enamel hypoplasia
    2. Medications e.g. ciprofloxacin, tetracycline, minocycline
    3. Dental fluorosis
    4. Childhood illnesses
    5. Ageing
    6. Trauma


There are several methods and products that are safe for teeth whitening, however, the method or products to be used are dependent on the causes of tooth discoloration and presence of  any oral conditions such as tooth fracture, receding gums, sensitive tooth etc. Generally, professional teeth whitening is done by the dentist using mostly carbamide peroxide to whiten the teeth. This product when broken down gives off hydrogen peroxide (the active ingredient for teeth whitening) and other bye products. This is considered a safe method of whitening the teeth.

There are three major methods for whitening the teeth and these include;

  1. In Office Treatment – This is the most appropriate & safest means of whitening teeth as it is administered and monitored by a dentist. It is termed In-office because it is done within a dental clinic. This process involves the use of a high concentration of hydrogen peroxide to whiten the teeth. This procedure can be done within an hour or a few days depending on the cause of the tooth discoloration and product used. It is also more beneficial as it gives a better treatment outcome within a shorter time. In- office treatment is recommended if you have any oral condition such as receding gums, sensitive tooth, broken tooth etc.
  2. At Home Treatment – This is a whitening procedure in which your dentist dispenses a product for you to use at home. Usually, your dentist will make a custom-fit tray for you at the clinic which fits your mouth and dispenses a gel for you that you will put in the tray at home and after which you will wear the tray for a certain time set by your dentist. You may have to wear the tray for a few weeks as prescribed by your dentist to whiten your teeth. Your dentist will determine if it is safe for you to use at home.
  3. Over The Counter (OTC) Treatment – This refers to the use of whitening products that can easily be sourced from the pharmacy or supermarkets. Unlike the products administered by a dentist, these locally sourced products do not contain carbamide/hydrogen peroxide, or, has very little concentration of it. For your safety, always check the constituent of any whitening product you buy, ensure it is endorsed by Nigerian Dental Association (NDA) and contact your dentist about the product if it contains hydrogen/carbamide peroxide. Examples of OTC products include whitening toothpaste, whitening strips.

For list of oral products approved for use in Nigeria, kindly visit


Teeth whitening is safe. However, there is possibility of having a few side effects which tends to diminish after a few days. The side effects include teeth sensitivity and irritated gum.

  • Teeth sensitivity-Your teeth may become more sensitive following teeth whitening. You may experience this on your first or second treatment, and it may diminish with time. Your dentist may recommend treating sensitivity with products that contain potassium nitrate and sodium fluoride gel.
  • Irritated gums- You may also experience gingival irritation. This is when your gums become irritated. This can happen because of contact on your gums with the whitening product. This side effect should go away after your treatments.


Generally, in order to maintain the whitened tooth, the following instructions are important;

  1. Maintain good oral hygiene. You are to brush twice daily (In the morning before eating and last thing at night before sleeping) with a fluoride containing toothpaste and a medium bristle toothbrush.
  2. Avoid eating colored food (palm oil containing food, red wine)immediately after the procedure for about one week or as prescribed by your dentist.
  3. Avoid acidic drinks (soft drinks), coffee, tea after the procedure for about a week or as prescribed by your dentist.
  4. Always rinse your mouth with clean water after eating.
  5. Regular dental visit (6monthly) for follow up and possibly repeat whitening procedure.



As long as you stick to dentist-approved methods, whitening your teeth is considered safe. Make sure to use the method that fits your needs and always follow the directions for the product. Contact your dentist if you experience any side effects.


Image of Partial edentulism
Partial edentulism

Edentulism is simply defined as toothlessness. It is a condition of one being toothless to a certain degree. It can either be partial or complete.

Partial edentulism – this occurs when someone has loss of one or more of his/her tooth but not all of the teeth.

Complete/total edentulism – this occurs when someone has loss of all teeth in the mouth.


  1. Dental cavity: when a tooth that has hole is left untreated for a long time, it may degenerate to the stage that the only viable option would be to have it removed.
  2. Gum diseases/peridontal diseases affects the alveoli bones, peridontal ligaments and gum which together form the principal support of the teeth resulting in loosening and falling out of the tooth.
  3. Trauma

Other risk factors include:

  1. Smoking: leads to gum damages, therefore it is best for nicotine addicts to quit;
  2. Age: studies shows that more than 70% of people over the age of 65 have had one or more tooth removed due to cavities or gum diseases;
  3. Genetics: if your blood relatives have removed their tooth, you may also have an elevated risk as well;
  4. Stress;
  5. Certain medical conditions such as diabetes, hypertension, rheumatoid arthritis might make one susceptible to tooth loss because they contribute to risk of developing gum diseases;
  6. Certain medications may cause side effects like dry mouth that can further develop gum diseases.



  1. Loss of facial aesthetics.
  2. Loss of fullness of the cheek, facial vertical height.
  3. Alterations within the lips and tongue making some pronunciations difficult.
  4. Gradual degeneration of the alveoli bone within the mouth which makes the tongue broaden out and creates difficulty for dentist when creating a denture.
  5. Masticatory difficulty.


  • Brushing your teeth twice daily (morning and at night)
  • Flossing after every meal
  • Visit your dentist twice yearly
  • Usage of dentist – recommended mouthwash
  • Prompt treatment of any existing tooth cavity.


Edentulism/tooth loss has a vast impact on an individual’s general and psychological health. Thus, early presentation and regular dental visits will help to prevent unnecessary loss of tooth and enhance proper oral management.





Image of Partial edentulism
Partial edentulism


Fixed Palatal Crib
Fixed Palatal Crib

Early and regular dental visit is essential in helping to maintain a child’s oral hygiene and promoting a good occlusion into adulthood. Some bad tooth alignment that is seen in some adults could have been better managed during childhood. In Nigeria, most pediatric visit starts at the age of 7-9 years and even at that more than 50% of children within that age group may not visit the dental clinic. Most pediatric visit is due to pain and when there is a need to wear an appliance, some parents are reluctant for various reasons; financial, cultural, psychosocial etc.

It is important for parents to understand that wearing of appliance in children is safe and may be necessary for both preventive and treatment purposes. Many children with persistent tongue or thumb sucking habits can be treated with appliances if behavioral management seems unhelpful. Appliances can also be worn to prevent misalignment of tooth, proper tooth eruption as well as helping to replace early loss of tooth in children.

It can be extremely difficult to encourage young children to wear removable dental appliances regularly.  Pediatric dental appliances can prevent injury to the teeth and may also reduce (or even eliminate) the need for extensive treatment later.


There are many types of pediatric dental appliances that can be recommended for various purposes. The major categories of pediatric dental appliance are as follows:

  1. Space Maintainers – Sometimes, primary (baby) teeth are lost prematurely due to trauma or decay.  Adjacent teeth tend to shift to fill the space, causing spacing and alignment problems for permanent (adult) teeth.  Space maintainers are inserted as placeholders until the permanent teeth are ready to erupt.   Depending on the position of the missing tooth and the condition of the surrounding teeth, the dentist may prescribe a band and loop, a crown and loop, a distal shoe or a lower lingual arch type of space maintainer to fill the empty gap. All spacer maintainers have similar function; however, the nature of the attachment to the adjacent teeth differs.  Fixed space maintainers are usually made of metal and are highly durable, while removable ones are rarely used with young children.
  2. Mouth Guards – The Nigeria Dental Association (NDA) recommends that children wear mouth guards when engaging in any potentially injurious activity, including sporting and recreational endeavors. The pediatric dentist can fabricate a customized mouth guard for the child, or a thermoplastic “boil-and-bite” mouth guard can be purchased.  Similar mouth guards are used for children who grind their teeth at night, a condition known as bruxism.
  3. Sucking Appliances – Children tends to have various habits, namely; thumb sucking, finger sucking, tongue sucking, tongue thrusting, lip sucking etc. Naturally, majority of children tend to outgrow their habit. However, children who continue to have habit after the age of 5 or 6 years risk oral complications such as; narrowed arches, impacted teeth, and misaligned teeth. Appliances such as goal post, palatal crib or rake, tongue crib, modified quad helix etc., can be used to correct various habits in children.


Other appliances include Expansion appliances used to widen the jaw arch in order to accommodate erupting tooth especially in children who have cleft palate, Bionator used for children in which their upper or lower jaws is proportionately smaller, Retractors used to correct misalignment and Retainers used to maintain tooth alignment.


Pediatric dental appliances are safe and may be necessary to prevent teeth misalignment in children as well as reduce cost of treatments in the future


Image of a baby born with teeth
Baby born with teeth

Teething is a normal part of a baby’s development during the first year of life. Most babies get their first tooth between 4 and 7 months of age. However, some babies are born with teeth and these can seem mysterious or superstitious to some families especially those culturally inclined. Some of these children tend to be deprived of parental love and care based on cultural or spiritual beliefs. Some ethnic groups in Nigeria refer to these children as ‘ogbanje’, ‘abiku’ etc. because they believe that the children are monstrous and bearers of misfortune.

These sets of teeth are referred to as natal or neonatal teeth depending on how early they grow in the child’s mouth and one should not be scared or worried about them unless the teeth interfere with feeding, or are a choking hazard.


Natal Teeth – These are teeth present at birth.

Neonatal Teeth – These are teeth that erupt above the gum within the first month (30 days) of life of the baby.


Natal teeth are relatively rare and occur in at least 1 out of every 2,000 live births. The rarity of natal teeth explains in part why some traditional beliefs were attached to it. The exact cause of teeth at birth is unknown. However. some medical conditions and predisposing factors are said to be associated with natal teeth.


  • Cleft Lip & Palate
  • Sotos
  • Hallerman-Streiff
  • Pierre Robin
  • Ellis-van Creveld
  • Down Syndrome
  • Ectodermal Dysplasia
  • Craniofacial Dystosis


  • Close Family members with natal teeth
  • Malnutrition during pregnancy
  • Poor maternal health during pregnancy
  • Congenital Syphilis
  • Endocrine disturbances


  1. Fully developed crown held down by little root
  2. Fully developed crown with no root
  3. Small tooth crown just emerging through the gum
  4. Unerupted but with evidence of tooth about to cut through the gum


Natal teeth that aren’t loose are usually left alone. But if your baby is born with loose teeth that have no roots, your doctor might recommend surgical removal. Some common complications of a loose natal tooth include;

  • Choking from accidental swallowing of the loose tooth
  • Feeding problems
  • Tongue injuries such as ulcer, inflammation etc.
  • injuries to the mother during breast-feeding
  • Dental caries on the tooth


No intervention is usually recommended unless they are causing difficulty to the infant or mother. However some recommend that they be removed as the tooth can cut or amputate the tip of the tongue. They should be left in the mouth as long as possible to decrease the likelihood of removing permanent tooth buds with the natal tooth. They should also not be removed if the infant has hypoprothrombinemia (a condition in which the baby can have spontaneous bleeding if the tooth is removed).


Being born with teeth is rare, but it’s possible. If your baby has teeth at birth, be sure to talk to your dentist. A dentist can help guide you through the process. Even if your newborn’s teeth aren’t considered an immediate concern, it’s important to monitor them to prevent any complications.


Strabismus is a medical condition when eyes don’t line up or when one or both eyes wander.
•. The eyes may turn inward (called Esotropia or Cross-eyed)
• Outward(Exotropia)
• Up (hypertropia)
• Down(hypotropia)


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