Do my young sons need fluoride for their teeth?
Dear Dr Donya,
I live in Medan and I have two sons, aged 3.5 years and 1.5 years. My elder son brushes his teeth with fluoride toothpaste twice daily. My younger son brushes without toothpaste at the moment. Can you recommend fluoride supplements for my sons? I asked pediatricians in Medan before, and the reply was fluoride supplements are not necessary until their permanent teeth appear.
-- Lina
Dear Lina,
Fluoride can get into the body and is taken up by the permanent teeth which are developing in the jaws or by direct application from toothpaste. Your first son already has fluoride toothpaste, and most young child swallow it so he will get fluoride from that and is at risk of getting too much fluoride. Doses in tablet form depend on how much fluoride you have in your drinking water for, as I wrote in a previous article, too much fluoride can also cause teeth problems.
As fluoridation of drinking water is not practiced in Indonesia, your first son needs 0.5 mg of fluoride but your second son will not need supplements until he is two years old, then he will need 0.25 mg. Remember to take your two sons to see the dentist regularly, too.
-- Dr. Donya
Dear Dr. Donya,
I have a question about economy class syndrome associated with air travel. Since I was young, from about the age of 15, I have always had a problem with my legs. If I'm too tired or overexert myself, I always have a blue block under the skin of my leg. Doctors say it is because my blood muscle is very thin, so if I overexert myself in activities, it will damage the muscle. Is that true? What should I do to combat the condition?
At the beginning of July, I am going to London by plane. I travel a lot in Indonesia, but usually not by plane, so this time will be my longest trip by plane. (the longest travel by plane I ever experienced was only seven hours). What do you advise for this?
I have another question as well. Every time I have my period, I always have a problem with headaches. They occur on the first and second day. is there anything I can do to avoid this? I'm 30, unmarried, blood group AB and work.
-- R. in Yogyakarta
Dear R.,
The problem of your legs is varicose veins, which are dilated tortuous superficial veins that result from defective structure and function of valves of the vein, due to high intraluminal pressure (in layman's terms, strain on the legs).
Varicose veins originate in the superficial system and occur two to three times as frequently in women as in men; 50 percent of sufferers have a family history of the condition. It affects the cosmetic appearance of the legs and also causes pressure in the legs after prolonged standing.
Leg elevation will relieve the symptoms. The treatment will be conservative, such as to avoid prolonged standing or elastic support hose which can compress the vein and cause more pressure.
The other cause can be from a defect in the valve system; you may have deep vein thrombosis if you sit a long time and do not move your leg so the blood gets stasis and struck. My recommendation is that when you are on the flight, move your legs, walk and stand once in a while.
Symptoms of headache when you have your period are normal but you can take some paracetamol or ibuprofen in the first two days around the clock to relieve pain. Also check with your doctor to see if you have any anemia or heavy blood loss that can cause headaches.
Take care and have a safe trip.
-- Dr. Donya