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Treating the 4 Common Dental Problems During Pregnancy

If you asked the average parent to name the roster of a prenatal healthcare team, they are bound to mention a few key players: the family doctor, obstetrician/gynecologist, sonographer, and perhaps the midwife.

What about the dental hygienist?

 

commin dental problems during pregnancy

Parents and healthcare providers often overlook the importance of oral health during pregnancy. However, multiple studies have indicated a link between poor oral health and adverse outcomes in pregnancy.

A comprehensive overview of research on this subject demonstrated that associations exist between periodontitis during pregnancy and pre-term birth, low birth weight babies, and preeclampsia.

Common Dental Problems During Pregnancy

In particular, there are four oral health conditions that become more prevalent during pregnancy:

  1. Gingivitis
  2. Dental caries/cavities
  3. Pyogenic granuloma
  4. Dental erosion

We’ve provided an overview of these four common dental problems during pregnancy, along with how dentists and dental hygienists can play a greater role in providing care to pregnant patients.

1. Pregnancy Gingivitis

During pregnancy, the body’s response to gingivitis-causing bacteria in the periodontal tissue changes. Some studies speculate the change is triggered by hormonal fluctuations, such as increased salivary estrogen levels during the second and third trimesters.

As a result, patients who had periodontitis before pregnancy may find that inflammation increases throughout the pregnancy. Those with no prior history of gum disease may develop periodontitis or notice increased bleeding and gingival crevicular fluid flow.

2. Dental Caries in Pregnancy

The risk of developing dental caries or cavities often increases during pregnancy. Patients may be affected by one or more contributing factors:

  • Decrease in salivary pH due to changes in diet;
  • Increase in acidity in the mouth due to vomiting;
  • Dry mouth; or
  • Poor oral hygiene care due to nausea and vomiting.

3. Oral Pyogenic Granuloma

Pyogenic granuloma appears as a small tissue overgrowth on the gums that can be smooth or lobulated and red or pink. These lesions are sometimes called ‘pregnancy tumours’ because they are more common in pregnant patients; however, pyogenic granuloma is not cancerous and often disappears without treatment.

Though not harmful, a pyogenic granuloma can be painful and unsightly.

4. Dental Erosion During Pregnancy

Patients who experience morning sickness or gastroesophageal reflux disease (GERD) in pregnancy may develop greater erosion of dental enamel. Although there is no way to reverse dental erosion that has already occurred, dental professionals can assist in preventing and reducing its effects.

Assisting Patients with Common Dental Problems During Pregnancy

Pregnancy can be a critical time for a patient’s oral health. Not only does it increase the risk of these common dental problems, but poor oral health care is linked to outcomes like preterm birth, low birth weight, and preeclampsia.

There are many ways in which dental hygienists can help contribute to positive outcomes through good oral health care at all stages of pregnancy:

  1. Encourage patients to have regular dental checkups during pregnancy, even if they are accustomed to seeing the dentist only once or twice a year. Emphasize the added importance of oral health care during this time in their lives.
  2. Be non-judgemental about new concerns the patient may have about dental treatment during their pregnancy. Many people have heightened concerns about medications, fluoride treatment, and dental x-rays during this time; answer their questions with patience.
  3. Reinforce the benefits of good oral hygiene care: twice-daily brushing for two minutes at a time, once-daily flossing, and using toothpaste with fluoride.
  4. Ask about any new medications or supplements the patient may be taking during pregnancy.

Celebrating Hygiene Month

We all have dental hygienists to thank for being a part of our healthcare team throughout different stages of our lives, including the journey towards parenthood.  This is the second in a series of articles we’ve published on this important role during Hygiene Month: a month to recognize hygienists and emphasize the importance of good oral hygiene.

Sable Industries is proud to produce quality dental tools used by registered dental hygienists and dentists across North America. Contact us today to learn how we can assist your dental practice.

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What You Should Know About the EPA’s Rule on Dental Amalgam Separation

The dental profession has long acknowledged the impact of dental amalgam on the environment. In the year 2014, the American Dental Association adopted nine principles on keeping amalgam particles out of dental office wastewater. Then, following consultation between the ADA and the Environmental Protection Agency, the EPA finally issued a final rule on amalgam separation on June 9, 2017; now, most dentists have until July of 2020 to comply.

 

EPA rules for Dental Wastewater

 

The final rule sets guidelines on everything from how to dispose of amalgam waste to minimum efficiency standards for amalgam separators (right down to the decimal point.) Though they may appear daunting, these regulations are not far from the existing APA best practices, and practitioners who start now should have no trouble meeting their obligations by 2020.

 

Dental Economics magazine has published a helpful summary of the rule. These are the main takeaways for dentists and other dental professionals looking to incorporate amalgam separation into their practices.

 

Who Needs to Use an Amalgam Separator?

Most dental offices in the United States are subject to the EPA’s rule on amalgam separation. In most cases, even those practitioners who do not place amalgam fillings must begin using amalgam separators. However, there are notable exceptions.

  • Certain dental specialists may be exempt from the rule, including practices that specialize in oral pathology, oral and maxillofacial radiology, orthodontics, periodontics or prosthodontics.
  • The rule does not apply to mobile units.
  • Dental practices that neither place nor remove amalgam except in limited circumstances (which the rule defines as fewer than 5% of procedures or nine cases per year) may not have to use an amalgam separator.

If your practice falls into one of these categories, it is possible you may not have to start using an amalgam separator. However, certain localities have dental amalgam pre-treatment requirements, and many states have rules that exist alongside the EPA’s new guidelines.

 

How Does the EPA’s Final Rule Differ from ADA Best Practices?

Although the American Dental Association worked with the EPA to develop the requirements, the result does differ from the ADA’s best practices in several important ways. The most significant differences are:

  • Amalgam separator efficiency requirement. The ADA recommended that dental offices use a system that removes at least 95% of amalgam particles from wastewater, in line with 2008 ISO 11143 standards. The EPA requires an amalgam separator to be 2008 ISO 11143–certified and remove 99% of amalgam particles.
  • Frequent inspections. The EPA imposes onerous inspection requirements on all dental offices that use an amalgam separator. Dental professionals must inspect the equipment as per Manufacturer Instructions and generate a visual inspection log that details who conducted the inspection, the results of examining each device, and a summary of any follow-up actions. 

Most amalgam separators manufactured and sold in the United States and Canada claim to operate at 99% efficiency. However, dentists who have already invested in the equipment should confirm that their system meets the EPA requirements before 2020.

 

How Can Dentists Demonstrate Compliance?

The rule requires that dental practitioners report compliance annually to their respective state Control Authority.

 

The Control Authority differs state-to-state, but it is typically an EPA regional office, a local wastewater utility, or a state environmental agency. Dentists in Alabama, Connecticut, Mississippi, Nebraska and Vermont should report to their state environmental agency; dentists in all other states can contact their regional EPA office to find out who acts as the Control Authority in their state.

 

You can read more about the importance of dental amalgam separation and tips for compliance on our blog.

 

 Please visit www.dds-epa.org for FREE record keeping software and more information.

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Dental Handpiece Innovation: Meet Sable’s 6 Newest Handpieces

The dental handpiece is almost as old as the practice of dentistry itself.

 

Most of its history involves incremental improvement. Handpiece innovation didn’t kick into high speed until recently, with the invention of the first belt-driven electric instrument at the turn of the 20th century and the air-driven handpiece 50 years later.

 

Today, manufacturers and dental professionals are constantly working together to achieve higher speeds, smoother cuts, greater control, and enhanced comfort for practitioners and patients alike.

 

E-Type Prophy package

 

That has always been our goal at Sable Industries: to continuously refine and innovate our offerings based on the insight of dental practitioners like you.

 

Celebrating 20 Years of Handpiece Innovation

Over the past 20 years, we’ve had the opportunity to speak with thousands of dentists, specialists and registered dental hygienists who use our dental handpieces every day. Their feedback has helped us develop the precise, powerful handpieces and components that have carved out our place in the industry.

 

For our anniversary we were excited to release six innovative dental handpieces into the market:

  1. E-Type 1:1 & 4:1 One Piece Contra Angle, an ultralight aluminum slow speed handpiece
  2. Access Pro Series, a high speed, fiber optic titanium finished handpiece with a compact head for optimum accessibility and visibility
  3. Rotamax Pro Series, a high speed, fiber optic titanium finished handpiece designed for maximum torque

Plus, for the duration of our anniversary sale, each of these new handpieces is buy-three-get-one-free.

 

E-Type 1:1 & 4:1 One Piece Contra Angle

We designed every facet of this E-Type handpiece to make your job easier, from cutting and polishing to cleaning and maintenance.

 

The lightweight aluminum body is sculpted to fit comfortably in the practitioner’s hand, and the contra-angle shaft gives access to those hardest-to-reach parts of the oral cavity.

A one-piece design was chosen to enable efficient cleaning and field repair.

 

As for maintenance, the E-Type 1:1 and 4:1 one piece contra angles include internal lubrication channels for faster lubrication and sterilization. This design ensures that the handpiece will remain properly lubricated and extend the life of the handpiece. You can purchase Sable’s prophy button to convert the screw-in prophy head to a snap-on prophy head.
 

Access and Rotamax Pro Series KL & NL

Our new high-speed Access & Rotamax Pro Series models feature:

  • State-of-the-art fiber-optics
  • Quadruple water spray for more efficient surface cooling
  • Innovative teardrop-shaped head design for greater visibility
  • Improved turbine and suspension system for a smoother, quieter operation.
  • Compatibility with KaVo style or NSK style couplers
  • Two-year warranty

The Access & Rotamax Pro Series KL/NL

The Rotamax Pro Series provides additional torque to handle removal of Zirconic crowns. Its sleek, titanium finish is durable and 40 percent lighter than stainless steel – putting more power in the practitioner’s hand while reducing physical demand.

 

The Access Pro Series features a mini-head design and optimum accessibility to all parts of the mouth.

 

Buy Three New Handpieces and Get One Free

The year 2018 marks our 20th anniversary as a Canadian manufacturer of high-quality high and slow speed dental handpieces. We felt it was the perfect time to release six new tools into the marketplace – and for a limited time, we’re offering a free dental handpiece with the purchase of any three of our latest offerings.

(free goods will be equal to or less than the lowest priced item).

 

Get in touch to learn more or claim this offer today!

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Importance of Dental Amalgam Separation

Dental amalgam has long been recognized as a safe and affordable material for fillings. However, the American Dental Association (ADA) acknowledges that amalgam waste from dental offices in the United States contribute 29.7 tons of mercury pollution to wastewater systems each year. This statistic prompted the Environmental Protection Agency (EPA) to finalize regulation on the use of amalgam separators in 2017.

Copyright: 123RF Stock Photo

 

This article provides an overview of the use of amalgam separation in the dental office, including the ADA’s best practices on amalgam separators.

 

Dental Amalgam and Mercury Pollution

Dental amalgam consists of approximately 40 to 50% mercury, 25% silver, and 25 to 35% mixture of copper, zinc and tin. These materials are bound together as a hard, stable substance.

 

Amalgam has been subject to numerous studies and reviews that demonstrate it is safe and effective for use in dental fillings. The problem with amalgam is not its effect on dental patients, but rather the difficulty of disposing of dental amalgam safely.

 

When dentists place new amalgam fillings or remove old ones, water containing amalgam particles is flushed into chair-side drains. These mercury-containing particles then enter the wastewater disposal system and water treatment plants. From there, the amalgam particles may be incinerated, land-filled, or made into fertilizer pellets for lawns or gardens. In each case, mercury from amalgam fillings is discharged into the environment, where it may bioaccumulate in fish and contaminate the food chain.

 

To summarize, dental offices that work with amalgam fillings (including “mercury-free” practices that only remove them) flush amalgam particles containing mercury down the drain and into the wastewater system. These particles ultimately become environmental pollutants.

 

One survey found that dental amalgam is the greatest contributor of mercury pollution in the wastewaters of California, Minnesota, Ohio, and Maine; numerous studies have also identified the dental industry as the top source of mercury in sewers in Canada and Europe.

 

Regulating the Use of Amalgam

The EPA’s National Pollution Discharge Elimination System (NPDES) mandates the reduction of mercury and other contaminants to ensure the discharge does not negatively affect water quality or people’s health. On July 14, 2017, the agency finalized regulation specifically targeting the use of dental amalgam.

 

The regulation applies to most dental practices that discharge waste into a public sewer or wastewater system. The basic requirements are:

  • Using amalgam separators (or equivalent devices) to remove dental amalgam solids from all amalgam process wastewater;
  • Implementing best management practices;
  • Complying with reporting requirements; and
  • Maintaining certain records documenting compliance.

Practices have until July 2020 to comply.

 

What Are Amalgam Separators?

An amalgam separator is a device installed on a dental vacuum line to filter out mercury and other particles from water waste before they enter the sewer system. The captured mercury can then be recycled to industry or safely disposed of.

 

Traditionally, dental practices used chair-side traps and vacuum filters to capture amalgam waste; however, the ADA estimates that 6.5 tons of mercury bypass these filters annually.

 

Amalgam separation is proven to reduce the impact of amalgam on environmental pollution. In Toronto, the amount of mercury in wastewater sludge decreased by 58% after regulation requiring the use of amalgam separators in dental offices took effect.

In addition to reducing environmental pollution, using an amalgam separator can help to extend the life of vacuum pumps by preventing solid particles from entering and damaging the pump.

 

To comply with EPA regulation, an amalgam separator must be ISO 11143:2008-certified to remove greater than 95% of solids by weight. Most amalgam separators on the North American market meet this standard.

 

Amalgam Separation Best Practices

To assist in complying with the new regulation, the ADA has published best practices for the use of amalgam separators. These practices recommend that dental practitioners:

  • Use chair-side traps, vacuum pump filters, and amalgam separators to capture and recycle amalgam particles.
  • Use pre-capulated mercury alloys instead of bulk mercury in amalgam fillings.
  • Salvage, store and recycle scrap amalgam whenever possible, including amalgam pieces from restorations and used disposable amalgam capsules.
  • Recycle teeth that contain amalgam restorations (ask your recycler whether these teeth must be disinfected first).
  • Never dispose of amalgam waste in biohazard containers, regular garbage, or down the drain.
  • Flush wastewater lines with line cleaners that minimize dissolution of amalgam (like BioPure Evacuation System Cleaner) instead of bleach or chlorine cleaners.

By implementing these practices and following the EPA regulation, dental practitioners, specialists, and registered dental hygienists can work towards reducing their impact on the environment.

 

Contact us to learn more about line cleaners that minimize amalgam dissolution. We look forward to assisting in building a more sustainable dental practice.

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The Importance of Pet Dental Care

Your pet’s oral health is important. Although it might not be something you think about often, dental care is a critical part of maintaining your cat or dog’s overall health.

 

Bacteria and plaque can harden on your pet’s teeth and form tartar. This can lead to gingivitis, receding gums, pain and tooth loss. Dental problems not only affect your pet’s teeth and oral health but can easily spread to other vital organs such as the heart and kidneys.

 

 

Recognizing the importance of pet dental care is an important step in giving them long, healthy lives.

 

Dental Care Helps to Avoid Pain

Annual oral examinations, dental X-rays and cleanings ensure that your pet’s dental health is in check. Oral pain can be frustrating for your pet and is often expensive to treat. Avoid this unnecessary problem by keeping a close eye on your pet’s dental health and incorporating your dental vet’s recommendations into your regular caring routine.

 

Preventative Care Avoids Added Expenses

Dental procedures can be expensive. That’s why it’s vital that you monitor your pet’s oral health frequently. Although basic treatments are usually included on a pet insurance plan, larger procedures are not. These treatments and surgeries range anywhere from a couple hundred to thousands of dollars. That’s why you must take care of things before they get serious.

 

Tooth Brushing is Important for Pets, Too

Like humans, pets need a dental routine in place. Although brushing your pet’s teeth is not as easy as brushing your own, it’s crucial for overall oral health.

 

Regular brushing is the first step in preventing tartar build-up and gum disease. Use a toothbrush and pet toothpaste. You can also use a finger brush or wrap gauze around your finger. If the process of brushing teeth is introduced gently and gradually, pets will usually tolerate cleaning.

 

Brush your pets’ teeth at least a few times a week. This will help maintain healthy teeth and gums. Pets can become agitated, so make sure they’re feeling calm or tired.

 

Recognize the Signs of Oral Disease

Check your pet’s mouth a few times a month to ensure their oral health is in check. Make sure gums are pink, not white or red, and teeth are clean without signs of brown tartar. Vomiting, loss of appetite, excessive drinking or urinating and bad breath are also signs of dental disease.

 

Other Techniques to Maintain Oral Health

There are many products that promote dental health in pets including textured toys, teeth-cleaning kibble and gels. However, your pet’s diet must contain at least 75% dental food for it to be effective. Look for products approved by the Veterinary Oral Health Council, and never use human tooth pastes with your pet.

 

Of course, having your pet’s teeth checked and cleaned by a professional is the best way to monitor their oral health and ensure they’re getting the best care possible.

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It’s Time to End These 6 Persistent Veterinary Dental Myths

Veterinary dentists and pet owners alike want what is best for their animals. Unfortunately, the subject of pet dental care is plagued with harmful misconceptions.

 

 

Is “dog breath” normal? Should dogs chew bones? Is it safe for groomers to use dental equipment? These are among the persistent veterinary dental myths we want to address in this article.

 

1. Bad Breath Is Normal in Dogs

Myth: Even healthy pups can have foul-smelling “dog breath”; it’s just one of those things that come with owning a dog.

 

Fact: In dogs and other pets, halitosis is a clear sign of gingivitis or oral infection.

 

The idea that “dog breath” is normal is a common misconception. The truth is that dogs with halitosis almost always suffer from significant to severe periodontal disease.  

 

Halitosis occurs when anaerobic bacteria in the mouth certain amino acids. Although it can result from gingivitis alone, oral infection is by far the most common cause.

 

Chronic bad breath is a clear sign that a pet needs veterinary attention.

 

2. It is Safe for Dogs to Chew Bones

Myth: A canine’s powerful teeth and jaws are built to chew through hard materials like bone.

 

Fact: Chewing bones poses numerous health hazards to dogs.

 

Much as dogs love to gnaw on a good bone, it’s not necessarily good for them. While it’s true that dogs benefit from having something to chomp on, there are many reasons why hard materials like bone, antlers and chicken’s feet are not a safe choice:

  • A dog’s teeth are susceptible to fractures, which are immensely painful and may require surgical treatment.
  • Bones and other firm materials can splinter into sharp pieces, causing gum or tongue lacerations, or becoming embedded under the gum line.
  • Bones are a serious choking hazard.
  • Since bones are not digestible, they can cause stomach and intestinal problems if swallowed.

Dr. Fraser Hale, a veterinary dental specialist, recommends owners use the “kneecap rule” to decide whether a toy is suitable for a dog. The rule goes like this: if you wouldn’t want someone to hit you in the kneecap with it, your dog shouldn’t be chewing on it. 
 

3. Dental Chews and Dental Formula Food Will Improve a Pet’s Oral Health

Myth: Using products marketed as ‘dental chews’ or ‘dental formula food’ can help improve an animal’s teeth and gums.

Fact: Not all pet dental products are effective.

It isn’t difficult to find chew toys, treats, and pet food that carriers the ‘dentist-approved’ label. Well-meaning pet owners collectively spend millions of dollars on these products each year.

However, not all ‘dental formulas’ are beneficial for an animal’s teeth (not more than the average bag of kibble, at least.)

Veterinary dental specialists recommend that pet owners look for the Veterinary Oral Health Council (VOHC) seal of approval before purchasing a product that purports to promote good oral health. The Council’s work is approved by the American Veterinary Dental College.

 

4. Dental Scaling by a Groomer Can Prevent Oral Health Issues

Myth: Dental scaling services offered by pet groomers are a good way to keep a pet’s teeth clean and healthy.

 

Fact: Non-professional dental scaling is cosmetic only and does not prevent or treat oral disease.

 

It is illegal in many places for pet groomers to offer non-professional dental scaling (NPDS). However, in some regions, the myth persists that this service can help pets stay healthy.

 

Dental scaling involves using dental equipment to scrape debris from the surface of an animal’s teeth. Some groomers purchase these tools and offer scaling services to clients at a lower cost than a professional dental cleaning performed by a vet.

 

Unfortunately, this non-professional dental scaling is merely cosmetic. Groomers lack the knowledge to identify oral health treatments, nor the ability to prescribe treatment. Without anaesthetic, they cannot remove disease-causing bacteria below the gumline.

 

Veterinary dental specialists recommend pet owners avoid these services, as they do nothing improve oral health.

 

5. You Can Judge A Pet’s Oral Health by Its Appetite

Myth: If an animal is still eating, it must not have dental issues.

 

Fact: Many pets will eat despite severe oral pain.

 

It’s true: loss of appetite and difficulty chewing are tell-tale signs of periodontal disease. However, these are far from the only signs, and many dogs, cats and other pets will not stop eating just because they’re in pain.

 

When an animal is in pain, they will often instinctively try to conceal it. It’s typical for an animal with serious oral health issues to clean their bowl as usual.

 

This is one reason why it’s important for owners to stay vigilant about their pet’s oral health and be aware of other warning signs, such as:

  • Red or bleeding gums
  • Pawing at the mouth
  • Loose or missing teeth
  • Facial swelling
  • Nasal discharge
  • Gum recession

Pet owners should also take steps to prevent these issues at home; which leads to the final veterinary dental myth that must be quashed.

 

6. Dogs Don’t Need to Have Their Teeth Brushed

Myth: Dogs clean their teeth naturally by gnawing on bones and chew toys, so they don’t need to have their teeth brushed.

 

Fact: Daily brushing is the best way to prevent oral health issues in dogs.

 

By the age of 3, over 85% of dogs have some degree of periodontal disease.

 

It begins when bacteria form plaque on the teeth, gradually working their way under the gums. Over time, oral bacteria damage the supportive tissue around the teeth. In serious cases, periodontal disease can destroy the gum, bone and ligaments holding teeth in place and even infect the bloodstream.

 

Fortunately, there is a simple way to deter this prevalent problem: regular brushing.

 

As demonstrated by this video, the process is no different from how we humans brush. Dog toothpaste is available in appealing flavours like chicken and seafood. Eventually, the routine can become as natural as brushing our own teeth.

 

Vets and veterinary dentists should encourage this practice among every owner they advise.

 

Dental Equipment and Supplies for Veterinary Specialists

Sable Industries is a premiere supplier of quality dental handpiece parts, dental equipment, and other dental supplies. We strive to provide the best tools of the trade to dentists, registered dental hygienists, and veterinary dental specialists across North America.

 

Contact us to inquire about our solutions for veterinary dental specialists.

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Do Dental X-Rays Cause Thyroid Cancer? How to Ease Patient Concerns About Dental X-Rays

Dental x-rays are an important diagnostic tool. They reveal oral health issues that could otherwise go unnoticed: areas of decay, bone loss, abscesses, tumours, and conditions of the root canal. Unfortunately, some people are wary of dental x-rays, dental practitioners aren’t always sure how to ease their concerns.

 

 

These tips can help you educate patients on the significant benefits and minimal risks associated with dental x-rays so they can make a well-informed decision about their care.

 

Do Dental X-Rays Cause Thyroid Cancer?

If you’ve worked as a dentist or dental hygienist in the last few years, you’ve probably heard it before:

 

Are dental x-rays safe? Can they cause thyroid cancer?

 

According to an article in Today’s RDH, much of the fear surrounding dental x-rays originates from a talk show several years ago. The show presented a link between the radiation from dental x-rays and thyroid cancer. Video clips shared widely through email and social media sites, sparking an increase in patients refusing x-rays out of concern for their health.

 

In truth, the link between dental x-rays and thyroid cancer is tenuous, and the show failed to explain how dental x-rays compares to other radiation sources (a dental x-ray is about 0.005 mSv of radiation, equalling less than one day of background radiation exposure.)

 

Regardless, this trend is a challenge to dental practitioners. The public is not well-informed about radiation, and not all practitioners are prepared to address their concerns. The absence of x-ray images can make it difficult to effectively diagnose and treat patients.

 

However, with the right approach and a bit of patience, many dentists and dental hygienists can help patients understand that dental x-rays are safe.

 

1. Have Empathy

For many patients, visiting the dentist is unpleasant to begin with. The added uncertainty surrounding radiation can make the experience more frightening.

 

Your patience and empathy can make a world of difference in this circumstance. As always, it’s crucial to communicate openly with the patient and take time to explain things in a way they understand.

 

2. Respect Different Backgrounds and Beliefs

Understand that dental x-rays are not common everywhere in the world. Newcomers, along with older adults who have little experience with the dentist, may not be familiar with dental x-rays.

 

Acknowledge that you may have to take a different approach with patients of differing cultural backgrounds. It may help to have an interpreter explain the process to them.

 

3. Explain the Precautions Taken

Take time to assure your patients that you and your staff take measures to ensure that dental x-rays are as safe as possible. Explain the purpose of a lead apron, lead thyroid collar, and the ALARA principle for radiation exposure.

 

4. Compare Dental X-Rays to Other Radiation Sources

A 2017 study examined different approaches to informing patients about radiation exposure from x-rays and other imaging tests. According to this research, patients prefer to receive the information in both oral and written formals, along with a table showing how radiation exposure from the test compares to background radiation.

 

The average American receives about 620 mrem of radiation each year, half of which comes from natural background radiation. The radiation ‘dosage’ associated with dental x-rays is just 0.005 mSv, less than a single day’s worth of background exposure.

 

Making this comparison can help patients understand that dental x-rays are not something to fear. However, the information should be delivered with empathy and not to belittle the patient’s concerns.

 

More Resources for Dentists and Dental Hygienists

Sable Industries is a trusted provider of quality dental equipment and supplies to practitioners across North America. Check out our oral health blog for more dental news and resources.

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Why Dental Hygienists Should Perform Extraoral Head and Neck Examinations

Caries. Gingivitis. Ulcerations. Bruxism. These are among the common ailments dental hygienists watch for in every routine dental examination. But there are some areas of inspection many hygienists overlook: namely, the oral structures of the head and neck.

 

Dental professionals, including hygienists, omit conducting an extraoral head and neck examination on patients on a routine basis. However, head and neck examinations can save lives, as they are key to identifying signs of oral cancer.

 

Importance of Extraoral Head and Neck Examinations

When oral cancer is detected and treated in its early stages, the 5-year survival rate is as high as 90%. However, because it often develops without pain or symptoms, patients rarely notice the disease until it has progressed into Stage 2 or beyond.

 

For this reason, dental hygienists and other professionals can greatly improve patient outcomes, or even save lives, by incorporating head and neck examinations as part of routine dental examinations.

 

Dental professionals conduct extraoral head and neck examinations by palpating important structures of the patient’s head and neck to assess and identify abnormal conditions. A thorough examination involves palpation of the jaw joints, parotid salivary glands, thyroid gland, masseter muscles, and various lymph nodes (submental, submandibular, cervical, supraclavicular, occipital, postauricular, and preauricular lymph nodes).

 

It is not necessary to perform these checks in any exact sequence, but the clinician should choose a sequence and apply it consistently to maintain awareness of abnormal versus normal conditions.

A well-practised clinician can complete this examination within four to five minutes.

 

How Dental Hygienists Can Perform Head and Neck Examinations to Improve Patient Outcomes

Unfortunately, many dental hygienists do not conduct thorough  head and neck examinations on patients.

 

The Canadian Dental Hygienists Association (CDHA) identifies various barriers that stand in the way: lack of time, insufficient training or knowledge, concern about client compliance, and lack of guidelines and tools.

 

But the capacity of these exams to improve outcomes for patients is too great to ignore. Dental professionals can potentially detect up to 84% of new oral cancer cases in the critical early stages. And, as demonstrated by an anecdote told by TGNA Clinical Coach and guest columnist Karina Bapoo-Mohamed, these 5-minute examinations can save lives.

 

Bapoo-Mohamed advised her patient to see a doctor ‘sooner than later’ after discovering an abnormality. Within days, the patient was referred for treatment for stage 1 oral cancer.

 

“Everyone that asks how/why I had it checked,” writes the patient, “and all I say is thanks to my Dental Hygienist.”

 

The CDHA sets out the following steps dental hygienists can take to improve their practice when it comes to extraoral head and neck examinations:

  1. Know the facts on oral cancer. Dental hygienists should be confident in their knowledge and ability to locate, review, and update baseline data.
  2. Know the early signs to look for. Perform extraoral head and neck examinations in addition to other routine dental exams. Use this fact sheet from Canadian Dental Association as a starting point for educating yourself on the signs of oral cancer.
  3. Effectively communicate findings to patients. Ensure that patients understand the urgency of identifying and treating a potential case of oral cancer in the early stages.
  4. Refer patients appropriately. Dentists and dental hygienists should establish a process for referring patients who could have oral cancer to a doctor who can conduct a biopsy.
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Airway Support in Dentistry

Medicine has long recognized the connection between a patient’s oral health and general health. While research on the precise mechanisms of this oral-system link is ongoing, we know that inflammation by oral bacterial contributes to inflammation in other parts of the body. In a recent piece for Hygienetown, RDH Shirley Gutkowski discusses an aspect of the oral-systemic link that is proving to be more significant than previously thought: airway disorders.

 

orofacial myology

 

Complications of the airway, particularly mouth breathing and sleep apnea, are growing concerns among dental professionals. Below, we’ll examine how dentists and dental hygienists can use airway support in dentistry to help patients improve their oral and overall health.

 

How Airway Disorders Affect the Oral-Systemic Link

In her article, Gutkowski contextualizes the issues through the work of pediatric dentist Dr. Kevin Boyd. Dr. Boyd is a leading scholar in Darwinian Dentistry, a medical theory exploring the link between modern systemic diseases and human evolutionary changes.

 

Darwinian Dentistry hypothesizes that the rapid industrialization of food has spurred evolutionary changes that leave us susceptible to airway disorders. Specifically, humans have smaller midfaces and smaller sinus cavities than our ancestors, contributing to mouth breathing while awake and apnea during sleep.

 

Mouth breathing causes numerous oral health issues: lower oral pH, dry gum tissue, malocclusion. But it has also been linked to systemic issues far beyond the oral cavity, including higher incidences of ADHD and learning disabilities in children.

 

The same is true about sleep apnea. Gutkowski points out the conditions associated with inflammation are nearly identical to those linked with sleep apnea, and many studies show an increase in inflammation in people who snore. In one study, seniors with abnormal pulmonary function had significantly higher incidences of gingivitis.

 

Airway Support in Dentistry

An increasing number of dental professionals are focusing on the airway, some even opening “sleep practices” that specialize in these disorders. Many of these dentists can provide patients with dental appliances designed to support the jaw during sleep, providing airway support to alleviate apnea symptoms.

 

The practice of Orofacial myofunctional therapy (OMT) is also gaining acceptance as an alternative method of treating airway disorders. OMT involves movements that strengthen the muscles involved in the airway complex. The results are impressive: OMT has been demonstrated to reduce apnea by 62% in children and 50% in adults.

 

There are several ways dental hygienists can play a role in airway support. It is likely that demand for these skills will increase as recognition of airway disorders in the oral-systemic link continues to grow among dental professionals.

  1. Become an expert. Registered dental hygienists can apply for certification as an Orofacial Myologist following completion of an IAOM-approved 28-hour course.
  2. Be breath-aware. Along with looking for signs of periodontal inflammation, hygienists can observe a patient’s breathing for potential issues. A patient who cannot breathe through the nose for 20 or more respiration cycles should receive a referral to an orofacial myology specialist.
  3. Practice preventative treatments. Since OMT takes time, hygienists can provide patients with fluoride varnishes in the meantime, which can help to prevent oral health issues associated with apnea and mouth breathing issues.
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Can Dental Problems Trigger Migraines?

Migraine symptoms have many potential triggers: bright light, changes in air pressure, allergies, high humidity, stress, and more. Can dental problems trigger migraines as well?

Dental problems can trigger migraine

 

According to the American Migraine Association, migraines affect over a billion people worldwide. Over 36 million people experience migraines in the United States alone.

 

What many people do not realize is that their migraine symptoms could be relieved by treating common dental problems.

 

An article in Dentistry Today explores the link between migraines and dental issues. Some of the dental problems that can trigger migraines include:

  • Loose teeth
  • Misalignment
  • Missing teeth
  • Bruxism (tooth grinding)
  • Clenching teeth
  • Caries (tooth decay)
  • Periodontitis (gum disease)

 

How Bad Bite Causes Migraines

Loose, missing, or misaligned teeth contribute to a bad bite. Bad bite strains the jaw muscles by forcing them to work harder to chew, swallow, and even keep the mouth shut. Over time, bad bite contributes to persistent muscle inflammation that can trigger painful migraines or headaches.

 

Pain that begins in the temporomandibular joints, which connect the sides of the jaw to the skull, can also lead to migraines and headaches.

 

Migraines often develop on one side of the head, beginning around the temple and spreading to the back of the head. Dentists observe that patients who complain of having frequent “one-sided” headaches are more likely to have dental problems relating to a bad bite.

 

Tooth Grinding and Migraines

Bruxism, or tooth grinding, is another common dental problem that can trigger migraines. Many people who experience tooth grinding do so at night, so they do not realize they have a dental problem, but do report persistent headaches or migraines.

Other signs of tooth grinding include:

  • Clicking sound when opening the mouth
  • Tender teeth
  • Difficulty opening and closing the mouth
  • Tongue indentations

Clenching or gnashing teeth causes inflammation in the gums and jaw muscles. As with bad bite, the inflammation caused by clenching or gnashing is a potential migraine trigger. These migraines often feel like a dull, constant headache originating around the temples behind the eyes.

 

Migraines, Tooth Decay and Gum Disease

Gum disease is linked to a number of health issues, including migraines. Periodontitis can “refer” pain to the head, which causes sufferers to feel they are suffering from headaches.

 

Throbbing toothaches caused by tooth decay can also trigger headaches or migraine episodes.

 

Are Dental Problems Causing My Migraines?

There is a strong connection between headaches, migraines and untreated dental problems. Fortunately, there are usually ways to treat the underlying issue and diminish the migraine symptoms.

 

Dentists can correct many of the dental problems that trigger migraines through simple dental procedures, orthodontic treatment, or a mouthguard. In addition to relief from migraine pain, patients will experience the benefits of better oral health.

 

While there is no guarantee that treating the problem will end the migraines, dentists can help determine whether the symptoms and dental problems are linked. It is always worth asking.

 

Patients who experience symptoms of bad bite, tooth grinding, tooth decay, or gum disease should see a dentist regularly and ask about headaches and migraines.

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