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Dental Hypersensitivity Treatment and Prevention Tips


You’re happily enjoying your favorite ice cream when suddenly you are met with a sharp pain in your mouth. If you have found yourself in this unpleasant situation, you could be suffering from dental hypersensitivity.


Dental or dentin hypersensitivity is a common, painful condition in which exposed dentinal surfaces produce sharp pain when exposed to air or hot, cold, sweet or very acidic foods and drinks.


It can affect any age group however is slightly more common in women and seems to peak between the ages of 20 and 40. Though temporary, the pain can become chronic with acute episodes. It can affect a single tooth or a variety of tooth surfaces, most often the canines and premolars of both arches.


Cause of Dental Hypersensitivity

Under normal conditions, the underlying layer of the tooth immediately surrounding the nerve is covered by tooth enamel and gums. Over time, the enamel layer can grow thinner and the gums recede, exposing the dentin surface. Any conditions wherein the dentin are exposed can lead to hypersensitivity.


Risk factors for developing dental hypersensitivity include:

  • Gingival recission due to periodontal disease
  • Gingivitis (inflamed and sore gums)
  • Dental caries
  • Cracked teeth
  • Acidic diet
  • Xerostomia (dry mouth)
  • Bleaching
  • Extreme toothbrushing
  • Using a hard-bristled toothbrush
  • Plaque build-up
  • Dental procedures (dentin sensitivity can increase after professional cleaning or tooth restoration procedures)
  • Teeth grinding

Treatment for Dental Hypersensitivity

Many people with dental hypersensitivity avoid dental treatment. This is not advised, as visiting a dentist can help rule out the underlying causes of your tooth pain.


Your dentist can determine the root cause of your tooth sensitivity and will be able to recommend the appropriate treatment to ease your discomfort and worsening of your condition. Different treatments for managing dentine hypersensitivity may be tried and modified based on the results.


Your dentist may recommend any of the following treatments:


  1. Desensitizing toothpaste: This toothpaste is available over-the-counter and can sometimes block pain after several applications. Your dentist can recommend the product which is best for you.
  2. Fluoride: Your dentist might apply fluoride to your teeth to strengthen tooth enamel and reduce pain. or may also prescribe a fluoride that you can apply at home.
  3. Desensitizing or bonding: Exposed root surfaces may also be treated by applying bonding resin to the gum surfaces.
  4. Surgical gum graft: A small amount of gum tissue can be removed from another part of your mouth to replace any missing gum tissue, to reduce its sensitivity.
  5. Root canal: If no other method is proving to be successful in treating tooth sensitivity, your dentist may recommend a root canal, known to be the most successful technique for eliminating tooth sensitivity.


Good dental care and oral hygiene are important for prevention and reoccurrence of dental hypersensitivity. Be sure to brush your teeth at least twice a day with a soft-bristle brush and gentle strokes. When drinking acidic liquids, such as citrus juice, coffee or wine, drink water to balance the acidic levels in your mouth.


Your dental self-care routine should include regular flossing followed with teeth brushing to prevent plaque build-up which can lead to gingivitis and periodontal disease.  Flossing removes plaque and bacteria that you cannot reach with your toothbrush.

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The Causes and Treatments of Receding Gums



Your oral health indicates your general wellness. It can be startling if you notice you have receding gums.


Receding gums can be painful, but they are also treatable.


But what is it and how can we treat it?


What Is Gingival Recession?

Gingival recession, or gum recession, is the process for which gum tissue surrounding the teeth is slowly worn away or pulled back. This then exposes the tooth or even the root of the tooth.


When this occurs, gaps form between the gum line and the teeth. These “pockets” allow for disease-causing bacteria to build up easily within the mouth.


Gum recession is a very common problem for many dental patients. And because it is a subtle build-up, most people don’t even notice they have it!


Early signs are typically the following:

  • Tooth sensitivity
  • Tooth appears longer than normal
  • A “notch” is felt near the gum line


Leaving gum recession untreated can result is severe damage to the supporting gum tissue and bone structure. The teeth themselves can be damaged then, which can result in tooth loss.


Causes of Gum Recession

There are many typical habits people do every day that can be causes of gum recession. Treatment, in turn, is often dependent on the cause.


Aggressive Brushing or Flossing

Ever heard the saying, “too much of a good thing is a bad thing”? This applies to brushing and flossing as well.


Gum tissue is a very soft and sensitive material.


The enthusiasm for oral health care is great, and many people lack such a thing, but in moderation. The Journal of Periodontology has done a study on aggressive brushing and hard toothbrushes. They found that hard brushing leads to more recession of the gums.


To summarize: it’s important to use a soft toothbrush and to brush not scrub your teeth. Brushing isn’t supposed to be painful!


Abnormal Positioning or Crooked Teeth

Misalignment of teeth can cause overlapping of teeth or gaps between.


When teeth aren’t coming together evenly, the force placed on the gums and the bone structure of the teeth can cause recession.


Similarly, lip or tongue piercings can have the same effect. The rubbing from eating or talking that is caused from the metal can irritate the tissue eventually wearing down the gum line.


Grinding Teeth

Do you notice that you wake up with a headache? This is a sign of grinding teeth in your sleep.


Grinding your teeth can not only cause gum recession but also can be the cause of many maladies. So, it’s important to talk to your doctor when you notice it!


While it can be the cause of many things, it is easily treatable with a mouth guard or several other options.



Your genetics determines a lot about your health and body. And that includes your mouth.


30% of the population may be predisposed to gum disease, regardless of care.


The characteristics about your gum tissue is determined by your genetics. If one or both of your parents have gingival recession, you are more susceptible to getting it too.


Poor Oral Health

With poor oral health, you are at risk for many bacteria including periodontal disease.


Gum infections like periodontal disease, wreck gum tissue and the supporting bone structure. Actually, gum disease is the main cause of gum recession.


Treatment for Gum Recession

Gum recession in mild cases is very treatable!


When you catch gum recession early, it means you likely won’t need professional treatment. Though you might not need professional care, it’s important to have your dentist identify and instruct you accordingly on treating it.


Simple steps like evaluating your flossing habits or using a different toothbrush can help.


But if you have a more serious case of gum recession there are a variety of treatments to support you. Depending on the severity and cause, you may need surgical treatment.


Your dentist will decide the best course of action for you. This would include determining how you could benefit from scaling and root planing.


Your oral health is extremely important, since your mouth is a good indication of your overall wellness. Contact your dentist if you notice anything out of the ordinary.

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Dental Office Waste Poses a Public Health and Ecological Risk

The dental community is made up of healthcare professionals that care about the environment and with that goal in mind, dental office waste management has become an important aspect of the modern dental practice.


The waste that dental offices generate while delivering dental care includes a variety of materials that present a potential challenge to the environment. Dental practitioners are responsible for proper disposal methods of these materials to ensure both the public’s safety and minimize their effect on the environment.


Examples of such waste items include:

  • Dental amalgam containing mercury,
  • Silver,
  • Lead,
  • Biomedical office waste including spent x-ray processing solutions, disinfectants, cotton, plastic, latex, and glass which may be contaminated with bodily fluids and sharps including lancets, needles, and syringes, and
  • General office waste.


Dental amalgam is a safe, durable, long-lasting, cost-effective material that has been used as a filling material for more than 150 years. Amalgam contains mercury, which is a toxic and bioaccumlative material, continuing to accumulate in living organisms, thereby posing a threat to plants, animals and humans should it enter the water system. Left uncontained, mercury has the potential to enter our food web, harming birds and fish.


Amalgam that is replaced or removed generates mercury-containing waste when amalgam particles are vacuumed from the mouth. These particles must be effectively collected and maintained. To this end, many dental practitioners have chair-side filtration devices that collect larger particles of dental amalgam removed via suction. Amalgam separators are devices designed to filter finer amalgam particles from the wastewater to reduce the amount of amalgam entering the sewage system.


There are standards and regulations in place in Ontario associated with the quality of the dental practice and amalgam waste disposal. The Royal College of Dental Surgeons of Ontario establishes and maintains a standard of practice under the regulated Health Professions Act, 1991, and the Dentistry Act, 1991.



Silver is another heavy metal that can be found in dental amalgam. It also occurs as silver thiosulfate in radiographic fixer, a solution used in the processing of dental radiographs (x-rays). The used fixer must not be washed down the drain. Dentists can install in-house recovery units that recover the silver for reuse.


Another common waste product from the dental office is unused film, since they contain unreacted silver that can be toxic in the environment.


Incorporating digital imaging as a replacement means to obtain dental radiographs reduces the amount of silver waste generated by the dental office.



Lead shields that are contained in each film packet used in traditional radiography are another waste product of the dental industry. Lead, like mercury and silver, is toxic to the environment and accumulates in the environment. These lead packets need to be collected and returned periodically to the supplier for recycling.


Biomedical Office Waste

Biomedical waste is one of the many types of waste regulated by the Ministry of the Environment and Climate Change. Biomedical waste includes any materials capable of causing disease such as blood-soaked gauze, tissues, and syringes.


General Office Waste

Dental offices can also minimize the effect of waste accumulation in the environment by implementing best practices such as:

  • Purchasing products with minimal packaging
  • Use of reusable plastic containers
  • Use of products made from recycled or partly recycled materials
  • Use of energy-efficient office lighting
  • Conscientious use of paper in the dental office for printing and use of both sides of a sheet of paper

By implementing best practices in the collection and disposal of dental office waste, a dental office can successfully minimize and substantially reduce the effects of dental waste on the environment.

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6 Reasons Why Privately Practicing Dentists Aren't Going Anywhere

There are many corporate-style dental practices cropping up, and plenty of advantages to being part of a large-scale dental service. But despite many smaller practices being scooped up, you can rest assured that privately practicing dentists aren’t going anywhere!




There is a lot to gain by remaining small! The freedoms that come with your own practice can benefit staff and dental patients alike.


1. Customer Service and Individualized Patient Care

Private dental practice has roots in the community. The smaller the practice, the more opportunities to create and maintain meaningful relationships with your dental patients. These connections are priceless and a huge advantage over corporate chatbots and AI customer service interaction.


While a corporation may push for quotas, introductory offers, and discounts ruled by their budgets, often at the patient’s expense—a privately practicing dentist will always be looking out for their patients’ best interests.


2. Human Resources

Having a solid, experienced team you can trust is key to delivering quality dental care. You have to rely on your team and be able to collaborate well in order to be successful.


As a practicing dentist running your own clinic, you have the ability to make any personnel changes you feel are necessary. It’ll be your responsibility to hire whomever you want to get a good group of team members that click together. You’ll have the freedom to implement your own policies, health benefits, bonus structure, and training programs.


3. Management

Nothing is more frustrating than having management make decisions that ultimately affect your patient’s care. As an employee of a large corporation, you would need to abide by the company’s rules, whether that means replacing your personal assistant or backing one brand of supplier exclusively over another.


However, the freedoms of owning a private dental practice do come at a price. There is all the hiring and firing, scheduling, insurance filing, accounts receivable, and other management decisions that go into running a business. To accomplish these tasks, you can hire an office manager that you feel is the most knowledgeable and who’s thinking is in line with your own.


4. Marketing

Being the master of your own marketing campaign offers huge rewards. You may be up against some large established dental corporations that have huge marketing machines, but you also have the freedom to share your own unique story. As a private practitioner, you can choose how to market yourself and stand out from the crowd.


5. Third-Party Vendors

The quality of dentistry you can provide is not always determined by skill alone. Dentistry skills rely on hardware, software, and a variety of consumables used to deliver high-quality dental care.


Running your own practice allows you to choose your own vendors by price and quality of service. It allows you to try out new cutting-edge techniques, equipment, and strategies. Additionally, you would not be constrained to a specific theory of dentistry and limited to only the techniques and treatment plans that the practice selects.


6. Your Goals as Privately Practicing Dentist

You’ve worked and studied hard to become a dentist. Becoming a cog in a large corporate dentistry wheel may not be your idea of success in your field. Starting your day with morning meetings reviewing financial metrics over delivering quality individualized dental care may not be in line with your goals.


As a privately practicing dentist, your focus is on making sure each patient receives the individualized care that they need, from taking the time to discuss brushing techniques to an after-hours dental emergency.

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Periodontal Disease May be Linked to Esophageal Cancer According to this Decade-long Study

Esophageal cancer is one of the most common cancers worldwide – eighth to be exact. Not only that but it is also the sixth most common cancer caused deaths.


Only 15-20% of all patients survive in 5 years.


Dr. Jiyoung Ahn is an associate professor and associate director for population science and the Laura and Isaac Perlmutter Center at New York University. She conducted a study, lasting a decade, that was focused on how oral bacteria can lead to periodontal disease and increase a patient’s chance of developing esophageal cancer.


What is Esophageal Cancer?

The esophagus is the long hollow tube within the body that connects the throat and mouth to the stomach.


Esophageal cancer is 3 times more likely to be found in men than women.


Esophageal cancer develops from malignant cells that form inside the esophagus, typically becoming a large tumor or mass that continues to grow.


There are two major types of esophageal cancer that develops in different ways and areas.

  1. Squamous cell carcinoma – cancer is formed inside the lining of the esophagus in thin flat cell. Usually it is found in the upper and middle part of the esophagus.
  2. Adenocarcinoma – within the glandular tissue is where a tumor forms. Typically, it forms in the lower section of the esophagus, near the stomach.

Those who have esophageal cancer may experience the following:

  • Chest pain
  • Heartburn
  • Difficulty swallowing
  • Coughing
  • Vomiting
  • Weight loss
  • Pain behind breastbone or throat region

The reason it has such a low survival rate is because it is caught in the late stages. When it is too far along. If left untreated, it can eventually spread to nearby organs such as lymph nodes, stomach, liver and lungs.


Periodontal Disease

Periodontal disease is an advanced form of gum disease. It stems from gingivitis, or inflammation of the gingival.


Healthy gums should be pale pink and tightly fitted around your teeth. With periodontal disease your gums become swollen or puffy, bleed when brushing or flossing and the gums are receding.


This occurs because of trapped bacteria under patient’s gums causes irritation. When plaque builds up to tartar, it requires professional care to remove.


While gingivitis is reversible, advanced periodontal disease is not. It leads to tooth decay and tooth loss.


With the leading cause of periodontal disease being poor oral health, make sure you have good oral habits. This includes brushing twice and flossing daily and regular dental checkups.


Dr. Ahn's Study

This study was based on prior research on how periodontal disease was associated with cancers in the mouth, head and neck. The study was primarily based specifically on the oral microbiota found as a result of periodontal disease.


Dr. Ahn’s goal was to identify whether the oral microbiota increased the chances of developing either adenocarcinoma or squamous cell carcinoma later.


The study was conducted using 122 000 different samples from patients who participated in the American Cancer Society Cancer Prevention Study II Nutrition and the Nation Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer Screen Trial.


Dr. Ahn found that after a decade, 106 patients developed esophageal cancer. They extracted their oral DNA and compared to the previous test.


Certain types of bacteria were linked to higher rates of esophageal cancer. Porphyromonas gingivalis connected to squamous cell carcinoma and Tannerella forsythia caused a higher risk of adenocarcinoma.


Both of these bacteria are linked to periodontal disease.


However, there was an interesting discovery regarding other types of bacteria. Several bacteria actually helped lower the chances of patients being diagnosed in the future.


Dr Ahn hopes to conduct more research in the future. She believes that learning more about the different bacteria will allow doctors to identify the disease predictively. It will help diagnose patients earlier and prevent the later stages of the cancer from occurring.

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How Dental Professionals Can Help Patients With Crohn's Disease

Crohn’s disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. It belongs to a group of conditions known as inflammatory bowel diseases (IBD) which occur when the immune system attacks healthy cells in the digestive tract.


The disease causes inflammation all along the GI tract, from the mouth to the digestive organs. Although there is no cure, dental professionals can help patients manage the oral manifestations of Crohn’s disease through medications, supplements and oral hygiene care.


How Crohn’s Disease Affects the Oral Cavity

Patients can experience several oral manifestations of Crohn’s disease. Some are directly related to the disease itself, while others are side effects of medications they take to manage the disease.


Common oral manifestations include:

  • Aphthous Ulcers: a condition marked by the formation of benign and non-contagious mouth ulcers (aphthae) in otherwise healthy individuals.
  • Xerostomia: also known as dry mouth, this occurs when the salivary glands in the oral cavity don’t produce enough saliva to keep the mouth moist. Dry mouth can increase the risk of dental caries, secondary decay and halitosis.
  • Erythema: when the gingival tissue appears irritated with localized redness.
  • Gingivitis: a type of periodontal disease caused by bacteria in the gum tissue.
  • Cobblestone appearance: when buccal mucosa has multiple bumps lining the tissue.
  • Oral Granulomatosis: swelling of the orofacial area. This is not a common reaction.

Not every case of Crohn’s will present in the same way. Each patient will require different treatment.


Although experts still don’t fully understand the relationship between Crohn’s disease and its impact on oral healthful, the connection is likely due to large amounts of inflammation.


Role of Oral Care in Managing Crohn’s Disease

There are several different forms of treatment for the oral manifestations of Crohn’s disease. Doctors typically prescribe a topical steroid, hydrocortisone ointments, vitamin supplements such as Vitamin B12, Calcium or Folate, recommend dry mouth products, and increased oral hygiene care.


Dentists and registered dental hygienists can provide hygiene instruction to patients with Crohn’s disease based on the individual’s needs and symptoms.


  • If periodontal issues are involved, we recommend the use of interdental brushes based on embrasure space size. The patient can then begin mouth washing daily and regular brushing  twice a day
  • If the patient is suffering from dry mouth, we recommend a dry mouth product. Fluoride varnish treatment and mouth product, fluoride varnish treatment and mouthwash to help increase saliva production and maximize enamel remineralization.
  • Baking soda-based toothpaste is another product we recommend for patients with a plaque and tartar control, have high caries risk, and low saliva production.
  • Research shows that diet and nutrition also play a huge role in flare-ups of Crohn’s disease.  
  • In addition, dental professionals can provide fluoride rinses, at-home trays, and fluoride varnish treatments for root caries prevention.

Crohn’s disease can be treated in a variety of ways. However, there is no cure for the disease. There are a variety of medications that can be prescribed, but at times, the side effects of these medications have their own risk factors.


Most people who take medication to help control Crohn’s disease typically end up needing surgery to help with symptoms.

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7 Questions to Ask if Your Dental Office is Up to Current Standards

Standards are crucial to maintain the quality of the dental office and the dental profession. They help gain and maintain trust of the patients.


Do you know if your office is up to code?


Here are 7 questions to consider, ensuring your hygiene department is up to the current standards.


1. Are you viewed as “just a cleaning”?

Patients that tend to postpone regular checkups lack the preventative care that dentists can provide. Without regular cleanings, patients return months later with cavities, gum disease and pain.


The expense of dental cleanings is an important one to make. Cleanings every 6 months may seem like a lot (especially without insurance) but they are necessary. It prevents more expensive and invasive treatments once a disease takes hold.


An example of this is the progression of gingivitis to periodontitis. Gingivitis is easily treatable if identified early on by a hygienist. However, if it is left untreated can lead to irreversible periodontitis.


Periodontitis can lead to:

  • Tooth loss
  • Decreased nutritional intake
  • Serious disease within your body

During regular appointments dental hygienists identify any areas of potential disease, provide thorough cleanings and advise for at-home care and techniques.


2. Do all your practitioners understand oral health affects overall wellness?

Proper care to your body, like nutrition, is equally important for patients oral health.


This is because your body is full of bacteria, typically the bacteria is harmless. Your natural defenses and good oral health can keep these bacteria under control.


Without that care is when bacteria can get out of control. This can lead to oral infections such as tooth decay and gum disease.


Studies can show that there are connections to internal diseases and oral hygiene. Known internal diseases include:

  • Endocarditis – This typically occurs when bacteria or other germs from other places in your body, such as the mouth develops. That bacteria then spreads through the bloodstream and into damaged areas of the heart.
  • Cardiovascular disease – heart disease, clogged arteries and strokes could be linked to inflammations and infections caused by oral bacteria.
  • Pregnancy and birth – Premature birth and low birth weight and periodontitis has been found to be correlated.

3. Are all oral evaluations with measurements comprehensively documented?

Whenever a dental practice is performed, it should be documented.


There are guidelines specifically designed to help practitioners meet the legal requirements for dental record keeping.


The following are basic record keeping information from the official RCDSO:

  • Accurate general patient information
  • A medical and dental history that is periodically updated
  • Accurate description of the conditions that are present on initial examinations (this includes entries such as “within normal limits” where appropriate)
  • Record of significant findings of all supporting diagnostic aids, tests and referrals like radiographs, study models, and reports
  • Diagnosis and treatment plan
  • Notation that informed consent was obtained from the patient
  • Description of all treatment that is provided, materials and drugs used and, if appropriate, the outcome of treatment
  • Accurate financial records

4. Do adult patients receive periodontal exams annually?

Comprehensive periodontal evaluations (CPE) are ways to assess patient’s periodontal health. It examines teeth, plaque, gums, bite, bone structure and any risk factors.


With yearly oral health assessments, both patients and dental professionals will know how healthy the patient’s mouth is. They will be able to notice any conditions like periodontal disease that have developed and in need of treatment.


5. Are there clear diagnostic distinctions between health, disease and maintenance oral health status?

If a patient has an active disease, is the hygiene department clear on case types of early, moderate and advanced conditions?


Everyone’s definition of something may be different.


As practitioners, we must make a point to make sure everyone on the team is on the same page. This will allow the documentation clearer to everyone and other members can easily pick up where it was left off.


6. Is there proper communication with the patients?

There are several important questions that will help initiate and maintain good communications with patients.


Is the hygiene team communicating with every patient the status of their supporting structures of bone and gums that hold their teeth in place?

  • What patient education tools, technology and visuals are being used to make sure the patient understands their status?
  • Do patients understand why they need the periodontal care and frequency regardless of how many sessions they have covered or what insurance pays?
  • Does the practice perform root planning, scaling and home care guidelines for patients with active disease?
  • Are patients with disease returning for their revaluation to assess their healing and success of gum therapy?

Proper communications are key for patients to understand what is happening to them.


Patients that receive good communications with their hygienist value the care provided. They can then place a degree of trust in the dentists for the success of treatment in the future.


7. Do your hygienists use intraoral cameras on all patients?

Intraoral cameras are one of the most important and useful tools to incorporate within the office.


They are tiny cameras that comfortable fit into the mouth and enables the dentist to show patients images of the mouth. This could be of individual teeth or the entire smile.


They allow patients to visualize what dentists recommend being done and show details that could easily be missed by standard examinations.


Additionally, they help uncover problems before they become serious or irreversible. Intraoral cameras can be crucial for conservation and preventative dental treatment.


Do you see any room for improvement in your dental office? Even little things, like making sure your front desk feels welcoming, can make patients feel more at ease.

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Can Aloe Vera Help Prevent and Reverse Gingival Inflammation

Everyone and their mother talks about the wonder plant known as Aloe Vera.


Sunburn? Time to get some Aloe Vera gel on!


Heartburn? Guess we’re having Aloe gel with dinner!


High blood sugar? Some Aloe Vera juice should do the trick!


But did you ever think it could even be used for your oral health in addition to your intestinal and skin health?


Recently, a study has taken place that may point dentists to recommend Aloe Vera mouthwash for their patients with gingival inflammation.


Patients have been found to heal faster and feel less pain when using Aloe Vera products for oral wounds. Could it be right for you?


A Brief History on Aloe Vera

Aloe Vera is a well-known succulent plant that originates from North Africa. Due to its many health benefits, it has been used as early as the Egyptian times. And for good reasons!


The inside of its leave contains a gelatinous tissue that is widely used for both medical and agricultural purposes. This gel has antimicrobial and antioxidant properties and is commonly used for:

  • Cosmetic products including moisturizer
  • UV protection
  • Burn wounds and foot ulcers
  • Food products and supplements
  • Herbal remedies
  • Oral health


What is Ginivitis?

Gingivitis is a mild but common form of gum disease. It will cause irritation, redness and swelling around the gums closest to the base of your teeth (gingiva).

It is extremely important to promptly take care of as it can lead to much more severe gum disease.


Good news! With good oral habits, you should be able to reverse the process easily.


What to look for

  • Swollen or puffy gums
  • Dark red gums
  • Gums that easily bleed when you brush or floss
  • Receding or tender gums
  • Bad breath

If you notice these symptoms, you may wish to contact your dental hygienist for a proper course of action.


Gingival Inflammation Causes

Gingival inflammation is caused from plaque buildup around the tooth base.


Plaque is a film composed of bacteria inside the mouth from food consumption. Particularly starches and sugars that interact with the natural bacteria, becomes plaque.


A large component of our diets contain starches and sugars therefore daily removal is required.


The plaque then turns into what is known as tartar. Tartar is hardened plaque under your gumline that has remained on the tooth and collects bacteria.


Tartar then creates a protective shield for bacteria which in turn irritates your gums.


The longer tartar and plaque are on your teeth the more they irate the gingiva which will lead to inflammation.


Without treatment, tooth decay may result.


What Increases the Risk of Gingivitis?

There are many reasons why you could be more prone to gingivitis. Such as:

  • Poor oral health habits
  • Smoking and chewing tobacco
  • Dry mouth
  • Poor nutrition or vitamin deficiency
  • Genetics and older age
  • Conditions that decrease immunity (leukemia, HIV, AIDS, cancer treatment)
  • Hormonal changes (pregnancy, menstrual cycle, birth control)
  • Viral or fungal medical conditions


Gingivitis Prevention

Simply, take good care of your mouth.


We’ve all heard it from the dentist: brush your teeth twice a day and floss daily. Dentists tell us these things for a reason. Because it works.


With regular visits to the dentist and overall good health practices, most patients can reverse gingivitis.


How Using Aloe Vera Can Help with Oral Health

Now how does Aloe Vera come into play with taking care of our oral health?


The gelatinous substance contains vitamins, minerals, amino acids and antioxidants. All which can help improve regulating our immune function.


Toothpaste with Aloe Vera when compared to regular commercial toothpastes found that it helped fight against tooth decay. It has natural antibacterial and anti-inflammatory properties because it contains anthraquinones. This makes aloe toothpaste to be just as good or even better than regular toothpastes.


Similarly, the gel can be used inside the mouth for healing of oral wounds.


For example, most people have experienced mouth ulcers or canker sores throughout their lives. They typically form underneath the lip inside your mouth and can last for up to about 10 days. Aloe Vera gel has shown that it can accelerate the healing process of the ulcers.


An Aloe Vera mouthwash has been a big target of study as it may help with inflammation of gingiva.


Aloe Vera Mouthwash Study

Researchers wanted to know if mouthwash with Aloe Vera would increase oral health compared to commercial mouthwashes.


Out of 6 randomized clinical trials and 1358 total subjects the following was found:

  1. 4 studies concluded that Aloe Vera was more effective than chlorhexidine (commercial mouthwash)
  2. 2 studies concluded that Aloe Vera was comparable to chlorhexidine.
  3. Aloe Vera was extremely effective in reducing gingival inflammation

The results of the study found that Aloe Vera mouthwash is comparable to chlorhexidine in most ways but not as effective when it comes to reducing plaque.


Overall, Aloe Vera in its various forms could be a more natural remedy for the everyday person. It performs comparably well against the commercial products and contains health benefits for other parts of the body.

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Needleless Local Anesthesia Approved for Commercial Use


One of the top fears in the world is the fear of needles. About 10% of the general population suffers from such fears. This can make going to the dentist something to be feared because typical anesthetics are administered using needles. 


A needleless anesthesia, called Kovanaze, might be a beneficial practice to ease the anxiety of needles and save patients from injections overall.


The History of Needleless Anesthesia

Since the 1940s, the use of Tetracaine (also known as amethocaine) has been used for eyes, nose and throat treatments. It is a local anesthetic, typically applied in liquid form to the desired area. It wasn’t until patients began to inform doctors that when used for nasal treatments, that their upper lip was also numb. This led researchers to look into the compound for dental applications.


About a decade ago, a pharmaceutical company called St. Renatus developed Kovanaze which was a combination of 3% Tetracaine and 0.05% Oxymetazoline. On June 29th, 2016 it was approved for dental use by the Food and Drug Administration. It is the first approved nasal anesthia. 


What is Kovanaze Anesthesia and How is it Used?

Tetracaine is a very temporary anesthetic, approximately lasting only 15 minutes. This makes it quite difficult to work on a patient in such a tight time limit, especially for intricate dental procedures. With the addition of Oxymetazoline, the duration was increased because it slows the systemic absorption of tetracaine.


Using it is extremely simple. Spray into the nostril that corresponds with the side in which the patient is having work on followed by another spray 4-5 minutes later. It is important to wait 10 minutes to ensure the effects are working, if not another spray may be administered for adults only.


The nasal spray treats the upper anterior teeth, specifically teeth 4-13 (See image). Initial tests resulted in an 84% success rate for teeth 4-13 and 96% effective for teeth 5-12. The premolars seem to have less success in having a consistent and reliable result using Kovanaze.


Additional testing has been conducted since with fantastic results. Out of 186 subjects, only two had any pressor response. This was likely caused by the Oxymetazoline component. A history of Hashimoto’s thyrotoxicosis, a relative contraindication to oxymetazoline, was found in one of the pressor response patients.


Kovanaze is unique because it does not anesthetize the lips. Dentists performing anterior restorations could find this to be invaluable. Precision is greatly improved for the placement of veneers and crowns. Additionally, due to the ability to move the lip in a natural way, patients are able to have more aesthetically pleasing results.


Drawbacks of Kovanaze Needleless Anesthesia

As with any medical procedure, there are of course risks associated with it.


Approximately 10% of patients have identified the following possible temporary side effects:

  • Rhinorrhea
  • Nasal congestion
  • Increased lacrimation
  • Nasal discomfort
  • Oropharyngeal pain

Like all other local anesthetics, there are limitations to who may be administered it. Children under 88 lbs, patients with uncontrolled hypertension, thyroid disease or taking MAOIs (Monoamine Oxidase Inhibitors) should not be given it.


Due to the fact that this is a very localized anesthetics, it is limited to only the maxillary and premolar anterior. For any of restorative work outside this region would require an injection to complete. 


Kovanaze is limited for hygiene procedures such as scaling and root planing because of unpredictable gingival conditions. Further testing will be conducted to determine if it will be able to produce the desired result.


This exciting new development allows for people to now have the choice to have an injection or not. Many people would jump at the chance to avoid it.


It is not only good for patients but also practitioners because it can put patients at ease and lowers the fear of the dentist office.


As this company continues to develop and improve this product, it’s our hope that new insights will be found that furthers the use for Kovanaze. Many people would prefer this option over an injection so if it can be used for more than just the maxillary and premolars of the anterior, it should be!

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The Importance of Discussing Health with Patients

It’s important to keep an open conversation with your patients.


Nutrition is the process of providing or obtaining the food necessary for health and growth. But not everyone is the same. You can’t give the same diet to every person. Based on their existing health and genetics requires varying compositions of healthy diets.


As dental hygienists, we can often see early signs of several different makeups. Because we can see these things, it is up to us to start a discussion with patients and highlight details that otherwise may not have considered from you.


Enamel Erosion Signs and Causes

For example, patients often are found with enamel erosion. On the surface of teeth, the hypoplastic enamel could be slick or smoother-looking. This is a result of your enamel being worn down from several dietary related causes like:

  • GERD
  • Alcoholism
  • Eating Disorders
  • Drug Abuse
  • Highly Acidic diets

Teeth may appear discoloured or even transparent, or they are overly sensitive. If this occurs, it is important to have open up a conversation with your dentist for potential causes or solutions.


Recommendations for Enamel Erosion

The problem with the enamel is that is it not a living tissue, so it cannot be regenerated naturally. It can’t be regrown artificially either actually.


Once enamel is gone, it’s gone.


There are however a few things that doctors will suggest minimizing further damage:


1. Use straws

By using straws, patients minimize the contact of liquid to teeth. This helps with sensitive teeth for particularly cold beverages too.


2. Wait 30+ minutes to brush your teeth after eating or drinking

When eating or drinking something, especially something particularly acidic, the tooth enamel softens from the foods. Brushing too soon after eating or drinking can damage the enamel when it is already in a sensitive or weak state.


3. Use a toothpaste without whitening or tartar control

Fluoride toothpaste is the best option because it is known to strengthen teeth and prevent tooth decay.


4. Chew gum with xylitol or fluoride mouthwash

Since xylitol is a natural sweetener and have shown signs that it reduces the amount of bacteria in your mouth that causes cavities. This is because xylitol cannot provide suitable nutrition for the organisms to flourish. The less cavity-causing bacteria in your mouth, the better environment for healthy teeth.


Similarly, fluoride mouthwash is great for protecting your teeth from acids and cavities. It is especially important for children with developing teeth because it can be a preventative.


5. Adapt to a carbohydrate-free or highly hypoglycidal diet

A study investigated the correlation with diet and enamel erosion and found an interesting correspondence. Patients with a carbohydrate-free diet (sugars, starches) reduce acid reflux and clinical manifestations were almost eliminated.


Tooth Decay Signs and Causes

The second example found commonly that dictates a conversation about diet with the dentist is signs of caries.


A high caries rate is related to a diet high in sugar and 51% of Americans have a sweet tooth.


Some signs of tooth decay:

  • Tooth aches or sensitivities
  • Visible holes in teeth
  • Staining on teeth (black, brown or white in colour)
  • Pain when biting

When dental hygienists notice signs of tooth decay, it is time to discuss the patient’s diet. This could lead to further discussions on daily foods consumed.


It’s important to gain insight into when the most sugar is being consumed. Even having one meal high in sugar will increase the likelihood of tooth decay.


Some foods that increase your likelihood of caries are:

  • Soda, juice and sports drinks
  • Candy
  • Fruit snacks
  • Frequent intake of starchy foods
  • Sugar in coffee

In 2014, the World Health Organization reduced the recommended daily sugar intake to 5%. The average adult should be consuming approximately 25 grams or 6 teaspoons of sugar per day. This not only helps prevent caries but also the risk of heart disease and diabetes.


Starting the Conversation

There are countless resources to open up the conversation about the importance of sugar or acidic free diets.

  • Contacting public health and nutrition department for local resources and pamphlets
  • Utilizing to evaluate a patient’s needs

For most patients, they just don’t know what to look for or where to start. So, it is up to dental hygienists to educate and work with the patients so they can have a happier and healthier smile.


It can’t just be one conversation either. Working closely with patients is the key to ensuring they have a well-balanced diet fit for their needs.


The more we communicate with patients the more comfortable they will be. By opening up, it may also alleviate stress and anxiety that often is associated with the dentist.


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