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.
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.
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.
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:
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.
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:
4 studies concluded that Aloe Vera was more effective than chlorhexidine (commercial mouthwash)
2 studies concluded that Aloe Vera was comparable to chlorhexidine.
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.
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:
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!
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:
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.
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.
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
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 choosemyplate.gov 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.
Not only should people be spoken to with a professional attitude in person but also on the phone or through email. Whenever dealing directly with customers, confidence and professionalism is key to make a successful impression.
Here are 6 mannerisms to consider when projecting your ideal front desk first impression.
1. Open with a Friendly Greeting and Nice Smile
A simple “Good morning, what can I help you with today?” could help build the beginning of a good relationship with your customer. This swiftly puts the needs of the customer before the needs of yourself, making them feel important.
One of the most important things that anyone providing customer service can do to dramatically improve your interactions is smiling. Not only does it convey to the customer that you are happy to assist them, but it improves your own mood too.
Happiness spawns happiness. Even customers having a bad day will likely be more pleasant if you continuously reply with a friendly tone.
2. Eye Contact
It may sound cliché, but it’s important to maintain strong eye contact throughout your interactions.
Eye contact indicates to the customer that you are present, listening and focused on them. It helps build a connection with them. They feel valued as a result.
By not engaging in eye contact, the customer could assume you do not want to help them, or that you are unsure about their inquiry. This could cause the customer to feel a negative association with you and the company you work for.
Not only that but eye contact is a huge trust builder. Especially with medical practitioners, gaining trust is crucial in order for the customer to be comfortable. Eye contact ensures that, as a receptionist, you know what you are talking about and thus your organization also does. Safety and security are the keys to building happy relationships with your customers.
3. Pay Attention to the Customer
Never ignore the customer. They are your number one priority. Show to the customer that they have your full, willing and undivided attention throughout the entire interaction.
You can demonstrate this by simply asking for their name and using it throughout the conversation. You will not only make the customer feel like they have your full attention, but people will feel a significantly increased rapport by making the interaction personal to them.
4. Speak Slowly
This might be considered odd but could help you improve information being presented for those that may get nervous or just generally speak quickly.
Stumbling or pausing is natural for people to do but it can come across as unprofessional. When speaking quickly, it can hinder the comprehension of information for your visitors. Your information should be clearly presented and speaking slowly limits the amount of opportunities for you to stumble or pause awkwardly.
By minimizing the faults in your speech, you project a very strong sense of knowledge and charisma. You become more enjoyable to listen to as a result.
5. Personal Presentation
How you appear when working is how you are representing your business. Customers will identify the products and your business as respectable because you show respect towards them.
Depending on your establishment, you may have a uniform, or you may be free to choose your own attire. In the case of the latter, you should tailor the wardrobe to the company standards.
When dealing with documents or products, something that is overlooked is keeping nails well-groomed and professional. Your desk should reflect this as well. A messy desk can make the company feel disorganized and sloppy.
Outward appearance is not all of your personal presentation though. How you present your outward appearance affects you too. Confidence is often conveyed through posture. Straight but still relaxed posture exemplifies natural confidence and a pleasant appearance.
Fidgeting and/or constant movement adjustments can distract the customer and make you appear unsure of yourself. Minimizing this can help you seem more engaged or present in the conversation.
Customers will always favour doing business with someone who is pleasant and happy.
Your attitude is a reflection on the respect you have towards the establishment. Similarly, it affects how you approach your job and the people you interact with. A negative attitude pushes the customer away.
It’s important to maintain a positive atmosphere, even when feeling subpar, because people often copy others’ emotions. What you convey to the customer is what you will most likely receive.
There are always ways for you to improve the impression you present to customers. This should shed some light on some areas maybe that have been neglected or introduced you to new ideas.
Dental waste management is an important aspect of your dental practice management.
Dental waste or bio waste accumulates throughout any given day in a busy dental practice. This clinical waste can include human tissue, bodily wastes, pharmaceutical products, syringes, needles, swabs and so on. Additionally, it may include x-ray fixer, developer and gypsum found in dental molds.
As in all healthcare facilities, these wastes need to be disposed of safely without any negative impact on the environment. Health and safety protocols are set to guide these disposal activities.
Amalgam – used as a restorative material – is made up of several chemicals bound together by mercury. The removal of old fillings and shaping/polishing of new fillings creates mercury-containing waste that poses a threat to the environment. Mercury has been declared a dangerous substance under the Canadian Environment Protection Act, 1999 and can do much harm if allowed to enter the environment through scrap, vapors, or waste water.
A Canada-wide standard states that amalgam traps and filters to collect the waste be implemented as a dental office’s best practice, allowing it to be recycled or disposed of in such a way that it does not enter the sewage system. An approved waste carrier should be contacted for recycling or disposal.
Used x-ray fixer and developer contains silver and are classified as hazardous under Ontario Regulation 347. Municipal bylaws place concentration limits on heavy metals such as silver entering the wastewater system which can affect aquatic life.
A dental practice should collect used fixer and developer solutions in separate containers provided by an approved waste carrier or supplier, who will then recycle or safely dispose. Silver recovery units can also be used to reclaim the silver from the fixer solution. Once the recovery cartridge is full, an approved waste carrier can recycle or dispose. Alternatively, dental practices can switch to digital equipment, eliminating the need for x-ray machines.
X-ray packets and aprons contain lead which is also classified as hazardous under Ontario Regulation 347. Lead can contaminate the soil and groundwater if disposed to landfill. An x-ray film manufacturer will often provide containers for recycling or disposal through an approved waste carrier. Lead aprons must not be disposed to the regular waste system. Approved waste carriers must be utilized for disposal.
Biomedical wastes are also classified as hazardous under Ontario Regulation 347. Bodily wastes may include blood-soaked materials, and human tissue. Extracted teeth, gauze, surgical gloves, and saliva-soaked materials are not included under the definition of biomedical waste provided they do not contain blood.
Blood-soaked materials should be collected in yellow liner bags marked with the biohazard symbol and disposed of through an approved biomedical waste carrier. If blood-soaked materials are stored on-site for more than 4 days, they should be stored in a refrigerated area, locked and separate from other supply areas.
Sharp objects used in a dental practice may include syringes, needles, and other sharp instruments such as scalpel blades and clinical glass and should be separated from any human waste. Sharps containers are puncture-resistant and leak proof and designed specifically for safe containment and disposal of these items.
Disinfectants and Other Chemicals
There are many chemicals used in dental clinics for sterilizing, disinfecting and cleaning. Some of these chemicals may be explosive if released to sewers in large enough quantities. Many of these chemicals can affect the environment adversely.
Follow the directions on Material Safety Data Sheets (MSDS) for the proper handling and disposal of all chemicals in the dental practice. Contact your local municipality for guidelines on disposal of solvents such as ethers, alcohols, acetone or chloroform.
As humans, there are few things we enjoy more in this world than sweets. But with tooth decay a full-on epidemic, alternatives to sugar are becoming more and more popular.
Not all sugar substitutes are considered equal, but Xylitol has great odds in the battle against tooth decay.
What is Xylitol?
Xylitol is a lower-calorie substitute for sugar. Manufacturers typically use Xylitol as a sugar substitute, since its sweetness is comparable to that of table sugar but with fewer calories.
With a similar taste to regular sugar, it also boasts a low glycemic index, making it a great choice for those diagnosed with diabetes.
Research suggests that Xylitol may also improve dental health, prevent infections and it possesses powerful antioxidant properties.
Where Does Xylitol Come From?
Xylitol is a naturally-occurring sugar alcohol found in the fibers of many fruits, vegetables, the bark of birch trees and other hardwood species containing the organic substance xylan.
Even though Xylitol is extracted from natural sources, it goes through a process called sugar hydrogenation to become a shelf-stable white powder for food and dental use.
Benefits of Xylitol
Xylitol can be beneficial for people with high tooth decay rate and risk.
Since it exists in many forms, Xylitol is easy to incorporate it into your daily diet and routine. Chewing Xylitol gum or using a Xylitol mint after meals can help reduce food debris and plaque, increase saliva flow, and inhibit the growth of unwanted bacteria.
Xylitol is widely marketed and easy to order or purchase.
Some of the main benefits of Xylitol include:
Low Glycemic Index. One of the negative effects of added sugar is that it can spike blood sugar and insulin levels. Xylitol contains zero fructose and has negligible effects on blood sugar and insulin
Dental Health. Many dentists recommend using a Xylitol-sweetened chewing gum since Xylitol boost dental health and prevents tooth decay. Animal studies also suggest that xylitol may increase absorption of calcium in your digestive system, protecting against osteoporosis and strengthening teeth
Ear infections. Incorporating Xylitol into your diet can help to reduce the frequency of ear and yeast infections. It turns out that Xylitol can starve some of the bacteria in the same way that it starves plaque-producing bacteria
Antioxidant Properties. For those looking to increase anabolism, Xylitol may be a key addition to the list of substances that can aid in this. Xylitol has been shown to increase Adenosine tri phosphate – a molecule made in every cell of your body also known as APT, to help fight muscle fatigue
Are There Any Downsides?
It should be noted that there are some situations where minor side effects could occur with Xylitol, though this is not common.
Xylitol is, however, very toxic to cats and dogs.
One of its benefits to humans is that Xylitol is absorbed slowly and has no impact on insulin levels. The same cannot be said for dogs. When dogs eat Xylitol, their bodies mistake it for glucose and start producing large amounts of insulin. When the dog’s cells start absorbing glucose from the bloodstream, hypoglycemia or even death can occur.
If you own a dog, be sure to keep Xylitol safely contained.
Manufacturers add xylitol to a range of foods, including:
Sugar-free candies, such as gum, mints, and gummies
Jams and jellies
Nut butters, including peanut butter
Xylitol is also an ingredient in some dental care products, including:
Other fluoride products
Xylitol may be better for dental health compared to consuming large amounts of sugar, however, it’s still a sweetener. As with other sugar alternatives, too much is not recommended. The best way to control dental cavities is to avoid excess sugar and strive for a balanced diet.
Scientists still don’t know how long-term use of e-cigarettes affects health—in part because e-cigarettes just haven’t been around long enough for the necessary rigorous research to be done.
“Comparing e-cigarettes to tobacco cigarettes is really like comparing apples to oranges. The exposures are completely different,” said Silvia Balbo, PhD, a member of the University of Minnesota Masonic Cancer Centre.
An e-cigarette is a battery-powered device that emits vaporized nicotine for the user to inhale. It simulates the experience of smoking tobacco without the smoke. They usually take the form of a long tube, meant to resemble a cigarette, cigar or pen. An increasingly popular e-cigarette device, called JUUL, is shaped like a USB flash drive.
Traditional cigarettes work by simple combustion: when tobacco is lit, it combines with oxygen and creates an inhalable smoke. E-cigarettes, on the other hand, heat a chemical-packed liquid that contains nicotine and a flavouring agent, like mint or fruity flavours, creating an aerosol. By delivering nicotine without tar and all the other nasty by-products of tobacco combustion, e-cigarettes are said to deliver smokers a healthier alternative.
DNA Damaging Chemicals Found
Researchers at the cancer centre enlisted the help of five e-cigarette users to characterize chemical exposure during vaping. They collected saliva samples before and after a 15-minute vaping session and analyzed them for chemicals that are known to damage DNA.
Three DNA-damaging compounds were identified—formaldehyde, acrolein, and methylglyoxal—whose levels increased in saliva after vaping. Compared to people who don’t vape, four of the five users showed increased DNA damage related to acrolein exposure.
E-cigarettes vs. Tobacco
Balbo’s research showed evidence that vaping could alter an e-cigarette smoker’s DNA and raise their risk of developing cancer. But that doesn’t mean vapers should turn to traditional cigarettes instead, she suggested. “It’s clear that more carcinogens arise from traditional cigarettes than from e-cigarettes.”
“It’s not as bad as smoking, but it’s not harmless,” research lead Irina Stepanov says. Stepanov is a professor with the University of Minnesota’s School of Public Health. Her most recent study shows a strong risk for mouth and throat cancer that previous research missed.
Her research uncovered NNN, N-Nitrosonornicotine, a cancer-causing chemical normally found in cigarette smoke, in the saliva in 16 out of 20 e-cigarette users.
“It can potentially put them at risk for developing oral cancer or esophageal cancer.”
While studies are yet preliminary, they do suggest that e-cigarettes pose greater health risks than originally thought and should be approached with caution. Ongoing research is needed to monitor the long-term safety of e-cigarettes.
The best thing a smoker can do for their health is quit completely. E-cigarettes can offer an option towards that end goal.
Scaling used to be a dental hygienist’s daily grind. But owing to advancements in ultrasonic scaling, the process has become increasingly efficient and effective. Not only is ultrasonic scaling more convenient to the hygienist than scaling with hand instruments, it has numerous benefits to patients’ oral hygiene as well.
Once activated, the tip of an ultrasonic scaler oscillates at incredible speeds up to 35,000 cycles per second. The hygienist guides the tip from the coronal to the apical of a tooth, pulverizing calculus so it can be washed away by a coolant spray.
Ultrasonic scalers remove plaque through a dual application of mechanical force and cavitation. The vibration of the tip creates pressure waves in the water dispersed as coolant, causing the formation and implosion of atomized gas bubbles. These shockwaves help to disrupt bacterial biofilm and fracture the calculus deposits as they are pounded by mechanical force.
The oscillating tip of an ultrasonic scaler is replaceable, with tips of various shapes and diameter available for different purposes. Thicker tips are generally suitable for use with higher power settings to remove heavier calculus deposits, whereas thin tips are used for light calculus or biofilm removal. In any case, hygienists should read the manufacturer’s directions as to a tip’s proper usage.
Benefits to Ultrasonic Scaling
Ultrasonic scaling is highly effective in removing subgingival/supragingival calculus from teeth without damaging roots or gum tissue. Other benefits to ultrasonic scaling include:
Using an ultrasonic scaler, hygienists can remove calculus from pockets between teeth and gums at probing depths that are unreachable with hand tools (4mm or greater.)
Ultrasonic scalers have replaceable, specially-designed tips that can penetrate difficult nooks and corners.
Since there are no sharp cutting edges and no ‘scraping’ sound, many patients find ultrasonic scaling is more comfortable than scaling with hand dental instruments.
A piezoelectric ultrasonic scaler uses transducers to convert electricity into mechanical energy using materials like quartz crystals. The device sends electrical energy to ‘activate’ the material within the handpiece and vibrate the instrument tip at 28,000 to 35,000 cycles per second. The tip vibrates in a back-and-forth motion and only the lateral sides are active.
Magnetostrictive ultrasonic scalers like the Autoscaler generate vibratory motion by transferring electrical energy to metal components in the handpiece. The tip operates in an elliptical motion at 25,000 to 30,000 cycles per second. Unlike piezoelectric scalers, all sides of the tip (lateral, face and back) are active in a magnetostrictive device.