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.
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.
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.
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.
Patient satisfaction is key to the success of any dental practice.
As a dental professional you will do whatever you can to ensure your dental patients are happy, comfortable and pain-free. You know that a dental patient who has a positive experience will keep returning and refer your services to their friends.
No matter how well you have prepared them, at one time or another you may have to deal with an unhappy denture patient. A denture patient will have a unique range of concerns over the procedure involved in getting dentures to replace their teeth. Educating your denture patient on what the procedure entails prior to treatment will help to alleviate their concerns. It’s essential to communicate effectively to your patients and manage their expectations.
Documentation is important and must be kept with the patient’s records. Dentists should follow the rule that if it’s not documented, it did not occur.
Follow these 3 steps to manage a patient that is having trouble adjusting to new dentures.
The first and most important thing you can do is listen to your patient. Be sensitive and remain calm while you try to understand the cause of any discomfort or pain.
If dentures are new, there is a transition period in adjusting to them. It’s only natural that replacing teeth with false teeth, or dentures can take time to get used to.
If the patient is suggesting you did a bad job, and is questioning your professionalism, resist the urge to get angry, and keep your emotions in check.
Assure your patient that new dentures need not be uncomfortable. Make sure they understand that you have their well-being at heart. Identify the problem and suggest possible solutions. Make sure your patient has been given all the necessary information on the proper care and handling of dentures.
Discuss the possible actions that you could take to help your patient. Most unhappy denture patients just want you to solve their problem. Some may push you to waive all or part of your fee. Others may request procedure changes or other concessions. Remember your end goal of a happy patient!
Common complaints from new denture wearers are:
Gum tissues are initially soft and need to time to heal. Gums will become smoother and firmer over time. Gums will continue to shrink and change, and they may need readjusting.
Gagging can be caused by a few reasons. Dentures may be too loose and move around, or they may be too large, touching the back of the throat. In some cases, a denture adhesive may help. In others, dentures may need to be relined or even remade. A soft lining material can be added to fill up space. This might have to be repeated every three to six weeks until your patient has completely healed, after which final adjustments can be made.
Sore spots can be eliminated by grinding down pressure points inside the denture.
Dentures Don’t Fit
Over time bones and gums can change and dentures won’t fit as well. A replacement set or modifications can be made.
Some people who wear dentures get mouth infections such as cheilitis. Cheilitis is a painful infection caused by the overgrowth of yeast, that causes cracking at the corners of the mouth. Stomatitis is also caused by too much yeast and causes small red bumps on the roof of the mouth. Both can be treated with medicine and proper fitting dentures.
Communication is the cornerstone of a successful practitioner-patient relationship. Dentists and registered dental hygienists hear this principle repeated throughout their education.
However, in most dental appointments, the practitioner does most of the talking.
If you’re a patient, these are vital questions to ask on your next dental visit. If you’re a practitioner, this list should help open the door to more productive communication with people for whom you care.
1. How Does Dentistry Impact My Overall Health?
There is a strong connection between a person’s oral health and the state of their health overall. Not only does the mouth offer clues to what’s going on in the rest of the body, but it can affect the body in ways patients often find surprising.
2. What is the Condition of my Gums, Teeth and Smile?
Given the connection between oral health and overall health, it is vital patients know where they stand. The appointment should not focus solely on the most pressing problems. Take time to discuss the state of the patient’s oral health as a whole.
3. How Does Your Oral Health Impact Your Everyday Life?
Patients in the dentist’s chair should never be shy about what’s bothering them. Even minor concerns can point to bigger oral health issues that should be addressed. Be sure to bring up everyday issues like swollen or bleeding gums, bad breath, loose teeth, and snoring.
4. How Will a Proposed Treatment Solution Benefit Me?
Part of a dental practitioner’s job is to ensure patients have the facts they need to make well-informed decisions about their oral healthcare.
Some treatments are necessary, while others are beneficial but optional, or purely cosmetic. It’s important that patients understand the urgency of a procedure and the possible consequences (if any) of not moving forward.
5. Is This the Right Practice to do this Work?
Many dentists are generalists, but some specialize in a particular area of dentistry. For certain treatments, patients may benefit from a referral to a specialist in areas like endodontics, orthodontics, or periodontics.
A dental specialist in the United States is a member of a Dental Specialist Organization recognized by the American Dental Association; in Canada, a specialist has completed specific postgraduate training and passed a Royal College of Dentists exam.
6. Is This the Right Time to Proceed with Dental Treatment?
Assuming the problem is not an urgent one, it may be better to postpone treatment until a later date. Many people have a limit on the total cost of dental care their insurance covers each year; performing different steps of treatment over a longer period can help the patient maximize their dental benefits.
The Importance of Practitioner-Patient Communication
We write about communication between patients and dental practitioners on this blog often. In this post, we aimed to help facilitate the process with questions every patient should ask (and which dentists and hygienists should encourage).
The occurrence of a cerebrovascular accident (CVA), commonly known as stroke, has a significant impact on a patient’s oral health. Dental hygienists can provide valuable support in the maintenance of oral hygiene as survivors recover and adjust to life after a stroke.
This article provides an overview of the role of hygienists in assisting stroke patients with oral hygiene care.
Patients typically undergo extensive rehabilitation, including occupational therapy. Traditionally, it was physical therapists that helped patients regain oral hygiene skills following the incidence of a stroke.
Each cerebrovascular accident case is unique; not all patients who are recovering from stroke present the same conditions or follow the same path in recovery. However, dental hygienists who wish to support these patients must be knowledgeable of the many ways stroke can impact the state of a person’s dental health and the ongoing care they require.
Assisting Stroke Patients with Oral Hygiene Care
Oral hygiene is an important part of a stroke survivor’s care and recovery. Regaining the ability to care for one’s teeth and gums gives patients a sense independence and control over their health.
For patients with lasting disabilities, dental hygienists can help empower the patient’s caregivers to provide quality dental care.
In most cases, patients are advised to wait at least six months after a stroke to receive non-urgent dental care, and to receive a post-CVA consultation with the patient’s physician. These are some of ways that dental hygienists can assist stroke patients with oral hygiene care:
If the patient uses oral hygiene aids at home, have the patient bring the products to the appointment and demonstrate their use. Hygienists can advise on the usage of these products to achieve the best possible results.
Hygienists can suggest products and methods that can help patients compensate for the loss of dexterity or cognitive impairment, such as floss holders, floss piks, electric toothbrushes, and brushes with a two-minute timer.
For patients with cognitive impairment or memory loss, hygienists can assist by providing all oral hygiene instruction in both oral and written form and including the patient’s caregiver in all appropriate discussions.
Celebrating Dental Hygienists
October is National Dental Hygiene Month: an initiative to celebrate the hardworking, compassionate dental hygienists who contribute to the cause of improving oral health care. Sable Industries is proud to support your work.
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?
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.
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:
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.
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.
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.
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.
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:
Know the facts on oral cancer. Dental hygienists should be confident in their knowledge and ability to locate, review, and update baseline data.
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.
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.
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.
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.
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.
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.
Become an expert. Registered dental hygienists can apply for certification as an Orofacial Myologist following completion of an IAOM-approved 28-hour course.
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.
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.