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Wisdom Tooth Extraction and Alternatives - Important Facts to Know

 

Are you experiencing discomfort in your back molars or your gums at the back of your mouth? Do you have trouble opening and closing your jaws, bad breath or a low-grade fever? You may need a wisdom tooth extraction to remove an impacted third molar and prevent further discomfort and infection. Before you have your tooth removed, there are some critical facts you need to know about wisdom tooth extraction and the alternatives.

 

Alternatives to Wisdom Tooth Removal

Extraction is often recommended for wisdom teeth as a preventative measure to minimize misalignment, eliminate overcrowding, or when the tooth is infected. However, in some cases, you may not need to have your wisdom teeth removed.

 

Coronectomy

A coronectomy is an alternative to wisdom tooth extraction and is recommended for patients when the wisdom tooth is impacted and presses on the lingual nerve or inferior alveolar nerve. These nerves control the sensation in your tongue, lips, and chin and can affect speech and chewing.

 

A coronectomy removes the crown of the tooth, leaving the roots in place. If the wisdom tooth root is not infected, a coronectomy may be an ideal alternative to wisdom tooth removal.

 

Operculectomy

An operculectomy removes the gum tissue that can develop over a partially erupted wisdom tooth. Debris and bacteria can get caught in this tissue, causing painful infections and inflammation. Removal of the operculum reduces the risk of bacteria build-up and may prevent the need for a wisdom tooth extraction.

 

Bring a Chaperone to Your Appointment

Whether you have a wisdom tooth removal, operculectomy or coronectomy, your dentist will still administer anesthesia to make you more comfortable during the procedure. In most cases, the site will be numbed using a local anesthetic. However, for complex wisdom tooth extractions or if you suffer from dental anxiety, you may need to be sedated.  

 

The side effects of sedation can take some time to wear off, so it is essential to bring someone along with you to drive you home after the procedure.

 

Rest with Your Head Raised

Your body’s natural reaction to tooth extraction is inflammation and swelling. However, uncontrolled swelling can lead to infection. To keep the swelling under control, rest with your head slightly elevated to drain fluid away from the area. You can also apply cold compresses to the side of your face and take over the counter anti-inflammatory medication.

 

Skip the Toothbrush

Avoiding brushing isn’t advice that you’ll usually hear from your dentist; however, you need to avoid using your toothbrush near the extraction site for the first 24 hours after surgery.

 

Also avoid spitting and rinsing, as well as drinking through a straw. The reason for this is that the blood vessels inside the empty tooth socket form a clot that seals the socket and prevents infection.

 

If the clot becomes dislodged, you are at risk of developing a condition called dry socket where the nerves of the tooth are exposed.

 

Stock Up on Soft Foods

Hard and chewy foods can aggravate the wound site, causing discomfort. Some nutritious foods for post-surgery recovery include yogurt, oatmeal, fruit and vegetable purees, eggs, and smoothies. Cold and tepid foods can also help to alleviate post-surgery swelling.

 

Bleeding Is Normal After Surgery

Although you may have stitches in the tooth socket, it is normal to experience some bleeding after surgery. Your dentist packs the empty socket with gauze which you should hold firmly in place for 30 minutes. Repeat until the bleeding abates. If the bleeding is excessive, call your dentist immediately.

 

Symptoms that you shouldn’t ignore include fever, numbness, increased swelling, pus from the wound or nose, and trouble swallowing or breathing. Any of these symptoms could indicate infection or nerve damage and need to be assessed by your dentist immediately.

 

Keep Your Wound Clean

There are several ways you can keep your mouth clean and hygienic. Rinsing with a saltwater solution helps to eliminate bacteria, clear debris from around the extraction site, and reduce discomfort after surgery.

 

Combine one cup of warm water with ½ a teaspoon of salt and gently swish the solution around your mouth for 20-30 seconds. Instead of spitting out the rinse, tip your head over the sink and open your mouth to expel the water gently.

 

Final Thoughts

Wisdom tooth extraction is a standard procedure to prevent impacted wisdom teeth from affecting your remaining teeth and jawbone. However, it isn’t always necessary to have your tooth extracted.

 

If you have your wisdom teeth extracted, follow your dentist's post-surgical care instructions carefully to ensure a speedy and comfortable recovery.

 

About the author

Dr. Fadi Swaida first graduated from the University of Western Ontario with an Honors BSc in Biology before graduating from the University of Manitoba’s Faculty of Dentistry. He is an active member of his church and enjoys football and being by the water! His outgoing personality and fun-loving character will ensure you always feel welcome at Dentist North York.

 

 

 

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Botox Has Become an Unconventional but Effective Treatment for TMJ

 

As a dental professional, you’re no doubt well aware of the negatives of temporomandibular joint syndrome or TMJ.

 

The temporomandibular joint connects the mandible (or lower jaw) to the temporal bone (or skull) in front of the ear. Other specific facial muscles that connect to the lower jaw are responsible for chewing.

 

When the pain of TMJ has been too much for over-the-counter pain meds, it’s been known for dentists to prescribe strong pain relievers such as prescription-strength ibuprofen. Patients have also been treated with low doses of tricyclic antidepressants like amitriptyline to relieve pain symptoms, but also to control bruxism and sleeplessness. 

 

Furthermore, it’s not uncommon for patients to be offered muscle relaxants for their TMJ-related issues.

 

Then there is an array of therapies, like oral splints and even physical therapy used to treat the condition. If the patient is suffering enough, there’s also a mandibular or multi-joint surgery that can be performed. Really though, this list of treatments is only scratching the surface.

 

In fact, recently, Botox injections have been utilized to treat TMJ syndrome ‒ with a great deal of success.

 

How Useful Are TMJ Treatments?

A small anecdotal study involving 26 patients from 2012 discovered that Botox could substantially decrease the pain associated with TMJ for up to three months. It also could increase mouth movements.

 

There were two other studies, published respectively in 2003 and 2008, that revealed similar results.

 

Of the participants in the 2003 study, 90% displayed symptom relief after failing to respond to more conventional treatment methods.

 

As is the case with most experimental treatments, these small sample sizes aren’t enough for most experts to offer their 100% stamp of approval. Yes, the results are undoubtedly encouraging.

 

Still, to endorse the full effectiveness of Botox treatments for TMJ disorders, experts need to investigate the results of further studies.

 

Are There Any Side Effects to Botox Treatments for TMJ?

Despite the potential for positive results, Botox treatments for TMJ do come with side effects.

 

Pain, redness at the injection site, muscle weakness, and bruising at the injection site is common in the first week after treatment. More serious side effects include headache, respiratory infection, flu-like illness, nausea, and temporary eyelid droop.

 

Then there’s a chance that your patients might experience a fixed smile for up to 6 to 8 weeks. This condition is a result of the paralyzing effect that’s brought upon by Botox treatments.

 

A Breakdown of the Procedure

One of the primary benefits of Botox treatments for TMJ disorder is that it’s a nonsurgical, outpatient procedure. Meaning, it’s non-invasive. It’s performed right in the dental office and only lasts from anywhere between 10 to 30 minutes.

Commonly, there are at least 3 injection sessions that span throughout a several-month period. The number of injections required depends on your patient’s needs and the severity of their condition.

 

Botox can be injected in a patient’s forehead, temple, jaw muscles, or anywhere else in the face/head area where there are pain symptoms. Resulting pain from the injection itself is minimal. It resembles a bug bite, and a cold pack or numbing cream can help to ease any discomfort.

 

Patients will generally experience improvements several days after the treatment. Though they can return to regular activities immediately after leaving your office.

 

When Should Botox Be Used to Treat TMJ?

While this treatment is more synonymous with cosmetic enhancement, it’s increasingly being used in the dental industry therapeutically.

 

Botox injections treat the symptoms of TMJ instead of the syndrome itself. Meaning, it’s meant to soothe the jaw tension, teeth grinding-induced headaches and lockjaw that can result from TMJ syndrome.

 

Still, at this point, Botox treatments for TMJ disorder are only experimental. It’s considered to be an off-label approach that has yet to be approved by the Food and Drug Administration. As such, these injections are currently only an alternative when more traditionally successful methods haven’t been able to give patients relief.

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Why ‘Natural’ Teething Necklaces Do More Harm Than Good

 

The teething process can be difficult for both parents and young ones alike. It’s only natural that parents want to protect their children from anything that might be causing them pain ‒ but they don’t always want to treat the problem with pharmaceuticals.

 

So, many parents look for homeopathic, all-natural solutions for their toddler’s teething problem.

 

Recently, dental professionals have noticed the growing trend of parents are treating their toddler’s gum pain with a natural teething necklace. Let’s take a closer look at what this alternative ‘healing’ method entails.

 

What are Teething Necklaces?

Natural teething necklaces are abundantly available and can be purchased for about $20 from boutiques and big-box stores alike.

 

Part of the reason these necklaces are making such a big splash on the market is that several celebrities have been proponents of the product.

 

The necklace is made of something called Baltic amber, which was formed over 45 million years ago. It’s an organic fossil resin that’s produced by pine trees native to northern Europe and the Baltic Sea. This unique amber has been used since ancient times as both an ingredient in perfumes and in folk medicine.

 

People who believe in the healing properties of Baltic amber claim it soothes teething symptoms because it releases succinic acid. Apparently, the substance is absorbed as an analgesic through a child’s skin.

 

Is There Any Merit to This Homeopathic Treatment?

In short, no. There’s no scientific data that can prove these necklaces are useful in any way as treatments. Conversely, research suggests that this homeopathic healing device actually does much more harm than good.

 
The Cruel Reality of Teething Necklaces

Upon even the most surface-level investigation, you’ll find that succinic acid won’t be dispersed from your child’s necklaces unless it’s heated at 200 Celsius.

 

Furthermore, these necklaces are safety hazards.

 

What’s worse, young children have been strangled by these necklaces. The FDA has warned the public about these amber necklaces, pointing out that they can lead to choking, strangulation, mouth injuries, or infection.

 

If the piece of jewelry breaks, a small bead might enter a toddler’s airway, causing them to choke. It’s also possible that the necklace can get caught on a child’s crib then wrap too tightly around their neck, causing strangulation.

 

Then, the jewelry might cut toddlers’ gums – which can lead to an infection.

 

For further context, studies by researchers from Nova Scotia tested the strangulation risk of 15 amber teething necklaces purchased from retailers in Canada. Their results showed that nearly half failed to open after applying 15 pounds of force for 10 seconds, which is an industry-standard.

 

Talking to Parents About Teething Necklaces

It’s always challenging to tell parents they’re doing something wrong with raising their children.

 

Therefore, when you notice a toddler wearing a teething necklace or a parent informs you that they’re utilizing the method, be sensitive to their situation.

 

Still, as a professional, you can inform them of the dangers that we’ve discussed above. In many cases, most parents will realize your advice is coming from a good place, so they’ll likely take immediate action.

 

You must provide these parents with a list of viable alternatives. After all, it’s unfair to drop a bomb about the teething necklace with no other solutions in mind.

 

Here are some practical alternatives to a teething necklace:

  • Large plastic toys that are safe for chewing
  • Cold or frozen cloths
  • Frozen bananas or apples
  • Massaging the gums

While we do understand any hesitation about traditional medicine for children, a mild pain reliever won’t do any harm when given to a toddler sparingly.

 

The Final Verdict on Teething Necklaces

Parents can go to unusual lengths to protect their children from pain. Sometimes they hear about alternative treatments that sound too enticing to pass up.

 

After all, an ancient analgesic with healing powers catered specifically to teething pain makes for an enticing proposition.

 

However, as an informed dental professional, you must discourage parents from purchasing these necklaces. It’s then equally as crucial that you provide viable alternatives to help with teething pain symptoms, so parents can take comfort in your care for their toddler.

 

 

 

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Should Chairside Saliva Tests Be Part of Your Dental Practice?

 

 

As dental professionals, we’re constantly looking for ways to help patients feel safe and comfortable under our care.

 

Unfortunately, there’s little we can do to change the fact that dentistry is, by nature, quite invasive. We still have a ways to go when it comes to finding less invasive means to diagnose and treat our patients.

 

One promising solution in this area is saliva testing ‒ a fast, cost-effective diagnostic tool which requires no painful pokes or scrapes. Saliva tests are increasingly utilized as a noninvasive way to monitor oral health status, disease onset and progression, and treatment.

 

Here, we’ll look at the reasons why more and more dentists are welcoming saliva test kits into their practices.

 

Why Use Saliva Testing in Dental Practice?

 

Saliva is a truly flexible fluid. Yes, it helps us eat, speak and maintain good oral health ‒ but it also contains a wealth of biochemicals that can tell us a great deal about a person’s overall health.

 

Oral fluid can be analyzed for proteins and related molecules, nucleic acid components (e.g., human and microbial DNA, mRNA and microRNA), and endogenous and exogenous metabolites. Saliva tests can help dentists assess a patient’s risk of caries and periodontal inflammation by analyzing cariogenic bacteria, acidity, blood, leukocytes, protein and ammonia.

 

In addition to oral health conditions, trace amounts of proteins and other substances linked to other systemic diseases can filter into saliva from blood serum. These salivary biomarkers have been investigated for detection and monitoring of diseases such as:

  • Human papillomavirus (HPV)
  • Autoimmune diseases, including Sjögren’s syndrome
  • Cystic fibrosis
  • Various cancers, including oral squamous cell carcinoma
  • Herpes simplex virus 1 or 2
  • Chlamydia trachomatis and Neisseria gonorrhoeae

Unlike a blood sample, saliva (along with secretions from specific oral glands, mucosal transudate and gingival crevicular fluid) is painless and readily available to collect from patients for analysis.

 

In many cases, it is possible to collect and test saliva samples right there in the dental office using portable, rapid test kits. When laboratory analysis is required, saliva samples have greater stability than blood in transportation.

 

Applications for Saliva Testing in Dentistry

 

In an article for Dental Economics, Dr. Richard Nagelberg illustrates how saliva testing could be used to help dentists and hygienists provide evidence-based treatment for periodontal disease.

 

Suppose a patient comes to you with telltale signs of inflammation: painful, bleeding gums and the early stages of gum recession. You don’t need a saliva test to tell you that this patient is likely suffering from gingivitis. However, the results test could inform an individualized treatment approach that could provide the best possible outcome for them.

 

As Dr. Nagelberg explains, a salivary test report would specifically indicate which antibiotics are indicated for each type of bacteria found in the saliva sample. A patient who is dealing with high-risk, highly pathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia would benefit from a treatment plan that is based on their increased risk of periodontal disease.

 

Efforts are underway to further the development of rapid, point-of-care tests to evaluate oral fluids. Ongoing research indicates that saliva could eventually be used to detect heart disease, diabetes, cancers and other conditions. Refinement of oral fluid tests may shed further light on our understanding of the oral-systemic link.

 

Imagine using a simple, chairside test to detect all manner of oral and systemic diseases. This could be the future of diagnosing periodontal disease, assessing cavity risk and more!

 

The Future of Saliva Testing in Dentistry

 

The development of salivary testing for the dental practice is still in its early stages.

 

Currently, there is still no established, uniform criteria for collecting human saliva in the dental practice. Although oral fluid testing by clinical laboratories is regulated to ensure test results are accurate, the regulations do not address the validity of the test. Additionally, to date, there are no FDA-approved salivary diagnostic tests for evaluating the risk of periodontal disease or dental caries.

 

Still, saliva testing for oral and systemic disease holds many advantages that make it ideal for use in dentistry. Surveys show that these types of chairside tests are appealing to dentists and patients alike.

 

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Geographic Tongue: Symptoms, Diagnosis, and Treatment

 

Geographic tongue, an inflammatory condition in which red, smooth patches without papillae appear on the surface of the tongue, is generally harmless. However, the pattern of these red patches (often called “islands”) may appear dramatically “geographic” in some patients and cause cosmetic concern. Often, these smooth, red patches will also migrate across the tongue, hence geographic tongue’s other name—benign migratory glossitis.

 

While geographic tongue is obscure enough to be included in the rare disease database of the National Organization for Rare Disorders, it is still estimated to be present in 1% to 3% of the population, meaning that you’ll likely encounter geographic tongue in your own practice.

 

That said, let’s dive into how you might diagnose geographic tongue, some symptoms to be aware of, and the available treatment options.

 

Symptoms of Geographic Tongue

In most cases, geographic tongue is asymptomatic, but the inflammation can become uncomfortable for some patients. Aside from the appearance of physical symptoms, patients with geographic tongue may also experience increased sensitivity or tongue tenderness.

 

Sensations of pain or burning are sometimes reported when those with geographic tongue consume foods and beverages which are spicy or highly acidic.

 

Diagnosing Geographic Tongue

Due to its dramatic, characteristic appearance, diagnosing geographic tongue is typically rather straightforward and can be confirmed with only an outward examination of the tongue—it's the management of this diagnosis which makes your awareness of the condition so important.

 

Understanding Geographic Tongue’s Implications in Overall Health

If geographic tongue is harmless and infrequent, you may be wondering why it’s essential to understand its signs and symptoms in order to make an appropriate diagnosis.

 

As a dental professional, the role you play in the overall well-being of your patients is crucial—by having awareness of geographic tongue and its implications in an individual's overall state of health, you become a valuable contributor to their quality of life.

 

And, while geographic tongue is generally considered idiopathic, ongoing research suggests that it may actually be a manifestation of systemic disease.

 

For example, scientific literature has suggested a relationship between geographic tongue and psoriasis, indicating that geographic tongue could be an oral manifestation of this skin condition. As a result, it’s recommended that general practitioners and dental professionals work together prudently to check for oral symptoms in psoriatic patients and to check for skin lesions in otherwise healthy individuals diagnosed with geographic tongue.

 

Others have posited that geographic tongue might be caused by vitamin B deficiency or irritation from alcohol or particular foods. For reasons we don’t yet understand, geographic tongue appears less frequently in people who smoke and more commonly in those with allergies.

 

In other cases, however, geographic tongue manifests in otherwise healthy individuals, complicating the search for a direct cause or consistent association with other diagnoses.

 

Treatment

It’s critical that you partner with a patient’s other healthcare providers in order to suggest appropriate management, especially when the patient experiences physical discomfort or anxiety surrounding geographic tongue.

 

For example, you might recommend rinsing with lukewarm saltwater, alkaline rinses, or anesthetic rinses to provide relief for mild cases of geographic tongue, or you may suggest that a patient follow up with their dermatologist if you suspect that their geographic tongue may be linked to a skin condition like psoriasis.

 

It has also been reported that some psoriasis patients who utilize systemic treatments have found improvement in their oral health and symptoms of geographic tongue, too.

 

Your Role as a Dental Professional

While we don’t fully understand the reasons why geographic tongue occasionally manifests, your prudence in identifying this condition during routine dental hygiene appointments and examinations can make all the difference in how a patient manages their overall health.

 

In addition to taking a complete medical history from patients with geographic tongue, it is also of value for dental professionals to provide sympathy and knowledgeable reassurance, given that the sometimes-severe appearance of geographic tongue lesions may lead patients to believe that there is something seriously wrong.

 

Remain aware of your duty to consult with their other providers and be prepared to provide information in order to educate the concerned patient. Your contributions will lead not only to better oral health but also to improved overall wellness.

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Treating Patients with Thyroid Disease as a Dental Hygienist

Thyroid conditions present oral and systemic manifestations that can challenge even the most seasoned dental professionals. Up to 15% of the general population has some form of thyroid abnormality, and many people have never been properly diagnosed - which makes treating them all the more complicated.

 

As a registered dental hygienist, there are ways you can help to identify and manage the oral manifestations of thyroid diseases. Here, we’ll discuss two of the most common thyroid diseases you’ll see in your practice: hypothyroidism and hyperthyroidism.

 

Oral Manifestations of Hypothyroidism

 

Hypothyroidism, also called underactive or low thyroid, is a decrease in the hormone production and functioning of the thyroid gland. Hypothyroidism most often affects women from middle age onward, but it can occur in people of any age.

 

Many people who have hypothyroidism present only a few or very mild symptoms. However, those with severe hypothyroidism can experience numerous symptoms including slow metabolism, weight gain, lethargy, sensitivity to cold, and puffiness of the face.

 

When treating a dental patient with hypothyroidism, you may notice one or more of the following common oral manifestations:

  • Salivary gland enlargement
  • Compromised periodontal health
  • Glossitis, or inflammation of the tongue marked by soreness, swelling and change in colour

People who experience severe hypothyroidism as a child may present long-term dental and craniofacial manifestations in adulthood, such as:

  • Enamel hypoplasia
  • Micrognathia, or undersized jaw
  • Mouth breathing
  • Thick lips
  • Macroglossia, or oversized tongue

Oral Manifestations of Hyperthyroidism 

 

Hyperthyroidism, also called overactive thyroid, is the unregulated production of thyroid hormones. It is most often called by an immune system disorder called Grave’s Disease and usually affects women under 40, but it can occur in people of all ages.

 

Many of the symptoms of hyperthyroidism mirror hypothyroidism in reverse - sensitivity to heat, weight loss, increased cardiac output are common. It can also cause emotional instability, tremors, abnormal heart rate and hypertension.

 

A dental patient who has hyperthyroidism may present the following oral manifestations:

  • Increased susceptibility to periodontal disease and dental caries
  • Enlarged extraglandular thyroid tissue (mainly in the lateral posterior tongue)
  • Burning mouth syndrome
  • Xerostomia or dry mouth caused by Sjogren's syndrome

Treating Dental Patients Who Have a Thyroid Disease

 

As a registered dental hygienist, it is important to understand how thyroid dysfunction could affect your patient care.

 

First, you are well-positioned to notice the symptoms of hypo- or hyperthyroidism and aid in early diagnosis. Your keen eye could be what points a patient in the right direction to receiving treatment for their condition.

 

For patients who have confirmed thyroid disease, it’s also important that you and your colleagues deliver care that will help, not harm. Complications can occur from improperly treating dental patients with thyroid disorders.

 

Rebecca Marie Friend, BS, RDH demonstrates this perfectly in a recent column for Today’s RDH. When an elderly patient came in presenting with hypothyroidism, Rebecca took the time to carefully review the patient’s health history and discuss the patient’s medications, including over-the-counter remedies. Not only did this discussion reveal an important oversight by the patient’s doctor, but Rebecca was able to provide the patient with a better understanding of the condition.

 

Rebecca also provides the following recommendations to hygienists and other dental professionals in treating dental patients who present with thyroid disorders.

 

  1. Establish communication with the patient’s endocrinologist and other healthcare providers. This will ensure that you are kept up to date with the patient’s medications and the rest of the healthcare team is aware of the patient’s oral manifestations.
  2. Plan treatment in a way that limits stress and infection. Patients with hypothyroidism are at greater risk of infection due to increased bleeding and delayed wound healing.
  3. Treat the oral manifestations of hypothyroidism and hyperthyroidism as needed, including periodontal disease, caries and xerostomia.
  4. Conduct an extraoral head and neck examination at each appointment. This will help you detect changes to the patient’s thyroid region.
  5. Be sure to always use a thyroid collar when taking patient X-rays. The thyroid gland is very sensitive to radiation, and excessive exposure is a known risk factor for thyroid conditions.
  6. Help the patient feel comfortable in the chair. People who have hypothyroidism could use a blanket to help keep their legs warm, while those with hyperthyroidism might appreciate you turning the thermostat down a few extra degrees.
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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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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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7 Methods of Disposing Dental Waste

 

 

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 Waste

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.

 

Silver-Containing Waste

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.

 

Lead-Containing Waste

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.

 

Bodily Wastes

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.

 
Sharps

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.

 

Using less harmful cleaning products and methods can reduce the impact on the environment and the need for special handling of waste in the dental practice.

 

Being Compliant

You can ensure your dental practice is compliant by:

  • Documenting the handling, transfer and disposal of all wastes from your dental practice. It is important that your dental office keeps accurate records and maintains all paperwork up-to-date.
  • Choosing a waste carrier that has a certificate of approval for the transport of hazardous waste which should include multiple waste classes.
  • Using recyclable containers provided by waste carriers where possible.
  • Confirming that the waste carrier complies with requirements under the TDGA (Transport of Dangerous Goods Act) requirements such as labelling and containment.

 

 

 

 

 

 

 

 

 

 

 

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