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How Effective Is Childhood Dental Advice From Non-Professionals?

 

Research shows that up to 90% of children across the globe deal with untreated dental caries.

 

These youngsters face the potential for long-term and short-term consequences: worsening pain and discomfort that intensifies without treatment, and difficulties eating, sleeping, learning, playing if the problem persists. Left untreated, the circumstances can be severe enough to necessitate surgery.

 

These adverse outcomes are discouraging, since they’re easily preventable with proper education.

 

As such, there’s really no substitute for providing quality education on this growing issue. And since not all families in the United States and Canada have consistent access to dental care, this education often comes from nurses, teachers, and social workers.

 

However, there are two crucial caveats:

  1. The information must be accurate.
  2. It also must be consistent.

Recently, a first-of-its-kind study published in the journal BMC Oral Health assessed the effectiveness of childhood dental advice given to expectant parents and parents with toddlers by non-dental professionals (such as teachers, social workers) on children's oral health.

 

Alarmingly, these researchers’ findings suggest that this non-professional advice yields mixed results.

 

Effectiveness of Preventive Dental Programs Offered By Non-Dental Professionals

 

In this study, researchers analyzed five databases, seeking out quantitative studies that assessed the success of dental interventions by non-dental professionals. The interventions were focused on expectant mothers and mothers of toddlers.

 

 All of the nine chosen studies measured the following results:

  1. Outcomes and changes in the children’s teeth just before the age of five; and
  2. Outcomes and changes of said children’s mothers at the same time.

The goal of this research was discovering if current mother-centric oral health programs are generating positive results. Researchers also wanted to discern the comprehensiveness of these programs, and whether they lack education that could be valuable to patients’ dental health.

 

The results were decidedly mixed. When the mother was guided by a well-rounded team of specialists (e.g., social workers, nurses, and dental professionals), the toddlers had fewer dental caries and extractions compared to toddlers with mothers not receiving guidance. The results were more positive when childhood dental advice was paired with free dental supplies such as toothbrushes, toothpaste, mouthwash, and interdental aids.

 

However, while the children of mothers with teams guiding them got off to a great start, these positive results don't continue after toddlerhood. Most of the mothers making use of these programs lacked a fundamental understanding of dental-related issues.

 

Additionally, there appears to be a lack of cohesiveness in dental education shared by non-dental professionals. Issues with accuracy and omitted details were both prevalent.

 

The Crucial Role of Dental Professionals

 

Despite a lack of statistical support, it is clear from the results that these programs do help many families who wouldn’t otherwise have access to care. However, it is also evident that such programs would benefit from greater involvement from dentists, registered dental hygienists, and other dental professionals.

 

As a dental professional, our success in enhancing these younger patients’ outcomes is predicated on how well we communicate with the non-dental professionals involved in their care. Dental professionals can provide accurate and viable information about dental hygiene best practices and preventative care that ensure families in these programs receive correct information and cohesive guidance.

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Dental Distancing: How COVID-19 Is Shaping the Future of Teledentistry

 

Depending on where your dental practice is located, you’ve likely reopened — but notice that patients are hesitant to visit your practice in-person.

 

These fears aren’t unfounded. The CDC’s COVID-19 Infection Prevention Team warns that dental settings have unique characteristics that warrant specific infection control considerations. Being in an environment where instruments create visible sprays with particle droplets of saliva, blood, and microorganisms feels risky, even where case numbers are low.

 

Now, we’d be remiss in failing to mention how there haven't been any COVID cases connected to dental practices as of yet. But with surfaces potentially being contaminated for 3 hours, industry professionals need to find a way to treat clients who refuse to visit their offices.

 

What can fill this gap in dental care?

 

Increasingly, it looks like teledentistry might be the answer.

 

What is Teledentistry?

 

Teledentistry applies the same principles of telehealth, except with the scope only revolving around oral health.

 

This kind of care utilizes various technologies to provide dental care and education to treat patients remotely.

 

Through the following methods (and more), dental professionals can provide “tele-dental” services to their patients:

  • Live video
    • This can happen with either Skype, Zoom, or other video-chat technology, and it happens in real-time.
  • Store and forward
    • Patients store and send their health information via radiographs, photographs, video, digital impressions, and photomicrographs to their practitioners.
    • The practitioner looks at this information at a different time than when it's sent (so, it's not in real-time).
  •  Remote Patient monitoring
    • Different dental practices can share information (usually through data processing services) to provide supportive care or direct care.
  • Mobile health
    • Mobile communication devices such as cell phones, tablet computers, and personal digital assistants (PDA) can help support dental care.

The Future of Teledentistry

 

Eventually, there will be a vaccine for COVID. At that point, fears over the virus will begin to subside. However, that doesn’t mean that teledentistry is only temporary.

 

Once you’ve shown patients the capabilities of teledentistry, it’s akin to opening Pandora’s box. Sure, there’s going to be instances where in-person visits are unavoidable. Yet research shows that patient success-rates are the same when they use telehealth compared to when they don’t.

 

Therefore, this convenient form of care doesn’t seem to come at the cost of quality.

 

There’s also the matter of general dental anxiety. Some patients fear oral care for reasons outside of the pandemic. Teledentistry provides these people with an option to avoid dealing with the stress of in-person visits. 

 

It seems like teledentistry will remain a significant part of many practices, even when everything returns to "normal."

 

The Long-Term Benefits of Teledentistry

 

Let’s take a look at the benefits that clearly outline why teledentistry is here to stay:

 

1. Reducing Overhead Costs

 

Virtual consultations manage to mitigate potential miscalculations for appointment times. The nature of emergency treatments isn’t always apparent when only a phone call is involved, leading to dentists blocking off too much time. Similar missteps occur with more straightforward visits for prescriptions.

 

Knowing how long appointments streamlines that day and ensures time is being spent most efficiently. Plus, prescribing medications during virtual calls opens up chair-time to patients who need it.

 

2. Removing Geographical Limitations

 

Teledentistry can be a fantastic boon for people that live in communities with limited access to dental care. They can receive guidance and prescriptions to better their oral health while at home or in the office. That's a far more realistic option than driving 2 hours for a half-hour examination!

 

Moreover, it gives you a chance to expand your patient-base by offering routine care to people who usually can't access it.

 

3. Improving the Patient Experience

 

Many patients are incredibly busy with their work and family. Teledentistry will meet these people in the middle. They won’t need to block off big chunks of time to drive and sit around at the office on top of the appointment.

 

Other patients lack transportation, and teledentistry offers them an alternative to paying an expensive cab fare or bothering someone for a ride.

 

Teledentistry Will Revolutionize the Dental Industry

 

You’ll want to strike while the iron is hot with teledentistry because it’s not going anywhere — even when the pandemic is long gone. As technology advances and patients begin to expect more from their dental care, adopting this technology will be a primary component of any thriving practice.

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Reviewing the Risk of Aerosols in Dentistry

 

As your dental practice begins to welcome patients again, their safety and that of your dentists, hygienists, and the rest of your staff is paramount.

 

With a heightened public awareness of cleanliness, sanitation, and safety, any hint of poor practices can damage your reputation. Furthermore, you can’t afford to put yourself, your team, and your community in harm’s way.

 

Since the human mouth is home to 700-plus species of bacteria, and dental practices warrant specific infection control considerations, we all must be vigilant.

 

Unfortunately, many dentists aren’t protecting themselves or their patients from the potential infections that come with being exposed to those germs, particularly in the form of dental aerosols.

 

What Are Dental Aerosols? Are They Related to COVID-19?

 

The working definition of a dental aerosol is a solid or liquid particle in a gas, produced during many dental procedures, under 50μm in diameter (anything bigger is classified as splatter.) Dental aerosols are created when scalers, drills, and other high-speed equipment interact with saliva, blood, or plaque.

 

Although not all dental aerosols are harmful, these airborne materials can contain harmful bacteria and viruses, including COVID-19. Dentists who treat patients using aerosolization are at high risk of infecting themselves, their dental assistants, and others working at their practice.

 

It should then come as no surprise that dentists find themselves afflicted with respiratory infections more frequently than most, due to the perils of their environment. In addition to concerns regarding COVID-19, there is also proof of aerosols harbouring other cross-infection risks, including the common cold, sinusitis, pharyngitis, pneumonia, tuberculosis, SARS, influenza, and swine flu.

 

Moreover, harmful pathogens caused by aerosols linger in the atmosphere long after you’ve finished with your patients. In fact, contamination occurs most frequently due to the inhalation of infectious particles after they have settled on surfaces.

 

Another way aerosol contamination often occurs is when the evacuation system or dental unit waterlines are of poor quality or have been compromised in some way. This can result from water stagnation, inadequate cleaning, heating of your chair unit, and reservoir bottle contamination.

 

The health risks of aerosols vary between patients, depending on their saliva, blood, plaque, and mucus, and if there's any infection present.

 

Managing Aerosols at Your Practice

 

The perils of aerosols can be mitigated through proactive aerosol management measures, such correct fittings, appropriate level masks, high volume suction, and the use of products that protect the patient’s nasal passages. You and your team should adhere to a comprehensive infection-prevention plan the moment patients enter the practice.

 

Given that the risk level of a dental aerosol depends on a patient’s health, you should gain a full medical history of your clients. This means completing a thorough examination and making your patient rinse their mouth with a microbial mouth rinse before treatments.

 

Face masks, of at least ASTM Level 3, should be snugly covering your mouth and nose. Only use a mask for one appointment, switching to a new one for each patient.

 

Regarding treatment-based equipment, flush lines and reservoirs with a microbial evacuation system cleaner like Bio-Pure. Bio-Pure is a non-foaming, 100% natural cleaner that can be used anywhere there is organic waste and water, including plaster traps, cuspidors, and drains.

 

Dental aerosols are a major concern for infection control within dental care, especially in light of COVID-19. We hope that this advice will help you and your team feel safer and better prepared to face this post-pandemic world with confidence. Reach out to us to learn more about any of our EPA-compliant cleaning products.

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Re-Opening Your Dental Practice? Know The New CDC/EPA Guidelines

 

As many areas reach Phase Two, the economy is beginning to re-open throughout North America. Even densely populated areas with higher COVID rates, such as Toronto, are emerging from stasis.

 

Slowly but surely, the streets are filling with people, and businesses are resuming their operations.

 

That means that, now more than ever, your dental practice needs to place a microscope on your cleaning and disinfecting procedures. The reasons are threefold:

  1. You want to put your clientele at ease, giving them confidence that you can maintain a safe environment.
  2. You must protect yourself, your staff, and your community from potential outbreaks.
  3. Given the nature of the work, dental practices already deal with an excess of germs; and dental professionals are at a higher risk of transmission than most.

Recently, the EPA & CDC published new guidelines on best cleaning and disinfecting practices. Here’s a link to the entire document, but we’ll break down the most crucial points in this blog.

 

Building The Framework of Your Cleaning & Disinfecting Plan for Re-Opening

 

When implementing a system for cleaning and disinfection of your practice, experts recommend you should craft a plan in these three stages:

 

1. Development

  • Evaluate your office/practice and assess the surfaces and materials that comprise the space.
  • Light switches, doorknobs, and other regular areas will need extra attention paid for cleaning and disinfection to reduce the risk of spreading germs.

2. Implementation

  • Now it’s time to execute on what you’ve developed.
  • To ensure optimal cleaning/disinfecting, thoroughly read the manufacturer's instructions for all products.
  • During any cleaning and disinfecting, ensure that you’re wearing gloves and other required personal protective equipment (PPE).

3. Maintenance and Revision

  • Continue to update your implemented plan based on evolving guidelines.
  • Also, keep an eye out for potential blind-spots you might have had during the development stage.

How to Properly Clean & Disinfect a Surface

 

People tend to conflate ‘cleaning’ and ‘disinfecting’ when they’re really two separate processes. One valuable source of information breaks down the dual-process in very straightforward terms:

  • For cleaning, your primary focus is the removal of germs, dirt, and impurities from surfaces. This way, you’ll mitigate the potential for infections to spread.
  • After cleaning is when disinfectant products do their best work. They kill the lingering germs on surfaces, thus further offsetting the possible spread of infection.

As has been established in the previous section, wear gloves and any other necessary PPE to keep yourself safe. Given that you’re working in a dental office, additional protective equipment should be considered.

 

Clearing Up the Confusion: Cleaners Versus Disinfectants

 

Cleaning can be performed with water and either soap or detergent.

 

Conversely, disinfectants are generally sprays, concentrates, and wipes—all of which can be employed in preventing COVID-19.

 

According to the EPA and CDC, following the product label instructions is a non-negotiable must. Doing so will keep you informed on how long you should leave products on the surfaces to successfully eliminate germs. There’s also the matter of rinsing the product so that you don’t ingest harmful chemicals. Plus, you want to keep those products out of the reach of children. 

 

Something else to consider is that it’s been suggested not to overuse or stockpile both disinfectants and PPEs. Given the current circumstances and the need to combat COVID-19, you need to do your part in preventing shortages in the case of emergencies.

 

Lastly, you might experience a situation where the EPA's requested disinfectants aren't accessible. In this instance, those same guidelines establish other ways to disinfect surfaces that are equally effective at staving off COVID-19. 

 

Click here for a list of CDC and EPA-requested disinfectants.

 

Other Crucial EPA & CDC Guidelines to Consider

 

Naturally, running a dental practice exposes you, your staff, and your clients to an array of excess germs compared to the average business.

 

Thus, measures must be in place to protect everyone who'll come into contact with your practice and the surrounding community. This means stringent social distancing rules must be maintained.

 

Furthermore, all practice staff should be wearing cloth face coverings and frequently washing their hands. Keep on top of federal, state, tribal, territorial, and local guidelines as they continue to evolve and shift in nature.

 

Adapting to the New Normal

 

These guidelines might seem a little bit intense, and something of a headache on top of everything else required to run your practice. After all, being successful in the dental industry requires in-depth focus and dedication outside of keeping your office COVID-proof.

 

However, maintaining these cleaning and disinfecting standards contributes to the greater good of society. All while keeping your practice safe. And eventually, at least until there’s a vaccine, these methods will slowly become second nature.

 

Above all else, you’ll find that these measures offer you tremendous peace of mind!

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Study: Without Precautions, PPE Use Causes Serious Skin Damage

PPE, short for personal protective equipment, has always been important to dental professionals. It helps us protect ourselves and our patients from the spread of germs and disease. But with the COVID-19 pandemic this year, wearing PPE is more crucial than ever.

 

Healthcare professionals are now the most at-risk group for coronavirus as they work in close contact with patients. The challenges surrounding PPE use, as well as the risk of PPE failure is unfolding before our eyes.

 

As a result, PPE must be used vigilantly by all healthcare professionals, including dentists and dental hygienists.

 

But one side effect of PPE that isn’t often discussed is the severe skin damages it can cause – especially when preventative measures aren’t taken to combat it.

 

Here, we’ll highlight how the use of PPE can result in skin damage, how to minimize skin damage, and how your own dental practice can be proactive in mitigating the risk.

 

Types of Common Skin Damage While Using PPE

 

A new study on medical workers treating COVID-19 patients discovered that 42.8% of staff experienced serious skin damage linked to the use of PPE. These items included masks, goggles, face shields, and protective gowns.

 

The study, published in Advances in Wound Care in June 2020, also concluded that the skin injuries put medical workers at an increased risk of infection of COVID-19 if insufficient prevention and treatment measures were not put in place.

 

The study consisted of 2,732 medical respondents. They were among the first healthcare workers fighting coronavirus in emergency departments, screening clinics, isolation areas, infectious branches, and as well as voluntary staff who wore PPE.

 

According to the study’s findings, 1,844 medical respondents experienced 4,735 skin injuries, equating to 2.6 skin injuries per respondent. Stage 1 injuries were registered by 81.1% of the respondents, 18.3% experienced stage 2, and 0.6% suffered from deep tissue injury.

 

Researchers discovered three main types of skin injuries relating to PPE: device-related pressure injuries, moisture associated skin damage, and skin tear.

 

Various factors increased the risk of skin damage. These include heavy sweating, longer daily wearing time, being male, and using grade 3 instead of grade 2 PPE.

Interestingly, skin injuries were more common in males than females, with 59.7% of men experiencing damage compared to 40.5% of women. Doctors were also more likely to suffer skin damage from PPE than nurses, with 51.9% of doctors experiencing injuries than 41.6% of nurses.

 

Skin injuries from PPE were also more common in the following groups:

  • Those wearing grade 3 PPE compared those wearing grade 2 (88.5% versus 21.0%)
  • Those using PPE longer than four hours than those with daily use time equal to or less than four hours (47.3% versus 18.7%)
  • Those older than 35 than those younger than 35 (46.3% versus 41.2%)
  • Those with considerable sweating than those without considerable sweating (91.3% versus 17.8%)

Avoiding Skin Damage When Using PPE

 

The same study also concluded that the treatment of skin injuries relating to PPE was insufficient.

 

Only 17.7% of respondents applied prophylactic dressings and lotions that protect the skin. Medical staff and managers overlooked skin protection during the early stages of the coronavirus pandemic, and respondents received no training or education in prevention.

 

To prevent damage to the skin when using PPE, dentists and hygienists are advised to use preventative methods such as prophylactic dressings and lotions to avoid tear and injury. If you so become injured, these wounds must be treated immediately with hydrocolloid dressing, oil, or cream to ensure a quick recovery and to avoid infection when treating patients.

 

Preparing for PPE Skin Injuries During a Pandemic

 

That’s because medical staff and managers overlooked skin protection during the early stages of the coronavirus pandemic. As well as this, respondents received no training or education in prevention and didn’t know how to use dressings.

 

Of course, in the height of the pandemic, the risk of skin injury is unlikely to be a priority. But today, as dentists and dental hygienists prepare to reopen, we can and should be vigilant.

 

To reduce the risk of skin injuries and infection in wearing PPE, dental professionals should provide their staff with resources and training in skin protection; and protective items should be chosen and distributed to staff according to guidelines.

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How To Prepare Your Dental Practice To Bounce Back From COVID-19

Your dental practice has undoubtedly felt the impact of COVID-19.

 

But when the dust settles from the crisis, and you begin to adapt to the new normal, people will begin to think about their oral care. Think about everyone who has put off receiving cleanings, checkups, and fillings due to shutdowns!

 

While you shouldn’t struggle too much to book patients, there might be hiccups along the way. Below are some helpful strategies that can help you bounce back and even thrive in a post-coronavirus world.

 

How Should You Prepare to Re-Open Your Dental Practice?

As we mentioned a moment ago, there’s likely going to be a backlog of patients needing dental care after emergency shutdowns come to an end. It’s been months, and people have neglected their oral health for too long.

 

Dental experts have pointed out that before the pandemic, there was a struggle in finding available, quality staff. Now, with time on your side, you can assemble a high-level team capable of efficiently managing the abundance of appointments that will flood your practice.

 

If you reopen without the personnel to keep things running smoothly, you may stumble out of the gate.

 

Prepare Your Staff For A New Reality

 

Now, you might be thinking: “But how can I get my staff ready for a post-COVID practice?”

 

The answer to this question is straightforward: communication.

 

A mistake of many practice owners has been a failure to keep in touch with furloughed staff, who would naturally fear the worst. Merely making a phone-call to your temporarily laid-off team members and updating them on where things stand could go a long way....even if it’s to tell them you’re not sure where things stand just yet.

 

Now, with rumblings about re-openings becoming more frequent, communication is more critical than ever. You can go over game plans, let everyone know about safety/sanitation expectations, and discuss how teamwork can help your practice make up for the lost time.

 

What to Expect In The Days and Weeks Prior to Re-opening

Frankly, your practice should expect some road bumps before re-opening.

 

Given the nature of this pandemic, and how scared everybody is, there’s going to be hesitation with dental practices. After all, even though most practitioners keep safe and adhere to strict cleanliness standards, there will always be concerns about the transfer of germs.

 

Furthermore, there will be worries about having enough personal protective equipment, such as gowns, gloves, booties, caps, and masks. These materials have been diverted to hospitals, and it might be challenging to ensure practices are equipped to stay safe and healthy.

 

The government should be providing your province, city, town, or region with expectations or guidelines of post-COVID standards and practices. Customers will also likely have an array of questions about what measures are in place to keep them safe.

 

Be understanding and empathetic with these questions, as well as transparent about what you know and don’t know.

 

Lastly, expect some hesitation from past patients who usually schedule maintenance checkups and cleanings. Many people are going to be out of work and without dental insurance, unable to afford your services.

 

So, when you’re trying to schedule appointments right before you re-open, some of your regulars might not be booking with you.

 

Whether you offer patients workarounds, such as the option to pay in installments, or you lower your prices is up to you. It might make sense to raise prices to make up for any potential loss in business due to the increased unemployment rate.

 

Your Practice Can Thrive in a Post COVID-19 World

Those in the dental industry have chosen one of the most practical fields of work in the world. No matter the state of the economy, people need their wisdom teeth taken out, cavities filled, and their teeth cleaned.

 

You’ve built a strong enough client-base to work around any COVID-related issues to successfully bounce back when the shutdown has reached its end. It’s what you do now, proactively, that will help you navigate the murky waters that will exist during life after COVID-19!

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How Dentists Can Build Resilience & Avoid Burnout in Tough Times

Tough times come and go, and one of the challenges is we never know exactly when they will strike. It could be a national emergency like COVID-19, a tragedy in your town, or even a personal setback.

 

In any case, these kinds of events can exacerbate what is already one of the biggest challenges in the dental profession: burnout.

 

Dentists, hygienists and other dental professionals report a very high incidence of stress and burnout, with concerns ranging from litigation to regulation to maintaining high standards of patient care.

 

What does burnout look like, and how can you avoid it in these difficult times? Below, we’ll help you recognize the warning signs and outline ways to build your resilience – whether times are good, bad, or somewhere in between!

 

What is ‘Burnout’ in the Dental Profession?

Burnout is a state of overall exhaustion that affects your mind, emotions, and body, caused by exposure to prolonged and excessive stress.

 

When you’re going through a personal struggle or affected by an event like COVID-19, there will always be times of greater stress in your life. Add that to the day-to-day challenges of managing your business and career… it’s easy to see how these forces combine into a recipe for burnout.

 

Burnout can stem from anything in your life that causes long-term stress. Living through a long, stressful period in your practice, whether your business is struggling to survive or overloaded with patients, is a common cause. Even if you don’t own the clinic directly, the strain from these types of situations can get to you – in fact, dental assistants show higher burnout scores in studies than other staff.

 

What Burnout Looks Like

Burnout makes every day feel like a bad day. It often feels like you have lost your passion for everything, and work that used to excite and challenge you suddenly seems dull and pointless. You may feel like nothing you do makes a difference, even when it does.

 

The main difference between ordinary stress and burnout is that burnout is a chronic condition. While stress is temporary, burnout is constant. When you’re experiencing stress, cynicism, exhaustion and frustration day in and day out, you could be experiencing dental burnout.

 

Everyone reacts differently to prolonged stress, so burnout won’t look the same in each person. It’s important not to discount your burnout simply because it looks different than someone else’s.

 

Common signs of burnout include:

  • Declining performance at work
  • Cynicism and a generally negative view of life
  • Physical illness, including headaches or digestive issues
  • Feeling exhausted no matter how much you sleep
  • Overall disengagement with work and your personal life

 

Once you’ve hit burnout, you may need professional help to recover. Don’t be shy about looking for a therapist, counsellor, psychiatrist or another mental health professional to help you get back on your feet.

 

How to Be Resilient and Avoid Burnout

The key to avoiding dental burnout is to prioritize your own needs. That can be very hard for dentists and hygienists, who feel they have such a strong obligation to others’ needs.

 

Because dentistry is a caregiving profession, it’s easy to get so focused on taking care of your patients and others in your life that you forget to nurture yourself. This is especially true if you spend a lot of time with patients, hearing their stories and sharing in their challenges.

 

However, you can’t give back when you’re pushed up against the wall. Taking care of yourself is how you maintain your ability to care for others.

 

Chances are you’re familiar with the notion of “self-care”, but many people are mistaken thinking it’s all about pampering yourself. Self-care goes far deeper than that. Pampering is great, but you need to take other steps as well!

 

Here are some ways to care for yourself:

  • Calm your mind with meditation or other mindfulness practices
  • Eat healthy meals that provide you with the energy you need
  • Exercise regularly to stay healthy and keep endorphins flowing
  • Prioritize time for hobbies and relaxing with loved ones
  • Don’t hesitate to seek out counselling or mental health services

 

It’s important to understand that having limitations does not make you a failure. Everyone has limitations. Recognizing that and respecting it helps you stay healthy and avoid burnout.

 

Make time for yourself. Realize the importance of your role and that your work makes a difference. When you do, you’ll be building resilience and protecting yourself from burnout.

 

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Study: Dental Amalgam Boasts Superior Contamination Resistance Than Other Materials

If you’ve been going back and forth on amalgam and whether you should continue using it in your practice, the findings of a new study could provide some clarity.

 

For two full years, five undergraduate students at Loma Linda University examined the impact of extreme contaminations on amalgam fillings during condensation. The goal of these dedicated research design students was to determine the shear-strength degradation effects on dental amalgam.

 

The researchers assessed the reaction of amalgam to gross contamination during condensation under the following elements:

  • Water
  • Saliva
  • Blood
  • Handpiece lubrication oil

The results, published under the title, “Amalgam Strength Resistance to Various Contaminants,”  demonstrated that amalgam is capable of withstanding “worst-case-scenario” levels of contamination equally or better than its alternatives, including resin-modified glass ionomer.

 

Just How Well Does Amalgam Retain Its Strength?

To summarize, here’s a breakdown of the findings discovered in the research discussed above:

  • Amalgam strength wasn’t reduced to a significantly statistical extent (p= 0.05) by water contamination.
  • Compared to water and blood-contaminated water, saliva reduced in between both.
  • In saliva, the final remaining strength was the same or more than the uncontaminated strengths recorded in the available literature for other restorable materials (e.g., composite resin, resin-modified glass ionomer, glass ionomer.)
  • Amalgam strength degradation was at its most significant – at around 50% – when fully immersed in handpiece lubrication oil during condensation. However, contamination from handpiece lubrication oil was proven to be highly unlikely in practice.
  • Still, the oil contamination resulted in amalgam strengths were the same or more than other available restorative materials while exceeding the minimum compressive strength of 35,000 pounds per square inch

How Do the Alternatives Compare to Dental Amalgam?

The results above already indicate the dental amalgam can withstand contaminative circumstances better than many alternatives.

 

Let’s look closer at the alternatives and see how they stack up.

 

1. Composite Resin Fillings

As the most regularly used alternative to dental amalgam, composite resin fillings are tooth-coloured and white. Acrylic resin is the primary material used in the making of these fillings—and they’re reinforced with powdered glass filler.

 

It’s common for composite resin colours to be customized to match surrounding teeth. They’re also often light-cured by blue light in layers to lead into the last restoration.

 

Yes, there’s no doubting the strength and blending capabilities of these fillings. Also, they don’t need much removal of healthy tooth structure for placement.

 

But they come up short in other aspects.

 

First and foremost, the composite resin is harder to place than amalgam—plus, they’re infinitely more expensive. Lastly, while they are strong, these fillings appear to be less durable than amalgam.

 

2. Glass Ionomer Cement Fillings

Organic acids (such as eugenol), bases (such as zinc oxide), and potentially acrylic resins can be found in glass ionomer cement.

 

Glass ionomer fillings are tooth-coloured like composite resin, and its properties seem most ideal for more meagre restorations.

 

These fillings cure on their own and don’t necessitate a blue light for the setting process.

 

While ease of use and quality of appearances are definite plusses with glass ionomer cement, they’re not particularly useful for more significant restorations.

 

Is Amalgam Usage Long for this World?

Of course, we can’t forget that these findings are only part of a bigger picture on the use of dental amalgam.

 

The material’s mercury content makes dental amalgam a public health and ecological risk, particularly after its removal. On July 14, 2017, the Environmental Protection Agency (EPA) finalized regulation specifically targeting the use and disposal of dental amalgam. In Canada, dentists must use amalgam traps and filters to collect amalgam waste and recycle it appropriately.

 

As such, many dentists – as a protective measure – are opting to use alternatives to amalgam for health, safety and ecological reasons.

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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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