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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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New Year, New Hygienist: 5 Ways to Define Your Ambition in 2020

 

 

Recently, writers at Today’s RDH posed its readers a rather thoughtful question:

 

How do you, as a dental hygienist, define ambition?

 

A total of 82 dental hygienists, young and old, shared their answers. And it probably won’t surprise you to learn that every one of them had a slightly different approach!

 

Many of the people surveyed equated ambition to career growth, and outlined what they planned to move forward: sharpening their skills, furthering their education and so on.

 

Some thought back to the reasons why they entered the profession in the first place, while others took “ambition” to mean broadening their role as a hygienist.

 

Perhaps the biggest takeaway from this survey is the desire dental hygienists have to do more. The responses paint a colourful picture of all the ways this career can evolve.

 

In the spirit of the new decade, let’s celebrate a few of the ways our fellow dental hygienists have defined their ambition in 2020 and beyond!

 

1. Focusing on Preventative Dental Care

“My ambition is to bring the public forward in knowledge of what a dental hygienist is and start having people get healthy. Change the model of dental health from restoring and treating disease to prevention.”

 

Bit by bit, the model of dental health is evolving from a restorative approach to a preventive one. And no one is in a better position to champion this shift than dental hygienists! Since you work closely with patients even before they require treatment, you’re in the perfect place to impart advice that can benefit their oral health for years to come.

 
2. Deeper Role in Day-to-Day Operations

“Ambition is the continuation of advancement, whether in the continued pursuit of clinical excellence or transitioning into different aspects of patient care.”

 

Who ever said hygienists should stick to the chairside? I don’t need to tell you that the office RDH often knows more about the practice’s ins and outs than anyone under that roof. Many hygienists are leveraging their expertise to successfully segue into aspects of dental management and administration, whether it’s helping to bring on new patients, taking charge of procuring dental tools and supplies, or ensuring the hygiene department is up to current standards.

 

3. More Holistic Approach to Patient Care

“Looking beyond the dentition to the entirety of the head and neck and oral/oropharyngeal cavity. Embracing all there is to know about not just the oral-systemic link, also the cancers of the head and neck oral and Oropharynx, and our role in each area.”

 

Research has emerged establishing a link between periodontal disease and systemic conditions such as heart disease, cancers, and diabetes. Ambitious hygienists are putting this knowledge into practice to help patients prevent and manage the systemic effects of periodontal disease.

 

4. Broadening Horizons

 “Ambition would be to work on legislation to advance a dental hygienist to a position like a PA. Not necessarily the dental therapist model but very close.”

 

Do you dream of one day being able to practice hygiene independently? Wish you could apply your knowledge of dental care delivery in a senior role? Well, you’re far from alone in that! In fact, there are scores of dental hygienists out there hoping to expand our opportunities outside of the operatory.

 

Hygienists are increasingly seizing the chance to lead initiatives, manage teams, and advising policy. There are more non-traditional career opportunities for hygienists in healthcare, management and sales than ever before! What’s more, some hygienists, like the individual quoted above, are also advocating for a broader clinical scope of practice ‒ perhaps along the lines of a dental therapist.

 

5. Mastering the Art and Science of Hygiene

“My definition of ambition in the dental hygiene profession is someone who does their best work on each and every patient.”

 

It’s an exciting time to be a registered dental hygienist. As the scope of practice continues to expand, so too will the career opportunities...but only for those who are prepared to take them!

 

Whether you’re just starting out in your career or well along the path, it’s never too late to refine your knowledge, improve your skills, and continue your hygiene education.

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How to Ask for a Raise as a Dental Hygienist

 

You know it just as well as I ‒ dental hygienists provide pivotal, foundational services that keep a dental practice thriving. We work hard every day to make a difference in the lives of our patients and work functionally alongside dentists and other dental professionals.

 

In some ways, you could say that we’re the face of the dental field.

 

So, do we deserve a raise?

 

Yes!

 

Not sure where to start or how to approach your boss about asking for a pay raise? Below, I’ve listed a few suggestions that I’ve picked up over the years from other veteran hygienists. All of these will help you to put your best foot forward when it’s time to have that all-important conversation!

 

1. Understand Your Contributions

Blindly asking for a raise won’t get you far, but conducting a thorough “self-review” before requesting a meeting with your boss will help you build a foundation for a powerful argument.

 

As hygienists, we spend our days caring for each of our patients while assuaging their fears, guiding them toward better oral health, and ensuring that their experience in the dental chair is a positive one. With all this in mind, it’s easy to forget that our practices are businesses, too!

 

Examine how you contribute to the overall functioning of the practice as a business, and use these facts to defend your request for a pay raise.

 

2. Back Yourself Up

Never underestimate the power of backing up your request with the facts.

 

Document your increase in production, list the ways that you’ve improved your place of employment, include patient reviews that you’ve collected during your self-review, and let your boss know whether you’re responsible for an increase in returning patients.

 

Provide numbers whenever possible. There's no denying concrete data!

 

3. Consider the Timing

When scheduling your meeting, avoid late afternoon or after-work hours.

 

At the end of the day, both you and your boss are likely to be tired (and maybe even a tad cranky). Not only does this mean you won’t perform at your best, but your request may more easily be shrugged off or flat-out denied. Instead, try for a lunch meeting.

 

Also, consider aligning this conversation with annual reviews or your anniversary as an employee, but don’t ask for a raise if your office has just invested in some new, expensive equipment! If this is the case, wait a bit.

 

4. Have Some Numbers in Mind

Your boss is likely to be more responsive to your request for a raise if you’ve already considered the increase you’re looking for.

 

Don’t put them in a difficult spot by requesting a raise and leaving the numbers completely up to them. Instead, requesting a specific increase will not only move the process along more smoothly but also open the door for further discussion and negotiation.

 

Balance is key here. By asking for too much, you risk appearing self-important and unprofessionally unrealistic. However, don’t ask for so little that you’re not fighting for what you deserve!

 

It may be helpful to use your increase in production as a guide.

 

5. Be Thankful

There’s a lot to be said for an attitude that’s balanced with both confidence and humility.

 

While it’s important to assert your self-worth, dedicate part of your meeting to emphasize how grateful you are for the opportunities you’ve received as part of the practice. Let your boss know that you’re always looking for ways to give back and make the office a better place.

 

You’re asking for the practice to value you, so be sure that you value the practice right back!

 

6. Prepare for Possible Outcomes

In a perfect world, your conscientious request for a raise would be honoured without question.

 

In reality, however, the results of your meeting may not be so simple. Regardless of whether or not you deserve a raise and regardless of how thoroughly you’ve proved your worth to your boss, your request may be declined simply because the office is financially unable to honour your request. This does not mean that your boss doesn’t value your contributions!

 

If you’re denied a raise, you may consider negotiating some non-financial benefits such as equipment upgrades, commute reimbursement, or vacation pay.

 

Above all, remain professional throughout this process; no matter the outcome, take pride in yourself and in your work. If at first you don’t succeed, wait several months and try again!

 

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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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How Proper Lubrication Can Extend the Lifespan of Any Dental Handpiece

As a dental professional, your handpiece is one of your single most important tools of the trade. You’d like to keep this trusted instrument performing good-as-new for as long as possible.

 

Unfortunately, handpiece maintenance isn’t always as simple as the sales brochure makes it out to be. Keeping a handpiece in top shape requires that you follow a strict regimen of cleaning and lubrication. That’s a lot to ask of anyone in a fast-paced, fully-booked dental practice.

 

Wish there was a way to extend the life of your favourite handpiece and spend less time on maintenance?  It could be easier than you think, if you choose your maintenance supplies wisely.

 

Why Your Handpiece Lubricant Makes a Difference 

As you know, cleaning and lubrication are the cornerstones of basic handpiece maintenance.

 

Handpieces must be cleaned after each use (even between sterilizations) to avoid cross-contamination, and daily lubrication is necessary to keep the turbine, air motor, shank and head in good working order.

 

It is important to follow cleaning with lubrication, as the abrasives found in handpiece cleaners can get into the mechanisms of the handpiece.

 

Today, many clinics use automatic handpiece maintenance systems to lubricate multiple handpieces simultaneously. However, lubricating a handpiece manually is relatively simple:

 

Disassemble the handpiece and remove the burr so you can reach its internal components.


Inject lubricant into the air drive port so that it reaches the turbine.


Lubricate both ends of the contra-angle, or remove the cylinder from the prophy angle and lubricate both ends.


Re-assemble the handpiece and operate, head down, for 10-30 seconds (depending on the manufacturer's instructions) without a burr to purge excess lubricant.
Wipe any excess lubricant remaining on the handpiece using a dry gauze pad or paper towel.

 

10 Tips to Extend the Life of Any Dental Handpiece

Proper lubrication is essential to getting the most life and the best possible performance from any dental handpiece.

 

Here are a few pointers on choosing a handpiece lubricant that can help you minimize downtime, reduce the frequency of repairs and avoid unnecessary costs while extending your tool’s lifespan.

 

Lubricate the Handpiece Chuck Separately

The handpiece chuck generally requires separate care and a direct dose of lubricant.

 

Lubricate Before Sterilization, Not After

A high-quality handpiece lubricant like Sable EZ Lube will not break down in autoclaving temperature or otherwise be affected by the sterilization process. Lubrication prior to autoclaving has also been shown to increase the longevity of air-turbine handpiece bearings.

 

Avoid Overlubricating Low-Speed Handpieces

Applying too much lubricant to a low-speed motor can saturate it and cause it to become sluggish.

 

Use a Product That Cleans And Lubricants At Once

This saves you valuable time when it comes to preparing your handpiece for sterilization. We’ve developed Sable EZ Lube to remove dirt and stains from handpiece surfaces while it lubricates.

 

Don’t Lubricate ‘Lube-Free’ Turbine Bearings

Certain Kavo and Star Dental handpiece turbines are not designed for direct lubrication.

 

Use a Food-Grade Handpiece Lubricant

We know that a handpiece can discharge lubricant in the direction of the bur for some 40 minutes after lubrication. Using a food-grade synthetic lubricant will ensure that this will not affect your patients.

 

Never Use Any Non-Dental Lubricant For Your Handpiece

Safety comes first! Non-dental lubricants may not be safe for your patients or good for your handpiece. Sable EZ Lube was developed in conjunction with Aerospace Lubricants Inc. specifically for dental handpieces.

 

Always Follow the Handpiece Manufacturer’s Instructions
Maintenance standards can vary between different manufacturers, and in different models from the same manufacturer.


Use The Adapter That Corresponds Your Coupling System
This will ensure that you deliver the right amount of lubricant to the deepest recesses of your handpiece. Our Sable EZ Lube comes in 500ml aerosol cans with nozzles available for most handpieces, including contras, straights, heads and low-speed motors.


Don’t Skimp on the Lubricant!
Your handpiece can’t function properly without proper lubrication!  If cost is a concern, there are affordable handpiece lubricants on the market. Sable EZ Lube is affordably priced, with cost savings of 20-30% over other top lubricant brands.

 

Have any questions about our handpiece lubricants? Get in touch with us and we’ll get back to you as soon as we can!

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8 Fun Dental History Facts You Didn't Learn in Hygiene School

 

Dentistry is as noble a profession as it gets, filled with some of the most caring people on earth. Still...it’s always taken a special kind of human to look someone in the eye, tell them to open wide and then courageously yank their teeth out! 

 

Visiting the dentist is no longer something most people lose sleep over...however, the same cannot be said of decades gone by. The age-old practice of the tooth has changed so much thanks to modern medicine and state of the art machinery. Dentistry has not always been so painless!

 

Let’s dig in to the long, rich and occasionally painful history of dentistry, including a few fun facts you probably didn’t learn in hygiene school.

 

1. Barbers Used to Double as Dentists

These gentlemen were known as barber-surgeons. It may seem quite barbaric to have the local barber extracting teeth and bloodletting, but it made sense in the medieval times, since it left more doctors available to attend to the war wounded.

 

Nothing quite like getting your wisdom teeth carved out with the same blade you were just shaved with!

 

2. Ornamenting Teeth Was All the Rage

The ancient Mayans used to bejewel their teeth by chipping at them and embedding small gemstones with glue. Although the outcome would be a dazzling and mesmerizing smile, the process was certainly not for the faint of heart.

 

In the industry today, this ancient practice by the Mayans isn’t too far from the modern practice of bejeweling your teeth...without the gruesome chipping part, of course. Nowadays, they’re called tooth gems, which some people use to give an extra shine to their smile.

 

3. Ever Wondered Where Toothbrushes Came From?

The need to maintain dental hygiene is not a 21st century phenomenon. In ancient times, people would snap a supple twig and chew the edges to spread out the fibers. Even today, some people prefer the twig toothbrush over the conventional toothbrush.

 

The Europeans used a rag and salt or soot for brushing their teeth until the English inventor William Addis invented toothbrush. This was in 1780 but by 1498, Chinese artisans had invented the toothbrush as we know it by using animal hair as bristles.

 

If you’re feeling naturally inclined to use a twig toothbrush, then you can consider trying a twig from the toothbrush tree.

 

4. Anesthesia Was Gross and Ineffective

Archigenes was a tooth doctor back in 15 A.D Rome. His idea of anesthesia for dental works was ointment made from hair-raising ingredients including roasted earthworms, spikenard and spider's crushed eggs. He would drill into your tooth then apply the ointment to relieve pain.

 

It’s hard to imagine that ointment would actually reduce pain, yet it was widely used ‒ maybe the sheer shock of having dead spider babies smeared on your gums was enough to kill the pain?

 

5. The Electric Chair and Teeth Have a Lot in Common

What does an electric chair have to do with teeth? Well, luckily not much...other than the fact that the inventor of the electric chair was also a dentist by profession and a professor who taught dental medicine at the then-University of Buffalo School of dental medicine in New York. 

 

The good news is that he invented the electric chair in the mid 1800s specifically for the purpose of execution and not dentistry. It’s a mild relief knowing that Southwick had no intention of experimenting the efficacy of electric current on tooth cavities.

 

6. Dentist Power Drills Were Powered By Feet

You might know that the dentist attending to the first president of the United States, George Washington, invented a foot engine to power his dentist's drill.

 

What you might not have known is that he used his mother’s spinning wheel making it into a torque to power the drill!

 

7. Dentistry Was a Lonely Profession

Until the year 1960, dentists were expected to do everything while attending to their patients. They would handle every procedure and tool on their own with no assistance! The result was weary and lonely dentists. 

 

This continued until four-handed dentistry was introduced, providing two extra hands (and a lot of camaraderie!) to help.

 

8. Tooth Decay Was Caused By Worms!

...Just kidding! Of course that was never true. But for a time, that’s what people really believed. 

 

After all, worms drill holes, and tooth decay is characterized by holes in teeth. This was a logical conclusion at the time. This old explanation for tooth decay was so believable it carried on in many cultures until the 1900s.

 

Today, we’re thankful for miracles like Novacaine and other tools and treatments that make your life (and the lives of your patients) easier. But we should also be thankful reflecting back on the dentists of old. Though they may have been misguided at times, they’re the ones who made it possible for us to offer the quality of care we can today!

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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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Struggling with a Difficult Patient? Here’s How to Manage 4 Difficult Dental Patients

In any business, there are customers that we like and customers that test our patience. The same goes for the patients that visit the dentist’s office.

 

And sometimes, it’s hard to handle them so that they have the best experience and you can do your job.

 

Here are 4 types of patients that can be difficult and how to manage them.

 

 

1. The Google Expert 

 

We all know that one patient.

 

They know all the latest and greatest medical news and can’t wait to share with the dental hygienist. Instead of giving them a cleaning, we’re bombarded with questions that have taken four years of dentistry school to learn.

 

“Why didn’t you use this treatment?’

 

“Shouldn’t you be doing this?”

 

It can be exhausting.

 

It’s wonderful that the patient is enthusiastic about getting involved with the process, but it can hinder dental hygienists’ trying to do their job and sometimes even be harmful to the patient.

 

So, what’s the best course of action?

 

Be firm with the patient and confident in your own education. It’s important to make sure that they know we have their best interest in mind and that we are a much better resource than anything they can find on the web. 

 

2. The Late Comer

 

It’s 3:50. Their appointment was at 3:30. At this point, we’re assuming they just aren’t coming.

 

That’s when they stroll on in. The only thing more frustrating than that is if it happens on the regular.

 

Lateness has a domino effect. Regardless if all the next patients are on time, there’s no way to get back that 20 minutes. The worst part is making other patients wait just because someone has chronic tardiness. It isn’t good for anyone.

 

The best way to manage lateness is to incorporate a late policy. And stick to it.

 

Anyone that is more than 15-20 minutes late to their appointment, cannot be seen that day and will have to reschedule.

 

Generally, patients will respect the set appointment time and it will reduce the amount of late arrivers.

 

3. The Nervous Patient 

 

Dental anxiety is no joke. Nearly 1 in 5 patients have some degree of dental anxiety.

 

As dental hygienists, no one wants to see a patient cringe and tense as we recline the chair or pull back their cheeks. But no matter what we try to do to calm them, nothing works.

 

Sometimes, their discomfort and tension can radiate onto us, making us nervous too.

 

The best advice is to stay calm yourself. This is much easier said than done but often times what you put out into the world you get back in return.

 

It may be beneficial to open up the floor to a discussion about what is causing the anxiety and how we, as hygienists, can ease that discomfort. By knowing what makes them the most worried, you can avoid or minimize that factor.

 

In extreme cases, the patient may need to consult their doctor for anti-anxiety medication to take before appointments.

 

4. The Chatty Cathy 

 

You love them, but at the same time they can be quite frustrating.

 

These are the types that will get to know you, ask about the kids or about upcoming vacations. They are often the sweetest patients you’ll get!

 

As much as they make the workday go by faster, they can eat into the appointment through their conversations and suddenly we’re behind schedule!

 

It can be challenging when managing a Chatty Cathy because we don’t want to be rude in any way but we also have to get the job done on time. But like any skill, managing chatty patients comes with time and experience.

 

Focus the conversations towards the beginning and end of the appointment as well as during the period of time before the patient is seen by the doctor. These time zones are optimal for conversations because they don’t interrupt your job but also give the patient a chance to socialize.

 

Not only that but it will also build a better relationship with the patient!

 

While these four types of difficult patients can pose a challenge, there’s nothing we, as dental hygienists, can’t handle.

 

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6 Reasons Why Privately Practicing Dentists Aren't Going Anywhere

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

 

Why?

 

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

 

1. Customer Service and Individualized Patient Care

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

 

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

 

2. Human Resources

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

 

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

 

3. Management

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

 

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

 

4. Marketing

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

 

5. Third-Party Vendors

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

 

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

 

6. Your Goals as Privately Practicing Dentist

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

 

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

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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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