October has come and gone, and cannabis is officially legal in Canada. What does this mean for your dental practice and your employees?
It means that there is going to be some change within your office, and you will have to take a few steps to keep a happy, well-informed team.
Your main priority is to gain an understanding of the regulations for medical and non-medical use, as well as the expectations of your staff. This knowledge is essential in establishing a clear, permissible policy on cannabis in your practice.
What’s the Policy on Cannabis in Your Dental Practice?
Take time to have a look at the current policies and practices in place. Do your employees understand their rights concerning cannabis use?
If you don’t have a clearly-outlined process in place, this is a great time to create a new one, adding in the new cannabis policies.
When Can Your Employees Use Cannabis?
Does the legalization of cannabis mean employees can use it at work?
In some cases, the answer is yes.
There is a “duty to accommodate” in Canada, which applies to those who are affected by a disability and require cannabis for a medical purpose. This allows prescription cannabis use in the workplace, but they must have medical notation.
That being said, your employees have a right to privacy. You may ask for a doctor’s notation, but it does not have to specify the impairment related to their medical cannabis use.
There is also a duty to accommodate those who are affected by cannabis smoke or vapour. You may have to establish a specific area of the office where employees can consume medical cannabis away from those who it negatively affects, or ask that users consume edible cannabis instead. Consider which approach will allow you to fulfill your duty while maintaining a positive, inclusive work environment.
Is Recreational Cannabis Use Legal in the Workplace?
Despite its legalization, it is not legal for employees to use recreational cannabis within the walls of your dental practice. Laws against smoking in the workplace still apply.
Additionally, the legalization of cannabis does not give people the right to be impaired on the job. This includes using cannabis before work if the effects will cause impairment during work hours.
According to workplace medical testing and assessments company DriverCheck, cannabis impairment can last for 24 hours. This is important to communicate to your employees, especially those who may use cannabis recreationally on the weekend, to ensure sobriety for Monday morning.
How to Discuss a Cannabis Policy with Your Employees
Communicating your policy to your staff is key. This is a new law, and everyone is still learning about it, so it’s important to be on the same page.
For medical cannabis users, it’s important to create a safe and open environment for employees to approach you with their medical needs. This will allow open and honest communication around cannabis use and a smooth accommodation process.
For recreational use, be sure to communicate your expectations to your staff verbally and in writing. Some may think that marijuana use is like cigarette use on company time — it’s important to debunk this right away.
When everyone understands the new policies, your office can move forward with the new cannabis law in a professional manner for both you and your patients.
Cannabis Legalization and Your Dental Practice
Communication is key. Ensure your policies are clear and both medical and non-medical policies and expectations are outlined. This will ensure a positive work environment surrounding cannabis and will make for a clear understanding for you and your team moving forward.
Helmet? Check. Goggles? Check. You’re ready to hit the ski slopes – almost.
What about your mouth guard?
Most people think orofacial protectors, better known as mouth guards, are only for contact sports athletes. However, the American Dental Association (ADA) has long encouraged the use of athletic mouth guards for people engaged in all kinds of recreational sports and activities, including non-contact activities like skiing.
One of the reasons mouth guards are not more widely used is the many misconceptions surrounding them. Do mouth guards cause gum disease or bad breath? Who really needs to use a mouth guard?
This is an area where dental hygienists and other dental professionals can step in to help. Below, we’ll discuss some of the questions (and misconceptions) you may hear about the subject of athletic mouth guards.
1. When to Use a Mouth Guard
Athletic mouth guards are designed to provide cushioning in the event the wearer receives a blow to the face. Though the device only covers the upper teeth, it also helps prevent injuries to the lips, tongue and cheek, since all can be hurt by broken teeth. Mouth guards can also help to prevent injuries to the jaw by reducing the force upon impact.
Some sports, like hockey and boxing, carry an inherent risk of these types of injuries. However, dental injuries are also prevalent in non-contact activities and exercises like ice skating and gymnastics. Falls are one of the most common causes of tooth injury. And it isn’t only children who are at risk – numerous surveys show that the risk of dental injuries is present for sports participants of all ages, genders and skill levels.
It is important to care for an athletic mouth guard properly. The device should be rinsed with warm water immediately after use, followed by a light brushing with a toothbrush (toothpaste is not necessary.) Since oral bacteria thrives in moisture, the mouth guard must be allowed to dry completely before storage. The mouth guard and its storage case should also be cleaned with denture cleaner periodically.
3. Different Types of Athletic Mouth Guards
There are three main types of athletic mouth guards available:
Custom mouth guards made by a dentist using an impression of the wearer’s mouth.
Over-the-counter mouth-formed or “boil and bite” mouth guards, which can be formed to fit the wearer’s mouth by submerging the device in hot water until it becomes soft and then placing it in the mouth.
Over-the-counter pre-formed stock mouth guards.
The most effective type of mouth guard is one custom-made by a dental professional and tailored to fit the unique shape of the user’s mouth. Not only does this type of mouth guard provide the best protection, it is also the most comfortable, meaning the user is more likely to wear it more often. Custom-made mouthguards can also last longer and be less prone to damage by the wearer.
For athletes who cannot afford or access a custom-made mouth guard, a store-bought device is still more effective than forgoing a mouth guard altogether. The ADA recommends that athletes look for over-the-counter mouth guards bearing the ADA Seal of Approval, which have met the organization’s standards for safety and efficacy.
4. Mouth Guards and Concussions
One of the classic arguments in favour of wearing a mouth guard is the notion that it helps to protect the wearer from a mild traumatic brain injury. In truth, researchers have yet to confirm this claim. However, one study found that high school football players who wore a store-bought mouthguard were more than twice as likely to suffer a concussion than players who wore custom-fitted mouthguards.
Regardless, there is no question that an athletic mouth guard can protect the wearer from injuries to the teeth, jaw, lips, tongue and gums.
Are Your Patients Protected?
Sports-related injuries constitute 12-39% of all dental injuries. Athletic mouth guards may not be mandatory for most recreational activities, but they can make the difference between a simple mishap and a costly dental injury.
The next time you see a patient, consider asking whether they plan to put on their ski boots and ice skates this winter. If the answer is yes, remind them of the benefits of wearing a mouth guard.
The occurrence of a cerebrovascular accident (CVA), commonly known as stroke, has a significant impact on a patient’s oral health. Dental hygienists can provide valuable support in the maintenance of oral hygiene as survivors recover and adjust to life after a stroke.
This article provides an overview of the role of hygienists in assisting stroke patients with oral hygiene care.
Patients typically undergo extensive rehabilitation, including occupational therapy. Traditionally, it was physical therapists that helped patients regain oral hygiene skills following the incidence of a stroke.
Each cerebrovascular accident case is unique; not all patients who are recovering from stroke present the same conditions or follow the same path in recovery. However, dental hygienists who wish to support these patients must be knowledgeable of the many ways stroke can impact the state of a person’s dental health and the ongoing care they require.
Assisting Stroke Patients with Oral Hygiene Care
Oral hygiene is an important part of a stroke survivor’s care and recovery. Regaining the ability to care for one’s teeth and gums gives patients a sense independence and control over their health.
For patients with lasting disabilities, dental hygienists can help empower the patient’s caregivers to provide quality dental care.
In most cases, patients are advised to wait at least six months after a stroke to receive non-urgent dental care, and to receive a post-CVA consultation with the patient’s physician. These are some of ways that dental hygienists can assist stroke patients with oral hygiene care:
If the patient uses oral hygiene aids at home, have the patient bring the products to the appointment and demonstrate their use. Hygienists can advise on the usage of these products to achieve the best possible results.
Hygienists can suggest products and methods that can help patients compensate for the loss of dexterity or cognitive impairment, such as floss holders, floss piks, electric toothbrushes, and brushes with a two-minute timer.
For patients with cognitive impairment or memory loss, hygienists can assist by providing all oral hygiene instruction in both oral and written form and including the patient’s caregiver in all appropriate discussions.
Celebrating Dental Hygienists
October is National Dental Hygiene Month: an initiative to celebrate the hardworking, compassionate dental hygienists who contribute to the cause of improving oral health care. Sable Industries is proud to support your work.
The dental profession has long acknowledged the impact of dental amalgam on the environment. In the year 2014, the American Dental Association adopted nine principles on keeping amalgam particles out of dental office wastewater. Then, following consultation between the ADA and the Environmental Protection Agency, the EPA finally issued a final rule on amalgam separation on June 9, 2017; now, most dentists have until July of 2020 to comply.
The final rule sets guidelines on everything from how to dispose of amalgam waste to minimum efficiency standards for amalgam separators (right down to the decimal point.) Though they may appear daunting, these regulations are not far from the existing APA best practices, and practitioners who start now should have no trouble meeting their obligations by 2020.
Dental Economics magazine has published a helpful summary of the rule. These are the main takeaways for dentists and other dental professionals looking to incorporate amalgam separation into their practices.
Who Needs to Use an Amalgam Separator?
Most dental offices in the United States are subject to the EPA’s rule on amalgam separation. In most cases, even those practitioners who do not place amalgam fillings must begin using amalgam separators. However, there are notable exceptions.
Certain dental specialists may be exempt from the rule, including practices that specialize in oral pathology, oral and maxillofacial radiology, orthodontics, periodontics or prosthodontics.
The rule does not apply to mobile units.
Dental practices that neither place nor remove amalgam except in limited circumstances (which the rule defines as fewer than 5% of procedures or nine cases per year) may not have to use an amalgam separator.
If your practice falls into one of these categories, it is possible you may not have to start using an amalgam separator. However, certain localities have dental amalgam pre-treatment requirements, and many states have rules that exist alongside the EPA’s new guidelines.
How Does the EPA’s Final Rule Differ from ADA Best Practices?
Although the American Dental Association worked with the EPA to develop the requirements, the result does differ from the ADA’s best practices in several important ways. The most significant differences are:
Amalgam separator efficiency requirement. The ADA recommended that dental offices use a system that removes at least 95% of amalgam particles from wastewater, in line with 2008 ISO 11143 standards. The EPA requires an amalgam separator to be 2008 ISO 11143–certified and remove 99% of amalgam particles.
Frequent inspections. The EPA imposes onerous inspection requirements on all dental offices that use an amalgam separator. Dental professionals must inspect the equipment as per Manufacturer Instructions and generate a visual inspection log that details who conducted the inspection, the results of examining each device, and a summary of any follow-up actions.
Most amalgam separators manufactured and sold in the United States and Canada claim to operate at 99% efficiency. However, dentists who have already invested in the equipment should confirm that their system meets the EPA requirements before 2020.
How Can Dentists Demonstrate Compliance?
The rule requires that dental practitioners report compliance annually to their respective state Control Authority.
The Control Authority differs state-to-state, but it is typically an EPA regional office, a local wastewater utility, or a state environmental agency. Dentists in Alabama, Connecticut, Mississippi, Nebraska and Vermont should report to their state environmental agency; dentists in all other states can contact their regional EPA office to find out who acts as the Control Authority in their state.
Chronic bad breath is a clear sign that a pet needs veterinary attention.
2. It is Safe for Dogs to Chew Bones
Myth: A canine’s powerful teeth and jaws are built to chew through hard materials like bone.
Fact: Chewing bones poses numerous health hazards to dogs.
Much as dogs love to gnaw on a good bone, it’s not necessarily good for them. While it’s true that dogs benefit from having something to chomp on, there are many reasons why hard materials like bone, antlers and chicken’s feet are not a safe choice:
A dog’s teeth are susceptible to fractures, which are immensely painful and may require surgical treatment.
Bones and other firm materials can splinter into sharp pieces, causing gum or tongue lacerations, or becoming embedded under the gum line.
Bones are a serious choking hazard.
Since bones are not digestible, they can cause stomach and intestinal problems if swallowed.
4. Dental Scaling by a Groomer Can Prevent Oral Health Issues
Myth: Dental scaling services offered by pet groomers are a good way to keep a pet’s teeth clean and healthy.
Fact: Non-professional dental scaling is cosmetic only and does not prevent or treat oral disease.
It is illegal in many places for pet groomers to offer non-professional dental scaling (NPDS). However, in some regions, the myth persists that this service can help pets stay healthy.
Dental scaling involves using dental equipment to scrape debris from the surface of an animal’s teeth. Some groomers purchase these tools and offer scaling services to clients at a lower cost than a professional dental cleaning performed by a vet.
Unfortunately, this non-professional dental scaling is merely cosmetic. Groomers lack the knowledge to identify oral health treatments, nor the ability to prescribe treatment. Without anaesthetic, they cannot remove disease-causing bacteria below the gumline.
Veterinary dental specialists recommend pet owners avoid these services, as they do nothing improve oral health.
5. You Can Judge A Pet’s Oral Health by Its Appetite
Myth: If an animal is still eating, it must not have dental issues.
Fact: Many pets will eat despite severe oral pain.
It’s true: loss of appetite and difficulty chewing are tell-tale signs of periodontal disease. However, these are far from the only signs, and many dogs, cats and other pets will not stop eating just because they’re in pain.
When an animal is in pain, they will often instinctively try to conceal it. It’s typical for an animal with serious oral health issues to clean their bowl as usual.
This is one reason why it’s important for owners to stay vigilant about their pet’s oral health and be aware of other warning signs, such as:
Red or bleeding gums
Pawing at the mouth
Loose or missing teeth
Pet owners should also take steps to prevent these issues at home; which leads to the final veterinary dental myth that must be quashed.
6. Dogs Don’t Need to Have Their Teeth Brushed
Myth: Dogs clean their teeth naturally by gnawing on bones and chew toys, so they don’t need to have their teeth brushed.
Fact: Daily brushing is the best way to prevent oral health issues in dogs.
It begins when bacteria form plaque on the teeth, gradually working their way under the gums. Over time, oral bacteria damage the supportive tissue around the teeth. In serious cases, periodontal disease can destroy the gum, bone and ligaments holding teeth in place and even infect the bloodstream.
Fortunately, there is a simple way to deter this prevalent problem: regular brushing.
As demonstrated by this video, the process is no different from how we humans brush. Dog toothpaste is available in appealing flavours like chicken and seafood. Eventually, the routine can become as natural as brushing our own teeth.
Vets and veterinary dentists should encourage this practice among every owner they advise.
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Most of us chew gum, and we chew it for a variety of reasons. Whether it’s a piece before a first date, or after a particularly strong cup of coffee, many of us use the chewy stuff to keep our mouths smelling clean and fresh as we go about our day.
We see gum promoted in advertisements as something you can use not only to keep your breath smelling fresh; but to whiten and clean your teeth, improving your oral health.
Exaggerated marketing, or bona-fide fact? The answer lies in the ingredients of the gum you choose to chew.
The Potential Benefits
It comes as no surprise that if you’re chewing gum with a lot of sugar in it, it’s going to be bad for your teeth. Sugar promotes the growth of plaque bacteria, which in turn promotes the development of cavities, the decay of enamel, and other issues.
It’s because of this that many companies, such as Wrigley’s, have begun to use both aspartame and a substance known as Xylitol as a substitute for sugar in their products.
A naturally occurring compound that has been shown to prevent tooth decay, the National Centre for Biotechnology Information writes that Xylitol, “reduces the levels of mutans streptococci … in plaque and saliva by disrupting their energy production processes, leading to futile energy cycle and cell death … Consumption of xylitol chewing gum for >3 weeks leads to both long-term and short-term reduction in salivary and plaque S. mutans levels.”
Sounds pretty good, doesn’t it? Less bacteria on your teeth means less enamel-eating acid created, which means a healthier mouth. Brands like Confadent advertise and discuss their use of Xylitol as a safe alternative to aspartame, and a plaque reducer.
According to Delta Dental of California, “With xylitol use over a period of time, the types of bacteria in the mouth change and fewer decay-causing bacteria survive on tooth surfaces.”
This sounds like a big-time benefit for your pearly whites, but how do the results compare to projection? Some research shows that the evidence regarding the long term benefits of Xylitol as a dental hygiene product is still unclear.
According to a review published by the American Dental Association in 2015, while there is some evidence that Xylitol may reduce tooth decay over a period of years, the evidence is low quality.
Research published by the Cochrane Library website suggests that there just isn’t enough high quality evidence to confirm that Xylitol prevents tooth decay.
Philip Riley, M.P.H., of the School of Dentistry at the University of Manchester in the UK, is quoted as writing, “More well-conducted, randomized placebo-controlled trials that are large enough (in terms of number of randomized participants) to show a difference, if one exists, are needed.”
The Cochrane Library review stresses in its conclusions, “We found some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste … The effect estimate should be interpreted with caution due to high risk of bias and the fact that it results from two studies that were carried out by the same authors in the same population.”
So, What to Do?
In the end, the conclusions are yours to draw based on the evidence given, but it’s safe to say that chewing gum with Xylitol is better for your teeth than its sugary counterparts. While there needs to be some more research done to better reinforce this conclusion, Xylitol has indeed been shown to reduce cavity causing bacteria in the mouth.
Still, if you want to keep your teeth healthy, at the end of the day no gum is a substitute for regular brushing and flossing. For more information on Xylitol, its benefits and drawbacks, you can check out this article from Access Dental, or this one from Delta Dental.
Everyone has a bad day at work from time to time. But if you find yourself feeling physically, mentally and emotionally drained on a regular basis, you may be on the road to chairside burnout.
It’s not hard to see why dentistry has one of the highest burnout rates of any profession. While rewarding, the work of a dental hygienist can also be enormously stressful. Hygienists often deal with long hours, tight schedules, and fussy patients in a fast-paced, high-pressure environment. One study found one in eight dental hygienists leaves work feeling emotionally exhausted by the demands of the job.
Follow these steps to prevent stress from leading to full-blown chairside burnout.
1) Know the Signs
Stress is hard to miss, but it’s not always as easy to see a burnout coming. The daily marathon of cleanings and consultations leaves little time to stop and think about yourself. Recognizing the signs of burnout is the first step to preventing it.
Burnout is marked by feelings of hopelessness, cynicism, and resentfulness. Once stress takes its toll, a normally-cheerful hygienist may start to become impatient and critical. The job may feel less rewarding or purposeful than it did in the beginning. Enthusiasm is replaced by a lack of energy, leading to less productivity. Some people suffer unexplained headaches or other physical complaints.
If you can relate to these signs, take time to gather your thoughts and reflect on your career as a dental hygienist. Try to understand where your negative feelings are coming from. Is it the physical demands of the work? Frustrating office politics? Lack of work-life balance? Like a bad toothache, you can only treat the problem once you’ve found the source of the pain.
2) Take Care of Yourself
Self-care is important in any career, but especially so for dental hygienists. You must make time in your busy day to do things that help you replenish your emotional energy, like walking the dog, taking a long shower, gardening, or listening to your favourite album. Use this time to focus on the present moment and practice positive thinking.
Since being a hygienist is physically demanding, it’s also important to take care of your body. Cardio is proven to help reduce burnout, and light exercise can help reduce the muscle and joint strain. If you’re feeling the burn, ask your doctor about physical therapy or other treatment for work-related injury.
3) Maintain a Work-Life Balance
Your work as a hygienist is important, but it doesn’t have to define who you are. Don’t fall into the trap of making life all about your job. If you’re constantly thinking about being chairside, even on your days off, you’ll only accelerate the burnout effect on your career.
Having things to look forward to outside of work is key to avoiding burnout. It can be something structured, like a college course or a sports league, or a casual hobby like photography. If you’re starting to feel burned out on the job, try something new in your off-time to instill new energy in your life.
4) Connect with Other Hygienists
It’s said that engagement is the antithesis of burnout, but when you’re having difficulty at work, it’s easy to forget why you pursued this career in the first place. People who experience chairside burnout often lose sight of the things they loved about being a dental hygienist.
One of the best ways to stay engaged in your work is to network with other dental hygienists. Your colleagues know the ups and downs of dentistry better than anyone. Sharing stories and advice will help you broaden your knowledge and keep in touch with your passion for dentistry. You can connect with others through online groups and forums, continuing professional development events, and your local hygienist association.
There has a lot of news recently about the injuries office workers can face if they do not have the proper ergonomic equipment available to them. Proper chairs, monitor height, and stretching exercises are just a few of the recommendations.
However, ergonomics is important in many professions, including dental practices.
Patients likely do not realize just how much physical work is involved on a daily basis for hygienists. However, the hygienists themselves soon come to realize the hard way when aches, pains, and nagging discomfort make themselves known.
Hygienist Jamie Collins, RDH, CDA, recently wrote about this subject for Dentistry IQ, covering the commonly known ailment nicknamed “hygiene hip.”
Aches and Pains
For most people, adjustments and medical appointments follow discomfort. Jamie admits this was also the case for her, but points out hygienists should follow the example set by dental schools and practice prevention.
After all, once discomfort sets in, it means your body is ailing.
Sometimes, these aches and pains indicate that issues are no longer reversible. You don’t want to spend all that time learning your craft only to find yourself in need of a career change because your body is ailing.
As you likely know from your day-to-day duties, you often must spend time in unnatural positions, particularly if the patient complains about the angle you have them on. This increases your danger of hip injuries, and raises the possibility of upper and lower back, neck, and wrist issues.
Have you started to experience problems like this? Chances are, you have.
Jamie points out that 64-93% of dental workers suffer from some kind of work-related Musculoskeletal Disorder. Stiffness, soreness, hip popping; are all signs of MSD, and indicators that you need to make some modifications.
Change Your Chair
How long have you had your operator chair? It is crucial for your body to have proper positioning throughout the day. If your current chair has become misshapen, or was not the best product to begin with, it is time to invest in a new saddle stool to improve your work posture. If the dentist is not willing to cover the cost, consider digging deep and buying the stool yourself. It beats spending time and money at the chiropractor and many uncomfortable days and nights.
Proper magnification and Instrumentation
Don’t forget the other equipment you work with. The better the magnification of the oral cavity, the less you have to bend, so consider adding a personal light to your loupes.
Practice preventive maintenance with your instruments. Sharp instruments decrease treatment time and physical strain, and a cordless handpiece helps to reduce possible wrist fatigue.
Breaks and Exercise
Frequent breaks help to prevent muscle fatigue, which leads to poor posture and discomfort. Practice stretching exercises during your shift, and be sure to exercise off the job. Pilates and yoga are very helpful, but Jamie emphasizes the key is to take time for your body and listen to its needs. Being comfortable aids productivity, which improves performance and the quality of care you can provide for your clients.