May 5, 2022

With Mother’s Day fast approaching, people around the country are preparing to pay tribute to the matriarchs of their families. Celebrations often include outings, gifts, flowers, cards, and meals at favorite restaurants. But not every mother gets to enjoy these traditions and festivities. For the 5 million seniors who are permanently homebound, simple things like enjoying a meal out are challenging, if not impossible. Even the act of eating poses significant obstacles for many of America’s elderly because of neglected dental care. Adult children and caregivers have an opportunity to demonstrate their affection and respect by helping their homebound loved ones lead healthier, more enriching lives. And with the advances in mobile dentistry, care comes to them.

Oral Health Challenges for Seniors

The Invisible Homebound

An academic study published by Mount Sinai (“Oral health status and needs of homebound elderly in an urban home-based primary care service,” R Gluzman, H Meeker, P Agarwal, S Patel, G Gluck, L Espinoza, K Ornstein, T Soriano, R V Katz, Spec Care Dentist 33(5): 218-226, 2013) projected the elderly population to reach 88.5 million by 2050, echoing concerns about the number of permanently homebound individuals:

In 2012, when that study was published, about 13% of the population was 65 years or older. Today, that number has risen to 16.5%, based on data from the Population Research Bureau. More distressing, according to the Department of Health and Human Services, 51% of these seniors live alone. The bigger challenge, however, is finding a way to treat the permanently homebound—a group of over 5 million seniors, an increase from 2 million in 2012, who have functional limitations that confine them to their homes. Many of them experience profound difficulty accessing office-based care. Some can’t at all. Because of this, they rely on overwhelmed family caregivers or succumb to illness.

Physical and Cognitive Impairments

According to the American Dental Association (ADA), the physical and cognitive impairments associated with aging hinder efforts at self-care for normal oral hygiene. Seniors with dementia may forget to brush their teeth. They may not remember how to brush. Seniors with arthritis may struggle with brushing and flossing because of pain in their hands or fingers. And for seniors who must take prescription medications regularly, the side effects of certain drugs produce adverse changes in oral health.

Health Risks Increase with Age

“​​Dental health is a vital component of your overall health,” wrote Lucy Wyndham in Dental News. “Oral health issues like periodontal disease and tooth decay have been linked to systemic conditions such as heart disease, stroke and infection. With age, the risk of tooth loss and other oral health problems increases, with more than 27% of people over age 65 having no remaining teeth. Edentulism can make it difficult to enjoy a varied, nutritious diet, which leads to further health complications and can diminish a person’s overall quality of life. For people in assisted living communities, it is important for caretakers to be aware of the dental needs of seniors and to take steps towards preventing dental and periodontal disease.”

The Centers for Disease Control and Prevention (CDC) pointed out that by 2060, 24% of the population will be over the age of 65. And they face growing oral health risks:

• Untreated tooth decay. Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.
• Gum disease. A high percentage of older adults have gum disease. About 2 in 3 (68%) adults aged 65 years or older have gum disease.
• Tooth loss. Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%). Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.
• Oral cancer. Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years.
• Chronic disease. People with chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) may be more likely to develop gum (periodontal) disease, but they are less likely to get dental care than adults without these chronic conditions. Also, most older Americans take both prescription and over-the-counter drugs; many of these medications can cause dry mouth. Reduced saliva flow increases the risk of cavities.

Solutions

Maintain Routine Care

The Blende Dental Group recommends that seniors take preventative steps to mitigate their risks of oral health problems and diseases.

• See a dentist twice a year to have teeth cleaned and examined
• Rinse with mouthwash once or twice a day (only if it can be done without swallowing)
• Floss at least once daily
• Brush twice a day
• Seek solutions for missing teeth, such as dentures, implants, or full mouth restoration for serious conditions
• Oral cancer screenings (at Blende Dental Group, we include screenings as part of every checkup and cleaning for patients of all ages)

Sometimes, however, these “simple” practices are far from easy for seniors with mobility or cognitive challenges. But forgoing dental care should never be an acceptable option. The modernization of house calls, mobile dentistry, and portable equipment overcomes these hurdles for seniors and those who care for them. It’s also a cornerstone of the Blende Dental Group, which is home to House Call Dentists.

Let Dental Care Come to You

Mobile dentistry: Care in the comfort of familiar surroundings

Our fully equipped team of dentists, registered dental assistants, and mobile hygienists provide in-home dental evaluations and treatments with portable dental equipment. Based on our assessment, we determine the level of care required and whether treatment can be delivered in the home or under sedation in our office or the hospital. Providing sedation in any of these locations allows us to complete care in as few as one or two visits.

Caring for Seniors Is Our Specialty

We partner with families, care facilities, and health care providers – including dentists, physicians, care managers, and social workers – to develop a targeted daily dental care plan that complements successful treatment. When homebound seniors experience discomfort, we’re dedicated to making treatment as comfortable as possible. Initial visits include exams, digital x-rays, cleanings, and emergency care as needed to rapidly eliminate infection or pain. Our medical and dental teams meet or exceed hospital grade standards for sterilization safety.

Our multidisciplinary team of nationally recognized dentists, anesthesiologists, and MDs allows us to offer everything from palliative treatment to full-mouth restoration in the safety and comfort of your home. We bring state- of-the-art mobile dental technologies to people who are homebound or have difficulty traveling to a dentist. We provide preventative, restorative, and emergency care 24/7/365.  Our teams handle the setup and breakdown of all portable equipment, as well as access to our teledentistry platform, which provides real-time access to video visits with your dentist, treatment plans, and more.

Give Your Mother the Gift of Health

Most people would probably question the notion of dental care as a Mother’s Day gift. But if you’re the adult child of a homebound senior, you understand how vital quality of life can be. The simple joys of eating a cherished meal or being able to speak and smile without complication are crucial aspects of interaction, socialization, engagement, and happiness. At Blende Dental Group, we adamantly believe that no barriers to dental care exist. We’ve built on our practice on this concept. So this Mother’s Day is an opportune time to spread the smiles and the love.

May 4, 2022

For many teens and adults, orthodontics offers a clear path toward straighter teeth and a more confident smile. Misaligned teeth are common and don’t generally pose oral health risks. So the decision to see an orthodontist is, more often than not, based on a person’s desire to achieve a cosmetically favorable result. But until recently, the only options available were braces, which not everyone found aesthetically pleasing. Clear aligners and “invisible braces” have since become incredibly popular, although differences exist between braces and products such as Invisalign – and those disparities go beyond appearances. Let’s explore the benefits of both and how to choose the approach that’s best for you.

Clear Aligners

Clear aligners are mouthpieces fashioned from medical-grade plastic. They’re custom-fitted to the patient’s mouth and work by applying pressure to teeth, directing them to the desired position. 

The Pros

Esthetics

In terms of looks, they are considered a discreet alternative to traditional braces because they can’t be noticed as easily. While they do offer some benefits over traditional braces, they also come with some tradeoffs. 

Comfort

Because clear aligners are made of plastic, they reduce the risk of cuts and minor irritation that braces can cause. Patients will still experience some discomfort while teeth are repositioned, just as with traditional braces. 

Eat What You Like

People with braces are cautioned against eating chewy or hard foods that can damage the orthodontics and provoke irritation. Examples include popcorn, gum, taffy, nuts, and others. Clear aligners, conversely, are removable devices. That means you can eat formerly forbidden foods. Brushing and flossing are also less challenging since the aligner can be taken out.

Fewer Dental Visits

Recommended treatments occur every four to six weeks with clear aligners, although some online companies offer products directly with no required visits to an orthodontist. Braces must be adjusted routinely. The convenience of clear aligners is a bonus for some patients, but they may not be the best option for every individual.

The Cons

Designed for Simple Corrections

Clear aligners are best suited to people who need only minor adjustments with their teeth and duration of treatment may take longer. They are poor substitutes for traditional orthodontics when treating more complex issues such as overbite, crossbite, abnormalities with the jaw, and other types of malocclusions. 

Must Be Removed

On one hand, the removable nature of clear aligners allows patients to eat whatever foods they crave. On the other hand, the devices must be removed while eating or drinking beverages other than water to prevent damage or staining to the plastic. Not every person will find this convenient. 

Discipline and More Frequent Care

On average, patients should wear clear aligners between 20 and 22 hours a day. And since the devices must be removed and reapplied regularly for eating and drinking, diligence is imperative for successful outcomes. Aligners are not a good option for those with compliance issues and those likely to misplace their aligners, for example in young children. The products can also cause halitosis and increase the risk of cavities for users with substandard oral hygiene practices. As a result, people may need to brush and floss more frequently throughout the day.

Braces

Braces have been and still remain the gold standard in orthodontics. Even though they’ve earned a reputation as aesthetically unappealing and uncomfortable, they offer a wealth of proven benefits. 

The Pros

Simple Solution for Complex Cases

Braces can universally treat even the most complex cases. Because they fasten to each tooth individually, they pack a more powerful punch than aligners. Orthodontists can make precise adjustments that deliver exceptional results, often faster.

Options

Many patients may think of braces as unsightly metal work in the mouth, but the devices have evolved. There are now braces that fit behind the teeth (lingual) or others made of ceramic, which provide a greater level of discretion and invisibility. 

No Need to Remove

Braces can’t be removed like clear aligners. Patients can drink what they like and eat most foods without worrying about taking the device out. They offer a straightforward approach to treatment without the compliance issues and additional maintenance that comes with clear aligners.

The Cons

Discomfort

Metal braces in particular have a reputation for causing small cuts and other irritation. Wax helps buffer against the potential problems, but patients will need to grow accustomed to wearing them. 

Appearance

The biggest advantage of clear aligners is that they are harder to detect than braces. Even lingual or ceramic braces are more noticeable than an aligner. 

Food Limitations and Frequent Treatments

As we pointed out previously, those who choose braces are slightly limited in what they can eat. Patients must also visit their orthodontist regularly for adjustments.

Pricing

Naturally, patients will also consider the price of treatment in their oral health decisions. And in that regard, braces generally win out over clear aligners. The average cost of traditional braces for a two-year treatment plan ranges from $2,000 to $6,000. Clear aligners are more expensive, coming in at $3,000 to $7,000.

Other Considerations

The reason braces endure as the go-to recommendation by most orthodontists is because they can treat any condition. Crooked teeth are caused by a variety of factors that include genetics, jaw size, poor myofunctional habits (e.g., thumb sucking, tongue thrusting, mouth breathing, etc.), malocclusion, poor nutrition, facial injuries, and more. While misaligned teeth usually pose no health risks, that’s not always true. As Healthline noted, crooked teeth can lead to some oral health complications.

• Periodontal disease. It can be hard to clean in between crooked teeth. This can result in tooth decay and gum disease. If left untreated, gum disease can lead to periodontitis, a more serious infection that can damage bones and teeth.
• Chewing and digestion. Crooked teeth can also interfere with proper chewing, which may cause digestion problems.
• Excess wear. Crooked teeth can also cause excess wear and tear on the teeth, gums, and jaw muscles, resulting in cracked teeth, jaw strain, temporomandibular joint disorder, and chronic headaches.
• Speech difficulties. If your teeth are misaligned, they can affect the way you articulate sound, causing problems with speech.

Our Advice

Simply put, always confer with your dentist to determine the best option and get a referral to an orthodontist. For minor corrections, clear aligners may do the trick. Overall, however, braces endure as a time-honored, proven, and affordable treatment option for any patient with any condition. 

 

Photos by Diana Polekhina on Unsplash and Rainier Ridao on Unsplash

April 29, 2022

We learned a lot during the past two years of dealing with a pandemic. For many people, one of those things was the word “bruxism.” Dentists around the country have witnessed a surge in excessive teeth grinding or clenching, technically called bruxism since the pandemic began. In 2022, however, the situation appears to have worsened, with a majority of Americans reporting high-stress levels due to financial concerns, inflation, the ongoing outbreak of COVID-19 variants, and Russia’s invasion of Ukraine, according to a new poll from the American Psychological Association. Of course, all of that has also created a spike in chronic teeth grinding, which wears down the protective layer of enamel on the tooth and leads to fractures, jaw pain, facial discomfort, and even loss of teeth in severe cases.

Grinding Is Our New Grind

“Many dentists attribute the recent surge in bruxism to increased stress, which has been linked to bruxism in a number of studies, though not as a direct cause,” wrote MedicalXPress, citing an article by Bethany Ao in The Philadelphia Inquirer, which illustrated the oral health concerns of bruxism.

Ao interviewed Thomas Sollecito, chair of oral medicine at the University of Pennsylvania School of Dental Medicine, who was not surprised by the increase in stress-related teeth grinding.

“I would be surprised if there wasn’t an increase,” he said. “The stress and distress of the world’s events will affect things like sleep and someone’s clenching and grinding. If we’re constantly under that duress, the frequency and intensity of clenching and grinding are just going to continue.”

Prior to the global outbreak of COVID-19, 50% of adults exhibited some form of grinding and muscle contractions in their jaws. Those statistics have continued to soar, even as the worst aspects of the pandemic fall behind us. “The top sources of stress were the rise in prices for everyday items due to inflation – namely gas prices, energy bills, and grocery costs – followed by supply chain issues and global uncertainty,” Carolyn Crist wrote in a recent article for WebMD. “About 87% of respondents said inflation was a significant source of stress, followed by 81% for supply chain issues and 81% for global uncertainty. In addition, 80% said they were stressed about potential retaliation from Russia through cyberattacks or nuclear threats, and 80% cited overall concerns about the Russian invasion of Ukraine.”

Despite the lack of a definitive connection between stress and chronic teeth grinding, researchers have demonstrated strong links between bruxism and emotions such as anxiety, stress, anger, frustration, or tension. Yet as the Mayo Clinic clarified, these are most often correlated with awake bruxism rather than sleep bruxism.

Bruxism Symptoms and Complications

As the Mayo Clinic states, in most cases, bruxism doesn’t cause serious complications. But it can produce complications that lead to discomfort or pain:

• Damage to your teeth, restorations, crowns, or jaw
• Tension-type headaches
• Severe facial or jaw pain
• Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth

The following signs and symptoms may indicate that you have bruxism:

• Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
• Teeth that are flattened, fractured, chipped, or loose
• Worn tooth enamel, exposing deeper layers of your tooth
• Increased tooth pain or sensitivity
• Tired or tight jaw muscles, or a locked jaw that won’t open or close completely
• Jaw, neck, or face pain or soreness
• Pain that feels like an earache, though it’s actually not a problem with your ear
• Dull headache starting in the temples
• Damage from chewing on the inside of your cheek
• Sleep disruption

Special Circumstances for Those with Special Needs

During an interview with Dr. Lindzy Goodman, DDS, of House Call Dentists, hosted by Inspired Memory Care’s Nettie Harper and Kelly Gilligan, Dr. Goodman indicated that COVID-19 and other anxieties have exacerbated the problem of bruxism.

“We have never seen so many fractured teeth because of grinding and clenching,” Dr. Goodman said. “We’re continuing to see stress generated dental emergencies more than ever during this time. We cannot just close our doors to patients, and we must take extra steps to stay safe.”

For people in assisted living or similar care facilities, these challenges are far greater to surpass. Patients with dementia, for example, don’t necessarily understand that process or have the ability to sit through a traditional visit. House Call Dentists immediately eliminate the first barrier to care. More importantly, this approach affords a stronger, safer, and more comfortable relationship between special needs patients, their caregivers, and dentists. 

House Call Dentists, operated by Blende Dental Group, has designed programs that introduce caregivers to new resources, train them on using tools such as cheek retractors and mouth supports, and provide ongoing guidance on preventative and palliative care options. Caregivers, whether the adult children of elderly patients or personnel employed by a facility, don’t actually have robust training in monitoring and administering oral care for patients with physical or cognitive disabilities. Education, therefore, remains an instrumental weapon in the fight for better oral health.

Focusing on Prevention

Dr. Goodman expressed that 90% of dental visits are preventable. The bad news is that many of us aren’t very good at it. 

• Over 70% of American seniors have periodontal disease.
• Nearly 50% of adults over the age of 30 have periodontal disease.
• About 65% of working adults already put off essential visits to the dentist.

Fortunately, there’s plenty of good news, too.

• Simply brushing twice daily and flossing once a day are two critical behaviors that are proven to prevent the risk of all oral infections — and they require only a few minutes each day.
• Dry mouth is an oral health risk. Drinking water throughout the day, rather than coffee or sugary beverages, can dramatically curb dental problems.
• Since the pandemic, dental offices have implemented some of the highest sterilization and disease prevention measures in the nation’s businesses. So routine visits remain completely safe.

Of course, there remain people who can’t visit the dentist because of special needs, cognitive disorders, physical limitations, or other challenges. For those with special needs, the dentist can come to them. House Call Dentists teams specialize in safe, sterile, and comfortable care onsite at a patient’s home or assisted living facility. 

Photo by JESHOOTS.COM on Unsplash

April 26, 2022

Health officials are warning of fresh COVID-19 outbreaks with new variants such as BA.2.12 and BA.2.12.1, surging across the United States. The fallout from the pandemic’s initial outbreak severely impacted the nation’s oral health. Dental practices around the world were forced to close. And when they did reopen, even after implementing enhanced safety measures, patients still put off routine visits. In 2021, the FDI World Dental Foundation declared this outcome a “dental disaster,” citing the adverse effects of a “catastrophic aftermath of the virus on the health of people’s teeth and gums in dental practices around the globe.” The good news is that vaccinated people remain at low risk of becoming ill from these variants and that dental practices continue to operate openly and safely. The bad news is that people are still skipping regular dental visits. Here’s what patients should know and why they should resume regular checkups.

A Dental Disaster We Can End Now

Disrupted dental care and treatments have generated exponentially augmented problems for patients, particularly those in high-risk groups. Many have since developed advanced tooth decay and related complications, including infections. Others missed soft tissue screenings for oral cancer. However, these conditions were largely preventable given that practices began opening their doors between the first and second wave of the pandemic. Because of exposure concerns or being accustomed to staying at home, patients have persisted in postponing  appointments.

High-risk patients, for example, tended to develop multiple problems, often exhibiting up to four simultaneously, according to FDI research. This population is generally advised to see a dentist every three to six months. Instead, the average today is nine months to a year – if at all.

There exists no direct evidence to support a conclusion that COVID-19 itself impacted oral health outcomes, but it certainly impacted core health behaviors, which influence the negative outcomes we’re witnessing. There are several factors to consider.

• Public health data reported significant increases in sweets, cookies, and other sugary foods during the quarantine and shelter-at-home periods.
• Purchases for oral health products declined below consumer averages in 2019 when lockdowns began.
• U.S. alcohol sales increased by up to 20% between 2019 and 2020,  according to data from Columbia Public Health.
• With shortages of fresh food products, people purchased more packaged goods, canned foods, and prepackaged meals, all of which contain preservatives and higher volumes of sugars and salts.
• More people relied on having meals delivered, which increased their intake of fast food and less healthy dietary alternatives than home-cooking.
• “More than 49 million US residents live in areas designated by the Health Resources and Services Administration as Dental Health Professional Shortage Areas,” the Centers for Disease Control and Prevention (CDC) said in its 2020 report on Oral Health Care and COVID-19.

All said, the combination of these behaviors and the lack of routine dental visits have led to the recent situation.

Getting Back on Track with Oral Care

In March of 2020, when the lock down of dental offices occurred, the Blende Dental Group remained open for their own patients as well as to handle the emergency overflow from the San Francisco Dental Society as well as both dental schools, which had effectively closed.  For roughly two years, dental offices have now been open to seeing patients. Yet, industry intelligence still suggests that too many patients are observing pandemic behaviors – particularly a reluctance to get back on track with regular dental visits. If the issue involves safety, patients should understand (especially those who have been vaccinated) that exposure risks are incredibly low.

“Between the first and second wave, dental practices in many countries were able to reopen,” FDI noted. “Dentists have always abided by the most stringent infection prevention and control protocols and have also revised hygiene measures mandated by governments during the COVID-19 pandemic. In addition, a recent survey indicates that oral health professionals have significantly lower SARS-CoV-2 infection rates than other healthcare workers in most parts of the world.”

At the Blende Dental Group, our teams have always incorporated hospital-grade sterilization techniques. Because of the COVID-10 outbreak, we strengthened those measures by exceeding all standards of immunizations for transmissible diseases. And we are continuing to embrace those protocols today. Our staff is fully vaccinated, outfitted with the best personal protective equipment, adhere to  stringent hand-sanitizing practices, and undergo regular health screenings.

Because our dentists as well as the entire clinical team are hospital trained, we were in full compliance with the state’s safety approach, which includes a minimum 2-week supply of PPE for our dentists and staff: N95 respirators, face shields, goggles, surgical masks, and other infection control equipment. The protocols we implemented during the waning stages of the outbreak remain in place to protect our patients.

• Optimized office layout, appointment scheduling procedures, and capacity limits
• Rigorous cleaning and sanitizing processes across every inch of the office
• Air purifiers with HEPA filters and UV-C lights in all lobbies, exam rooms, and workspaces

For patients who still feel hesitant or have difficulty commuting, Blende Dental Group’s robust offerings can accommodate them. Our practice modernized and reinvented the concept of house call with the inception of House Call Dentists, where our mobile teams use the latest innovations in mobile dentistry technology.

We have also helped pioneer the adoption of virtual dentistry. As the CDC explained, “The COVID-19 pandemic has thrust alternative modalities such as teledentistry to the forefront of policy considerations. Teledentistry supports the delivery of oral health services through electronic communication means, connecting providers and patients without usual time and space constraints. Teledentistry’s unique ability to connect disadvantaged, primarily rural communities and the homebound with dental providers makes this method particularly well-suited to address lack of access during and after the pandemic.”

We developed a comprehensive teledentistry solution called CUSPID. Video consults connect patients to a dental provider through a laptop, tablet, or smartphone, allowing a dentist to diagnose problems and accelerate treatment options, which may include electronic prescriptions. When follow-up care is required, next-day appointments can be booked. CUSPID includes dedicated portals for dental providers and patients. The software is private, secure, and fully compliant with HIPAA.

Patients Have Options, Not Excuses

The barriers to accessing dental care continue to erode every day. Patients can return to dental offices confidently as stringent safety protocols remain in place. Advances in mobile dentistry and teledentistry further break down the hurdles to seeing a dentist. This is a critical point for high-risk patients who were disproportionately impacted by the pandemic, most commonly affecting seniors and children. But options for care exist. And putting off checkups only increases the risks of problems, which lead to more complex procedures.

There are also regulatory issues to take into account. California law, for instance, requires children to receive a dental checkup before their first year of public school. The deadline to get the exam and fill out the paperwork is May 31.

Oral health isn’t just isolated to the teeth, gums, and mouth – it affects so many other parts of the body. It’s time to start seeing the dentist regularly again, and leading practices have created more pathways for accessibility, convenience, and peace of mind.

April 22, 2022

Images courtesy of the Oral Cancer Foundation, www.oralcancerfoundation.org

More than 65% of working adults put off essential visits to the dentist. Their reasons vary. Some cite rigorous work schedules or family commitments that absorb much of their free time. Still others blame long, arduous commutes for skipping routine trips to the dentist. However, advances in mobile dentistry, the modernization of house calls, and the rise of teledentistry platforms now give patients more options for resuming regular checkups. Maintaining good oral hygiene is important. Early detection of oral cancer, which is performed only by dentists during screenings, is critical. Because April is Oral Cancer Awareness Month, let’s learn more about the disease and how your dentist can help.

Be Aware of Oral Cancer and Its Risks

“Oral and pharyngeal cancer (cancer of the mouth and upper throat) collectively kills nearly one person every hour of every day of the year,” the American Association of Oral and Maxillofacial Surgeons (AAOMS) explains. “Of the people newly diagnosed with these cancers, only about 60% will live longer than 5 years. Moreover, many who do survive suffer long-term problems such as severe facial disfigurement or difficulties eating and speaking. The death rate associated with oral and pharyngeal cancers remains particularly high due to the cancer being routinely discovered late in its development.”

Last year, an estimated 54,000 cases of oral cancer were diagnosed. About 43% of those individuals were not expected to survive beyond the five-year mark. Unlike other cancers, this disease is less frequently discussed in the media. And with only 35% of adults attending routine dental screenings, the risks are high. That’s why dental associations across the nation attempt to raise awareness of the problem every April during Oral Cancer Awareness Month. 

For 23 years, these organizations have joined the non-profit Oral Cancer Foundation in this campaign. They include the Academy of General Dentistry Foundation, the American Academy of Oral and Maxillofacial Pathology, the American Academy of Oral and Maxillofacial Radiology, the American Association of Oral and Maxillofacial Surgeons, the American Academy of Oral Medicine, the American Academy of Periodontology, the American College of Prosthodontics, the American Dental Hygienists’ Association, and the California Dental Hygienists’ Association. 

Oral Cancer Symptoms and Risk Factors

The Oral Cancer Foundation encourages people to “regularly check for signs and symptoms of oral cancer between dental visits and to see a dental professional if they do not improve or disappear after two or three weeks.” Although the causes of oral and pharyngeal cancer vary, the predominant culprits are tobacco use and/or excessive alcohol consumption. Symptoms include the following.

• Any sore or ulceration that does not heal within 14 days
• A red, white, or black discoloration of the soft tissues of the mouth
• Any abnormality that bleeds easily when touched (friable)
• A lump or hard spot in the tissue, usually on the border of the tongue (induration)
• Tissue raised above that which surrounds it – a growth (exophytic)
• A sore under a denture, which even after adjustment of the denture, does not heal
• A lump or thickening that develops in the mouth
• A painless, firm, fixated lump felt on the outside of the neck, which has been there for at least two weeks

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States – and it can contribute to oropharyngeal cancer. HPV-caused oral cancer generally includes one or more of the following symptoms.

• Hoarseness or a sore throat that does not resolve within a few weeks
• A swollen tonsil on just one side, which is usually painless
• A painless, firm, fixated lump felt on the outside of the neck, which has been there for at least two weeks
• A persistent cough that does not resolve after many days
• Difficulty swallowing – the sensation of food getting caught in your throat
• An earache on one side (unilateral) that lasts for more than a few days

“Research has identified a number of factors that may contribute to the development of oral and oropharyngeal cancers,” the Oral Cancer Foundation said. “Historically, those at an especially high risk of developing oral cancer have been heavy drinkers and smokers older than age 50, but today the cancer also is occurring more frequently in nonsmoking people due to HPV16, the virus most commonly associated with cervical cancer.”

Getting Screened for Oral Cancer

Screenings are tactile and visual in nature. They’re also quick, painless, and non-invasive.

How Often Should You Get Screened?

The Oral Cancer Foundation recommends that patients undergo screenings for oral and oropharyngeal cancers on an annual basis, beginning around age 18. If individuals are smoking or chewing tobacco, screenings should commence at the age they begin using those products. At Blende Dental Group, we include screenings as part of every checkup and cleaning for patients of all ages.

“Oral tissue scanning is standard for every patient, despite their age,” said Dr. Lindzy Goodman. “We perform a soft tissue exam, palpate the thyroid, and check for hard  lumps or abnormalities.”

“Soft tissue exams should take place from the patient’s first experience,” noted Tanvi Obrock, Blende Dental’s head hygienist. “During annual dental exams, extraoral and intraoral screenings are always performed.”

Dr. Debra Chau added that “any time you get a cleaning is a good time to get looked at.”

What’s Involved in a Screening?

Some early warning signs can be observed with the naked eye as visible pre-cancerous changes in tissue, most often for those who smoke or drink heavily. Oropharyngeal cancers are located in the back of the mouth. They occur frequently in the tonsils and at the base of the tongue, where it begins curving down into the throat. These areas can’t easily be detected by sight alone. With cancers resulting from HPV, this area of the mouth is particularly vulnerable. There are a variety of methods dentists use to identify cancer.

• Dialog with your dentist is equally important. Part of detecting whether oral cancer exists involves interviewing patients to determine potential symptoms.
• A visual examination of the mouth, tongue, and throat helps our dentists spot red or white patches along with mouth sores.
• During a tactile examination, the dentist runs his or fingers through the patient’s mouth to feel for bumps or other abnormalities.

“Right now, more oral cancer cases are coming from people with HPV, especially men,” Dr. Goodman noted.

What Happens if the Dentists Suspects Cancer?

“Dentists won’t diagnose cancer,” Dr. Goodman explained. “If something looks suspicious, next steps involve a biopsy or a referral to a specialist. Biopsies are the gold standard for detecting cancer.”

During a biopsy procedure, a sample of cells is removed for laboratory testing to determine whether cancer is present. We also refer patients to an oral or maxillofacial surgeon.

“An oral surgeon is the first referral,” said Dr. Chau. “We may also suggest that patients see a head and neck physician.”

Always remember that early detection can boost your chance of survival from 50% to 90%. That’s why it’s imperative to attend annual screenings and report any symptoms to your dentist if they fail to improve within two to three weeks.

April 19, 2022

Until the pandemic, people never realized how much they would come to rely on virtual solutions. Digital communications have changed the way people communicate, shop, engage socially, and even manage their health. These advances continue to open new doors for enhancing our lives in a world that craves easy access and  on-demand services. However, the benefits of teledentistry extend far beyond convenience. Virtual dental care helps patients cope with travel-related stresses, particularly for those who must commute long distances or those who cannot easily leave their homes, such as seniors in assisted living facilities and special needs patients.

Increasing Growth and Adoption of Virtual Dental Care

During the pandemic, teledentistry came into its own on a large scale. It minimized the risk of exposure to the coronavirus for patients and dental professionals. It also significantly reduced the load on hospital emergency rooms related to dental problems.  Today, teledentistry is no longer a niche service offering. The pandemic may have ushered in widespread adoption, but its growth was gaining traction well before the outbreak of COVID-19. According to surveys conducted by DentaVox in 2019, nearly 80% of U.S. households said they expected to rely on it over the next five years. In some fashion, it’s likely to become a new standard in all of dentistry. As Daniel W. Croley, DMD noted in his article for Dental Economics, “The market is expected to reach $2.6 billion by the end of the decade.”

Teledentistry is the remote delivery of dental care, consultation, follow-up care, and education through telecommunications. The idea is as old as the telephone itself. But with advances in video conferencing and online platforms, the systems have become incredibly robust. Video consults connect the patient’s laptop, tablet, or smartphone to a dentist who diagnoses the problem and accelerates treatment options, which may include electronic prescriptions for antibiotics and non-narcotic pain medication. When follow-up care is required, next-day appointments can be booked. There are several advantages.

• Enhances the patient experience when physical visits aren’t possible through personal interaction with a dental provider by phone or video
• Offers immediate online scheduling, expedited assessments and treatment recommendations, and faster access to a network of available dentists from the comfort of the patient’s home
• Protects information through private, secure, and fully HIPAA compliant protocols.
• Improves the quality of diagnosis through video interactions because patients can better describe their conditions using body language, pointing to problem areas, or even showing what’s happening inside their mouths

“A 2020 report by the Agency for Healthcare Research and Quality found dental practices that set up telehealth services were able to remotely evaluate patients and develop recommendations, provide problem-focused and urgent care evaluations, offer pharmacological management, and follow up on emergency care,” wrote Croley.

How Teledentistry Helps Dentists Treat Patients

Teledentistry brings value to both dentists and patients in a number of ways. Three of the most important, after initial evaluations, involve post-treatment services, access to care for those who cannot travel, and patients experiencing dental emergencies.

After Care

Teledentistry is a fast and effective way for dentists to monitor patients after treatment. These virtual consultations allow dentists to assess how well patients are healing over the video connection. This process eliminates the need for patients to travel, making them more likely to participate. For dental practitioners, these platforms contribute to the reduction of operating costs, as Croley explained: ​​ “The added value to the dentist is reduced overhead since patients do not need to come in for their appointments, thus eliminating the need for setup and sterilization of rooms, chairs, and instruments.”

Greater Access

Busy days, long-haul travel, and other obstacles prevent people from visiting their dentists regularly. For people who live in rural areas and bustling metropolitan areas, reaching their dentists is no easy feat. For seniors and patients with ambulatory issues, the challenges are even greater. “Caregivers or adult children can help oversee the technology for teledentistry by using a mobile phone or computer, which could help seniors know when they need in-person care and when they might be able to postpone it,” Croley said.

For children or phobic patients, teledentistry can help dentists conduct checkups from the comfort of their patients’ homes, reducing their reluctance to see a dentist by instilling a better sense of ease.

Emergencies

The ability to triage patients on demand allows dentists to assess a person’s condition and determine whether a dental emergency exists. If so, the dentist can take immediate action to alleviate pain by calling in a prescription while scheduling an appointment for care. Within the overall healthcare industry, virtual consultations for emergencies have the potential to reduce the number of emergency room visits at hospitals and urgent care centers, which usually redirect patients back to their dental providers after treating the pain.

Part of a Growing Mobile Ecosystem

Digital platforms and teledentistry systems represent only part of this equation. RDH Magazine noted that “as dental practices and health-care organizations increasingly explore ways to include mobile delivery into their current model of care, the mobile dentistry movement continues to gain traction as one of the most popular up-and-coming trends within the profession.”

Sinca 2008, House Call Dentists has fully utilized all the breakthroughs in portable equipment — such as x-ray units, treatment carts, and compressors. These advances have made the House Call Dentists division of the Blende Dental Group busy in both San Francisco and New York, with a focus on those with special needs: the geriatric, patients with physical or mental challenges, the permanently homebound, and others. Combined with teledentistry, an entire population of underserved people are now receiving all levels of care without barriers.

April 14, 2022

Cities and states across the country have gradually lifted mask mandates that were imposed during the outbreak of COVID-19 and its variants. Generally speaking, no states are now directing people to wear masks. Hawaii, the last state to do so, ended its requirement on March 25. With these easing restrictions and a renewed sense of liberation after a couple of fraught years, families are naturally returning to parks, playgrounds, beaches, events, and physical activities they enjoyed prior to the pandemic. But as sports resume and facial coverings dwindle, it’s important to remember that April is National Facial Protection Month. You may no longer need a mask, but you should still take precautions to ensure the safety of your mouth during group sports and other athletics.

Is There Really a National Facial Protection Month?

Yep, National Facial Protection Month is a real thing. It may not be as popular with folks as Talk Like a Pirate Day or National Doughnut Day, but it’s something the dental community takes seriously in its efforts to promote oral health and raise awareness of preventable injuries.

National Facial Protection Month is sponsored by the Academy for Sports Dentistry, American Academy of Pediatric Dentistry, American Academy of Pediatrics, American Dental Association, American Association of Oral and Maxillofacial Surgeons, and the American Association of Orthodontists.

“Spring often brings a flood of patients suffering with head, mouth and facial injuries resulting from sports-related accidents to doctors’ offices and emergency rooms,” the American Association of Oral and Maxillofacial Surgeons (AAOMS) explains. “Many oral and facial injuries can be easily prevented with the use of sports safety equipment like helmets and mouth guards.”

We tend to associate head and mouth injuries with contact sports such as football and hockey, yet several activities also pose risks, particularly for children: bicycling, skateboarding, snowboarding, and more.

Protecting Your Pearly Whites and Baby Blues

You can play hard, but the nation’s top dental associations also want you to play safe. Recreational and organized sports, despite safety measures from organizers, still lend themselves to painful injuries. There are recommended steps we can take, however, to reduce the possibility or severity of contact.

Mouthguards are a Must

Mouthguards cost a lot less than extensive oral surgery, and they are a proven defense against mouth injuries. The American Dental Association endorses mouthguards as essential in preventing up to 200,000 dental injuries each year. The ADA also states that athletes are 60 times more likely to incur damage when not wearing this kind of protective gear.

The ADA also recommends wearing a properly fitted mouthguard to reduce the incidence and severity of oral injury in sporting or recreational activities, particularly activities with significant risk of dental trauma or orofacial injury. That means spending a bit more money on a professional-grade guard rather than the “boil and bite” kind, which wear down rapidly, interfere with breathing and speaking, and fail to fit properly, leading to uneven cushioning against impacts.

Mouthguards should be considered for a sweeping host of activities, not just contact sports. Here are some examples to drive the point home.

• Basketball
• Handball
• Soccer
• Lacrosse
• Water Polo
• Baseball
• Skateboarding
• Equestrian Events
• Surfing
• Gymnastics
• Skydiving
• Skiing
• Bicycling

A well-constructed mouthguard should have the following characteristics:

• be properly fitted to the wearer’s mouth and accurately adapted to his or her oral structures;
• be made of resilient material approved by the U.S. Food and Drug Administration and cover all remaining teeth on one arch, customarily the maxillary;
• stay in place comfortably and securely;
• be physiologically compatible with the wearer;
• be relatively easy to clean;
• have high-impact energy absorption to reduce or limit transmitted forces upon impact.

Better yet, check the label to make sure the product you’re considering bears the ADA Seal of Acceptance, which means it complies with ANSI/ADA Standard No. 99:2001 (reaffirmed 2013), Athletic Mouth Protectors and Materials. This standard sets the technical specifications for athletic mouthguard characteristics and physical properties, as well as instructions to manufacturers regarding labeling and packaging.

Wear a Helmet

Helmets absorb the energy of an impact and prevent damage to the head. For younger people, also consider helmets for non-contact activities such as biking or skateboarding.

Add a Face Shield

Helmets are great protection against falls, wipeouts, and hits. Baseball batters must wear a type of helmet. Football players wear helmets. However, sports like hockey expose the face and mouth to additional dangers with pucks flying around at high speeds. During activities where any sort of projectile could come into contact with the face, a plastic shield offers better protection.

Have Fun, Not Fractures

Some electric toothbrushes come equipped with pressure sensors, which beep or stop the head’s movement when aggressive brushing is detected. It’s not an imperative feature for most people who are evaluating what device to buy, but it can provide tremendous benefits for individuals who are switching from manual to electric toothbrushes for the first time.

Sure, your dentist enjoys seeing you, but usually for routine checkups and cleanings. Many dental emergencies are preventable – not just by maintaining healthy hygiene and habits, but also by taking steps to safeguard your mouth and teeth from dangers that can rip the fun out of a sport or the comfort out of a dental visit. 

For more information on facial safety practices and advice, talk to your dentist!

April 12, 2022

According to data from the Oral Health Foundation, 12 million Brits have switched to electric toothbrushes over the last five years. An estimated 34 million U.K. adults, 67% of the population, now use an electric toothbrush. In the United States, Consumer Reports says the figure is roughly 132 million people, citing research by marketing analysis firm Mintel. Obviously, there’s been significant growth in the adoption of electric toothbrushes (and a decline in poking fun at English smiles). That also means more products have appeared on the market. So the questions become: how effective are these devices, what differentiates them, and how do you decide which to use?

Are Electric Toothbrushes Effective?

In 2014, the Cochrane Oral Health Group carried out an independent review of studies dating back to 1964. Yes, electronic toothbrushes predate Sonicare, which was unveiled in the early 1990s. A random sampling of 5,068 participants found that “there was an 11% reduction in plaque at one to three months of use, and a 21% reduction in plaque when assessed after three months of use. For gingivitis, there was a 6% reduction at one to three months of use and an 11% reduction when assessed after three months of use.”

Dentist and vice-president of clinical development at Tend, Marc Schlenoff, also noted that these devices lessen the force applied to cleaning teeth and gums, which reduces the risk of gum recession and eroding tooth structures.

Another study, compiling 11 years of research, concluded that users of electronic toothbrushes displayed healthier gums, less tooth decay, and a tendency to keep their natural teeth longer than those who relied on manual brushing. Dr Nigel Carter OBE, CEO of the Oral Health Foundation, said this study backs up what smaller data have previously suggested: “Health experts have been speaking about the benefits of electric toothbrushes for many years. This latest piece of evidence is one of the strongest and clearest yet – electric toothbrushes are better for our oral health.”

“As the science behind the advantages of electric toothbrushes is mounting,” Dr. Carter added, “the decision whether to invest in one becomes much easier.”

Electric toothbrushes may also yield better results for certain groups, experts say. For instance, older adults, especially those with arthritis or limited mobility, might not have the dexterity to maneuver a manual toothbrush effectively. Powered brushes do much of the work and their larger handles are easier to grip.

All of that said, there is no reason for consumers to abandon traditional brushes. According to dentist and American Dental Association (ADA) spokesperson Dr. Ada Cooper, a manual toothbrush actually can deliver nearly the same  dental hygiene benefits as an electric toothbrush, although many dentists and researchers believe the latter to have a slight edge.

What to Look For

Brush Movement

Not all electric toothbrushes are created equal. Brush movement is one of the major differences. The movements of electric toothbrushes tend to span three types: rotating, oscillating, and sonic. Rotating, or rotary, brush heads move in a circular back-and-forth motion, over the surface of the tooth. Oscillating indicates a brush that moves in a side-to-side fashion. Sonic toothbrushes, popularized by the Philips Sonicare brand, vibrate the bristles at high speeds, up to frequencies of 50,000 movements per minute. As to which movement is the best, conclusive research has not been determined.

Reporting on the “7 Very Best Electric Toothbrushes” for New York Magazine, Jenna Milliner-Waddell, Karen iorio Adelson, and Ambar Pardilla interviewed dental practitioners to get their takes.

Dentist Sharon Huang of Les Belles NYC explains that sonic toothbrushes use a sonic wave to dislodge debris all on its own, which she likes because it requires less force to get the job done. “The rotation mechanism, you actually have to touch the tooth and it’s rotating and it’s helping you clean it,” she says. “The sonic toothbrush has a sonic wave. So if you’re in the vicinity, and you’re not even touching your tooth, it’s supposed to be dislodging bacteria.” The sweet spot is a toothbrush that does it all, but orthodontist Janet Stoess-Allen, says that because teeth are curved, “rotating heads are more effective in getting to all sides of them.”

Bristles

All of the experts surveyed in the New York Magazine article agreed that hard-bristled brushes were best suited for “scrubbing grout from your bathroom tile.” They unanimously preferred soft-bristled brushes, particularly for people with sensitive teeth and gums.

Another reason to consider soft bristles is the power of electric toothbrushes. A 2017 study published in the journal PLOS One found that electric toothbrushes were more likely than manual to abrade dentin, the tissue directly below the tooth’s enamel, which can become exposed when enamel wears away or gums recede. Abrasions to the dentin increase tooth sensitivity and can hike cavity risks.

“For the study,” Consumer Reports explained, “researchers took dentin samples from teeth and then used a machine that simulated the effects of eight-and-a-half years of brushing. They found that sonic toothbrushes caused the most abrasion to the dentin, followed by oscillating, and that manual toothbrushes—especially those with rippled bristles—created the least…  In fact, a gentle touch with a soft-bristled toothbrush—whether manual or electric—is the safest bet.”

Pressure Sensor

Some electric toothbrushes come equipped with pressure sensors, which beep or stop the head’s movement when aggressive brushing is detected. It’s not an imperative feature for most people who are evaluating what device to buy, but it can provide tremendous benefits for individuals who are switching from manual to electric toothbrushes for the first time.

Timer

To get the best results from your cleaning  regimen, dentists recommend two minutes of brushing: 30 seconds for the fronts and backs of your upper and lower teeth. Many electric toothbrushes compensate for this by including a built-in timer that beeps or briefly pauses at the end of each 30-second interval.

Major Differences

As manufacturers compete in their attempts to reach consumers who now have more choices, they have introduced a wide variety of devices into the market. Apart from certain functional aspects, such as bristles and head movement (e.g., oscillating, rotary, sonic), the primary differentiators come down to a few characteristics:

• Aesthetics
• Features
• Cost

Aesthetics

Sure, a toothbrush is a practical device, but that doesn’t mean every person favors a utilitarian design. In many households, a toothbrush can double as a piece of bathroom decor. You’ll find whimsical and cartoon-inspired brushes for children, sleek and modern looking devices such as Quip, and colorful yet streamlined brushes from brands like Goby, which the New York Magazine reviewers described as “eye candy for your bathroom counter.”

Features

We’ve already discussed the core features of most electric toothbrushes, those that speak to functionality and effectiveness, but there are many other options manufacturers have added to bolster the appeal of their devices. Keep in mind, however, with increasing feature sets comes a spike in costs.

• Battery versus charging. Some people prefer the portability of brushes powered by battery rather than those that must charge on a stand or dock.
• Apps. Believe it or not, brushes like the Oral-B 8000 use Bluetooth technology to connect the device with an app on your phone. As New York Magazine explains, ​​”You can get real-time feedback on your brushing habits,  help you know where you’ve brushed so you don’t miss a spot, and coaching to get you through the recommended two minutes. You can easily see this diagnostic report using the included phone holder that suctions onto the mirror.”
•  Battery Life. Most brushes last about two weeks on one charge. Brushes such as Pro-Sys VarioSonic Electric Toothbrush have a prolonged battery life of one month on a single charge. For frequent travelers, this convenience could be an important consideration.
• Single Use. Not everyone is ready to leap headlong into the world of automated toothbrushes. For those looking to test the waters, there are non-rechargeable brushes on the market. A popular model is the Oral-B Pro-Health Anti-Microbial electric toothbrush, which offers a variety of colors and a low selling price.

Cost

Writing for Everyday Health. Caitlin McCormack explained that “electric toothbrushes cost as little as $5 for battery-operated units and up to $200 or more for feature-rich models, so there is a choice for every budget.”

Best Practices for Choosing an Electric Toothbrush

McCormack also offered solid advice on criteria to keep in mind when making purchasing decisions for electric toothbrushes.

• When shopping for an electric toothbrush, you’ll want a model that is gentle on gums, without sacrificing cleaning power.
• Look for a handle with a soft-touch grip, which will make the toothbrush easier to maneuver when cleaning all those hard-to-reach places where plaque can build up.
• Consider the replacement brush head options (and their cost) when selecting an electric toothbrush. The ADA recommends replacing the brush head at least every three months.
• A splurge-worthy benefit worth considering is a built-in, two-minute timer, which helps ensure that users brush long enough.
• Additional features such as pressure-sensing technology and adjustable program settings can help improve brushing technique, but aren’t really necessary.

Which Brush is Best?

The 16 dentists interviewed by New York Magazine came to the consensus, as did many dentists, that “choosing between Sonicare and Oral-B is like picking between a Mercedes and BMW. It’s mostly personal preference.” These two brands have earned the seal of approval from the American Dental Association.

Sonicare

• Sonic technology, modeled after ultrasonic cleaning instruments used by dental professionals, allows the brush to vibrate at such frequencies that plaque can be dislodged with little effort from the user.
• There are several models and price-points to meet the needs of many customers.
• Aesthetically, Philips has developed a compact model called Philips One to compete with newer, nimble brands like Quip and Burst, which promote sleek designs. That said, these two brands lack the same amount of  research and development that Philips (Sonicare) and Braun (Oral-B) have devoted to their products.

Oral-B

• Oral-B uses rotary technology, which is modeled after the  polishing handpieces used by dental professionals.
• The small, round brush head is more suitable for those with smaller mouths.
• There are several models and price-points to meet the needs of many customers.
• Oral-B models tend to emphasize travel and  on-the-go options more than Sonicare.

In the end, dental industry professionals recommend these two brands. That said, brushing with any toothbrush, either manual or electric, is better than not brushing at all.

March 9, 2021

Prior to the pandemic, a disconcerting number of U.S. adults had routinely skipped visits to the dentist for basic care. Since the outbreak of COVID-19, those numbers have risen dramatically. A recent dental association survey found that more than half of Americans polled said they have put off routine dental visits due to COVID-19. As we’ve illustrated in previous posts, preventative oral care is essential, particularly for the nation’s homebound population. Despite concerns over exposure to infection or being in environments where the risk of contracting the coronavirus are high, dental practices have demonstrated an enviable safety record. And now there’s even better news. The California Department of Health recently announced an expansion of vaccines that will alleviate lingering fears and get patients back into the chair.

Delay Leads to Decay

Unfortunately, too many Americans forgo dental treatment. In some situations, the culprit is the U.S. healthcare system. About 130 million Americans lack private dental coverage. That includes 22% of children between ages 1 and 17, 40% of adults between 21 and 64, and 70% of seniors age 65 and older. While legislators and politicians debate the merits of reform or propose new solutions, we still have a population of individuals who lack the care they need. 

Yet even among people with access to insurance, dental care seems to fall short of being a primary health consideration. Their reasons vary. Some blame rigorous work schedules or family commitments that absorb much of their free time. Still others cite long commutes to their providers’ offices. The pandemic shifted those priorities. As emergencies arose—complicated by the hurdles in obtaining prompt treatment—patients quickly seized on the importance of maintaining preventative care. 

Dentists now top the list of health practitioners that Americans want to see more often, according to the Adults Oral Health & Well Being Survey: “According to the survey, 42 percent of Americans don’t see a dentist as often as they would like, beating out their primary care doctor (29 percent), dermatologist (23 percent) and the ophthalmologist (17 percent).”  

Of course, hesitation persists among wary patients who still question the safety of re-opened offices and overall sterilization standards. 

Dental Practices Have Exemplified Best Practices

Dental offices, according to studies performed by the American Dental Association, emerged as one of the safest healthcare-related facilities. “The organization published a study today that reports that less than 1 percent of dentists nationwide have been found to be COVID-19 positive, which is far less than that of other health professionals,” Healthline noted in a topical article. “The report includes data from nearly 2,200 dentists surveyed in June 2020. It’s the first of its kind to show U.S. dentists’ COVID-19 rates as well as safety practices.”

• Experts attributed the positive outcomes to safety policies and disinfectant practices that dental offices have had in place for decades. 
• The established best practices aside, many dental practitioners took the extra precaution of enhancing their safety protocols by introducing germ-killing UV lighting systems, advanced HEPA air filtration systems, redesigned office layouts to accommodate social distancing, COVID testing stations, augmented personal protective equipment (PPE), and more.

Patient concerns are understandable and warranted, but given the extraordinary safety records of most dental practices—combined with the augmented sterilization techniques these offices have launched—there’s no reason to avoid resuming a regime of regular oral care. The reality is that bacteria in the mouth can create long-lasting infections and chronic inflammation, which may contribute to the development of heart disease, complications in dealing with diabetes, and increased risks for stroke, pneumonia, or respiratory problems. 

Expanded Vaccinations

In a Nov. 20 letter to the CDC Advisory Committee on Immunization Practices, ADA President Daniel J. Klemmedson, D.D.S., M.D., and Executive Director Kathleen T. O’Loughlin, D.M.D., observed “there may be a limited supply of COVID-19 vaccine” once available. They also expressed concern that dentists and dental team members aren’t currently included in the agency’s outline to help states plan a vaccination response to the virus despite the fact that “dentistry is an essential health care service.”

In the letter, the ADA noted the National Academies of Sciences, Engineering and Medicine’s recent recommendation that dentists and their teams be placed in Phase 1a of those who should be afforded early access to a COVID-19 vaccine. Thanks to the developments of specialists from the site Danielle Ofri, it was found that the purpose of antibiotic therapy in case of burns is to prevent the spread of purulent infection, characteristic of such wounds. Necrotic tissues at the site of a severe burn become a breeding ground for various microorganisms. Antibiotics are usually not used for mild burns.

“There is nothing routine about dental care,” wrote Drs. Klemmedson and O’Loughlin. “Beyond treating immediate pain, dentists evaluate, diagnose, prevent and treat diseases that can be life-changing or even life-threatening. For example, early detection of oral cancers and serious infections can lead to early treatment. Delaying treatment for months, weeks, or even days can make the difference between dying early, having a life-changing abnormality and living a normal, healthy life.”

By January, the Centers for Disease Control and Prevention (CDC) confirmed that dentists, dental teams, and dental students had been included in its initial recommendation for health care personnel to be among those offered the first doses of COVID-19 vaccines.

Not only are dentists and their staffs vaccinated or receiving vaccines, newly expanded parameters for vaccinating the public many also help assuage any lingering fears for patients.

“On February 12, the California Department of Public Health announced health care providers may soon vaccinate people age 16-64 who suffer from a number of health conditions,” the San Francisco Chronicle (SFGATE) reported. “This decree, which goes into effect on March 15, which will add several million people to the number of people eligible for vaccines in California.”

The conditions on the list include the following:

• Cancer, current with debilitated or immunocompromised state
• Chronic kidney disease, stage 4 or above
• Chronic pulmonary disease,  oxygen dependent
• Down syndrome
• Immunocompromised state (weakened immune system) from solid organ transplant
• Pregnancy
• Sickle cell disease
• Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies (excludes hypertension)
• Severe obesity (Body Mass Index ≥ 40 kg/m2)
• Type 2 diabetes mellitus with hemoglobin A1c level greater than 7.5%

Other people may also qualify “if, as a result of a developmental or other severe high-risk disability, one or more of the following applies:”

• The individual is likely to develop severe life-threatening illness or death from COVID-19 infection
• Acquiring COVID-19 will limit the individual’s ability to receive ongoing care or services vital to their well-being and survival
• Providing adequate and timely COVID care will be particularly challenging as a result of the individual’s disability

Naturally, the health concerns related to the pandemic will continue to take precedent until the nation reaches a point at which a sense of normalcy is achieved. But putting off dental care shouldn’t be an option or excuse. With the proven safety records and increasing vaccination rates, it’s time to make oral health a priority again.

December 17, 2020

It’s probably not shocking news to most people that a resurgence of COVID-19 has come roaring back during the holiday season. Health officials warned early in the summer months that we could face a “dark winter” given the anticipated rise in social gatherings and seasonal celebrations common to this time of year. Yet nothing associated with the outbreak of the novel coronavirus has left the world with situations we could readily label as common or normal. Yes, it’s a drag. Yes, the saturation of countless articles and media shock pieces about the pandemic have worn folks down.  But although we’re all well aware of the general health crisis, too few people are focusing on the subsequent oral healthcare problem. COVID-19 hasn’t just become a pain in the you-know-what, it’s created concerning levels of pain in the mouth.

The pandemic is a real headache, now causing real toothaches

Grinding Is Becoming Our New Grind

Dentists around the country have witnessed a surge in excessive teeth grinding or clenching, technically called bruxism, since the pandemic began. Chronic teeth grinding wears down the protective layer of enamel on the tooth, which leads to fractures, jaw pain, facial discomfort, and even loss of teeth in severe cases.

“Many dentists attribute the recent surge in bruxism to increased stress, which has been linked to bruxism in a number of studies, though not as a direct cause,” wrote MedicalXPress, citing an article by Bethany Ao in The Philadelphia Inquirer, which illustrated the oral health concerns of bruxism related to the pandemic.

Ao interviewed Thomas Sollecito, chair of oral medicine at the University of Pennsylvania School of Dental Medicine, who was not surprised by the increase in stress-related teeth grinding.

“I would be surprised if there wasn’t an increase,” he said. “The stress and distress of the world’s events will affect things like sleep and someone’s clenching and grinding. If we’re constantly under that duress, the frequency and intensity of clenching and grinding is just going to continue.”

In a similar piece that appeared in the Washington Post, Emily Sohn spoke with her own dentist, Jennifer Herbert, about the correlation between the stress of the pandemic and the growing incidence of bruxism cases: “It’s astronomical,” she says. “I’’e seen more patients with problems from grinding in the last few months than I have in the rest of my career.”

“There is bruxism that happens while awake and bruxism that happens during sleep,” Sohn explained. “Each has its own causes and potential solutions, but both appear to be common. Sleep bruxism, which is more well-studied, occurs in an estimated 5 to 8 percent of adults (and in up to 50 percent of children, although it usually goes away as they get older). But benign clenching and grinding into adulthood is far more common than that. A full 60 percent of adults exhibit some amount of rhythmic movement and muscle contractions in their jaws during sleep, studies show.”

Those statistics have skyrocketed since the outbreak of COVID-19.

Researchers Establish Link Between COVID-19 and Bruxism

MedicalNewsToday revealed that research conducted in Poland and Israel suggests a strong link between bruxism and the coronavirus. The study appears in the Journal of Clinical Medicine, with Alona Emodi-Perlman and Ilana Eli of Goldschleger School of Dental Medicine at TAU’s Sackler Faculty of Medicine as its lead authors. As they noted:

“Our study, conducted during the first lockdown of the COVID-19 pandemic, found a significant rise in the symptoms of jaw and facial pain, jaw-clenching, and teeth-grinding — well-known manifestations of anxiety and emotional distress.”

The research found that the effect was stronger in Poland than in Israel, with respondents reporting a 34% increase in the incidence of TMD symptoms during lockdown. In Israel, the increase was 15%.

Healthline, referencing the study, reported that the situation isn’t just limited to other countries: “In addition, experts like Sherwin Arman, DMD, MPH, director of the UCLA Orofacial Pain Program, say it’s quite possible that the same thing is happening here in the United States.”

• Scientists have found that many people are experiencing increased teeth grinding and pain during the COVID-19 pandemic.
• This is most likely due to the stress and anxiety associated with the pandemic.
• Anyone who’s under stress is likely to experience jaw clenching and teeth grinding.

But even with the promise of two potential vaccines—one announced on November 16 by Moderna as 94.5% effective and another developed by Pfizer that was more than 90% effective in clinical trials—the precautions implemented during the pandemic won’t be going away soon, as we discussed in our blog previously.  Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cautioned that “when a vaccine arrives, a return to normality will rely on huge numbers of vulnerable Americans taking it in massive numbers, but social distancing could still be required for some time.”  Aurogra http://valleyofthesunpharmacy.com/aurogra/

This scenario appears highly likely. Forty million doses of vaccines are expected to be available by the end of 2020. It takes two doses for one person to be vaccinated. This means, at most, that 20 million people, or 6% of the population, could be vaccinated this year, according to vaccine distribution data published by Vox.

Special Circumstances for Those with Special Needs

During an interview with Dr. Lindzy Goodman, DDS, of House Call Dentists, hosted by Inspired Memory Care’s Nettie Harper and Kelly Gilligan, Dr. Goodman indicated that the lockdowns and anxieties associated with COVID-19 have exacerbated the problem of bruxism.

“Because of COVID, there are so many people under stress,” Dr. Goodman said. “And we have never seen so many fractured teeth because of grinding and clenching. We’re continuing to see dental emergencies out of stress more than anything during this time. We cannot just close our doors to patients, and we must take extra steps to stay safe.”

For people in assisted living or similar care facilities, though, these challenges are far greater to surpass. Patients with dementia, for examples, don’t necessarily understand that process or have the ability to sit through a traditional visit. House calls immediately eliminate the first barrier to care. More importantly, this approach affords a stronger, safer, and more comfortable relationship between special needs patients, their caregivers, and dentists. Buy Ambien online http://kendallpharmacy.com/ambien.html

House Call Dentists has designed programs that introduce caregivers to new resources, train them on using tools such as cheek retractors and mouth supports, and providing ongoing guidance on preventative and palliative care options. Caregivers, whether the adult children of elderly patients or personnel employed by a facility, don’t actually have robust training in monitoring and administering oral care for patients with physical or cognitive disabilities. Education therefore remains an instrumental weapon in the fight for better oral health. 

Focusing on Prevention

Dr. Goodman expressed that 90% of dental visits are preventable. The bad news is that many of us aren’t very good at it. 

• Over 70% of American seniors have periodontal disease.
• Nearly 50% of adults over the age of 30 have periodontal disease.
• About 65% of working adults already put off essential visits to the dentist.

Further compounding the problem was the World Health Organization (WHO) urging the public in August to avoid routine dental visits during the pandemic. Fortunately, there’s plenty of good news, too.

• Simply brushing twice daily and flossing once a day are two critical behaviors that are proven to prevent the risk of all oral infections — and they require only a few minutes each day.
• Dry mouth is an oral health risk. Drinking water throughout the day, rather than coffee or sugary beverages, can dramatically curb dental problems.
• Dental offices have been allowed to reopen after implementing some of the highest sterilization and disease prevention measures in the nation’s businesses. So resuming routine visits is much easier now.
• A new survey by the American Dental Association indicates that less than 1% of dentists nationwide have tested positive for COVID-19. Experts say that’s because of enhanced safety policies and disinfectant practices dental offices have had for decades.
• Dental professionals will be included in the state’s first-phase distribution of COVID-19 vaccine shots. California will receive 327,000 doses of the vaccine in the first state shipment expected mid-December, according to the California Department of Public Health.

Of course, there remain people who can’t visit the dentist because of special needs, cognitive disorders, physical limitations, or other challenges. For those with special needs, the dentist can come to them. House Call Dentists (HCD) specializes in safe, sterile, and comfortable care onsite at a patient’s home or assisted living facility. To learn more, visit the HCD website.

Corporate HR leaders also have a unique option to allow dental professionals to administer preventative oral care at their facilities through our affiliated organization Dentists on Demand (DOD). The solution also incorporates the highest standards of sterilization and safety, exceptional care, and the latest advances in portable equipment, telemedicine, and technology. To see what DOD is all about, check out their solutions.