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Children’s Dental Visits Amid the COVID-19 Pandemic

Researchers at the C S Mott Children’s Hospital at Michigan Medicine conducted a national poll in January in an effort to understand what is happening to children’s dental health -- particularly children’s preventive dental care - during the COVID-19 pandemic. asian boy with dentist - SM - paid - shutterstock 1730214226

 

Safety of Visiting a Dentist During the Pandemic

Those polled were parents of children ages 3 - 18 were asked how they felt about taking their children to a dentist. 

  1. ⅔ felt it was safe to get pediatric preventive care during the pandemic

  2. 19% were uncertain

  3. 14% believed it was unsafe.

 

What Happened When They Tried to Make an Appointment?

40% had not tried to get a preventive care appointment during the pandemic. Of these parents

40% were trying to protect their children from COVID-19 and 28%did not make an appointment because their children were not experiencing dental problems at the time.

 

The 60% of parents who tried to make an appointment for preventive care encountered challenges:

  • ⅓ said it was harder to get preventive care

  • 24% faced a delay when trying to make an appointment

Another 7% of parents said they were unable to get an appointment for their children when they tried. This was the case mostly for parents with Medicaid (15%). It was true for only 4% of those with private dental benefits and 5% of those with no insurance.

 

There Was Also Good News

More than 25% of the parents polled said their child had improved in at least one aspect of oral care since the beginning of the pandemic. These changes were mostly related to brushing, flossing, and avoiding sugary drinks: 

  • 16% were brushing more often

  • 11% were flossing more often

  • 9% were using fluoride rinse more often

  • 15% were drinking fewer sugary beverages.

All of these changes, of course, help to prevent tooth decay. 

 

Why Do Preventive Visits Matter So Much for Children?

There are many reasons that preventive dental visits are important for children. Among the most common reasons for dental care are these:

  • To prevent cavities and tooth decay.

  • To remove accumulated tartar and plaque.

  • To deal with small problems before they become bigger, more painful, or more costly to fix.

  • Good oral health supports good general health.

  • To teach a child that oral health is important.

  • Children who have checkups are more likely to have a more positive attitude about visiting the dentist. 

 

Sources: Dr Bicuspid (drbicuspid.com); C.S. Mott Children's Hospital National Poll on Children's Health at Michigan Medicine

 
 
Chronic Jaw Pain

Chronic Jaw Pain Infographic

 
A Few Words about Controlling Aerosols

Controlling aerosols in the dental office is one of the important steps we take every day with every patient to limit the possibility of COVID19 virus transmission. (You can find a summary of many of the steps we take to protect our patients and our staff here.) covid-fogging - pixabay cco free - 19-5010565 640

 

Much COVID19 research indicates that human saliva is one of the most common ways that COVID19 is transmitted from person to person. In many contexts, the saliva is dispersed when we speak, cough or sneeze. Tests have shown that these aerosols can carry Coronavirus germs for six feet or more. Hence, the social distancing recommendations from the CDC.

 

Some aerosols are created and released or dispersed during dental procedures. We want you to understand what we do to protect our patients and our team. Here are the primary steps:

  1. Patients use two rinses that kill COVID19 germs in the mouth.

  2. When polishing teeth, we use limited low-speed polishers. 

  3. We thoroughly clean each operatory after each patient.

  4. We fog the office 3 times daily to kill airborne particles.

  5. We use Isolite on all restorative procedures, trying to limit aerosols as much as possible.

  6. Clinicians’ gowns are changed between every patient so as to not spread any aerosols.

  7. We are wearing KN95 masks under a level 3 mask under a face shield.

  8. As many surfaces as possible are draped in disposable plastic to remove aerosols.

  9. The reception room has been rearranged and patient waiting time is limited to provide social distancing..

  10. Air flow in dental operatories has been redirected to cleanse the air in a HEPA-UVC air cleaner. 


But what is Isolite? Many of our regular patients already know about Isolite because we integrated this technology into our office almost 10 years ago.  Isolite is a device that isolates a work area, provides suction, retraction, and light in a single device. This makes it easier to work inside your mouth and it protects your mouth from injury and from swallowing or inhaling any fluids or debris created during the procedure. Isolite meets the CDC recommendation that High-Velocity Evacuation (HVE) be used to reduce aerosols and spatter created during a procedure. Isolite provides “continuous intra-oral HVE suction to reduce aerosols up to 90% before they escape the patient's mouth.”

 
Dental Drill Appreciation

Today is National Dental Drill Appreciation Day. 

Archaeological evidence indicates that in the area of the Indus Valley Civilization, a form of dentistry was practiced as long ago as7000 BC. Teeth were discovered with3.5 mm depth drilled holes. Leonardo da Vinci (in the 15th century) sketched a design for a turbine that was powered by compressed air. This was one of his many inventions that weredental drills - paid - shutterstock 189732512 never created. 

Later, mechanical hand drills were used, but they were slow. A patent was issued in 1864 to a British dentist for a “clockwork dental drill.” It was faster, but noisy. Four years later an American dentist designed a pneumatic dental drill that was powered by pedal-operated bellows. Three years later, a pedal-powered drill was built in 1871. In 1871, the first electric-powered drill revolutionized the practice of dentistry. 

The dental drill is used for a great range of purposes extending from the obvious use to remove decay and prepare a space for a filling or for a root canal. Other uses include extracting teeth in surgery, polishing fillings, cosmetic dentistry, and more. Today, dental drills are available that are powered by different means, that operate at various speeds and are made at several angles. Some now include lighting and water to remove debris and cool the drill. There are also many varieties of burrs for various tasks. In fact, I read an article just last weekend about using lower speed drills to minimize aerosolization during the COVID19 Pandemic. 

Let’s send up a cheer for the amazing and versatile dental drill!

 
 
Genetic Inheritance Matters in Oral Health

You might have heard someone say that their oral health problems are genetically inherited -- “it runs in the family.” You might not politely and move the conversation to another subject. Or you might challenge the statement and respond that the belief is not true. You have been told frequently that cavities and gum disease are determined by diet and dental hygiene habits. dna-pixabay cco free - 5297378 640

 

Which answer is right?

 

In a great many cases, there is not a single cause of chronic oral health problems. Both genetic inheritance and oral hygiene are factors in your oral health, as well as diet, other illnesses, and more.

 

How Does Genetic Inheritance Cause Oral Health Problems?

  1. A recent study at the University of Pittsburgh School of Dental Medicine discovered that a “polymorphic variation in a gene called beta-defensin1 (DEFB1)” increases your predisposition to develop caries (cavities) and periodontal (gum) disease. 

  2. Two types of proteins (amelogenins and nonamelogenins) determine the formation of dental hard tissues (like enamel). This determines key characteristics of the enamel -- size, shape, and shade) and your propensity to cavity (caries) development. 

  3. A compromised immune system -- whether genetic, medication or illness -- creates an environment that facilitates the effects of the oral bacterium Streptococcus mutans, a common cause of cavity development.

  4. People who are genetically intolerant of fructose have a deficiency in the enzyme fructose-1-phosphatase aldolase. This enzyme affects the metabolism of glucose and causes a drop in blood glucose levels after ingesting fructose. This affects the number of sugars in your mouth and their effects on your teeth. 

  5. Some people are genetically insensitive to bitter tastes. These people are unable to perceive bitter or sweet tastes. In order to taste sweetness, a high amount of sugar is needed. Sugar, of course, is a leading cause of cavities.

  6. Saliva is important in protecting your mouth from bacteria. It contains antimicrobial peptides (AMPS), which has antibiotic properties. Individual differences in salivary AMP concentration combined with a genetic predisposition to a reduced concentration defines the rate of cavity development.

Genetics and Periodontitis

Periodontitis is now understood to be an inflammatory disease that attacks the gums and bones around your teeth. Studies have found that people with aggressive periodontitis (AgP) are affected by a genetic factor that contributed to more than 50% of all cavities in these children and 25% in adults. 

 

To date, 38 genes have been demonstrated to be related to periodontitis. Research studies have found more genetic activity in causing aggressive periodontitis compared to chronic periodontitis. A DNA alteration has been isolated in people with chronic periodontitis.

 

Many factors, including genetic factors, contribute to dental health. This makes it more important to be diligent in our oral hygiene regimen. 

 
 
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