Wanted: Dental Mentors

If you are planning a dental career, you need a good mentor to guide your path. A mentor offers you helpful information to shape your career successfully. Mentors share their knowledge, wisdom and experience; helping you to assess your strengths and weaknesses in dental profession and sometimes personally.

According to 2014 Gallup polls, a good mentor can make a significant impact on a students’ career and overall well being. The results were based on feedback from close to one million Americans of varying ages and with different educational backgrounds.

Finding a mentor can be challenging but the payoff can be great. A mentor can help you with practice management, interpersonal skills and real world experience that would not be normally taught in a dental school. He or she can help motivate and inspire you to keep going when times are tough and can help you see the ‘big picture’. A mentor can help and guide you discover the best easiest way of doing professional things and will help you to avoid learning lessons the hard way.

Qualities of a Mentor

  • Dental mentors should have good names and reputations among the dental community. A great mentor will be at the top of the respect chain, a young dentist should look for this in whomever he or she chooses to look to for advice.
  • A mentor should have professional and personal stability. Dentistry involves hard work, and we should not stop learning. Maintaining professional and personal stability are crucial for overall health. Stability keeps the practice on an even wheel, minimising the lows and making it easier to achieve sustainable growth.
  • A mentor will be able to teach you many techniques which help you increase patient flow and enhance your professional skills. There are many available practice-management groups/study clubs that can assist you in establishing a practice.
  • Young dentists should look for accessibility and would face a myriad of new problems and issues. They are usually not secure in their clinical abilities or skills, and mentors can help them overcome their insecurities and avoid the various pitfalls they encountered in their early days of practice.

Dentists who become involved in various community outreach programs, civic programs and local dental societies help establish their names in the public and show they are involved members of their hometowns. Patients usually prefer this kind of personal relationship and association with their dentist — having your name out there maintains a lasting bond which, in turn, strengthens the patient–dentist relationship.

Young dental entrepreneurs may have to contact their mentors at any time, so connecting without fear of the mentor looking down on them or speaking to them in a condescending manner is important. For some clinicians, it means face-to-face meetings on a regular basis. For others, communication via texts email and few face-to-face interactions may be more realistic.

If you’re seeking a mentor, there are a variety of resources to consider. You can start by talking to a dentist in your community or contact your state dental association/organizations. By associating with a professional organisation, it is more likely that you will be introduced to professional experts who may be made available to mentor you or who may know someone who could serve as your perfect mentor.

Role of a mentor in shaping your career

While many of us have been inspired by any individual/team of mentors, the inspiration or guidance can help a young budding clinician in several ways:

  • Development of an effective career plan
  • Guidance in selecting the best subject/specialty for higher studies keeping your clinical skills, ability in mind
  • Learning management skills to run your new clinical practice
  • A successful mentor can be presumed to have good business and communication skills too
  • For post graduates, your department guide is the key person in guiding you with publications/thesis/articles.

How to choose the best mentor for yourself?

Look for the best CDE Programmes/Comprehensive Courses/Fellowships/International Certification Courses.

Always remember, a great clinician does not necessarily make the best of a mentor; neither a top mentor essentially needs to be super successful clinician in private practice.

The term ‘Mentor’ refers to someone who can train, guide you with clinical & business skills, thereby bringing the best out of you.

Now with the boom of short courses, workshops & many unauthorized Hands-On training sessions it may be difficult to score out a genuinely expert & experienced mentor. So try checking credentials of the Mentors/Professors, before joining any course/Postgraduate specialty.

Mentor – Student Relationship

Mentoring is relationship-oriented; it seeks to provide a safe environment where the mentee shares whatever issues affect their professional and personal success. To be helpful, mentoring requires time in which both partners can learn about one another and build a climate of trust. This in turn creates an environment in which the mentee can feel secure in sharing the real issues that impact their success.

Mentoring is never one-sided. It should be based on mutual understanding where responsibilities and arrangements are clearly understood and documented.

Two sides of the story

The role of mentor can be immensely satisfying and watching someone grow and reflect on their own learning and development can be an enhancing experience.

The benefits of mentoring include gaining insight into the mentee’s background and history, as well as enjoying the satisfaction of sharing expertise and experience.

For the mentee, there are many rewards. Learning from the mentor’s expertise, receiving constructive criticism in key areas like communication and interpersonal relationships, as well as acquiring specific skills and knowledge that are relevant to personal goals in order to develop that all-important insight. It can also be a great bonus to have a trusted person with whom to share frustrations as well as successes.

Conclusion

Mentoring should be based on mutual understanding where responsibilities and arrangements are clearly understood and documented. Proper remuneration should be agreed in advance and outcomes monitored through recognised assessment methods, any expectations should be reasonable and achievable.

There is obviously a duty of care involved in the relationship and while each individual practitioner has responsibility for patients in whose treatment they are involved, mentors should be aware that there could be assumed an ethical dimension even when they are not treating the patient personally, and that as a result there could possibly be implications if there are adverse outcomes.

References

Louise Nash

Article on Dental Mentors, Archives Summer 2017

DDU Journal

Tyler Lee

Mentors Improve your chances of Success

Vol.99 | Issue 5

Dental Economics

Importance of Mentors in Dentistry

Dental Products Report

World No Tobacco Day 2019

World No Tobacco Day
World Health Organization (WHO) and global partners recognises 31 May as World No Tobacco Day every year.
The objective is to spread awareness of deadly and harmful effects of tobacco smoking and second-hand smoke exposure; along with this, to discourage tobacco consumption in any form.
WHO focuses on ‘Tobacco and Lung Health’ on this day and this campaign spreads awareness:
  • Tobacco’s negative impact on people’s lungs, from causing oral cancer to chronic respiratory diseases
  • Disseminate awareness for reducing tobacco consumption
  • Engage stakeholders across multiple sectors for an anti-tobacco campaign
Goals of World No Tobacco Day campaign
  • Highlight risks due to tobacco smoking and exposure to second hand smoke
  • Reduce the magnitude of death and illness of lung diseases caused by tobacco smoking globally
  • Create awareness of emerging evidence of the link between tobacco smoking and tuberculosis deaths
  • Illustrate feasible actions and measures to reduce the risks to lung health posed by tobacco through public and government information programs

Ageing & Its Effects on teeth

Ageing is a normal, genetically dictated physiological process. Sixty-five years was selected as the dividing line between middle-aged and elderly individuals by Germany in 1880s & United States in 1900s; people above 65 are termed as geriatric. Any citizen above 60 is considered as a ‘Senior Citizen’ or ‘Elderly’ in India.

There is a gradual 2.3% increase in the population of those 65 years or older. Currently, there are about 600 million people aged 60 years or older; this figure is expected to double by 2025. India has a vast population of more than 1.2 billion and around 100 million elderly in 2012, and the number is expected to increase by 323 million by 2050. It is constituting 20% of the total population of our country.

As dentists, we mainly provide dental treatment in the form of preventive and restorative measures to the elderly. The preventive measures include enforcing oral health-maintaining behaviour such as toothbrushing twice daily, use of fluoride toothpaste, daily interdental cleaning and avoidance of sugar.

It is highly recommended that geriatric patients make dental visits at least every six months for clinical re-evaluation irrespective of their dentate status. The restorative measures include restoring jaw structures, gingival margins, discoloured teeth, missing teeth, etc. So, while we are at it, let us see the age-related oral changes the elderly group of patients undergo.

Age-related Oral Changes

Teeth

Tooth gets affected due to wear and attrition; colour gets altered due to changes in dentin thickness, loss of translucency and pigmentation of anatomical defects. The changes in enamel include attrition, erosion, abrasion, fluoride content increases, enamel cracks and enamel lamellae increase. The changes in the dentin are due to the pathologic effect of dental caries, abrasion, attrition or other operative procedures leading to the formation of reparative dentin, dead tracts and sclerotic dentin.

In the case of pulp, there is a reduction in the size of the pulp chamber and the number of cells. There is an increase in collagen fibres, narrowing of blood vessels, degeneration and loss of nerve fibres and pulp calcifications. An increase in cementum thickness at the root is seen by 5 to 10 times with increased incidences of hypercementosis.

Periodontal Ligament

An increase in the number of fibroblasts with more significant collagen and elastic fiber content, by contrast, a decrease in organic matrix production. The width of the periodontal space increases with occlusal loading.

Alveolar Bone

As we age there is thinning of cortical bone, increase in porosity, loss of trabeculae, cellular atrophy and sclerosis. In the case of the maxilla, maxillary teeth are directed downward and outward due to which bone reduction is upward and inward. The resorption on the outer cortex is more significant and more rapid because the outer cortical plate is thinner than the inner cortical plate.

Thus, the maxilla becomes smaller in all dimensions and the denture bearing area decreases. Whereas the mandibular ridge resorbs primarily on the crest of the ridge leading to a reduction in the residual ridge height. As a result, the mental foramen lies at or near the level of the upper border of the ridge. The genial tubercles appear projected above the upper border of the mandible in the symphyseal region. The cortical bone at the angle of mandible becomes thinner.

Oral Mucosa

Oral mucosa in the elderly turns thin, smooth, dry-satin like with the loss of elasticity and stippling making it more susceptible to injury and decreased repair potential. The gingiva loses stippling and becomes edematous in appearance. Due to the thin keratinized layer, gingival tissue is easily injured. Gingival recession and loss of periodontal attachment are common findings.

Salivary Changes and Challenges

Salivary flow reduces due to salivary gland atrophy. There is a decrease in ptyalin and increase in mucin. The viscous and ropy saliva results in plaque formation and growth of cariogenic bacteria. Xerostomia is a common finding either due to systemic disease, medications or therapeutic head and neck radiation.

Tongue and Taste Changes

The tongue has a smooth, glossy or red and inflamed appearance with disturbed taste sensation. Soreness and burning sensation are commonly encountered in post-menopausal women. Another common finding is the presence of varicose veins on the ventral surface of the tongue.

Mastication and Deglutition

In partially or fully edentulous patients, the masticatory ability further decreases. Biting force is said to be decreased by 16% of its original value in older patients. Ultrasound imaging studies have assessed that the oral and pharyngeal phases of swallowing are longer in the elderly than younger adults.

Common Oral Disorders in Older Adults

  • Oral Mucosa Cancers, Vesiculobullous, Ulcerative, Inflammatory diseases
  • Dentition Root caries, attrition, fracture/chipping
  • Periodontium Gingivitis, Periodontitis, abscesses, tooth loss.
  • Salivary Glands Hypofunction, Cancers
  • Sensory Function Olfactory dysfunction, Dysgeusia
  • Motor Dysfunction Dysphagia, aspiration, masticatory muscle weakness
  • Pain Sensation Atypical facial pain, Burning mouth syndrome, Trigeminal neuralgia, TMDs
  • Prosthesis Atrophic mandible, ill-fitting dentures, inflammatory lesions secondary to ill-fitting dentures, poor denture hygiene

Special Considerations

Geriatric patients should be explained about the treatment plan in simple language. Begin with the most critical information to be conveyed first and try to limit new information as much as possible. Write instructions in a language understood by them or their caretaker and provide useful educational material. Use teach-back method to confirm patient understands.

Teach–Back Method: Confirmation of Understanding

Do not ask a patient “Do you understand.”

Ask the patient to explain or demonstrate

Avoid closed-ended yes/no questions, instead, ask questions that begin with “How” and “What.”

Information should be organised such that the most important points stand out and repeat this information.

Conclusion

Older adults are the most rapidly growing segment of the world population. Hence, dentists must possess the knowledge to manage older adults, age-related oral changes and the common oral disorders affecting the elderly to enhance their quality of dental treatment.

References

  • Dhankar K, Ingle N A. Geriatric Dentistry: A Review. J Oral Health Comm Dent 2013; 7(3)170-173
  • Issrani R, Ammanagi R, Keluskar V. Geriatric Dentistry – Meet the need. Gerodontology 2012; 29: e1–e5
  • Greenberg MS, Glick M, Ship JA. Burket’s Oral Medicine. 10thed. New Delhi: CBS
  • Greenberg MS, Glick M, Ship J A. Burket’s Oral Medicine. 12thed. New Delhi: CBS

Ozone in Dentistry – A Paradigm Shift

Abstract

Today we are suffering from one problem or another repeatedly. Given this situation, how would it sound if someone says that one can cure any health hazard by using some home ingredients after following some small procedures? Wouldn’t it be great? This article will elaborate on how to prepare a one stop solution for your problems – ozonated olive oil – at home, its benefits and also its application in dentistry.

Introduction

Ozone is basically a protective shield of earth which protects us from harmful UV radiations. It also helps to control air pollution. Symbol of Ozone is O3 .It contains three atoms of oxygen molecules. We all have felt many a times, a particular fresh smell after every rainfall – that is because of Ozone only. The first Ozone generator was developed by Werner Von Siemens in Germany in 1857 and in 1870 there is the first report therapeutically of Ozone being used to purify blood by C Lender in Germany. In 1881, certain evidences were found for use of Ozone as a disinfectant which was mentioned by in a book on Diphtheria. The world’s first water treatment plant using Ozone was installed in Ousbaden Holland in 1893. Ozone was used medically to treat wounds and other infections during World War 1. The name ozone was given to a gas (a Greek word that means “smell”) by the German chemist Christian Frederick Schonbein of the University of Basel in Switzerland 1840 (Seidler et al.; Veranes et al., 1999).2

Medical grade Ozone is a mixture of pure of three atoms of oxygen versus two atoms in a normal oxygen molecule.1 Due to presence of this extra oxygen atom, Ozone has anti-microbial properties, it act as a stimulator for immune system, act as a analgesic, has anti- hypnotic properties, antibacterial and anti-fungal properties.

Due to its properties, it is used for sterilisation and disinfection. It is nowadays used in every field including medical, veterinary and dental field also. Ozone has these amazing properties due to which dentists are ready to transform and become the part of revolutionary ozone therapy by using Ozone in very controlled application.

Generation of Ozone

There are three different systems of generating Ozone gas.

  1. The Ultra violet system which produces low concentrations of Ozone used in aesthetics and air purification.
  2. Cold plasma system used to purify air and water.
  3. Corona discharge system produces high concentration of Ozone. 1

The bacteria and viruses lack protective layers. So Ozone can easily penetrate and play a role of antibacterial property here. Whereas, healthy normal cell contain their protective layers, so Ozone causes no harm to it. The ozone oxidant potential induces the cellular walls destruction and cytoplasmic membranes of bacteria (Thanomsub et al., 2002). 2

How to make ozonated Olive Oil at home?

Yes, it’s possible to prepare Ozonated olive oil at home. For this, high quality extra-virgin oil is required. This extra-virgin olive oil is putting through the process of ozonation. Because Ozone is hard to stabilize, passing it through a tight container with lead helps, after which Ozone gas begins to stabilize in olive oil. An Ozone generator is required ideally to create Ozonated olive oil because Ultraviolet machines are not quite strong and effective to prepare Ozonated olive oil. Place olive oil in the glass jar or in a container that comes along with generator. The jar should be connected to the generator and should be covered before the generator is turned on. Initially tiny bubbles will appear on the top of jar which signifies the process of Ozonation has begun. This process is time consuming and when the color of the olive oil becomes clear and thick, it indicates the complete formation of Ozonated olive oil. This Ozonated olive can be stored easily.

Among the various systems of ozone production, coronal discharge system is used for the production of ozone gas in ozone generator. It releases high concentration of oxygen which is required for antimicrobial and healing properties in medical and dental field. The other system of ozone production is cold plasma system, ultraviolet system, electrolyte system which is low concentration ozone generation (below 2 ppm) used for air purification and water purification and not same as coronal discharge. So, Coronal discharge system is comparatively much batter then others.

Properties of Ozone

  • Immunostimulator
  • Antimicrobial
  • Disinfectant and used in sterilisation
  • Analgesic
  • Anti-inflammatory and natural antibiotic
  • Ozonated olive oil can be use for cosmetic purpose and has a fast healing effect.

Various forms used in Dentistry

  1. Gaseous Ozone: Gaseous form is used to sterilise instruments, disinfection of instruments and surfaces, sterilisation of lesions, cavities & in RCT, for air purification in clinic.
  2. Injectable ozone: This form is used for fast healing in surgeries cases, trauma, implant placements, fracture, large lesion, intralesional injections, submucosal injections.1
  3. Aqueous: This form is used to purify water, as a carrier medium for grafts, hair follicles.
  4. It replaces antibiotics and analgesics
  5. Ozonated activation of NaOCL, EDTA, grafts at site in oral cavity, activation of grafts during hair transplants.

Application of Ozone in Dentistry

  • Periodontics: It is used for complete oral prophylaxis which includes scaling and root planing. It can be recommended for patients to cure hypersensitivity and as a mouth rinse also. In periodontal diseases, the gingival, sulcus and pocket depth can be irrigated with ozonated water and ozonated gas . For some lesions, ozonated oil is recommended for topical application. Single visited inflamed lesion can be cured.
  • Aesthetic dentistry: It is used for topical application on scars of skin for effective healing. It is used as a hemostat, to control bleading during surgical procedure and to disinfect cavities and margins of the lesion.
  • Endodontics: Ozonated water can be used to irrigate the canals. To sterilise the canal ,ozonated olive oil works efficiently. Infected canals with complete remission of periapical lesion is also treated with ozonetherapy. With its direct application it prevent caries on tooth,which is applied with the help of silicon cups.1
  • Oral surgery: No worries after extraction, because of ozonetherapy! It accelerates the process of healing after surgical procedure without complications. In case of noninvasive surgical procedure, pre and postsurgical cycles of Ozone therapy can be conducted. These cycles consist of eight sessions lasting for about 3 minutes each. Besides this, its antibiotic and anti fungal therapies have been applied for the treatment of bisphosphonate induced osteonecrosis of jaw.1
  • Prosthodontics: In case of edentulous patients, to cure the ulcers because of impingement of denture, ozone gives magical effects if topically applied. Ozone is also used to disinfect the denture due to it properties. Also ozonated water is used to disinfect the crown and bridges. To prepare a vital tooth, as a desensitizer, ozone can be use.
  • Oral medicine: It provide relief from ulcerated oral mucosal lesions. Intralesional injection and topical application both gives positive results. It is used as a carrier medium to carry a graft for biopsy and further surgical procedures.
  • Orthodontics: During orthodontic treatment there are more chances of caries as there is more chance of food accumulation. To prevent caries, patients are given mouth rinses with ozonated water.
  • Implants: It is used to disinfect the surgical area and surgical instruments as well. After the surgical procedure, a controlled amount of ozonated oil is used and applied on the surgical area. It promoted the healing without complications. In case of peri-implantitis, ozone therapy is indicated as it have antimicrobial, antibacterial properties. A study of gaseous Ozone showed the selective efficacy to reduce adherent bacteria on Titanium and Zirconia implants without any interferences in their adhesion properties. It also induced proliferation of osteoblastic cells. Ozone eliminates Porphyromonas gingivalis from all surfaces with in 24 sec to below the detection limit (99.94%), while Streptococcus sanguis showed the highest reduction on zirconia substrates (90%) and was more resistant. 3

Conclusion

Ozonated oil has some amazing properties and gives excellent results. It is used in every field related to human care and medical science due to its unique properties. All its properties are due to the presence of enriched oxygen. Ozonated olive oil even can be prepared at home. By using ozone therapy in dentistry, treatment time is reduced and side by side it reduces the complications along with fast healing effect on the operating site. This new era of ozone world may change the way we treat patients in the future.

References

  1. Komali G. Ozone Therapy-A Revolutionary Noninvasive Therapy in Dentistry. Open access Sci Rep.2012:1(10):1-3.
  2. German I, Rodrigue A, Andreo J, Pomin K et al. Ozone therapy in dentistry: A systematic review. Int. J. Odontostomat.,2013:7(2):267-278.
  3. Hauser-Gerspach I, Vadaszan J, Deronjic I, Gass C, Meyer J, et al. Influence of gaseous ozone in peri-implantitis: bactericidal efficacy and cellular response. An in vitro study using titanium and zirconia. clin Oral Investig 2012:16: 104-59.

 

Save Live: Clean Your Hands – World Hand Hygiene Day 2019

Hand Hygiene Day is celebrated on 5th May every year. World Health Organization (WHO) conducts various activities to spread the importance of clean hands. The basic aim of this day is infection prevention and control. Meanwhile, Clean Your Hands is the main tagline for this campaign. WHO has taken the initiative to ask healthcare providers especially and general public to keep their hands clean.

WHO aims to achieve better health and well-being of all aged people through effective and affordable medicines and vaccines.

Infection Control and Prevention, including hand hygiene, is critical to achieve universal health coverage goals as it is a most practical and evidence-based approach with demonstrated impact on quality of care and patient safety across all levels of the health system.

Many diseases are transmitted from individual to individual by contaminated hands while consuming food. Maintaining hand hygiene is crucial for infection prevention and control program.

Various posters are available on the WHO site; one can download them and help WHO achieve these goals by spreading the message in the public interest. WHO is conducting surveys on infection prevention and control program. Detailed information is available on their website only.

https://www.who.int/infection-prevention/campaigns/clean-hands/5may2019/en/

Probiotics in Children – A Pediatric Dentist’s Overview

Probiotics including living microbes beneficially affect the health of the host. It is abundantly available in yogurt and other dairy products. According to the International Scientific Association, Probiotics and Prebiotics are defined as “Live microorganisms, which when administered in adequate amounts, confer a beneficial effect on the health of the host.”

Prebiotics are non-digestible food ingredients such as fructooligosaccharides (FOS), Lactulose and inulin that beneficially affect the host by selectively stimulating growth and increase the activity of a limited number of probiotic like bacteria in a colon.

Probiotics can be varied; they can be yeast, bacteria or moulds. Most commonly, bacterial species are predominant. Some of these species are:

  • Lactic Acid Producing Bacteria (LAB): Lactobacillus, Bifidobacterium, Streptococcus
  • Non-lactic acid-producing bacterial species: Bacillus, Propionibacterium
  • Non-pathogenic yeasts: Saccharomyces
  • Non-spore forming and non flagellated rod or coccobacilli
Advantages of Lactobacillus
  • It produces enzymes responsible for the metabolism and digestion of carbohydrates and proteins
  • Helps in synthesis of vitamin B and vitamin K
  • Helps in breakdown of bile salts
  • Enhances innate and acquired immunity
  • Inhibit pro-inflammatory mediators.
Advantages of Bifidobacterium
  • Metabolises lactose and generates lactic acid
  • Synthesizes vitamins
  • Ferments indigestible carbohydrates
  • Produces beneficial short-chain fatty acids
Properties of Probiotics
  • Non-pathogenic and non-toxic
  • Produces a beneficial effect
  • Tolerates the gastrointestinal environment
  • Has a good shelf life
  • Replaces and restates intestinal microflora
Role of Probiotics in dental caries

Probiotic and modulation in bacterial molecular genetics have been used to replace cariogenic organisms such as mutans streptococci and Lactobacillus species with strains of bacteria that are not cariogenic. One such example is S. mutans with a glucosyltransferase C (gtf C) gene mutation.

The acidogenic potential theory and formation of water-insoluble extracellular polysaccharides (glucans) from sucrose lead to the adhesion of colonisation of bacteria causing dental caries. These glucans are synthetise by glucosyltransferase B, glucosyltransferase C, and glycosyltransferase D genes.

The mutated gtfC gene lowers the ability of S. mutans to produce extracellular glucan, and the decrease is from 51% – 33% of the biofilm volume in extracellular matrix component of mixed oral biofilms.

Hillman et al. obtained S. mutans strain that produces a bacteriocin active in other S. mutans strains into the oral cavity that replaces the naturally-occurring cariogenic strains.

Role of Probiotics in periodontitis

In halitosis, the use of gum or lozenges containing S. salivarius K12 is known to reduce the levels of volatile sulphur compounds.

In chronic periodontitis, Lactobacillus brevis and L. reuteri ATCC55730 and ATCCPTA5289 strain available in probiotic chewing form play an important role in reducing inflammation.

They decrease the levels of pro-inflammatory cytokines,

collagenase activity and other inflammatory markers in saliva and gingival crevicular fluids.

Role of Probiotics in Orthodontic Treatment

Orthodontic brackets and wire create an environment of cariogenic bacteria to grow, also it causes white spot lesion after removal of brackets. Fruit yogurt with Bifidobacterium animalis subsp. Lactis DN -173010 is helpful in the reduction of salivary mutans streptococci in orthodontic patients with fixed appliances.

Role of Probiotics in Oral Cancer

Probiotics are known to interfere at various stages of the cancer process,  by interfering with chromosomal and DNA damage. However, further study is required to develop specific regulations on their consumption.

Role of Probiotics in Oral Candidiasis

Candida is a common commensal of the oral cavity, constitute about 50% of the entire oral microflora. Cheese containing probiotic L. rhammnosus GG has proved a reduction in oral candida.

Indications of Probiotics
  • Rotavirus diarrhea
  • Can be used if the child is resistant to specific antibiotics
  • Food allergies and lactose intolerance
  • H. pylori infection
  • Inflammatory or Irritable Bowel Syndrome
Conclusion

Probiotic is the natural way to maintain overall health and also protect the oral cavity from various dental diseases. Dairy products and yogurt containing probiotic strains of bacteria are useful in the prevention of caries in early childhood. During childhood, the gastrointestinal flora is not established and administration of probiotics at that time gives positive life-long health. Therefore, a pediatric dentist plays a vital role in maintaining and instilling positive life-long health through probiotics.

References
    • Kraft-Bodi E, Jorgensen MR, Effect of Probiotic bacteria on oral candida in Frail Elderly, JDR Clin Research Supp 94(9)2
    • Haukioja A (2010) Probiotica and Oral Health. European Journal of Dentistry 4: 348-355.
    • Suvarna VC, Boby VG (2005) Probiotics in human health. A current Assessment. Current Science 88: 1744-1748.
    • Twetman S, Blicks CS, Probiotics and oral health effects in children, Journal of Clinical Pediatric Dentistry 2008; 18:3-10
    • Narwal A, Probiotics in Dentistry – A Review Journal of Nutrition & Food Sciences. 2011 1:5

Hepatitis B and associated factors among dentists

Hepatitis B and associated factors among dentistsHepatitis B and associated factors among dentists

Hepatitis B is a DNA virus with double-stranded, which is a species of genus orthohepadnavirus and a member of family viruses known as Hepadnavirus. The world health organisation has estimated that nearly 325 million people are suffering and living with chronic hepatitis B or C virus infection (HBV, HCV). Those patients are facing high challenges as they don’t have an easy access to testing and an appropriate treatment. Nearly 1.34 million deaths are caused due to viral hepatitis and it is the comparatively same number as TB but greater than immunodeficiency virus. Though result has been found that hepatitis death is rising and nearly 96% hepatitis mortality is caused by HBV and HCV. Nearly 257 million people affected by HBV and it is also observed that it is spread from mother to child at birth. WHO reported that nearly 84 per cent of children received an HBV vaccine and about 3 recommended doses to reduce new infection. In healthcare professionals, HCV is typically spread through a route of unsafe injections and also via injecting drug use. HCV can be cured by direct-acting antiviral drugs with a short relative time since there is no vaccine.

Implications for dentist and clinical staffs

During training, most dentists and clinical staffs are considered to be vaccinated and tested through response by conforming to primary course. A routine booster benefit for vaccination to known responders are small and it can be deferred until the year-end, whereas in case of trainees it is yet not received. During ongoing period of temporary recommendation, a group of staffs is considered to be poorly less for vaccination.

Responsibilities of health care practitioner

The responsibility of health care practitioner includes reporting their infection status. Procedures and control policies are based upon disciplinary action in order to follow infection prevention failure. Healthcare workers with infection seek medical care from some qualified doctors in order to manage the condition.

They must be aware of the requirement for immunisation against infectious disease and also maintain records of personal immunisation health care worker in case of specific circumstances may be susceptible particularly to certain infections and also must work with occupational health must ensure their safety.

Symptoms of HBV

Hepatitis B virus infection is ranging from mild to severe. They usually appear after been infected for about one to four months. A post infection is witnessed in the early two weeks and young children may not have any symptoms. In certain cases, symptoms such as abdominal pain, joint pain, fever, weakness and fatigue with nausea and vomiting is witnessed. The individuals exposed to hepatitis B immediately consult a doctor which is important and also helps in undergoing for better health. A preventive treatment helps to reduce the risk of infection and receive treatment within 24 hours of exposure to a virus.

Prevention method of HBV

In order to prevent hepatitis b virus, a vaccine is given in a series of 3 to 4 doses. One must ensure that children, babies, teenagers adults should get vaccinated for their better health.

Newborn babies must be vaccinated at the age of 6 months nearly 3 shots and the infant must undergo.

The person who is having hepatitis along with the healthcare workers living must undergo vaccination.

Mothers who gave birth to infants with acute hepatitis B or who had the infection in the past must get the hepatitis b vaccine within a span of 12 hours of birth.

Never share a toothbrush, razors, nail clippers with an infected person. Make sure that pregnant woman must get tested for this virus and also blood used for transfusion must be screened for hepatitis.

It is safe to wear latex or plastic gloves while cleaning contaminated instruments which is blood tinged.

Most of the infected adults are able to fight off this virus so that infection is cured. The liver has the potential to heal itself, but an inflammation caused by HBV results in permanent damage.

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DISCLAIMER : “Views expressed above are the author’s own.”

Anaesthesia and Sedation for Your Child: Questions to Ask Your Dentist

Anaesthesia and Sedation for Your Child: Questions to Ask Your DentistAnaesthesia and Sedation for Your Child: Questions to Ask Your Dentist

Anaesthesia and Sedation for Your Child: Questions to Ask Your Dentist

Children may require treatment due to infection and dental pain. Sometimes the child may need to undergo sedation or anaesthesia. The overall aim is to ensure they receive pain-free and safe treatment. The probability is that there are many aspects to consider. In some dental procedures for children, the child will be required to be in a totally reclined position. There may be some drilling noise which could create anxiety or fear for some children.

There are different types of sedation and anaesthesia used on children in paediatric dentistry:-

Mild sedation is used in adults and older children too. Oral surgeons and dentists can use this type of sedation safely to allow them to perform their work efficiently.

Moderate sedation is used so children experience sleepiness and breathing is normal. Most of the time children do not remember the dental procedures performed by the dentist or oral surgeon.

Deep Sedation includes IV (intravenous medication) which helps the child to sleep properly. The children may find it difficult to breathe, so they make noises sometimes in their semi-conscious state. It is always best to be monitored by an additional qualified professional about the child’s heart rate, blood pressure, oxygen saturation or breathing and rhythm of the heart.

General Anaesthesia is required in both normal and special need children. This anaesthesia is completely pain-free and it allows the child to sleep. The dentists or physicians or professional anaesthetist administer and monitor the child’s condition while the oral surgeon or dentists perform the procedure. Anaesthesia can be given in well-equipped dental clinic or hospital.

Nitrous Oxide is a mild and less invasive. It is well known as laughing gas or a giggle gas. The child feels more relaxed and usually does not sleep because of sedation.

The drugs used for sedation can be administered through various routes including nasal inhalation, oral, intravenous, intramuscular and subcutaneous are some of the popular ways used depending on the condition of the child, the procedure to be undertaken and required level of consciousness. Sedation of paediatric patients may have associated risk factors such as sleep apnea, airway obstruction, cardiopulmonary impairment, laryngospasm. Patients may face adverse effects after getting discharged from the hospital or dental clinic due to dental sedation. Probably, the adverse events are likely to occur within the first 8 hours but may prolong for 24 hours. Due to the anaesthetic effect, the risk of trauma may arise among the children while chewing and/or biting. It particularly occurs in young children due to their development. The toxicity of dose-related to the local anaesthetic agent is reactions of hypersensitivity independently.  All the local complications are the fracture of the needle, IV injection, damage to the nerve, block failure, palsy of facial nerve and infection. Respiratory arrest, seizures, unconsciousness are the effects of the central nervous system.

Question you may ask your dentist.

  • Who will provide the preoperative evaluation of the child including their past dental and medical history?
  • What experience does the anaesthetist require to give anaesthesia or sedation which is planned before the procedure?
  • Does the experience and training of dentists meet all the standards of the authority guidelines while using anaesthesia and sedation?
  • Do the staff have the training and experience in assisting with sedation for the emergency resuscitation procedures such as health care providers and basic life support for providers?

During and after the procedure.

  1. What is the level of general anaesthesia or sedation as compared to the local anaesthesia used for children in dental procedure?
  2. Are general anaesthesia, or minimal sedation or, deep sedation or moderate sedation used in order to sedate the child?
  3. How will the child be monitored after and during the procedure in the hospital or dental clinic?
  4. What are the appropriate equipment and medications available immediately in case of emergency?
  5. Whether or written emergency plan of response for medical emergencies management is held by the hospital authority?
  6. Will the provider give us the instruction note and the contact information for the emergency in case of complications or concerns by the sedation/anaesthesia after returning back home?

In consideration of the cognitive development of child’s proposed procedure of dental work manages the important aspect of pediatric dentistry and adequate assessment of preoperative procedures are required for the appropriate desired result. It must be advised to parents to keep the child’s mouth clean. There will be fewer chances of failure or option of repeated treatment procedure.

The number of child patients is increasing. They need rehabilitation of dental procedure under general anaesthesia. The dentists will select the appropriate technique based on the child’s characteristics. The knowledge of the paediatric dentist helps to serve quality dental care with safety and comfort for the patient.

References:

Joginder Pal AttriRadhe SharanVega MakkarKewal Krishan Gupta,1 RanjanaKhetarpal, and Amar ParkashKataria Conscious Sedation: Emerging Trends in Pediatric Dentistry, Anesth Essays Res. 2017 Apr-Jun; 11(2): 277–281.

Charles J. Coté, Stephen Wilson the Work Group on Sedation, Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update, American Academy of Pediatrics, American Academy of Pediatric Dentistry, Revised  110(4):836 , 89(6):1110

PriyanshiRitwik, BDS, MS,Linda T. Cao, DDS,† Ronald Curran, DDS, and Robert J. Musselman Post-sedation Events in Children Sedated for Dental Care AnesthProg. 2013 Summer; 60(2): 54–59.

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DISCLAIMER : “Views expressed above are the author’s own.”

Changing your mouth and teeth with age

Changing your mouth and teeth with ageChanging your mouth and teeth with age

Over time, there is loss of brightness and cracks in the enamel. Teeth also tend to turn yellow and wear away as a result of attrition, erosion or abrasion. With wear, the dentine of the tooth is more and more exposed and can cause hypersensitivity.

Gums and alveolar bone

With age, the gum loses its elasticity and becomes thinner. These changes make it more susceptible to bacterial infections and loosening (recession) thus helping to bare the roots of your teeth. This exposure of the roots can lead to dentin hypersensitivity.

The bone, for its part, may show signs of resorption thus giving less support and support to the tooth.

Mouth mucosa, cheeks and tongue

Becoming thinner and slimmer, they are more vulnerable to ulcers, trauma and different infections. The ability to heal is also slower.

Saliva

Saliva has antibacterial and antifungal properties. The older we get, the less saliva we produce. This decrease in salivary flow may result in difficulty swallowing, chewing and digestion, impairing your speech and causing dry mouth (xerostomia). This lack of saliva can also be accentuated by various medications or treatments (radiotherapy), mouth breathing and certain diseases. In addition, xerostomia increases the carious risk.

Well sealant and cracks

If you look closely in your child’s mouth, it is possible to notice cracks on the top of the permanent molars and premolars. The presence of these furrows causes food debris and bacteria to accumulate more easily and promote the formation of tooth decay.

Preventative application of sealant inside pits and crevices helps protect the tooth against attack by decay-causing bacteria. For good dental hygiene, we recommend that you combine this process with the daily use of dental floss, as well as regular brushing.

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DISCLAIMER : “Views expressed above are the author’s own.”

Hygiene advice and tips for children

Dental hygiene for childrenDental hygiene for children

Children’s food contain a lot of sugar, so it is suggested to rinse the mouth and clean the teeth after consumption.

Change the toothbrush every three months or as soon as the bristles are frayed or bent by wear

Rinse the toothbrush after each use and let it air dry.

Since bacteria can lodge at the bottom of the toothbrush between the bristles, it is recommended to change it after a high fever or contagious disease.

The supervision of brushing your child’s teeth is desired until age 8, the age at which he will have better dexterity. Despite good supervision, it is essential that you complete the brushing. It is also very important to make sure your child does not swallow fluoride toothpaste to prevent dental fluorosis.

All fluoride products (toothpaste, mouthwash and gels) should not be within your child’s reach and stored in a safe place.

Quantity of toothpaste recommended:
  • 5 and more: size of a pea
  • teenagers and adults: 1 cm or less

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DISCLAIMER : “Views expressed above are the author’s own.”

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