We’re living in a unique and, to be honest, confusing time. The “novel” in novel coronavirus literally means “new” – it’s something we’ve never encountered before. It took months, it seems, for virologists and other experts to figure out even the most basic things, such as how the virus is spread. 

At the same time, the “rules” have continued to change from week to week. Travel has always been discouraged for obvious reasons as we move from lockdown to partial opening and back to to lockdown.

What we do know now is that COVID-19 spreads from an infected person to others through respiratory droplets created when an infected person coughs, sneezes, sings, shouts, or talks. These droplets vary in size from large droplets that fall to the ground rapidly (within seconds or minutes) near the infected person, to smaller droplets (or “aerosols”), which can linger in the air under some circumstances.

Another thing we know is that dental health is a signifcant part of overall health. It’s commonly accepted wisdom today that periodontal or “gum” disease (one of the most common human diseases), if left untreated can increase the likelihood of a variety of serious cardiovascular conditions and other health complications.

Understandably, this leaves many people in a quandary. Visiting any space which other people may frequent is now a choice. At the same time, regular professional care is essential in terms of maintaining optimal oral health. Our job as health care providers is to ensure that we can provide an environment that is as safe as possible so that our patients can enjoy uninterrupted access to the professional care they need.

Every office will have their own protocol. As an example, the following are the precautions we’ve put in place: 

Apart from the standard protective measures one would expect, we have installed the most advanced air purification system available throughout our office. This technology creates an environment of surgically clean air – the same found in operating rooms and laboratories.

In addition to surgically clean air, these are the improvements and procedures that are in place at our own practice:

• Appointment times will be staggered and patient check-outs expedited to minimize the number of people in the office at any given time and maintain physical distancing.
• Plexiglass barriers have been installed in the waiting area to prevent any unnecessary contact with support team members.

It’s important to remember that we are all in this together. If you have any questions or concerns about your visits to a dental practice, contact your provider and make sure you get the information you need to help you make decisions for you and your family. 

I could see he was thinking about this. I thought I could bring the conversation around to his dental condition. “Bob, let’s compare you to your sets of golf clubs.” He was listening. “It’s as if, when you were a young man, God gave you a set of new golf clubs. As a dentist, I call them teeth. You used them through the years as you refined your golf game, but in time you broke the 9-iron. You went to the Pro Shop and tried to get a new one. It was a 9-iron, of course, but the grip, the shaft and the swing weight were not quite the same as your original set. It was okay; you knew how to adjust, if you remembered to accommodate for the differences. However, as time went on, you had the same experience with your 7-iron, the 4-iron, the pitching wedge and your favourite wood. In time you were adjusting your swing and stance every time you used a club. You noticed that there were times when certain muscles would get sore and that, too, would get in the way of your swing until finally you decided to get fitted with a whole new set of clubs.” I continued, “You went to a professional who put you through a whole series of tests and thorough evaluations to diagnose and plan the best solutions that fit your uniqueness. And you not only got one completely new set of golf clubs, you got two. “You see, there are so many dentists who believe that you, a very busy man – a Driver so they think – want them to get you into and out of the dental office with dispatch. They respond in a crisis mode to your event. In the best interest of my patients, I slow down the process, I am as thorough as you would be in your decision-making. In the short range and long range, it is be better for all concerned,” I concluded.

I believed he finally understood his present dental condition. As we said good night and shook hands, Bob said, “Would you be so kind as to give me your business card?”

All to often, dentists encourage you to adopt a crisis or reactive system for your dental care for lack of any other option they can offer. I would encourage everyone to think about the dentistry you have received and consider whether a proactive approach has a place in your dental care.

The link between oral health and overall health is indisputable and we’re learning more all the time about the important mouth-body connection.

Here are some of the research Hi-Lites:

INFLAMMATION is the main factor underlying the oral (mouth)-systemic link. Research has shown that periodontal disease is associated with several other diseases. For a long time it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions. 

Periodontal (gum) disease is a chronic inflammatory disease that destroys bone and gum that support the teeth. The American Academy of Periodontology estimates that 75% of Americans are affected by periodontal disease ranging from gingivitis to more severe periodontitis. Inflammation is the body’s immediate and first response to injury. The first phase includes redness, swelling and heat. Inflammation appears to be a common link between several common diseases. Inflammation serves to contain the injury to the local site and protect the body from further damage.

C-reactive protein (CRP) levels increase in the blood with inflammation. Elevated CRP is a risk factor for several chronic or long term inflammatory diseases.

Chronic inflammation, such as periodontitis, is damaging and can cause tissue loss. It can negatively affect all organs and tissues  in the body.

A significant body of research has linked periodontitis to several other systemic inflammatory disease such as diabetes, arthritis, hypertension, osteoporosis, respiratory diseases, cardiovascular disease, stroke and more. Periodontitis is the 6th complication of diabetes.

The American Heart Association has published Level A Evidence that a link exists between periodontitis and arterial disease.

What the research concludes? Periodontal (gums) care will improve your oral health status and reduce systemic inflammation, and though the research is not conclusive, periodontal care will likely be good for overall health as well.

If you wake up in the morning with a sore jaw and stiff jaw, you may be doing what 80 to 90 per cent of Canadians have dome at some point in their lives – grinding your teeth in your sleep.

Bruxism – the technical term – can go undetected for years because most grinders are completely unaware of their habit (it’s only audible in 20 per cent of cases) and because it damaging effects on the teeth, jaw and jaw muscles can happen so gradually. Women and men are equal opportunity grinders though women are notoriously more susceptible to experiencing TMD, temporamandibular disorder.

Each bruxing session lasts from a few seconds to a few minutes at a time and usually occurs at 90-minute intervals during the night. The effects are often felt in the morning, after a night of heavy grinding and clenching: a sore jaw and popping or clicking sounds in the jaw. After years of bruxing, the results are more visible: fillings start to break down and the front teeth may begin to look flat, chipped and translucent at the edges. By this point, as much as two millimetres of enamel has been worn away.

ONCE A BRUXER, ALWAYS A BRUXER?

Not necessarily. Some people may grind long into their lives, while others brux only at certin times in their lives – the night before an exam or an important meeting, for example. If you suspect you’re a grinder, call or email us for an appointment to determine whether it’s serious enough to need treatment.

Tooth enamel is the outermost covering of your teeth. It’s the hardest substance in the body, made primarily of the minerals calcium and phosphorus and protects the sensitive inner layers from hot, cold and acidic foods.

Tooth enamel cannot grow back once lost. Acids found in foods and drinks is the leading cause of loss of tooth enamel. The process is called Demineralization and it means a loss of the minerals that make up the enamel. Signs of “Acid Erosion”, as the process is called, are evident in 25 – 40% of adults.

Dentin deminarlizes at pH 6.5 and enamel demineralizes at pH 5.5. Enamel with fluoride, called fluorapatite, demineralizes at pH 4.5. ProNamel toothpaste is pH neutral. See chart for acidities of various foods.

However, tooth enamel can be Remineralized by saliva. Saliva can also neutralize acidity from either food and from the waste released from the bacteria, found on teeth, after eating sugary foods. Fluoride is a significant help in the Remineralization or “strengthening” of enamel against acid erosion.

Not all toothpastes were created equal.

Pronamel Is Specially Formulated For Tooth Sensitivity

Pronamel has 5% Potassium Nitrate which is the same desensitizing agent used in Sensodyne Ultrafresh.

A surprising a number of healthy foods and drinks like fruit and juices can have harmful levels of acidity. PRONAMEL toothpaste has been specially formulated to AFFECTIVELY limit the damaging affects from acid erosion from such foods. Coupled with very low abrasiveness and a desensitizing agent, PRONAMEL toothpaste stands out amongst the best.

In today’s appearance and youth-conscious society, the dull, stained effects of tooth discolouration represent a common dental complaint. Beyond the professionally managed teeth whitening options like Britesmile, Opalescence and Zoom whitening, people are employing new, everyday products in their ongoing struggle against yellow teeth and other forms of discolouration. From whitening strips and take-home trays to whitening toothpaste and chewing gum, people are going to various lengths to achieve and maintain a white, attractive smile.

TYPES OF DISCOLOURATION

Tooth discolouration falls into two main types: extrinsic and intrinsic.

Extrinsic or external discolouration occurs in the outer layer of the tooth, called the enamel; enamel stains can range from white streaks to yellow tints or brown spots and pits. Common culprits include Food / Drink such as tea, coffee or red wine, Tobacco use or Poor Dental Hygiene (plaque can yellow with time).

Intrinsic or internal discolouration occurs in the inner structure of the tooth, called the dentin, when the dentin darkens or displays a yellow (or gray) tint. Trauma to a tooth, medications such as tetracycline taken during pregnancy, genetics and excessive fluoride (fluorosis) intake can commonly discolour teeth.

ARE WHITENING TOOTHPASTES THE SOLUTION?

Whitening toothpastes are somewhat abrasive. This characteristic enables them to effectively remove surface stain. However, in doing so, enamel is removed also. As enamel is worn away, dentin and its yellowish hue is revealed. Over many years, the so-called “whitening” toothpaste becomes a “yellowing” toothpaste. Toothpastes such as ProNamel by Sensodyne (GlaxoSmithKline) are very kind to enamel and very unlikely to contribute to enamel abrasion.

What Works and What Doesn’t?

For internal discolouration including yellowing, orange and light brown, the best results are achieved by using a combination of in-office and at-home bleaching systems. Periodic re-treatments are also usually required.

A side effect of professional whitening can be tooth sensitivity that can linger up to 24 hours. Products are available to help reduce or eliminate sensitivity.

Whereas extrinsic staining can be effectively treated using various “whitening techniques” including professional polishing, intrinsic staining may be more stubborn, potentially requiring alternative cosmetic treatment such as porcelain veneers.

Prevention and Maintenance

Certain lifestyle choices can help prevent tooth discolouration, as well as keep your teeth white after whitening. For example, avoid stain-causing foods and beverages, as well as overexposure to fluoride. If you are a coffee drinker and/or smoker, quit or cut back. Rinse your mouth with water after having wine, coffee or other drinks/foods that can cause tooth stains. Intrinsic stains caused by damage to a nerve or blood vessel in a tooth may be prevented with root canal treatment to remove the inner part of the tooth, called the pulp, before it decays and darkens.