dental hygiene information

Parents flip the lip

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I drafted this post some time ago but held back. I didn’t want parents to think I am criticizing them. I understand how many times throughout a child’s life that parenting can be difficult. I don’t want to add to any external pressure, but reading an article yesterday that “the federal government is spending a million dollars to send five chartered plane loads of Nunavut children to the hospital in Churchill, Man., for dental surgery”  pushed me into sharing this. That coupled with the fact that after discussing this with a patient of mine she stated “I wish you would tell all parents this”. This is my attempt to reach more parents.

Dental decay is preventable

Granted there is an access to care issue for these Nunavut children in this media report, but that wouldn’t explain the situation in other areas of Canada. There is no shortage of tooth decay and dental treatment being carried out in Calgary by pediatric dentists.

Parents – please flip the top lip up and have a look at your baby’s teeth. Do this often, and realize that brown spots are not normal. Flip the lip when you brush. Their tight little lips prevent thorough plaque removal. Often it is far easier to brush the side of their teeth that the tongue touches when they open wide for this task, than to brush the surface covered by their lips.

Take your child to a dental health care provider by age 1 year (6 months after 1st tooth erupts). Yes, it is a short apt if nothing is wrong, but a very important appointment. Don’t wait until there is a problem, or until age 3 years old. Do they have the appropriate number of teeth for their age? Are they tongue tied? Is their lip tied? Are you struggling to clean their teeth? Are you confused about toothpaste that is age appropriate?  This is only a fraction of what could be reviewed and discussed at this first visit. Regulated dental healthcare workers are required to attend continuing education. That phrase “when we know better, we do better” applies. Therefore, what was reviewed at your older child’s exam 9 years ago maybe be quite different than what is reviewed today with a much younger child.

Wipe off baby teeth with a washcloth or baby toothbrush

Don’t lay a baby down with any liquid other than water

Don’t let a child sip for extended times from a sippy cup – think if it this way – every time they take a sip of apple juice (even diluted) a 20 minute acid attack takes place in their mouth (approximately). If they are sipping from their sippy cup intermittently for 1.5 hours (length of a kids movie) that is almost 2 hours of acid attack

Why fruit juice?….  Why not water?

When the time is right – Have Dental Sealants Placed

I am a parent and trust me there was a period of time that it took myself and my husband to hold our son down so that we could brush his teeth –  he was about 2.5 years old when he began to hate having his teeth brushed. I mean hate it. Of course, we hated doing it just as much.   Me: ” It’s your turn”;  my husband: “No, it’s your turn”  – and usually it would take 2 of us to do it. I would put my thumb in my son’s mouth toward the back baby molars- where when he bit down it wasn’t with any amount of force. Then while my thumb was there, we could get his teeth brushed. He couldn’t close completely so I could maneuver a toothbrush around. The thumb technique sometimes allowed me to do it without help from a second adult. This nightly battle went on for about 6 months- then he was over it. He began to want to “do it himself” of course, but the deal was – he had a turn then an adult had a turn. This event takes minutes, not hours – get it done – get it over with.

Children DO NOT have the dexterity to brush and floss well enough until age 10. If you don’t believe me, have them “do it themselves”, then put disclosing liquid on their teeth. The liquid that turns plaque bacteria purple or red. You will then understand how a child who “brushes everyday” still gets cavities. They aren’t brushing well enough to remove the majority of plaque. It’s not their fault, it’s not that they aren’t trying. They don’t have the co-ordination. Sometimes once “disclosed” – it is quite evident that they are right or left handed and they have missed an entire quadrant of their mouth. Not just one or two teeth, but 5 or 6 teeth. They have spent the time in the bathroom and they report the deed is done, but an adult really needs to assist.

As far as flossing on their own? seriously? there are many adults who don’t even feel the need of this 1-2 minute activity warrants doing. A child left to their own devices may use a floss pick or floss and get a percentage of the spaces. If you actually watch them, they get one spot, skip 2 spots and so on. If this part of home care is a nightmare- consider a child’s waterpik flosser or GumChucks (much easier for a parent to use on a child).  Those tight spaces are where many cavities form.

Give some thought to yourself – did you ever have cavities? if so at what age did you have the most dental treatment? If you have never had decay – fantastic. Congratulations. You won’t have to spend time and money over your life having the dental fillings placed when you were a child drilled out and replaced several times over. Once a tooth has been cut with a dental drill and a filling placed, it is destined for future dental treatment. Fillings don’t last forever, especially the white resin fillings. All of this can be PREVENTED.

As a dental hygienist, my children are not immune to tooth decay, so I knew it had to be done, and I considered it a chore. It is important to me that I prevent what I know can be prevented. Why was I then cursed with a child who hated having his teeth brushed?

I know why. I was a dental assistant before I became a dental hygienist. I assisted a dentist with operating room privileges. We treated children under general anesthesia in a hospital. It was difficult to see such small, young children laying on an operating table – their feet going nowhere near the foot of the bed, and their eyelids taped shut during the procedure.This was not a children’s hospital – so these were adult hospital beds.  Usually, treatment involved several injections of anesthetic, pulpotomies (this is basically the equivalent to a root canal treatment but on a baby tooth), stainless steel crowns cemented to hold intact what was left of the decayed teeth, several fillings, and some extractions if the teeth were so badly decayed. As I suctioned and watched eyelids try to flutter I cast judgment on these children’s parents. In my mind I questioned to myself – “who would let their children’s teeth become decayed like this, and why don’t parents brush their kids teeth?”   This is why my son gave me grief – and of course, that is when I realized just how difficult it is to carry out dental home care at times. Often it’s not that brushing isn’t happening, it’s that it isn’t happening well. Today’s typical diet is inducive to dental decay. Let your children, or your grandchildren or any children you know be the exception.

So I sympathize with new parents, parents of multiple kids, tired and overworked parents – but please, as tired as you are, please get through this chore at night before bed – at least, and monitor what it is in contact with their teeth throughout the day. Do what you feel is in the best interest of your child.

Early Childhood Cavities – why be concerned?

Feds spend $1M to fly Inuit children south for dental surgery

Cavities on the increase for kids

Sedatives Cited in Toddler’s Dental Office Death 

Anesthesia in young kids may carry developmental risks

If you live in Calgary or Claresholm, bring your kiddies in for a no charge first visit.

If you have young children at home, or children who you feel would do better in their home environment – a mobile dental hygienist is a great option – they bring their equipment to you.

Autism In The Dental Hygiene Chair

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autism ribbonApril is Autism Awareness month, and this week is National Dental Hygienists week, so I decide to blog about both. I dedicate this blog post to my friend Allison and all families who know Autism and Aspergers well. During my time as a dental hygienist I have been exposed to clients of all ages and backgrounds including those with unique needs. After recently meeting Allison I became aware that I did not have any experience with autistic children.

How is that possible? Did I in fact treat autistic children but didn’t know it? Would a parent not indicate that on a medical chart? Could I treat clients in a city with a population of 1 million and not see 1 autistic child when the stats from Centers for Disease Control and Prevention (CDC) identify that 1 in 88 children is diagnosed with autism? Was I so oblivious that I may have chalked up a child’s behaviour to “high maintenece” when really it was typical behaviour of an autistic child?

I don’t know the answer. I knew that after reading Allison’s blog post “Life with Liam“, about an orthodontic appointment for her 9 year old son that I was certain I may not know how to make a dental hygiene visit for an autistic child a positive one, an experience that both child and caregiver look forward to as opposed to viewing it as one more necessary but unpleasant life task. This was disturbing to me because I sincerely want to make dental hygiene visits a great, educational experience for both children and their caregivers. It is with children I feel hygienists have the opportunity to make the greatest impact – sharing  preventative dentistry knowledge – ensuring a life of “no drilling & filling”.

Of course I studied “special needs” in dental school, but how much could I recall of dealing with autism? not much. I was feeling very inadequate with my limited knowledge of the unique challenges associated with dental hygiene home care, best time of day for dental hygiene appointments, and management in the clinic. I was also certain my dated knowledge wouldn’t hold a candle to the reality of today for these families. Continuing education throughout life is a reality.

I have since learned that Autism is a general term, and there are various functioning levels – each individual is just that –INDIVIDUAL.  Autism Speaks Canada has an informative website and states that “Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. They include autistic disorder, Rett syndrome, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome. ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. ”

It is best for the caregiver to outline the functioning level of the child (where they are on the spectrum)- as well as details about sensory issues that may arise and discuss how to best handle them when at a dental hygiene appointment. If this conversation can happen prior to the child’s appointment that would be best. The dental hygienist will welcome any information that can facilitate an enjoyable visit. You know your child best, and know what sensory stimuli could be avoided or reduced. A dental hygiene clinic can have some advantages in terms of sensory stimuli when compared to a traditional dental clinic. There will be no dental drilling noises, smell of root canal mediciments, or dental materials like monomer being used in a hygiene clinic. Lighting may be an issue, so best to discuss this ahead of time. Caregivers can practice a visit at home before going to the clinic so the child has some familiarity with what may happen – practicing laying back, looking in the mouth, and counting teeth.

From the dental hygienists perspective be prepared to book a longer appointment so it isn’t rushed, the child has the time needed, you can answer all of the caregivers questions, and you can review techniques for oral home care. Repetition and routine can be very reassuring for autistic children. Establishing a relationship with one particular dental hygienist, rather than seeing someone different each visit can achieve this. Like appointments with all children, what works one day may not work the next, so be prepared with knowledge and do not hesitate to ask for recommendations from caregivers, and have patience. The first appointment may end up being a familiarity time, and perhaps no treatment carried out. Stretch your mind and skills and grow with the child & family.

Are you a dental hygienist looking for a resource to use? Dental hygienist and mother, Karen Raposa devoted six years of her life to writing “Treating the Dental Patient with a Developmental Disorder”. She cited her autistic son as her inspiration for writing the book. This book shares information on how to provide dental health services for patients with developmental disorders. You will also find the best information comes directly from parents and caregivers. Keep an open mind…. we are always learning.

Signed, SEALED, & Delivered : For Children & Adults

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Seal Out Tooth Decay before It Happens!

How can you prevent yourself or your children from getting cavities? it’s easy SEAL THEM OUT… with Sealants!

Do you remember why your dental hygienist or dentist put sealants or more commonly known as “white coats”, “clear paint” or “protective paint” on your back teeth when you were younger? Has your dental hygienist or dentist recommended having them placed? If so, you might be asking; what are sealants anyway?

The main and most important reason for getting sealants is to avoid tooth decay. They are thin, plastic coatings painted on the chewing surfaces of the back teeth… because our back teeth are primarily used for chewing; the chewing surfaces are rough and uneven surfaces with pits and grooves. Toothbrush bristles cannot get into the tiny pits and grooves of these teeth so germs and food can get stuck for a long time causing a cavity to form if not prevented.

Sealants are put on in dentists’ offices, dental hygiene clinics, and sometimes in schools. They are painted on as a liquid and quickly harden to form a shield over the tooth. A special light is often used to “cure” the liquid.

 

Do you know if you have any sealants now? Are they in good condition? Do you or your children need sealants?

Visiting your dental hygienist and/or dentist can help determine and exam when, and on whom will need sealants. Going in for your regular dental cleanings and check-ups will let us and YOU informed.

 

Having sealants placed on teeth before they decay will also save time and money in the long run by avoiding fillings,root canal treatment, and  crowns (also called caps) used to fix decayed teeth. Sealants are simple and painless and can last many years!!

Some dental insurance plans cover the cost of sealants. Check your dental health care booklet or call your insurance company for details!

 

What else can you do to protect against decay?

Yep, you guessed it… with proper oral hygiene care of daily tooth brushing and flossing which can help prevent tooth decay. Pit and fissure sealants are most commonly placed on molar teeth. These back teeth are harder to get at, especially with toothbrush they need the extra protection to keep the germs out! That is why sealants cover the chewing surfaces of the back teeth and help making our daily routine of proper oral home care a bit easier.

Call us to ask questions about preventative sealants- we are happy to share information to prevent tooth decay! (403)457-2044

Put your money where your mouth is…

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Do you think the cost of a dental cleaning in Calgary is expensive? outrageous? or could you care less about the cost because your health and teeth are worth it?

If you think the cost of a dental cleaning is high, then you will find the cost of treating gum disease by a periodontist, or having one cavity repaired with a filling outrageous!!

For some of you reading this- you are going to question  “who would not spend money having their teeth cleaned?”   This blog is not for you –  you already get it. Your teeth and overall health are important, you would go without cable tv if you had to in order to afford dental cleanings. You probably drink your coffee through a straw so your teeth do not become stained. You take the Dr.Oz quiz “ How clean is your mouth” and you ace it!! You brag to co-workers about the wonderful flossing grade your dental hygienist gives you at your appointments. Or maybe you have dental insurance and have never given a second thought to the cost of a dental cleaning.

This blog is for those that value their oral health but don’t believe they can afford dental cleanings, or it is for those for those that don’t get it – yet. I want to highlight how the cost of dental cleanings can be viewed as an investment in oral health, and since your mouth is attached to the rest of the body – an investment in overall well-being. Who wants destructive mouth bacteria travelling the blood highway through the body? Yes- it is true the bacteria in your mouth causing bad breath, disease, bleeding gums loves to travel- where? to your heart, to the site of your knee replacement, your new hip – everywhere. It has been linked to pre-term delivery of babies (1).

 I suggest looking at the cost of preventative dental cleanings over a year, rather than on a  per visit basis.

 If you neglect your oral health, your teeth and your gums – you will pay for it at some point. Perhaps it will be in terms of bad breath, bleeding gums, decayed teeth, tooth abscesses, loss of teeth, time missed from work due to dental pain and emergency dental appointments, or maybe you will end up struggling with ill-fitting dentures and not being able to chew your food properly. Does this sound horrible? it should…and I haven’t even touched on the overall health conditions that are linked to gum disease. Hygienists provide oral cancer screenings. When was the last time your medical doctor checked the tissues inside your mouth?

Why do I say this? I hear comments and concerns from public that the costs of basic dental care, including examinations, xrays and dental cleanings can be prohibitive.  Dental Hygiene Clinics can help to ease the financial cost of prevention and treatment of gum disease, and keep healthy mouths healthy! You see the same Registered Dental Hygienists at Lifetime Smiles Dental Hygiene Clinic that you would see in dental clinics. You can also keep your diet in mind for an outcome of oral health. Inflammation plays a keey role in both gingivitis and periodontitis – read more about nutrition and inflammtion.

We answer many questions about the cost of dental cleanings. The cost generally works out to $35 month for 2 professional dental cleanings a year. There are those that do such a great job with their home care that the cost is less ( yes, it is true some people do actually floss daily- it is not a myth). This is without any type of reimbursement from your dental insurance or health spending account (if you have either). Obviously treating active gum disease is going to cost more, as is treating cavities and other dental conditions. The cost for childs dental cleaning is less.

 I see patients that are wearing implant supported dentures for dental cleanings. No teeth remaining. I unscrew the denture attachments- remove the dentures and then clean the build up from around the implants. So even people with out teeth remaining still need to see dental hygienists!  These patients could tell you what teeth are worth- or sorry, I should say they can tell you what the cost is to replace ill-fitting dentures that floated around in their mouths. One woman told me she has spent the equivalent of 2 automobiles on achieving dentures that fit well ( attached to dental implants), that allow her to chew properly, eat and speak in front of others with confidence knowing that her dentures are not going to move around or make a clicking noise.

 What could you trade each month that costs $35, to cover the cost of 2 dental cleanings a year? What are your teeth worth? What is your overall health worth? I would love to hear from you. I could easily go without Sushi..well maybe not easily.

Want a payment plan at our clinic? no problem- just ask. What if $35/month is still not feasible? There is assistance for low-income groups in Alberta for dental treatments, for children, and emergency dental treatment resources. Lifetime Smiles Dental Hygiene clinic sees children under 3years of age for their first visit at no cost. Ask us if your need dental help – we are a very resourceful group.

Journal Reference:

    1. Y. Fardini, P. Chung, R. Dumm, N. Joshi, Y.W. Han. Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection. Infection and Immunity, 2010; 78 (4): 1789 DOI: 10.1128/IAI.01395-09

 

test saliva and prevent dental cavities…who knew?

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Saliva, aka SPIT – is very important. Your may have even been complimented at your dental cleaning appointment by your dental hygienist on your saliva. It usually goes something like this:

dental hygienist “wow, you have a lot of saliva”   

patient (who is now wondering is that good or bad) “what does that mean?”

Saliva is very important :

– helps to wash food particles off the teeth and surfaces inside the oral cavity

– contains antibacterial components – comes in handy when babies are putting everything in their mouths

– contains minerals that can help repair tooth enamel that has started to break down

– helps to buffer acids and restore neutral pH when you’ve consumed foods that have created an acidic environment

– can be tested for presence of drugs in the body

-Japan’s Keio University and University of California, have been working on developing saliva testing technology that can detect pancreatic cancer, breast cancer and oral cancer

– dental hygienists can perform saliva testing in the clinic to determine if there is a high level of the strains of bacteria that play a role in the initiation of dental decay

Lifetime Smiles Dental Hygiene clinic in efforts to assist in preventing dental decay can perform saliva testing. If it is determined that you are at a high risk (large population of decay causing bacteria), recommendations can be made to help change amounts of bacteria and treat the infection.   Yes, dental decay is caused by bacteria and is a bacterial infection. Dental decay is the most common chronic infection of early childhood.

Should an adult be concerned? yes, as dental decay is the leading cause of tooth loss in adults.

Prescribed medications and other health problems can decrease the amount of saliva produced, or dimish the neutralizing properties, thus creating a higher risk of dental decay.

Discuss this with your dental hygienist or other dental providers. Dental hygienists love to assist in prevention, as I have indicated in previous blogs, dental hygienists love to talk “prevention”.

 

The billing of a dental hygiene appointment demystified…

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The hygienist I see told me I should be seen every 3 months, is this legit? and what am I being billed for at these appointments?

In the past it was customary to fall into the trap of dental insurance dictated “once a year”, or “once every 6 months” frequency of dental cleanings. Often patients will state “I can only have a cleaning every 9 months, because that is what my insurance covers”…well you can actually go as often as you want, insurance won’t cover every visit, BUT YOU CAN go as often as you want …if you hate flossing you could go to see the hygienist every few days …but seriously you have other places you need to be so Floss! 

Keep in mind your dental insurance coverage is NOT based on what you may require. It is coverage negotiated and provided as a benefit package – typically by an employer. Or a “package” you apply for.  

Due to the status of the health of your gum tissues and bone levels, the hygienist may recommend that you are seen every 3 months for plaque and calculus removal, or 4 months, or 6 months, or 9 months  ….you get the picture. Everyone’s health is different, and so are the dental hygiene needs of each patient.  I would be more concerned if the dental hygienist you see doesn’t customize your hygiene frequency to your specific needs. Hygienists use information such as the amount of calculus that forms in your mouth, the depth of the periodontal pockets measured (yes, all that poking and number calling..3, 2, 3…. is useful), bone levels, amount of tissue bleeding, as well as your overall health and risk factors to decide what is going to give you the best chance at achieving top-notch oral health , and the benefit of keeping your teeth for life!!

What does that mean in terms of dental insurance? Well get to know your coverage.  A dental “cleaning” is actually a very general term because your dental hygiene visit will likely include scaling and or root planing, polishing, application of desensitizing materials, diagnostic radiographs to assess bone levels, or reviewing which plaque removal aids would be best for you. The hygienist may even create teeth trays to wear at home with remineralizing materials to prevent decay. Each individual has individual needs.  That is why your invoice when you leave a dental hygiene appointment has a list of individual procedures.

And what does all of that dental lingo mean?   Scaling and rootplanning in Canada are billed in time units.

1 unit of scaling = 15 minutes of removing deposit (or as my friend likes to call it “scraping the teeth”)

Polishing involves paste, removes daily sins like coffee, tea and red wine stain, smoothes rough areas so plaque bacteria cannot attach as easily

Fluoride can be gel, foam, varnish or rinse applied topically to teeth – again this should not be an “automatic treatment”, rather the dental hygienist will determine if it or a fluoride alternative is suitable for you. There are also fluroride free – re-mineralizing agents that can be used to strengthen and prevent decay.

Insurance Plans usually have limitations such as 1 polishing procedure per 9 months…or 1  exam and x-rays per 12 months)…

Insurance coverage for scaling units may include – 16 units per calendar year,  if you have a great plan maybe coverage will state unlimited scaling units per year . You could have a plan that covers only 2 units of scaling a year.  *This may be a combination of root planning and scaling..you have to ask questions of your insurance provider if it is not clear.

The good news is that you may require scaling, root planning at these 3, 4 or 6 month hygiene visits, but don’t necessarily need polishing, or xrays and a check up exam every visit. So what the dental hygienist is recommending may actually fall within your dental insurance limits,  good news!!     Be thankful you have any dental coverage at all, as there are many people without .

Bad news  – and its not really bad news – if it doesn’t fall within your dental insurance find out how much it would cost you? 2 units of scaling may not cost quite what you think in terms of dollars, and may mean that if you visit the hygienist 4 times a year and you are willing to pay for 2 of the visits… you get to have healthy gums, a healthy mouth, and a healthy heart which contributes to overall health.  One patient told me they spent more on their pet last year than they did on their teeth.

The other solution…follow advice from your dental hygienist in terms of what you can do at home …and then repeat this daily.

What is a Dental Hygiene Clinic, and who are dental hygienists anyway?

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I am asked some of these questions often, so if one person wants to know, many probably do..

Regulations enacted under Alberta’s Health Professions Act (effective November, 2006) allow registered dental hygienists to provide services in a variety of practice settings in addition to working in a dental office. Often called “Independent Hygienists” ….I know new lingo

Practice settings include a dental hygiene clinics, mobile services or both. Yes – thats right a mobile hygienist could come right to you…or visit nursing homes to see your loved ones. Please, someone send a dental hygienist to me if I am ever in long term care or can’t make it to a dental hygiene appointment. Hygienists on the move.

Lifetime Smiles Dental Hygiene Clinic is stationary- we can’t come to you- but please feel free to come to us- we welcome all patients. If you want to find out more about a mobile hygienist have a look at the College of Registered Dental Hygienists of Alberta(CRDHA)- they have a list of independent hygienists in Alberta. If you are in a province other than Alberta – contact the provincial association for a list.

As indicated on the CRDHA site in their practice, Registered dental hygienists in Alberta do one or more of the following:

•assess, diagnose and treat oral health conditions through the provision of therapeutic, educational and preventive dental hygiene procedures and strategies to promote wellness,
•provide the services described in this section as clinicians, educators, researchers, administrators, health promoters and consultants.

Registered dental hygienists in Alberta:
•have met the educational and other requirements criteria for registration.
•apply a dental hygiene process of care model.
•practice with a foundation of evidence-based knowledge and theory.
•practice collaboratively with clients, colleagues and other health care professionals.
•provide client-centred services to prevent and treat oral disease and promote wellness.
•are involved in a variety of key responsibility areas related to dental hygiene practice (e.g. clinical, education, health promotion, administration, research, etc.).
•are legally, ethically, and professionally accountable for their practice and recognize personal limitations.
•maintain ongoing competence (e.g. through continuing education, research, reflective practice, practice hours, etc.).
•possess additional education, competencies and/or certification when performing advanced practice procedures.

Wow…and if that is not enough hygienists can apply to be on specific rosters indicating that they have the education and competencies to:

•prescribe the limited medications used in dental hygiene practice
•administer local anaesthetic by injection    (aka. freezing)
•prescribe and administer nitrous oxide/ oxygen for conscious sedation

So to summarize, registered dental hygienists are one smart group!!      and while I know we have a reputation of being   “lecturers of flossing”…we care a great deal about teeth, oral health and overall health…

 

Want to find a dental hygiene clinic, or mobile clinic in Canada? Locate a Dental Hygienist.com allows a search by city, province or name