Google for a Day – Comprehensive Answers about Cold Sore and Dentist

Dental Revelations Blog-11

To treat or not to treat? The answer should be easy one to answer. Why isn’t it?

My most popular post by far has been Cold Sore Is Herpes – Cancel Your Dental Appointment Because Your Dentist Won’t!. It proves that people certainly know that herpes simplex virus is not something that you could compare to common cold for example. They are unsure what to do when you have a cold sore and you have booked a dental appointment. And like with many other matters that you are not sure about, people turn to their all-knowing friend Google.

But it’s not only the patients who are unsure. Also the dental professionals seem to be confused and represent their questions to Google. How do I know this? Well, WordPress has very useful statistics that include also the search terms people have used when they end up to my blog. I have kept an eye on the search terms and I got this idea to write a post about them and act as a search engine for you. So here it is. The search terms (ST) and my answers.

ST: Can you go to the dentist with a cold sore?

Preferably not. Any treatment that can be postponed should be postponed.

ST: Can they take out a wisdom tooth with a cold sore?

Only the ones that cannot be postponed. If the wisdom tooth is risking your life due to an acute infection and signs of the infection are spreading to your bloodstream then it should be removed even if you have a cold sore.

ST: Why won’t the dentist see me when I have a blister in my mouth?

Because your dentist knows his business. Any responsible dentist would postpone the treatment if there are signs of herpes infection inside your mouth, lips or nose. But your dentist could explain a bit more why he didn’t see you so you wouldn’t have to google it. Here’s further reading about cold sore as an occupational hazard.

ST: Can dental treatment cause cold sores?

In theory, yes. If the practice’s cross infection control protocol is not up to the standards and they treat people with cold sores, the virus can be passed on to the next patient. The virus can stay infectious as long as 2 hours in the surfaces of the surgery and the instruments. If the next patient has never had any type of herpes infection, she’ll get primary herpes first. That’s nasty thing to have if you are an adult. Cold sore can follow as a secondary herpes after a while.

ST: Cold sore, herpes simplex, dental appointment.

I hope these things never meet in real world. Unless absolutely necessary.

ST: Does an orthodontist still take you if you have a cold sore?

If the treatment can be postponed, it should be postponed. But having said that, if the orthodontist treatment is such that no rotating, high-speed drills are to be used then it might be ok to do the treatment if the cross infection control is up to the standards.

ST: Can I have dentist with a cold sore?

Are you sure you want one? Wait until it clears and you’ll find that he is exactly the same person without cold sore. Just less infectious.

ST: Can I have a dental treatment with a cold saw?

Well, you actually could. We have instruments that look like a saw.

ST: Can you get oral herpes from the dentist.

Yes if your dentist’s cross infection control is not up to the standards and they treat patient’s with cold sore. Herpes virus can survive 2 hours in the surfaces that have not been adequately disinfected.

ST: How dental professionals can prevent from getting herpes?

Do not treat patients with cold sore. If you must (patient’s life is at risk), protect yourself with visor mask, take care of your skin as healthy skin on hands works as barrier to pathogens, use gloves, try to avoid using high-speed instruments and sonic scaler as they produce aerosols that carry pathogens, do only what is necessary until the time when the cold sore has healed. There’s no point in covering the cold sore with plaster or similar as the herpes simplex virus is also in the saliva. You should also read this article.

ST: Should a dental hygienist treat a patient with a cold sore?

Treatments the hygienists perform are rarely such that cannot be postponed. So do not take a risk. If you still act against my advise, protect yourself as advised above and do not use sonic scaler. And cross your fingers. You should also read this (scroll down to Case histories).

ST: Dentist refused to treat due to herpes.

Hooray! We have hope! Hold on to your dentist, he clearly knows his business!

ST: Dentist won’t treat me bc herpes.

Another good and responsible dentist somewhere out there! Be happy!

ST: Can I still have a filling with a cold sore?

No dentist should make you a filling when you have a cold sore. Making a filling requires high-speed rotating instruments that have water cooling system. They produce aerosol when used and the aerosols carry pathogens far and wide – possibly in the eyes of the dentist, nurse and yourself! Even if you wear protective eye-ware.

ST: What to do if patient has herpes simplex dental nurse.

I’m afraid there is not much you can do as the dentist is considered to be the one who is responsible for the treatment. The dentist decides if the treatment can be carried out. He shouldn’t of course treat patients with cold sore unless patient’s life is at risk but as you probably know the reality is very different. When you begin working with a new dentist, ask him how he deals with patients who have cold sore. If he is all about money, money, money, change jobs. Protect your health and your future as dental nurse. You can always show the dentist my article about cold sore or this article. Maybe that’ll convince him.

ST: Do dentist still remove teeth if you have a coleslaw.

We do find many things from people’s mouths. Sometimes even coleslaw between the teeth. I don’t think the dentist minds. He just wants to get your tooth out.

(It’s an obvious spelling mistake or an auto-correct error but I couldn’t resist making fun of it.)

Advertisements

Oral-B Gum & Enamel Repair Original Toothpaste Review

20180223_123729

Oral-G Gum & Enamel Repair Original toothpaste

Today I am going to review a toothpaste for the first time ever. It is a toothpaste that was given to me by a representative of Oral-b. It is called Oral-b Gum & Enamel Repair Original toothpaste and it is Oral-b’s newest toothpaste.

Here’s the manufacturer’s selling speech about the toothpaste on their website:

  • It defends against acid erosion and helps to repair enamel
  • It provides antibacterial action to help rejuvenate gums
  • For sensitive teeth – clinically proven
  • Oral-B Gum & Repair Original toothpaste comes with a mild flavour and a smooth texture

The Design

Dental Revelations Blog-8

The design of the packaging looks simplified and minimalistic which I very much like. This is welcome change from their previous toothpastes’ outlook that had too much information in a small space.

The tube is still easy to open, but there is small change in the lid. It used to be made of metal which at least in my opinion is better recycling-wise than plastic. Small detail but still. Can’t help this image of whales’ intestines full of plastic popping in my mind. But then again the whole tube is plastic.

Dental Revelations Blog-9

The Testing

Staying on the environmental subject. The plastic and the whales. There has been lots of talk over microbeads that are found in many consumer products. Even in toothpastes. These microbeads will eventually find their way into the sea and cause problems to the oceans as persistent pollutant. The representative who gave me this Gum & Enamel Repair Original toothpaste sample promised that there are no microbeads in it. The ingredient to look for is polyethylene when you want to make sure there is none of them. I found no polyethylene in the ingredients list (see at the end of this post). Great.

The texture of the toothpaste looks smooth as they promised but when you take closer look, it is not that smooth after all and the fear of microbeads is getting stronger again.

Dental Revelations Blog-10


The texture of the Gum & Enamel Repair Original toothpaste

20180223_123927


Closer look of the toothpaste reveals tiny beads.

The tiny granules are clearly visible but these could be actually hydrated silica (abrasive), not microbeads.

Ok, time to add toothpaste to my toothbrush. Like with Oral-b Pro-Expert toothpaste, this new one is also quite runny and can be messy if you are not quick enough. Once I had applied toothpaste to my toothbrush I was in a rush to take a photo before it dripped on to the table.

20180223_124052

I use my beloved Philips Sonicare

and with this brush the runny texture is actually better than the ones that are stiffer pastes. But I can see that the sink in the bathroom will have toothpaste marks here and there. Also, note to myself – do not let husband use this toothpaste as he brushes his teeth after he has put his suit on. Silly man.

So lets put the toothpaste in my mouth. It does begin to formulate foam which means there is soap in the toothpaste. Not the best option for somebody with sensitive soft tissues or dry mouth. Soap aka sodium lauryl sulfate can make the mouth dry and also it has been linked to canker sores aka aphthous ulcers (although nothing is scientifically proven and oh boy don’t I hear it from the rep e-v-e-r-y time).

Very soon I begin to feel burning sensation on first third of the tongue (the tip of the tongue), both top and bottom of the tongue. Also the tongue feels slightly numb. This carries on all through the brushing and after spitting the toothpaste out. Now, I do advise my patients not to rinse after brushing but the burning sensation is so strong that I must rinse lightly. Once I did that and bit my teeth together, I could feel biting on some grit. This made me think about the abrasiveness of the toothpaste. It is new toothpaste so the RDA value (Relative Dentine Abrasivity) was impossible to find. I will add the RDA value as soon I find it out.

Ten minutes after brushing the burning can still be felt. Also I feel that the layer of skin inside my lips is peeling off. This has been “a feature” with Oral-b Pro-Expert toothpastes and the reps have said it’s absolutely normal and will diminish when using the toothpaste for longer period of time. My colleague asked the rep if this new Gum & Enamel Repair Original toothpaste does the same. I must say that I cannot remember the rep’s exact answer but I think she said this toothpaste should cause less of the peeling of the mucosa. Well it doesn’t. At least with me. If anything I think the peeling of the mucosa is quicker than with Pro-Expert toothpaste.

Twenty minutes after brushing I can still feel the burning feeling slightly. I guess some people will associate this burning feeling with effectiveness of the toothpaste. The more it burns, the more effective it is. As a dental professional I must say that this is not true. No toothpaste should feel uncomfortable to use.

Would I Recommend?

To be honest, most likely I will not recommend this toothpaste to anyone. Not after I took a closer look at the ingredients. One ingredient has been nominated as Allergen of the Year for 2018 by American Contact Dermatitis Society. This ingredient is called propylene glycol.

The list of ingredients is long and to my mind the longer the list is the more side-effects there will be. My favourite toothpaste that I recommend to my patients a lot has only eight ingredients (aqua, crystalline sorbitol, hydrated silica, crystalline xylitol, PEG, anhydrous natural betaine, cellulose gum, sodium fluoride (1500 ppm F), sorbate). Oral-b Gum & Enamel Repair Original toothpaste has nineteen! Three of these ingredients can have adverse reactions to one’s health – propylene glycol, CI 77891 and sodium lauryl sulfate.

Also the fact that I got this burning feeling in my mouth tells me this toothpaste is not suitable for most of the people. Remember that it should not feel unpleasant to use a toothpaste. Certainly it should not hurt. So change if it does.

The Ingredients

Here are the ingredients of the Oral-B Gum & Enamel Repair Original toothpaste and short explanation of what they are (by clicking the link you will find more information):

  1. Glycerin – an organic compound most commonly from animal fat and vegetable oil
  2. Hydrated Silica – abrasive
  3. Sodium Hexametaphosphate – anti-stains and anti-tartar
  4. PEG-6 – The abbreviation PEG = polyethylene glycol. Possibility for adverse reaction. An emulsifier and foaming agent
  5. Propylene Glycol – the American Contact Dermatitis Society’s Allergen of the Year for 2018. An emollient and emulsifier.
  6. Aqua – the main carrier for all ingredients. Helps dissolve other soluble ingredients. Helps the mechanical process of cleaning teeth in mouthwashes
  7. Zinc Lactate – such a difficult ingredient to find any information solely on zinc lactate. Lots of information on zinc but there must be difference in different types of zinc? If anyone finds trustworthy site with information on zinc lactate, please drop me a line.
  8. Sodium Gluconate – to sequester calcium and helps to prevent gingivitis
  9. CI 77891 – titanium dioxide (nanoparticles). A thickening agent and colourant.
  10. Sodium Lauryl Sulfate – soap, the foaming agent. Can work as an irritant.
  11. Silica – a mild abrasive to clean teeth.
  12. Aroma – a chemical compound which adds odours to dental products.
  13. Sodium Saccharin – an artificial sweetener
  14. Carrageenan – an extract from a red seaweed. Binds and gels all the ingredients together
  15. Trisodium Phosphate – stain remover and de-greaser
  16. Stannous Fluoride – the good in the toothpaste
  17. Stannous Chloride – antibacterial
  18. Xanthan Gum – a thickening agent
  19. Sodium Fluoride – the good in the toothpaste

If you are interested in other common ingredients in toothpastes that can cause adverse reactions, click here.

Edit 21.6.2018

Want to know what the rep told me about the RDA level of the Oral-B Gum & Enamel Repair Original toothpaste? Click here to find out.

You might also like

RDA Value in Toothpastes – Any Relevance?
GC Tooth Mousse Review and Advice for Use
Hands up Who Knew That Zinc in Toothpaste Can Cause Dry Mouth?
Testing Oral-b Smart Phone Holder, Take 1
Testing Oral-b Smart Phone Holder, Take 2

Anti-Patients

Dental Revelations

Dental Revelations Blog-24982

I have a confession to make. I am not perfect as a dental professional even though my posts may give the expression that I do everything as we are taught at the dental school. I do my best but I have weaknesses as well.

Another confession. I sometimes feel quite overwhelmed by some patients’ way of arguing about the well researched facts on dental health. Banging your head against the wall is not fun in the long run and in our business it tends to make us cynical and worn out mentally.

Of course there are good days and bad days. On bad days I have thought about changing my profession to the one where I could sit between piles of paper and no-one to talk to (anyone care to hire me?). On bad days I have given up trying to convince the patient about cleaning between the teeth when I have faced a non-cooperative patient…

View original post 1,373 more words