Coronavirus in Dentistry and How to Protect Yourself

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Like doctors and nurses in hospital, the dental professionals are more at risk of contracting viruses. Dental offices can also be a place where the viruses, such as corona can spread if the cross infection control is not up to the standards.

I have gathered the most important things here for dental professionals to check to make sure you are protecting yourself, the staff and the patients. I have not gone into things like instrument disinfection because that should be organised regardless the coronavirus. If in doubt, read this

Use Soap

Something we should remember when using hand sanitiser is that it does not kill all the viruses like norovirus (the one causing the winter womiting disease). Therefore it is advisable (also advised by the World Health Organization, WHO) for all of us to wash hands 20 seconds with soap even though it is pain in the backside to wait for the hands to dry so that you can pull on the examination gloves. Remember to use disposable hand towels to dry your hands and close the tap either with your elbow or with the hand towel to prevent re-contamination of your hands from the tap.

Cover Up

In the normal situation where we treat healthy patients, a lower fluid resistance and filtration efficiency are acceptable (personally I use either ASTM Level 2 or Level 3 masks). But when we are at greater risk of treating a patient who might carry airborne diseases like coronavirus, TB and influenza, we should use masks that have the maximum filtration. These face masks you recognise from the markings FFP2. 

It is even better if the face mask has a visor attached to the mask. But even if it has the visor, use also safety glasses/your normal glasses under the visor. If the face mask doesn’t have a visor, use safety glasses or separate visor – also on top of your normal glasses. 

Now, I would use also disposable hats like they do when performing oral surgery because people (me too) have these mannerisms of touching our head, scratching our head etc. for example on a lunch break. And do we always notice we do that? If we don’t, then how do we know to wash our hands straight after before we take another bite from the sandwich.  

Check Your Surface Disinfection Liquid

Today is the day to look deeper into the small print of your practice’s disinfection liquid. I did some research some time ago because I wanted to find out if the liquid we were using was killing everything it was meant to. I found out that not all of them kill for example norovirus. And if they don’t kill norovirus, I doubt that they kill coronavirus. 

I cannot tell you which one to use, but the bottle should have all the information needed. If not, contact the supplier or the manufacturer. One thing I noticed when I did my research that the disinfection wipes and liquids for sensitive surfaces are the ones that do not kill viruses.

Wipe Wider

It is good idea to wipe the door and chair handles (the unit’s of course but also the regular chairs) with disinfection wipes. Also it is good idea to go through the other handles of the practice many times a day – even the ones outdoor. 

Provide Hand Sanitiser for Patients

Place a bottle of hand sanitiser in the waiting room. I saw my physiotherapist yesterday and first thing I did was to wash my hands.  Common people do not realise to do this so could you perhaps ask your patients to wash their hands (for 20 seconds) when they arrive to the surgery?

Continue reading “Coronavirus in Dentistry and How to Protect Yourself”

Wild West of the Home Whitening

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Oh dear, where to begin.

The reason I chose this topic for my next post is that I was reading a dental blog that gave homemade teeth whitening tips to people. I’m sure the intention was good when they listed all known household items than can whiten the teeth. You see people love to get self-help tips on their health – especially on their teeth to avoid seeing the dentist. But dental professionals should know better not to advice certain things as they can very quickly cause permanent damage to the teeth.

(This is a reminder for all of us not to believe everything you read from the net especially regarding your health)

Stains

There are two types of stains on your teeth. Surface stains and deep stains.

Surface stains build up from coffee, tea, red wine, smoking and certain spices, mouthwashes and vitamin supplements (iron in a liquid form).

Deep stains are those that will make the natural colour of your teeth (which you will see after scale and polish when the surface stains have been removed) yellower. The older you get the yellower the teeth will get (or have you seen elderly people with pearly white teeth? If you have they are false).

So what will damage your teeth? I will tell you. Starting from the worst. But at first for clarification

  • I will not give any instructions on how to use these substances
  • it won’t be a comprehensive list of the substances that is advised to use for teeth whitening purposes but a list of most common ones

Whitening Toothpaste

There are normally two types of whitening toothpastes. Toothpastes with increased abrasivity (normally all most common brands’ whitening toothpastes e.g. Crest, Golgate, Arm&Hammer) have high RDA level (higher than RDA 100) and if used regularly, it can lead to toothwear. This toothwear is permanent. I never advice anyone to use these toothpastes on regular basis.

Safer types of whitening toothpastes are the ones that do not have high RDA level but are based on papain enzyme which whitens the teeth. Examples of these toothpastes are brand Youtuel (RDA 40) and Glodent. When I used Youtuel for the first time somewhat 20 years ago, it was impressive how well it removed surface stains.

If you are interested to read a study about papain enzyme as whitening ingredient, click here.

Lemon

Would you love to get white teeth with practically no money spent at all (as you get the lemons anyway for cooking etc) plus super sensitive teeth and eroded enamel to go with the deal? Yes? Use lemon.

An advice to use lemon for teeth whitening isn’t under any circumstance acceptable by a dental professional. Lemon is highly acidic fruit and can erode the teeth when used regularly. Erosion will result in sensitive teeth. Imagine if you already have thinned enamel for any reason and you start to use lemon for whitening purposes. You will soon find out it wasn’t a wise move as your teeth will become so sensitive to the cold that even breathing through your mouth hurts. Also the thin enamel will make you more prone to decay.

In 2005 BBC had to apologise publicly for a lemon tooth whitening tip when one of its programmes recommended lemon as a money saver to families. I happened to watch this programme and couldn’t believe what I was seeing. Thank goodness British Dental Health Foundation soon found out about the programme as well and complained to the BBC.

I’m not convinced that the apology reached everyone who watched the programme.

Strawberry and Baking Soda

Now combination of these two used daily for longer period of time will damage your enamel. Baking soda works as abrasive and strawberry as an acid. A very bad combination.

Safe frequency of use is once a week.

Baking Soda

It is slightly abrasive to teeth and can damage the teeth especially if used with vigorous brushing technique.

Do not use baking soda if you have braces. It can soften the glue.

Salt

Salt crystals can scratch the enamel. Make sure to let the salt dissolve in the water before using it (kinda looses the point of using it, doesn’t it?).

Hydrogen Peroxide

Hydrogen Peroxide is the only known substance that removes deep stains. It doesn’t remove the surface stains so scaling and polishing is normally needed prior the whitening.

There are products over the counter (OTC) that contains hydrogen peroxide but these should be used under a supervision of a dentist as the excessive use of hydrogen peroxide will weaken the enamel permanently.

After Words

If you cause damage to your enamel by these abrasive or acidic home whitening products, it will be permanent. Thin enamel not only make the teeth sensitive to cold and prone to decay but it also makes the teeth look darker or yellower in colour. The dentin under the enamel is more yellow than the enamel and it will start to show through when the enamel gets thinner.

Important facts to remember

  • you can never ever change the natural colour of your tooth by lemon, baking soda, strawberry, whitening toothpastes etc. You may be able to remove the stains from the surface of the tooth but not the actual colour that is different with every individual
  • you should never replace fluoride toothpaste with any of the above means. Thinning of the enamel together with lack of fluoride will speed up sensitivity and decaying
  • all the means of whitening the teeth will result in damage of the enamel at certain level
  • any of the whitening products do not whiten fillings or crowns
  • the surface stains will carry on building up after the whitening if you carry on smoking and drinking coffee/tea/red wine. Also the new whitened natural colour of your teeth (whitened by hydrogen peroxide) will little by little get more yellow for the same lifestyle reasons

An impartial information about the risks of teeth whitening is almost impossible to find. The internet is full of practices advertising themselves and saying it’s all fine and dandy to do the whitening. So be cautious!

If you are interested in reading reliable article click here.