Climate Change and Dentistry

Dental Revelations Blog-18

The Climate Report in 2018 wasn’t much fun to read. In fact it was rather depressing and raised many worries over the future of our children and their children. We might even face a situation where many adults living today will face the consequences of polluting our Planet Earth. We’ve all seen the warning signs – natural disasters, unusual weather like long heatwaves in countries where it is normally mild weather, extreme dryness causing crops to die just to name few.

Despite the fact that the report was worrying and depressing, I hope that all of you have read it. Hiding your head in the sand will not make it go away or change the fact that it is going to affect you as well.

We should all participate in saving the Planet Earth. Participating in saving ourselves and our children. That can be done by thinking what changes you can do in your everyday life to help in this cause. There are plenty of choices we make every day that can make a difference to the world’s future.

You can choose a product in the food store that use minimum amount of packing. For example choose muesli which has simple paper bag packaging and which is locally produced (or in your home country). Choose fruits and vegetables that have simple packaging or no packaging at all (there are re-usable fruit bags available).

Choose local fruits and vegetables or the ones that are not shipped from the other side of the world.

Reduce the amount of red meat in your diet or become a vegetarian (I’m not vegetarian but I have almost stopped eating red meat) ‘cos plant-based diet it is far more environmentally friendly than meat-based diet. Think about how large area of fields are needed to herd livestock and to grow food for them when these areas could be used for growing plant based food for humans or for growing trees that help the Planet to get rid of the carbon dioxide – it is a gas that is the largest contributor to the climate change.

Also, once you’ve done your environmentally friendly food shopping, do not use plastic bags to pack your stuff. Instead take a re-usable bags with you when you go food shopping. And why not use them the with all your shopping? Do we really need to tell everyone that we’ve been shopping at Harrods or Louis Vuitton? When the climate change reaches the point that our lives are at risk, these status symbols have very little meaning. So have one re-usable bag always tucked inside your LV hand bag, car, rucksack or pocket.

There are plenty of things we can do differently as long as we think we can make a difference. If everyone would think that it makes no difference if you buy these passion fruits that are shipped from the other side of the world or that it makes no difference if you recycle or not, we are doomed.

Together we can make a difference and you can change the way you do things in every aspects of your life, including your professional life. Personally speaking, I have noticed that I feel more and more guilty over the fact that dentistry is so very environmentally unfriendly.

Single-use materials

We produce massive amounts of waste every day. We have many disposable materials that we throw away after each patient. Many of the disposable materials are made of plastic. There’s no way going around it as disposable, single-use materials are the best option when it comes to cross infection control.

Water

Also, have you ever thought about how much water we use everyday? We wash our hands many times a day. Our rotary instruments require water, our instrument maintenance cycle requires water, our aspiration system loooves water (this is how one maintenance guy for the dental units expressed it) so we suck water into it in the morning, between every patient and in the evening. Well, at least this is how it should be done to prevent the backflow.

Backflow means bacteria and viruses travel towards the patient inside the suction tube. When patients close their mouth and form a seal around the tip of the saliva ejector, a partial vacuum occurs. Blood, viruses, saliva, bacteria, debris might travel as far as into the patient’s mouth. If you don’t believe me, read this. This of course means the patients should not close their mouths around the suction.

I have tried to change my way of using water by closing the tap (with my elbow) while I rub my hands together with soap – you know this should last 15 seconds for the soap to kill e.g. norovirus that is causing Winter Vomiting Disease. In that 15 seconds lots of water is wasted if you keep the tap on. The surgery should have taps that are easily operated without using fingers – the tap should be long enough (medical tap) for you to be able also open it with you elbow. There are also sensor-operated taps that will stop the water flow when hands are moved away from the tap.

Chemicals

We use many different chemicals that are bad for the environment. There’s no way going around this one either. Unless the manufacturers are trying to develop chemicals for disinfection that are more environmentally friendly.

Oral Hygiene Recommendations

On top of everything else we recommend to our patients products that are made of plastic. That’s why the wooden triangle-shaped tooth pick has become a product I recommend more and more (I have written about it in one of my previous posts). Of course it’s not suitable for all the patients, but for those that it is, it will make a difference in the amount of plastic waste.

Conclusion

There are not many things we can change in practising dentistry. But even the smallest changes matter. So please everyone, think about what change you can make and challenge your colleagues and friends to participate in saving the Planet.

Lets make it a norm rather than an exception to re-cycle and to live sustainable life.

Lets do it for our children.

Dental Revelations Blog-17

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Years of Malpractice – How Is It Possible?

dental-revelations-blog

Where there is smoke, there is fire. Dentists negligent behaviour should be act upon.

Ever wondered how it is possible that the dentists who are not practicing dentistry up to the standards get caught only after years of practicing the profession? Well you have come to the right place to find out.

Is It the Patients’ Fault?

Nope. Absolutely not.

The patients cannot tell the difference between a good and bad dentist when it comes to the skills of a dentist. Or if the procedures have been done as they should and if they are necessary in the first place. Or if the instruments entering their mouth have been properly cleaned (take a look at my previous post about this).

An average patient can only judge the dentist by the looks of him and the practice, and by the dentist’s chair-side manners. The rest is build on a trust of receiving good and adequate care. But every once in a while this trust is broken and the dentist ends up in the headlines.

But please remember that not all the dentists ending up to the headlines are rogue dentists as I have written previously.

Collegiality Gone Bad

Collegiality between the dentists means respect to one another’s abilities to work towards the same purpose. Helping patients. But collegiality has an ugly side as well. It is an unwritten code between the dentists which means one should not interfere or especially under any circumstances criticise a fellow dentist’s work. It is a code one should not break. The hygienists are expected to play by the same rules.

Now, this creates a problem. When a dentist is underperforming, the colleagues hear this from the hygienists and nurses. They see see it from the teeth of the patients who come too see them instead of their regular dentist (e.g. for emergency visit or whilst the regular dentist is on a holiday). They know there is a problem but very rarely they raise questions.

Instead the patient is kept under an illusion that the regular dentist has made the right decisions by distorting the truth.

Distorted truth:

“This decay is in such a difficult area to notice.”

The truth:

“This massive decay is so big that even my half-blind grandmother would find it.”

Distorted truth:

“Your dentist has marked it as an early decay, something to be kept an eye on… it has now grown bigger and needs a filling.”

The truth:

“Your dentist needs to have his eyes checked. This decay should have been filled ages ago. If you are lucky enough, you avoid the root canal treatment.”

Conclusion

It should be every dentist’s duty to report problems in colleague’s way of practicing dentistry. The Code of Ethics by ADA state the following:

Dentists should be aware that jurisdictional laws vary in their definitions of abuse and neglect, in their reporting requirements and the extent to which immunity is granted to good faith reporters. The variances may raise potential legal and other risks that should be considered, while keeping in mind the duty to put the welfare of the patient first. Therefore a dentist’s ethical obligation to identify and report suspected cases of abuse and neglect can vary from one jurisdiction to another

In my opinion, you don’t pull out the biggest guns if you suspect negligent behaviour from your colleague. The dentist in question should be given adequate time to correct the problem e.g. by revising.

The privilege of dentists to be accorded professional status rests primarily in the knowledge, skill and experience with which they serve their patients and society. All dentists, therefore, have the obligation of keeping their knowledge and skill current.

If nothing changes, more severe means should take place. This includes giving warnings and as a last resort filing a complaint to the relevant authorities.

Naturally, if the negligence is severe, one should not hesitate to contact authorities urgently.

The bible of dentistry aka ADA’s Code of Ethics 2018 in full.

 

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Repost with Forewords: Cold Sore Is Herpes – Cancel Your Dental Appointment Because Your Dentist Won’t!

Dental Revelations Blog

I am reposting one of my blog posts in the light of the news of the 10-year-old Briony who died from herpex simplex virus which the doctors failed to diagnose.

In this blog post I wrote about a dental nurse who contracted the herpes simplex virus whilst the dentist was treating a patient with a cold sore. I wrote that the GP diagnosed a primary herpes (meaning she had never had herpes infection which most people do have as a child). What I did not share with you was the fact that the dental nurse attended the GP’s practice on Friday and the GP sent her home thinking she had gingivitis. The nurse tried to tell the GP that she had seen a periodontist in her practice due to the ulceration in her mouth and it definitely wasn’t gingivitis. Nevertheless the GP advised the use of chlorhexidine mouthwash and sent her home.

Over the weekend she developed high fever (40 degrees) and could not eat anything due to sore mouth. At this point the ulceration was covering every corner of her mouth including the lips. She returned the GP’s practice on Monday morning and was barely able to stand up. Still the GP insisted it was gingivitis. But at that point the nurse realised the GP needed to see more than what he could with her just opening the mouth and him poking with this wooden spatula. So she grinned as wide as she could. The GP jumped back and said “Well that is definitely a herpes infection!” and prescribed the antiviral medication.

So it is not so uncommon that the herpes infection goes undetected by the professionals. This is one more reason to take the virus seriously – even though the deadly side of the virus should be enough of a reason, eh? Please read my post Cold Sore Is Herpes – Cancel Your Dental Appointment Because Your Dentist Won’t!

In case you haven’t read the news about Briony, click here.

My heart goes out to Briony’s family who must be devastated. RIP little Briony.


A patient came in for a long appointment to have a bridge done. This appointment was to include filing down the teeth to abutments which meant that the high-speed drill was to be used. A lot. High …

Source: Cold Sore Is Herpes – Cancel Your Dental Appointment Because Your Dentist Won’t!