Dental Care is an Essential Service - Dental Disease and COVID-19

During this time when health is on everyone’s mind, staying healthy has become an important component of everyone’s routine.  One aspect to staying healthy also includes your dental health.  More evidence is becoming available that the health of your teeth and gums impacts your immune health and your body’s response to the Coronavirus.  A recent study has linked gum disease to COVID-19 deaths.  Aspirated bacteria from your mouth may serve as reservoir for Coronavirus.

A three-month study by a Los Angeles dental surgeon and South African healthcare researcher finds a strong link between COVID-19 deaths and gum disease. The study, released August 18, 2020, found patients with gum disease release high levels of a harmful protein that spreads to the lungs, triggering a life-threatening respiratory crisis.

COVID patients with high levels of IL-6 (A protein that promotes inflammation) have a 22 times greater chance of being placed on a ventilator.  Bacteria from inflamed gums can be aspirated and adhere to the lung epithelium, promoting infection. This harmful protein, IL-6, causes increased inflammation. The study found that if you get COVID the high levels of IL-6, put you at a much greater chance of being placed on a ventilator and, consequently, an increased chance of death. The authors cite Centers for Disease Control and Prevention statistics that indicate of all COVID patients on ventilators since the pandemic began, nearly 80% have died.  A study published in May indicated the rate of recovery had increased to 64% as treatment methods improved.

The study by U.S. dental surgeon Dr. Shervin Molayem and South African scientist Carla Pontes suggests COVID patients with gum disease are more susceptible to a respiratory crisis known as a cytokine storm, essentially an overreaction of the body’s immune system.

“Gum disease has been linked to other breathing ailments, including pneumonia and chronic obstructive pulmonary disease, so we weren’t surprised to find a link to respiratory problems with COVID-19,” Molayem said in a press release. “What shocked us was the discovery of the protein’s devastating, life-threatening impact to patients once they’re hospitalized. One tiny, inflammatory protein robbed them of their ability to breathe!”

Bacteria from inflamed gums can be aspirated and adhere to the lung epithelium, promoting infection and subsequently showing up in lung fluids. The bacteria cause secondary infections that can serve as a reservoir for the coronavirus. Mechanical ventilation decreases clearance of oral secretions, increasing the bacterial load and probability of pneumonia development.

“As the death toll keeps climbing, the CDC now predicts the virus will be among the leading causes of death in the United States, just behind heart disease and cancer,” Molayem said. “Now … we’ve confirmed periodontitis makes it even deadlier.”

The researchers said they hope their findings compel nursing homes to improve dental screening protocols, since 80% of all COVID-19 deaths have been among the elderly, and urge hospitals and emergency room doctors to check new patients for gum disease.

It is easier to stay healthy than to become healthy.  Now more than ever please stay current with your dental cleaning frequency.  Keep taking your vitamins, supplements, getting good sleep and exercise. The best way to stay healthy is to live a healthy lifestyle.    If it’s been some time since you have had a dental examination and teeth cleaning, do not delay.  Schedule your dental appointment as soon as possible.  Dental offices are one of the safest places to visit with all the precautions that are in place to maintain infection control.  It is our commitment to keep are patients safe and healthy.

Dr. Craig Aebli, DDS, MS, FAGD has been promoting good oral health for more than 30 years. Oakport Dental, 2421 S. Maple Ave.

Snoring and Obstructive Airway Disease

Do you snore or know someone who does?  It may be a sign of a more serious condition known as obstructive airway disease or sleep apnea.  The three main warning signs of obstructive sleep apnea are:

·        Loud, persistent snoring

·        Pauses in breathing, accompanied with gasping episodes when sleeping

·        Excessive sleepiness during waking hours

People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.  In most cases the sleeper is unaware of these breath stoppages because they don’t trigger a full awakening.

Stopping to Breathe is Serious

Left untreated, sleep apnea can have serious and life-shortening consequences: high blood pressure, heart disease, stroke, cancer, gastric reflux, headaches, automobile accidents caused by falling asleep at the wheel, diabetes, depression, Alzheimer’s, and other ailments.

Sleep apnea is seen more frequently among men than among women, particularly African-American and Hispanic men. A major symptom is extremely loud snoring, sometimes so loud that bed partners find it intolerable. Other indications that sleep apnea may be present are obesity, persistent daytime sleepiness, bouts of awakening out of breath during the night, and frequently waking in the morning with a dry mouth or a headache. But none of these symptoms is always present. Only a sleep study in a sleep laboratory or a home sleep study can show definitively that sleep apnea is present and how severe it is.

Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.  With each apnea event, the brain rouses the sleeper, usually only partially, to signal breathing to resume. As a result, the patient‘s sleep is extremely fragmented and of poor quality.

Sleep apnea is very common, as common as type 2 diabetes. It affects more than 25 million Americans, according to the National Sleep Foundation. Risk factors include being male, overweight, and over the age of 40, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and health care professionals, the vast majority of sleep apnea patients remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotence, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated.

Who can help me find out if I have Sleep Apnea?

Health professionals trained in identifying the symptoms of obstructive sleep apnea can help determine if you are at risk.  Your primary care physician, a sleep physician, or a dentist can help you with identifying your risk.  Usually a sleep test can be prescribed, which can be done at home or at a sleep lab.  If you snore and have no obstructive breathing, a dental device can be made to stop the snoring.  If you have mild to moderate sleep apnea, which must be diagnosed by a sleep physician, a dental device can be used or continuous positive air pressure (CPAP).  Your doctor or dentist can advise you what may work best for you. 

If you suspect you or a loved one may have an obstructive airway disease, get help.  Your life may depend on it.

Dr Craig P. Aebli, DDS, MS, FAGD is trained in treating patients for snoring and sleep apnea.  He is located at Oakport Dental in Sanford, FL (407)323-5340, www.seminolesleepsolutions

Is it Safe to visit the Dentist? Dentistry in the Age of Covid-19

Since the pandemic with the coronavirus started, everything in the world has changed. The way we interact and do business has seen profound changes in order to prevent the spread of the virus.  This of course has affected the way medical and dental offices are operating.

Most everyone is wearing masks now. Dental office personnel have been wearing masks on a daily basis for very many years. However, many things have changed in the way dental offices are operating since re-opening during this pandemic. Infection control has always been routine in most dental practices. Covid-19 has now elevated infection control standards to a whole new level.

The guidelines for practising dentistry safely has been outlined by the CDC and the American Dental Association. So that patients and office personnel are kept safe, these are the new protocols all dental offices should be doing. Walking into the front door of your dental office may not me be allowed anymore. Once you arrive at the office, you may have to call the office and tell them you have arrived. Someone from the office may meet you at your car to ask some health questions and take your temperature. If you are cleared, you may enter the office. Everyone in the office should be wearing masks. You should wear a mask until you are in a treatment room. Dental office workers may be wearing gowns, long sleeved lab coats, and face-shields as well. A limited number of patients may be allowed in the office at one time. Additional persons or family members may be asked to wait outside.

Treatment rooms may be isolated with some type of barrier and have extra air purification systems. The dentist or hygienist may use an extra oral suction device while working in your mouth to keep the air clean from aerosol spray. As always, all surfaces are wiped down and disinfected. All instruments are sterilized. All these measures as designed to create a clean environment and to prevent cross contamination.

Can I put off my dental appointment until after the COVID-19 pandemic is over? 

Regular dental appointments are an important part of taking care of your overall health. While it can be tempting to put off your regular checkup until things feel more “normal” again, we advise against it. Routine appointments give me an opportunity to check for a number of health conditions and catch them early. Some conditions, like tooth decay, can be more difficult, painful and expensive to treat if they’re left undetected. Your health and safety is, and has always been, a top priority. Dentists and staff are taking every precaution to limit the risk of COVID-19 transmission at your visit.

How is the dental team monitoring themselves for COVID-19? 

Staff at a practice should be subject to daily health screenings. This includes taking their temperatures to make sure they don’t have a fever and asking them a series of health-related questions each day to make sure they’re not experiencing any symptoms of COVID-19.

You said you cannot see me as a patient because of my COVID-19 risk. Can you do that? 

Yes. The safety of patients and the dental team is the highest priority. As Dentists, we use our professional judgment and guidance from Centers for Disease Control and Prevention (CDC) and ADA to determine risk levels for seeing patients. If it was determined that you are high risk, or had a high temperature on the day of your appointment, a discussion about which factors may determine a delay of service, so that you can self-monitor and reschedule.

Is it Safe to Visit the Dentist?

Because of all the measures being done in dental offices to insure the safety of patients and staff, the dentist is probably one the safest places you can visit now. A study done by MIT, and reported by Fast Company, has concluded that visiting a dental office is one of the safest businesses to which you can go.

Ref.:  https://www.fastcompany.com/90516328/mit-researchers-say-these-are-the-unsafe-businesses-to-avoid-during-covid-19-and-these-are-okay

https://www.ada.org/en

Dr. Craig Aebli, DDS, MS, FAGD has been treating patients safely for more than 25 years.
Oakport Dental, 2421 S. Maple Ave, Sanford, FL 32771, (407)323-5340, www.oakportdental.com

Do I have TMJ and What Does It Mean

TMJ actually stands for temporomandibular joint (TMJ). It is the sliding hinge, connecting your jawbone to your skull.  You have one joint on each side of your jaw. If you have a problem with that joint it can be a TMJ disorder, also called a temporomandibular disorder or TMD.  It can cause pain in your jaw joint and in the muscles that control jaw movement.

The exact cause of a person's TMJ disorder is often difficult to determine.  Your pain may be due to a combination of factors, such as genetics, arthritis or jaw injury.  Some people who have jaw pain also tend to clench or grind their teeth (bruxism), although many people habitually clench or grind their teeth and never develop TMJ disorders.

In most cases, the pain and discomfort associated with TMJ disorders is temporary and can be relieved with self-managed care or nonsurgical treatments.  Surgery is typically a last resort after conservative measures have failed, but some people with TMJ disorders may benefit from surgical treatments.

Symptoms

Signs and symptoms of TMJ disorders may include:

• Pain or tenderness of your jaw
• Pain in one or both of the temporomandibular joints
• Aching pain in and around your ear
• Difficulty chewing or pain while chewing
• Aching facial pain
• Locking of the joint, making it difficult to open or close your mouth

TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there's no pain or limitation of movement associated with your jaw clicking, you probably don't need treatment for a TMJ disorder.

Causes

The temporomandibular joint combines a hinge action with sliding motions. The parts of the bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disk, which normally keeps the movement smooth.

Painful TMJ disorders can occur if:

• The disk erodes or moves out of its proper alignment
• The joint's cartilage is damaged by arthritis
• The joint is damaged by a blow or other impact

In many cases, however, the cause of TMJ disorders isn't clear.

Risk factors

Factors that may increase the risk of developing TMJ disorders include:

• Various types of arthritis, such as rheumatoid arthritis and osteoarthritis
• Jaw injury
• Long-term (chronic) grinding or clenching of teeth
• Certain connective tissue diseases that cause problems that may affect the temporomandibular joint

When to see a doctor

Seek medical attention if you have persistent pain or tenderness in your jaw, or if you can't open or close your jaw completely.  Your doctor, your dentist or a TMJ specialist can discuss possible causes and treatments for your problem. If your problem is muscle related, and the tension in them is from grinding or clenching your teeth, a custom made mouth or night-guard may be indicated.  A proper examination and evaluation by your dentist or TMJ specialist can determine the best way to treat your condition.

Ref.- Mayoclinic.org

Dr. Craig Aebli, DDS, MS, FAGD has been treating patient with TMJ related problems for more than 25 years.  Oakport Dental, 2421 S. Maple Ave, Sanford, FL 32771, (407)323-5340, www.oakportdental.com

Harmful Habits for Your Teeth and How to Break Them

With the new year upon us, many people make new year resolutions to start the year with positive behaviors that can improve their health and overall well-being.  Some of those habits can impact your dental health as well.

Some of the harmful habits that affect the health of your teeth include:

1. Nail biting
2. Brushing too hard
3. Chewing on ice
4. Grinding and clenching
5. Constant snacking and sipping on soft drinks
6. Using your teeth as tools

We will look at each one of these habits and what you can do to break them.

Nail biting

The habit: This nervous habit can chip teeth and impact your jaw joint.  Placing your jaw for long periods of time in a protruding position can place pressure on it.  This can lead to jaw joint (TMJ) soreness and dysfunction.

The solution: Bitter-tasting nail polishes, stress reduction and setting small, realistic goals can help. If certain situations are triggers, hold something to keep your fingers busy.

Brushing Too Hard

The habit: Brushing for two minutes twice a day is one of the best habits you can get into. Just make sure you’re not trying too hard. Brushing with a hard toothbrush, or brushing too hard, can damage teeth and irritate gums. It can also cause gum recession and abrasion of the tooth roots at the gum-line.

The solution: Use a soft toothbrush with the ADA Seal of Acceptance at the proper pressure. Don’t think of scrubbing, think massage.  Save the hard toothbrush for cleaning the grout in the bathroom tile.  Another option is using a power toothbrush that uses an ultrasonic vibration to do the cleaning work for you.

Chewing on Ice

The habit: Tooth enamel is a crystal. Ice is a crystal. When you push two crystals against each other, one will break. Most of the time it’s the ice, but sometimes the tooth or a filling will break.

The solution: Drink chilled beverages without ice, or use a straw so you're not tempted. The risk of chewing ice is greater than any pleasure that comes from chewing it.  Since ice is really cold it can make your teeth more sensitive.

Grinding and Clenching

The habit: This can cause chipping or cracking of the teeth, as well as muscle tenderness or joint pain. You might also feel like you can’t open your mouth wide or cause chewing with pain.

The solution: Relaxation exercises and staying aware makes a difference.  A nighttime mouthguard can also help. Clenching may also be a sign of sleep disordered breathing or sleep apnea. If you can’t breath while you’re sleeping your body forces your jaw to move to open your airway. You’ll have less tooth damage, less pain and muscle soreness, and better sleep. See www.seminolesleepsolutions.com for more information on sleep apnea.

Constant Snacking 

The habit: Grazing all day, especially on sugary foods and drinks, puts you at a higher risk for cavities. When you eat, cavity-causing bacteria feast leftover food, producing an acid that attacks the outer shell of your teeth.

The solution: Eat balanced meals to feel fuller, longer. If you need a snack, make sure it's low in fat and sugar. If you indulge in the occasional sugary treat, follow it with a big glass of water to wash away leftover food.

Using Your Teeth as Tools 

The habit: Your teeth were made for eating, not to stand in as a pair of scissors or hold things when your hands are full. When you do this, you put yourself at a higher risk of cracking your teeth, injuring your jaw or accidentally swallowing something you shouldn’t. 

The solution: Stop and find something or someone to give you a hand. Your mouth will thank you.

Reference: www.mouthhealthy.org

Dr. Craig Aebli, DDS, MS, FAGD has been promoting health oral habits for more than 30 years. Oakport Dental, 2421 S. Maple Ave. Sanford, FL 32771. (407) 323-5340. www.oakportdental.com