Category: Dentistry

Recent research has compared how the dental industry looked during Covid-19 and before the pandemic. This has implications for the modern day, as many people are yet to return to a dental clinic since the pandemic. The findings were rather concerning, with there being many decreases in various areas, including preventive healthcare like check-ups and restorative procedures.

In concerning news, new research has found that there has been a significant decrease in the provision of preventive oral healthcare services when compared to the levels seen prior to Covid-19 [1].

These results have raised concerns that there could be a long-term impact on oral health. This may only be evident in years to come.

The authors of the research have proposed a few potential explanations for this. Regardless of the reasons behind this, it is a concerning situation.

Dentistry in the Covid-19 pandemic

Dentistry was one of the most affected industries during Covid-19. Routine and non-emergency dentistry was suspended in 2020, resulting in only those requiring urgent dental care receiving treatment [2].

As a result of this, tens of millions of people around the world missed their planned dental check-ups. Some people are still waiting for these appointments to be re-scheduled, with some dental clinics continuing to work through a backlog of appointments.

The Research

The research was undertaken by Delta Dental, an institute that is dedicated to advancing oral health for all Americans. Their findings were published in the Journal of the American Dental Association [1].

The research team were looking to assess the impact that the Covid-19 pandemic had on oral healthcare that was provided between July 2020 and December 2021 [1]. This included the peak months of the pandemic.

The team used national claims data. In order to gain a picture of oral healthcare during the above time period, they used past data as a comparison tool. Therefore, the team used data from 2017 to 2019 – as this represented pre-pandemic dentistry [1].

Then, the data was sorted into various treatment categories. This allowed the researchers to identify which treatments had seen a rise or fall during the pandemic.

When the research team compared the two data sets, there were concerning findings. This included the realization that all age groups – especially those aged under 65 – had seen worse statistics post-pandemic [1].

For children aged from 0 to 5, the use of sealants and topical fluorides other than varnish were significantly lower in 2021 [1].

For children aged 6 to 18, there were huge decreases. Regular check-up diagnostics, operations, surgery and periodontic procedures were all down in 2021 compared to 2019 [1].

For adults, as well as having similar trends to those seen in the 6 to 18 age group, they also had significantly less gingival surgery [1]. Therefore, this suggests that there was a lack of surgeries for gum disease in this time.

However, the researchers did find that in adults, incidences of root planing and scaling – two methods used in treating gum disease – had increased [1]. This suggests that in the absence of any surgery, patients compromised by utilizing root planing or scaling for their gums.

The only increases seen were in the use of silver diamine fluoride and prefabricated crowns [1]. This suggests that many who needed emergency care opted to use a crown, as it typically provides more stability to the tooth that has been worked on. This may have been a way of providing longer-term success to what was most likely a short-term fix from a dental clinic.

Long-term impact

The overall picture suggested that there has been a trend towards less patients having preventive care. The lack of check-ups and other preventive care is very concerning.

It is very likely to have long-term implications. We may see in the next few years a large number of people needing restorative work done, as many have not returned to a clinic since the pandemic.

Other barriers exist too, including cost and access to dental clinics. Then there has also been decreases in employer-sponsored dental benefits too [3].

Joseph Dill is the Chief Dental Officer at Delta Dental [3]. He discussed the findings. Dill noted that “while we’re through the pandemic, we’re just beginning to understand the long-term impacts it could have on the nation’s oral and overall health” [3].

Moreover, Dill has pointed out some concerns. For example, he said that “the reduction in preventive procedures seen across age groups could lead to an increase in caries or deterioration of periodontal status, particularly for people who require regular preventive and maintenance care” [3].

Furthermore, Dill also pointed out the implications of this on physical health. He said that “this can exacerbate other health problems, like risk of stroke, high blood pressure, and diabetes” [3].

There are certainly a number of concerns caused by these findings. Hopefully though, we will soon see a resurgence in the number of appointments being booked.

Thinking points…

1) The researchers in this study have pointed out the physical health consequences that poor oral health can have. Let this be a reminder to you of the importance of your oral health! Remember to keep good care of your teeth and attend regular dental check-ups. We recommend making an appointment now!

2) Some people haven’t made a dental appointment since dental clinics reopened after Covid-19. If you are one of these people, we strongly recommend that you book a check-up as soon as possible! This will provide a dentist with the chance to look at your oral health and provide treatment options if needed. Therefore, remember to book soon!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a wide range of dental treatment options and advice aimed at improving their oral health.

We advise our patients to attend our Calgary-based dental clinic twice a year for a regular dental check-up. When problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals. To try and prevent problems, it is important to brush your teeth at least twice a day and floss regularly.

Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, tooth whitening and Invisalign™! Many people find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, all of our services at our Calgary dental clinic Savanna Dental are in line with the Alberta Dental Fee Guide.

We would love you to visit our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Dill, J., Fontana, M., Bader, J., Chaffin, J., Strock, S., & Eckert, G. (2023). Impact of the COVID-19 pandemic on oral health care use in the United States through December 2021. The Journal of the American Dental Association. 154 (10): P937-947.DOI: https://doi.org/10.1016/j.adaj.2023.07.012.

[2] Rivas, K. (2020). Amid coronavirus, avoid nonessential dental care, WHO says. Available: https://www.foxnews.com/health/who-coronavirus-avoid-nonessential-dental-care. Last accessed: 26th October 2023.

[3] Delta Dental Institute. (2023). New research from Delta Dental finds a significant decrease in the provision of preventive oral health services resulting from the pandemic, raising concerns about long-term impacts. Available: https://www.prnewswire.com/news-releases/new-research-from-delta-dental-finds-a-significant-decrease-in-the-provision-of-preventive-oral-health-services-resulting-from-the-pandemic-raising-concerns-about-long-term-impacts-301961466.html. Last accessed: 26th October 2023.

Tooth decay can result in inflammation in the dental pulp – which is the innermost part of the tooth. Trying to avoid this is crucial, as it usually requires a Root Canal treatment. Now, a research team has looked at how the mechanisms involved in dental inflammation and root damage can be impacted by various situations. This is an important subject area to review.

Recent research has yielded discoveries regarding the mechanisms involved in dental pulp inflammation and root damage [1].

These discoveries will enable a search to take place for medications that can stop bone loss, when a tooth becomes impacted by endodontic infection.

What is the dental pulp?

The dental pulp refers to the innermost part of the tooth. Therefore, it sits below both enamel and dentin, and contains blood vessels, tissues and nerves.

When teeth become decayed, it can result in a tooth’s pulp becoming inflamed. This often advances to the stage where there is an infection at the root of a tooth, which is known as an abscess.

When this happens, a root canal treatment is normally needed to save the tooth. This is a more complex dental procedure that rarely provides permanent results [2].

The Research

The results involving the mechanisms involved in dental pulp inflammation and root damage have come from two research papers [1].

Both studies were published in the Journal of Endodontics [1]. They both used the key element of the aforementioned mechanisms as a basis for their studies.

The key element is tumor necrosis factor-a receptor-1 (TNFR1), which, when binding to the cytokine TNF-a, causes inflammation to develop [1].

The researchers used various situations to experiment this element. This is where the two studies took different approaches – although both involved analyzing the pathway between TNFR1 and TNF-a.

In the first study, the researchers looked to see how the pathway reacted to dental pulp capping – which is a procedure where bioactive materials are placed over an exposed pulp, thereby encouraging healing [3].

They found that when TNFR1 is altered, it results in inflammation and subsequent bone loss [3]. It can result in severe problems, including rapid demineralization.

The team used a mouse that was deficient in TNFR1 to discover this. They took tissues at both 7 and 70 days, which resulted in an analysis taking place, helping them to reach their conclusion.

In the second study, the researchers investigated how the pathway reacted following root canal contamination [4]. This effectively involves a situation where a person has root canal but the pulp becomes contaminated.

They found that the pathway reacted well. Furthermore, they demonstrated that when the pathway blocks the presence of microorganisms, the number of issues can be reduced [4].

The researchers found that the pathway could assist in protecting against inflammation and bone loss – which is crucial in oral health [4].

After analyzing these situations, the research team concluded that the difference between these situations was the presence of microorganisms [1].

The next steps

The research team are hoping that now that there is a better understanding of the mechanisms involved in inflammation of the dental pulp, that it could be possible to search for a medicine that can assist with stopping bone loss [1].

Paula Silva, who took part in both studies, said that the group “realized from these research findings that a treatment protocol could be developed” – which he suggested was “a very interesting target” they aim to reach in the future [1].

While such creations are likely to be quite some time away, this research has helped scientists to understand what is involved in dental pulp inflammation. Therefore, this can help with future research and the potential development of a medicine to target these issues.

Thinking points…

1) The research looked at the topic of dental pulp inflammation. Tooth decay is the main cause of this. If you don’t catch tooth decay early, it can eventually result in the pulp becoming inflamed. Therefore, rather than a simple cavity filling being needed, it can require a root canal treatment. Make sure you look after your teeth and visit a dental clinic at the first sign of decay!

2) Following on from the above point, it is very important that you attend dental check-ups on a regular basis. Here at Savanna Dental, we recommend that you go to a dental clinic at least once every six months. This will enable any issues to be identified and then treated. We recommend booking an appointment now!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a wide range of dental treatment options and advice aimed at improving their oral health.

We advise our patients to attend our Calgary-based dental clinic twice a year for a regular dental check-up. When problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals. To try and prevent problems, it is important to brush your teeth at least twice a day and floss regularly.

Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, tooth whitening and Invisalign™! Many people find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, all of our services at our Calgary dental clinic Savanna Dental are in line with the Alberta Dental Fee Guide.

We would love you to visit our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Constantino, L. (2023). Discovery of mechanism involved in dental inflammation paves way to therapies against bone loss. Available: https://medicalxpress.com/news/2023-10-discovery-mechanism-involved-dental-inflammation.html. Last accessed: 9th October 2023.

[2] Watson, S. (2021). Tooth Pulp Function and Inflammation. Available: https://www.verywellhealth.com/tooth-pulp-dental-terms-1059180. Last accessed: 9th October 2023.

[3] de Almeida-Junior, L. A., Araujo, L. D. C., Lamarque, G. C. C., Arnez, M. F. M., Kapila, Y. L., da Silva, L. A. B., & de Paula-Silva, F. W. G. (2023). Reparative Dentin Formation Following Dental Pulp Capping is Mediated by TNFR1 In Vivo. Journal of Endodontics. 49 (10): p1329-1336. DOI: https://doi.org/10.1016/j.joen.2023.06.015.

[4] de Almedia-Junior, L. A., de Carvalho, M. S., Almeida, L. K. Y., Silva, R. A. B., Silva, L. A. B., & de Paula-Silva, F. W. G. (2023). TNF-α–TNFR1 Signaling Mediates Inflammation and Bone Resorption in Apical Periodontitis. Journal of Endodontics. 49 (10): p1319-1328. DOI: https://doi.org/10.1016/j.joen.2023.07.013.

Recent research has looked into how flossing technique impacts the effectiveness of flossing. Flossing is a key part of oral health and is an excellent tool to protect your teeth and gums. However, flossing is something that many people ignore. For those that do floss, the research has shown that using the correct technique can boost their oral health.

The importance of flossing cannot be understated. It is crucial for removing debris that a toothbrush can’t reach, and helps protect against cavities and bad breath.

However, while most people brush their teeth regularly, flossing is something that many people forget to do. Furthermore, for those that do floss, many do not know how to do so effectively.

Recent research has looked into what impact proper flossing technique has [1]. The results show that flossing is very important and has a positive impact. This impact is more pronounced when proper flossing technique is used.

Background

Flossing can help remove debris from food and anything else in the mouth. Furthermore, it stops dental plaque from forming, aiding cavity prevention. It also helps gum health.

The United Kingdom’s NHS recommends that people floss from the age of 12 [2]. But while dentists always praise flossing, there has been some debate on its effectiveness.

2016 Associated Press article

One of the key factors in this research was a somewhat controversial article from the Associated Press in 2016 [1]. The article, which used findings from numerous studies, stated that there was “little proof that flossing works” in the long-term [3].

At the time, it caused some debate on if flossing was actually effective. Dentists pointed out that gum disease can take many years to develop – making long-term studies unrealistic [1].

The Research

The research was carried out by a team from Tufts University School of Dental Medicine. Their findings have been published in the Journal of Dental Hygiene [1].

As mentioned, the research team wanted to provide evidence that dental flossing is an effective activity, which could dispute the findings of the Associated Press [1].

One of the first things they realised was that many people weren’t flossing accurately. Therefore, this limited the effectiveness of flossing.

They recruited 36 study participants. These participants all had a diagnosis of Gingivitis – the earliest stage of gum disease [1]. Gingivitis is a very common condition. With bleeding gums being a common symptom of gingivitis, the researchers decided this would be the key area that they would look out for.

Then, the participants were split into two groups. One group were trained to floss using a technique called “adapted horizontal vertical flossing”. Meanwhile, the other group were left to continue their usual flossing style [1].

The participants were asked to floss every night for an eight week period. After eight weeks, the researchers looked to see how common bleeding gums were among both groups.

Incredibly, those that had used the adapted horizontal vertical flossing technique had seen a 70% reduction in bleeding gums [1].

Also, those that flossed using their own technique saw a 30% reduction in bleeding gums [1]. This shows that even when the optimal technique isn’t used, any form of flossing can still have a positive impact.

Overall, the researchers concluded that people that learned and consistently used proper flossing technique showed fewer signs of gum disease and other oral health problems. However, the study also found any form of flossing can be effective.

What is proper flossing technique?

The study recommended that the below technique should be used [1]:

• Wrap each end of a 15–18-inch length of floss around the ring or middle finger of both hands.

• This should leave around 5-6-inches of floss to use. Hold this floss with the index finger or thumb of each hand. Use around three quarters of floss between the fingers of each hand.

• Start at one end of either the top or bottom set of teeth and apply the floss to the curved surface of the tooth – essentially bending a “c” shape around the tooth.

• Carefully move the floss in a forward-backward motion and upwards and downwards – this should remove any debris

• Continue this process for each tooth [1]

By following the above technique, it should result in effective flossing. This can boost your oral health and protect your gums.

The authors were pleased with the outcome of the research. Paul Levi of Tufts University, said that this was the first study “to prove that a person using floss with a specific technique will have less gum infection than a person who just does what they normally do” [4].

Making flossing a regular part of your oral hygiene routine is crucial! Furthermore, as this study shows, using an effective method is equally important!

Thinking points…

[1] Flossing can protect against cavities and gum disease. Another important part of preventing oral health is to attend regular dental check-ups. A check-up provides a dentist with an opportunity to take a look at your oral health in detail, and identify any problems. It is important to frequently attend check-ups. We recommend booking an appointment now!

[2] Many people do not floss. This might be due to not feeling it is worthwhile, being lazy, or just forgetting. But as this research has shown, it can have very strong results for our oral health. Therefore, try and find a way of incorporating flossing into your bedtime routine – and ensure you do it either just before or straight after brushing your teeth. We recommend figuring out a routine now!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a wide range of dental treatment options and advice aimed at improving their oral health.

We advise our patients to attend our Calgary dental clinic at least twice per year for a regular dental check-up. At these check-ups, we provide a comprehensive review of a patient’s oral health. If any problems are detected, we have many treatments available. For example, these include cavity fillings and root canals. To strengthen your oral health, we recommend brushing your teeth at least twice a day and flossing regularly.

Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, teeth whitening and Invisalign™! Many people find that these treatments have a positive impact on their appearance, confidence and self-esteem.

Moreover, all of our services at our Calgary dental clinic Savanna Dental are set in line with the Alberta Dental Fee Guide. This ensures transparent and fair pricing.

We hope to see you soon at our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Basali, D. H., Hong, I., Finkelman, M., Dragan, I. F., Gyurko, R., Uzel, N. G., & Levi, P. A. (2023). The Effect of Dental Flossing Instructions and Technique on Interproximal Bleeding: A randomized control trial. Journal of Dental Hygiene. 97 (4): p36-45.

[2] NHS. (2019). Why should I use dental floss?. Available: https://www.nhs.uk/common-health-questions/dental-health/why-should-i-use-dental-floss/. Last accessed: 23rd September 2023.

[3] Associated Press. (2016). Untitled. Available: https://apnews.com/article/f7e66079d9ba4b4985d7af350619a9e3. Last accessed: 23rd September 2023.

[4] Ragovin, H. (2023). You could be flossing all wrong, if you’re even flossing at all. Available: https://medicalxpress.com/news/2023-09-flossing-wrong-youre.html. Last accessed: 23rd September 2023.