Category: Oral Health

The American Dental Association (ADA) has produced new recommendations for dentists over the use of radiographic exams. These new recommendations have been produced by an expert panel, and aim to improve safety for dentists and their patients. These recommendations will result in some changes to dentistry.

The American Dental Association (ADA) has issued new guidance and recommendations over the use of radiographic exams [1].

These new guidelines mark a departure from previous advice that has been used consistently in the past. The new advice comes from an expert panel.

The changes aim to improve protection for both dentists and patients. Dentists will need to take these recommendations on board.

Background

Radiography is a very important part of modern-day dentistry. It refers to the use of X-Rays – called radiographs – which produce detailed images of a patient’s mouth.

Radiographs help a dentist to analyze the teeth of their patients. An X-Ray can help to identify any tooth decay, bone loss, gum disease or an infection. They aid a dentist in their diagnosis of dental problems.

The research also took into account something called Cone Beam computed tomography, which is a type of X-ray machine which is used at times where a regular dental X-ray doesn’t provide sufficient detail [2].

However, there are risks involved in radiography. Research shows that long-term exposure to dental X-rays can in some cases result in extreme conditions like brain tumours and thyroid dancer [3].

Therefore, looking at the safety of radiography is very important. It is important to state that dental clinics have measures in place to limit the damage of X-rays, with dentists taking precautions against harm.

The Guidelines

The guidelines have been formulated by an expert panel. Their main focus has been on radiography – which is a key part of healthcare.

Subsequently, the recommendations have been published via the Journal of the American Dental Association [1].

These recommendations have come after an analysis of 95 existing research articles, guidance documents and regulations based on radiography [1]. Moreover, this analysis allowed the team to analyse the overall safety profile of radiography.

The ADA recommend that prior to taking radiographs, dentists should consider what diagnostic information is required from the images, in order to benefit patient care and improve clinical outcomes [1].

Furthermore, the ADA suggested thyroid and abdominal shielding during dental imaging is no longer recommended. Also, they recommend that the use of protective shielding should be discontinued [1].

This is based on how lead aprons and thyroid collars – which are normally used by dentists for protective shielding – can actually block the X-ray beam, which can mean an X-ray picture isn’t captured correctly [1].

Instead, the ADA have said that evidence suggests modern digital radiography equipment, along with restricting the X-ray size to only the area that needs to be captured, can better protect dentists and patients alike [1].

In regards to cone bean computed tomography, the recommendations also state that this should only ever be used when regular X-rays have not provided the required diagnostic information [1].

There are other, smaller recommendations put forward. For example, the ADA have also recommended ensuring that patients are positioned properly for the most accurate X-ray pictures, and the need to adhere to any federal or state regulations on radiation safety [1].

The ADA believe that these recommendations will improve protection against radiation in dental radiography and the aforementioned cone beam computed tomography [1].

Summary

Understanding and acting upon the implications of radiation is important. These recommendations should help dental clinics to achieve this.

These recommendations will hopefully improve safety for both dentists and patients. The recommendations apply to all patients, regardless of their age or health [1].

Dr. Purnima Kumar is the Professor of Dentistry at the University of Michigan’s School of Dentistry. He also chairs the ADA’s Council on Scientific Affairs – who produced the recommendations [4].

Commenting, Kumar said that the ADA “encourage dentists and their teams to review these best-practice recommendations, comply with radiation protection regulations and talk with their patients about any questions or concerns before ordering dental imaging” [4].

These recommendations are important for everyone in dentistry. It can improve safety for dentists, dental clinic staff, and patients, along with providing other benefits.

Thinking points…

1) These recommendations are unlikely to impact patients too much, so there is no need to change your regular dental appointment schedule. We recommend that you visit the dentist at least twice a year. At a regular check-up, a dentist can have a thorough look at your mouth, provide advice and suggest treatment if needed. If you are due an appointment, we recommend booking now!

2) When reading this article, you may feel concerned about the use of X-rays in dental clinics. However, please do not worry! There are many safety precautions in place which ensure safety for both patients and clinicians. If you have any questions or worries, we recommend speaking to your dentist at your next appointment!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice, with the aim of improving oral health and boosting overall wellbeing!

We advise our patients to attend our Calgary-based dental clinic twice a year for a dental check-up. If any 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™! Our patients find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, the fees of our services at our Calgary dental clinic Savanna Dental are set 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] Benavides, E., Krecioch, J. R., Connolly, R. T., Allareddy, T., Buchanan, A., Spelic, D., O’Brien, K. K., Keels, M. A., Mascarenhas, A. K., Duong, M-L., Aeme-Bowe, M. J., Ziegler, K. M., & Lipman, R. D. (2024). Optimizing radiation safety in dentistry. The Journal of the American Dental Association. (Pre-publication issue). DOI: https://doi.org/10.1016/j.adaj.2023.12.002.

[2] RadiologyInfo.org. (2022). Dental Cone Beam CT. Available: https://www.radiologyinfo.org/en/info/dentalconect. Last accessed: 9th February 2024.

[3] Hwang, S-Y., Choi, E-S., Kim, Y-S., Gim, B-E., Ha, M., & Kim, H-Y. (2018). Health effects from exposure to dental diagnostic X-ray. Environmental Health and Toxicology. 33 (4): e2018017. DOI: https://doi.org/10.5620%2Feht.e2018017.

[4] Versaci, M. B. (2024). Using thyroid collars during radiographic exams no longer recommended by ADA. Available: https://adanews.ada.org/ada-news/2024/january/using-thyroid-collars-during-radiographic-exams-no-longer-recommended-by-ada/. Last accessed: 9th February 2024.

Water Fluoridation is commonly regarded as one of the most effective health advancements in recent decades. Studies have consistently shown the benefits of water fluoridation to oral health. However, with fluoride commonly found in other products, can governments and policymakers justify the costs of further water fluoridation projects? Now, new research has tackled this topic.

Recent research has looked into the impact of Water Fluoridation programs in England. This includes both existing programs, and potential projects in the future.

The research suggests that while existing water fluoridation programs help to save money, there is no guarantee that future schemes will follow the same pattern [1].

This is an interesting finding, with water fluoridation a topic that elicits differing responses from many nations. These findings may help to guide future government policies.

What is Water Fluoridation?

Water Fluoridation refers to the process where a small amount of the natural chemical Fluoride is added to the public water supply. Numerous studies have shown that water fluoridation is associated with a reduction in cavities [2].

However, water fluoridation has also proven to be a controversial topic. Many countries have banned its practice outright, citing ethical concerns, and the potential dangers to over-exposure to fluoride.

This research took place in the United Kingdom. Approximately 11% of those living in England live in areas with water fluoridation schemes [3]. Therefore, the majority do not. The cities of Newcastle and Birmingham are among the largest areas to have water fluoridation schemes [3].

As the majority of research into water fluoridation was conducted prior to fluoride being added to toothpaste in the 1970s, it has been argued that more contemporary research is needed.

The Research

The research was carried out by the University of Manchester. Their findings have been published in the Community Dentistry and Oral Epidemiology journal [1].

Their research forms the largest ever study into the effects of water fluoridation on the dental health of adults [1]. In England, the majority of people access their dental care through the National Health Service (NHS).

The research involved looking at 6.4million adults and adolescents living in England [1]. Across these millions of adults, some lived in areas with fluoridated water, while others didn’t.

This created two cohorts. The researchers looked to see how patients in each cohort reacted over a 10-year period. Furthermore, this involved looking at areas like fillings, teeth extractions, tooth decay and missing teeth [1].

Overall, the findings were largely positive in respect to water fluoridation. Over the 10-year period, areas with water fluoridation cost £10.30 per person on average [1]. Moreover, NHS treatment costs were £22.26 lower per person – representing a 5.5% reduction compared to those in areas without water fluoridation [1].

Moreover, patients in fluoridated areas paid marginally less in dental charges. Unlike the majority of the NHS, dental care is not free in the UK. On average, those in fluoridated areas paid £7.64 less than their counterparts in non-fluoridated areas [1].

In locations where water fluoridation was in operation, there was a 3% reduction in NHS invasive dental treatment like fillings and extractions [1]. Moreover, there was a 2% reduction in decayed, missing, and filled teeth [1]. These reductions were in comparison to a group of people that lived in non-fluoridated areas over the 10 years.

The researchers came to the conclusion that the public sector saved £16.9million between 2010 and 2020 due to water fluoridation [1]. This presents large savings to the NHS.

Are the benefits worthwhile for the future?

Based on the findings, it could be argued that water fluoridation is worthwhile, and that further water fluoridation programs should take place.

However, the NHS needs to take cost into consideration, and may need to judge if the outlay required for further water fluoridation programs can be justified based on cost savings.

For example, while there were benefits to those in fluoridated areas, these improvements were rather marginal. Therefore, it is questionable as to whether or not these modest improvements can justify the expenditure involved.

A new water fluoridation scheme that would replicate similar programs from 2009 would cost approximately £50million. Therefore, based on this research, it would take around 30 years for the NHS to experience any savings [1]. This represents a significant time period.

It has also been argued that people have more access to fluoride through toothpastes and mouthwashes in the present day. This also adds to the suggestion that water fluoridation programs are not entirely needed for future generations.

Summary

Water fluoridation has been hailed as one of the most important health advancements in recent decades. There are many benefits to it, despite some opposition to it.

But water fluoridation isn’t enough on its own. Excellent oral hygiene and regular check-ups are needed. After all, there have been concerns from dentists over tooth decay levels.

For example, lead author Dr. Deborah Moore – from the University of Manchester – has said that “tooth decay remains almost universal by adulthood, even in populations that have had access to fluoride toothpastes and fluoridated water from birth” [4]. Therefore, even those in fluoridated areas are still able to develop tooth decay.

Overall, while existing water fluoridation programs in England provide marginal savings for the NHS, there is no guarantee that new schemes would continue to provide such cost savings. This represents an interesting dilemma for health professionals and policymakers going forward.

Thinking points…

[1] While the addition of fluoride to toothpaste and mouthwash products has helped to protect against cavities, we all need to ensure we have excellent oral hygiene! This includes attending regular dental check-ups, as this provides your dentist with the chance to examine your mouth, provide advice, and suggest treatment if needed. You should attend the dentist at least twice per year. We recommend booking an appointment now!

[2] Do you know if the area you’re in has fluoridated water? It can be interesting to find out! Why not have a discussion about the topic with those around you to see how everyone feels towards its practice? Feel free to share this article with your friends and family to start a discussion! You could also speak about it to your dentist if you need further advice.

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice, with the aim of improving oral health and boosting overall wellbeing!

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™! Our patients find that these treatments have a positive impact on their appearance, confidence and self-esteem.

Moreover, the fees of our treatments at our Calgary dental clinic Savanna Dental are set in line with the Alberta Dental Fee Guide. This ensures transparent and fair pricing, with no hidden costs.

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] Moore, D., Nyakutsikwa, B., Allen, T., Lam, E., Birch, S., Tickle, M., Pretty, I. A., & Walsh, T. (2024). How effective and cost-effective is water fluoridation for adults and adolescents? The LOTUS 10-year retrospective cohort study. Community Dentistry and Oral Epidemiology. (Pre-publication issue).DOI: https://doi.org/10.1111/cdoe.12930.

[2] Slade, G. D., Grider, W. B., Maas, W. R., & Sanders, A. E. (2018). Water Fluoridation and Dental Caries in U.S. Children and Adolescents. Journal of Dental Research. 97 (10): p1122-1128. DOI: https://doi.org/10.1177%2F0022034518774331.

[3] Department of Health & Social Care. (2022). Health and Care Bill: water fluoridation. Available: https://www.gov.uk/government/publications/health-and-care-bill-factsheets/health-and-care-bill-water-fluoridation. Last accessed: 17th January 2024.

[4] Addelman, M. (2024). Future benefits of water fluoridation not guaranteed, study shows. Available: https://medicalxpress.com/news/2024-01-future-benefits-fluoridation.html. Last accessed: 17th January 2024.

The announcement of the Canadian Federal Government’s National Dental Care Plan was hailed as an exciting and transformative moment for healthcare in Canada. However, various provinces have raised concerns over how existing dental programs will co-exist with the government’s plan. This has resulted in concerns that many Canadians will see a change in their dental care, while costs of the federal plan could also rise significantly.

The National Dental Care Plan has received a rather lukewarm reaction from Canadian provinces, with questions raised over how existing programs can co-exist with the federal government’s plan.

As a result, some provinces are reviewing their own dental plans [1]. Therefore, many Canadians may see a change in the dental care they receive, following the outcome of these reviews.

Background

In December 2023, the Canadian Government finalized the details of the national dental plan [2]. The plan aims to provide financial assistance towards dental care to those from low- and middle-income families.

The plan will be rolled out using a phased approach – with seniors and children among those to first receive access to the plan [1]. The current plan suggests that the full rollout will be complete from 2025.

The plan has been met with excitement from many dentists and dental professionals. Moreover, the plan is expected to have a very positive impact on the oral health of Canadians.

However, one of the main issues with the plan involves the concern regarding the co-existence between current provincial programs and the new plan [1].

Problems of co-existing

Following the announcement of the plan, Health Minister Mark Holland said that the program was intended to “fill the gaps”, rather than replace existing provincial dental programs [1].

However, this has proven to be problematic. Amidst concerns that provincial programs will change their approach, Holland has since said the provinces shouldn’t “shove” dental costs onto the government [1].

For the provinces, they are in a position now where they feel they can change their existing programs in a way that offsets many residents towards the federal government’s plan.

If provincial programs do change, or even entirely shut down, the price of the national dental plan could rise significantly. Already, the cost has risen substantially, with the cost expected to be $4.4billion per year. This is on top of the initial $13billion budget.

Different approaches

One such example comes from the province of Prince Edward Island (PEI). PEI has an existing dental plan, although it provides far more limited provisions compared to those seen in the federal program.

Therefore, in PEI, there is a belief that there will be a change in how dental bills are covered in the province, once the federal program is up and running [1]. For example, the federal plan will be open to far more PEI residents compared to the existing plan.

Furthermore, Alberta is another province that has an existing dental program. This program is aimed at children and seniors. However, as with PEI, the program is not as comprehensive as the federal program. Therefore, this will reduce the need for Alberta to run their own dental program.

Spokesperson Charlotte Taillon has said that Alberta wanted to see the federal government invest in existing programs, rather than start “an entirely new insurance-based plan” [1].

Moreover, Taillon said that Alberta “urged the federal government to work with the provinces and territories” to improve existing coverage [1]. However, this didn’t happen. Instead, the government opted to introduce their own program.

Taillon went on to say that Alberta is “currently reviewing the federal announcement” – suggesting that changes are likely to be made after the review [1].

The province of Nova Scotia is also said to be “currently reviewing the federal dental program details to better understand the impacts it will have on dental programs” within the province [1].

In the province of Ontario, they launched a senior’s dental program in 2019 [1]. A spokesperson for the province has said they aren’t expecting any immediate changes based on the federal plan. However, changes in the future cannot be ruled out.

What will happen next?

Each individual province will have their own decision to make in terms of altering their existing plans. Each province will have their own circumstances to consider, including the size of the population and their needs.

Once reviews have taken place, it is likely that we will see changes in existing provincial programs. Therefore, some people may need to access services in a different way, or some may lose some access altogether.

The federal government is hoping that the provincial programs will remain in place after these reviews. This would help to keep the costs down, and keep existing infrastructure in place. There is no timeline on how long these reviews will take.

The aim of the dental plan was to see a vast improvement in the oral health of Canadians around the nation. But we now run the risk of seeing little improvement due to the problems in co-existence between provincial and federal dental plans.

Thinking points…

1) Many people appear to be planning on waiting for the dental plan to be rolled out before next attending the dentist. However, we strongly recommend that you do not change the timing of your regular dental check-ups, especially as the full rollout of the plan is probably around a year away. Attending a check-up at least twice per year is crucial. Therefore, remember to attend appointments regularly! We recommend that you make an appointment soon!

2) One of the leading reasons for the dental plan is concerns over the cost of dental care in Canada. For many people, cost is a big barrier. However, here at our Calgary-based dental clinic Savanna Dental, our fees are set in line with the Alberta Dental Fee Guide. This means that our prices are fully transparent, competitive and reliable. You can find out more about us on our website Savanna Dental. We would love to see you at our Calgary dental clinic soon!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice, with the aim of improving oral health and boosting overall wellbeing!

We advise our patients to attend our Calgary-based dental clinic twice a year for a dental check-up. If any 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™! Our patients find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, the fees of our services at our Calgary dental clinic Savanna Dental are set 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] Tasker, J. P. (2023). Provinces are reviewing their own dental care programs as Ottawa announces federal plan. Available: https://www.cbc.ca/news/politics/provincial-dental-programs-reviewing-1.7059399. Last accessed: 6th January 2024.

[2] Government of Canada. (2023). The Canadian Dental Care Plan. Available: https://www.canada.ca/en/health-canada/news/2023/12/the-canadian-dental-care-plan.html. Last accessed: 6th January 2024.