Monthly Archives: April 2015

The Dangers of DIY Dentistry

by Implantadmin Posted on April 27, 2015

Late last week I came across an article online that discussed a topic that left my mouth wide open: the growing popularity of do-it-yourself dentistry in the United Kingdom.

Published in the UK’s Daily Mirror, the article featured the story of Ian Boynton, a 42-year-old Iraq war veteran, who, due to excruciating toothaches and an inability to find a National Health Service dentist or afford private care, resorted to pulling out 13 of his teeth with pliers in the last two years. With few natural teeth left Boynton is having difficulty eating and is in need of some type of prosthesis, be it a denture or implants.

Considering that the Daily Mirror is a tabloid and has a checkered history of factual accuracy, I wasn’t sure what to make of this report. But a quick Google search on DIY dentistry (which returned over one million hits) opened my eyes to a burgeoning —and potentially risky — niche business. While I can’t confirm Mr. Boynton’s story, a similar article appeared in The Guardian (a mainstream hard news publication) lending credence to the idea. And according to a 2012 study by the British Dental Health Foundation, a charity organization, one in five Britons would remove their own teeth or ask a friend to assist in the extraction.

In case you think this is all strictly a British phenomenon, one of the lead dental DIY kits, made by DenTek®, is headquartered in Maryville, Tennessee, near Knoxville, and ships more than 250,000 kits per year and is sold on Amazon. Granted, marketing on the package clearly states that the product is intended as “temporary filling material.” Visit DenTek’s website and the product is categorized under “Dental First Aid Kit.”

So what are professional dentists to make of all this “bathtub gin?”

Emergency Care vs. Primary Care
In general I think our response should be relative to the type of DIY effort employed, and specifically how these take-home “solutions” are used. In a pinch, such tactics can be great for emergencies like temporarily securing a loose crown or replacing a lost filling. And as DenTek® rightly points out in its marketing, temporary fixes should always be followed up by a professional dentist. Even dental practices in the U.S. that offer take-home teeth whitening kits, (far less risky than pulling out ones teeth with a hand tool more fit for the family garage than the medicine cabinet) for instance, encourage patients to return for follow-up visits to ensure that the whitening procedure was done right.

What we don’t want to see is the birth of an unregulated cottage industry that promotes potentially unsafe dental practices. The Mirror article was quick to report additional examples where DIY dentistry caused more harm than good. Using metal pliers to extract teeth can be particularly dangerous from an infection standpoint. Botched home remedies might also cause an uptick in after-the-fact dental visits that cause a backlog for regular patients.

While the cost of dental care without insurance can be high, dentists and dental staff should be flexible in working with patients in ways that meet their needs. One of the simplest ways to reduce procedural cost is to encourage lifelong preventative maintenance dental visits. Like a well maintained car, it’s much easier to pay for an oil change than it is to replace a seized engine. Our bodies are similar. Regular cleanings prevent tooth decay and reduce the chances of a costlier root canal or extraction in the future.

Going forward, I very much hope Mr. Boynton gets the dental care he needs to live a normal, fully functional life. For the millions of other patients in the U.S. and U.K., consider visiting your local dentist — before unpacking the pliers.

Autism Awareness in the Dental Office: Finally Something to Smile About

by Implantadmin Posted on

Since the 1970s April in the medical community has meant one thing: Autism awareness. Thanks to the steadfast efforts of advocacy organizations like Autism Speaks and the Autism Society, among others, much has been learned about the disorder.

Yet despite that knowledge and a wealth of new treatment methods, the incidence of autism continues to rise. A spectrum disorder impacting a person’s sensory processing capabilities, social skills and sometimes cognitive function, today 1 in 68 children born in the United States are diagnosed with some form of the disorder — nearly twice the rate of a decade ago, according to the Centers of Disease Control.

While the debate rages over what’s driving the increase — environmental toxins and/or better, more accurate diagnosis and genetic factors —at the patient care level the debate is moot. Children with autism must be treated effectively and that treatment cannot be delayed. That’s true especially when it comes to dental visits.

Surveys continue to show that autistic children are more likely to have difficulty visiting the dentist. In fact, according to one survey of 400 parents of children with autism, nearly two-thirds found oral cleaning at the dental office difficult. Some parents, overwhelmed by the task, delay making a first appointment until their child is 10 or older. A smaller percentage of parents give up entirely, avoiding the dentist until an emergency forces an appointment.

Not surprisingly, such delay tactics ultimately backfire. By not instilling good oral hygiene at home and by avoiding dental visits, parents encourage poor behaviors that could cause more problems in the future. It’s well documented that advanced gum disease and tooth decay has been linked to a variety of medical problems, including: obesity, heart disease, diabetes, cancer, and even Alzheimer’s — though this last claim requires additional research.

Building a Better Dental Experience

The key to helping autistic children have a better dental experience is “early intervention.” This is a term often used in education. Early intervention is the process by which a child is introduced to behaviors and learning strategies that improve their ability to process information and act in age-appropriate ways. In the school setting occupational therapy is particularly common as it assists with sensory integration.

In the run-up to a dental visit, parents should begin discussing the experience with their child and even have them practice lying back on a reclining chair and opening their mouth for as long as they can. They may even want to purchase a mouth mirror so parent and child can count teeth just like the real dentist. As much as possible good behavior should be praised or rewarded, while poor behavior corrected, but not admonished. Once the child is actually in the office, it’s imperative that the dentist knows what types of noises, smells and lights are likely to upset their patient. In accommodating dental practices (particularly pediatric ones) a pre-dental visit is scheduled.

Consider this appointment a “trial run” where the child has an opportunity to sit in the real dental chair and become comfortable in their new surroundings, as well as getting to know the dentist that will eventually poke and prod inside their mouth. Over follow-up visits (sometimes several) the dentist can perform more and more of a complete checkup. Some dentists have even been known to perform partial examinations in their waiting rooms, in the backseat of cars, or during house calls. One dentist put it like this: “if they’re not comfortable coming in [to the dental office] — get the exam done somehow.”

It should go without saying, but physically restraining a patient or inducing oral sedation should be options of last resort. Restraints may only further unsettle an anxious patient while drugs can sometimes have unexpected reactions in autistic and disabled children. Yet disturbingly, a 2012 study published in Pediatric Dentistry suggests that these practices are more common than they aught to be. According to the study, 18 percent of parents of autistic children reported the use of restraints “often” or “almost always” during a dental visit while 40 percent reported the use of pharmacology like anesthesia. Complicating matters further, there’s at least preliminary evidence that suggests many dentists will not provide care for autistic children in the first place.

Patience with your Youngest Patients
But with the strategies outlined above, it’s clear that with a little extra time and patience, an autistic child should be able to tolerate most dental visits, without taking more drastic measures. Although Autism Awareness Month might be ending this week, there are millions of parents in the U.S. whose children have been diagnosed with the disorder. There are 11 other months of the year where a dentist appointment can be made. Perhaps, one day soon, you’ll receive a call from an anxious parent with an autistic child. Maybe they’ve made dozens of frantic phone calls to find a dentist who will treat their child; a dentist who will be receptive to the process required.

Perhaps, after reading this article, you’ll find it in your heart to accept the case and get the exam done. This is your moment to be more than a healer. It’s your chance to be a leader. Lead by accepting an autistic child’s case and you’ll be rewarded in ways that go well beyond revenue.