Massage: Get in touch with its many benefits

Massage: Get in touch with its many benefits

Massage can be a powerful tool to help you take charge of your health and well-being. See if it’s right for you.

Massage is no longer available only through luxury spas and upscale health clubs. Today, massage therapy is offered in businesses, clinics, hospitals and even airports. If you’ve never tried massage, learn about its possible health benefits and what to expect during a massage therapy session.

What is massage?

Massage is a general term for pressing, rubbing and manipulating your skin, muscles, tendons and ligaments. Massage may range from light stroking to deep pressure. There are many different types of massage, including these common types:

  • Swedish massage.This is a gentle form of massage that uses long strokes, kneading, deep circular movements, vibration and tapping to help relax and energize you.
  • Deep massage.This massage technique uses slower, more-forceful strokes to target the deeper layers of muscle and connective tissue, commonly to help with muscle damage from injuries.
  • Sports massage.This is similar to Swedish massage, but it’s geared toward people involved in sport activities to help prevent or treat injuries.
  • Trigger point massage.This massage focuses on areas of tight muscle fibers that can form in your muscles after injuries or overuse.

Benefits of massage

Massage is generally considered part of complementary and alternative medicine. It’s increasingly being offered along with standard treatment for a wide range of medical conditions and situations.

Studies of the benefits of massage demonstrate that it is an effective treatment for reducing stress, pain and muscle tension.

While more research is needed to confirm the benefits of massage, some studies have found massage may also be helpful for:

  • Anxiety
  • Digestive disorders
  • Fibromyalgia
  • Headaches
  • Insomnia related to stress
  • Myofascial pain syndrome
  • Soft tissue strains or injuries
  • Sports injuries
  • Temporomandibular joint pain

Beyond the benefits for specific conditions or diseases, some people enjoy massage because it often produces feelings of caring, comfort and connection.

Despite its benefits, massage isn’t meant as a replacement for regular medical care. Let your doctor know you’re trying massage and be sure to follow any standard treatment plans you have.

Risks of massage

Most people can benefit from massage. However, massage may not be appropriate if you have:

  • Bleeding disorders or take blood-thinning medication
  • Burns or healing wounds
  • Deep vein thrombosis
  • Fractures
  • Severe osteoporosis
  • Severe thrombocytopenia

Discuss the pros and cons of massage with your doctor, especially if you are pregnant or you have cancer or unexplained pain.

Some forms of massage can leave you feeling a bit sore the next day. But massage shouldn’t ordinarily be painful or uncomfortable. If any part of your massage doesn’t feel right or is painful, speak up right away. Most serious problems come from too much pressure during massage.

What you can expect during a massage

You don’t need any special preparation for massage. Before a massage therapy session starts, your massage therapist should ask you about any symptoms, your medical history and what you’re hoping to get out of massage. Your massage therapist should explain the kind of massage and techniques he or she will use.

In a typical massage therapy session, you undress or wear loose-fitting clothing. Undress only to the point that you’re comfortable. You generally lie on a table and cover yourself with a sheet. You can also have a massage while sitting in a chair, fully clothed. Your massage therapist should perform an evaluation through touch to locate painful or tense areas and to determine how much pressure to apply.

Depending on preference, your massage therapist may use oil or lotion to reduce friction on your skin. Tell your massage therapist if you might be allergic to any ingredients.

A massage session may last from 10 to 90 minutes, depending on the type of massage and how much time you have. No matter what kind of massage you choose, you should feel calm and relaxed during and after your massage.

If a massage therapist is pushing too hard, ask for lighter pressure. Occasionally you may have a sensitive spot in a muscle that feels like a knot. It’s likely to be uncomfortable while your massage therapist works it out. But if it becomes painful, speak up.

McGlone Dental Care has Massage Therapist on Staff

Michelle Stefun, LMT

Michelle’s philosophy – ‘Massage’ means many things to many people. Some massage is comparable to getting your nails done—full of treatments and pampering. Some forms mimic physical therapy involving a significant amount of pain and effort on your part. And others are basically your daily rub-down of moisturizer—honestly, your toddler could do that. There’s nothing wrong with these forms of massage, but I’ve chosen a starkly different course for my work. I am, first and foremost, a healer. Patients get my full attention in each session. I’ve found that the body heals best in a state of rest. Therefore, my work is a blend of medical treatment and relaxation. 

​Similar to the human body, trees require a degree of flexibility and balance. They are flexible enough not to snap with every wind gust. Their branches spread over them for balance. And finally, trees pour back into their environment. They provide oxygen, habitats for wildlife, and food for many. In the same way, massage therapy should enable you to be more active in your world—whatever that world looks like. I make no claims to ‘fix’ anything, yet I’ve seen this treatment provide dramatic improvement for my patients. I am a facilitator to each individual’s journey toward healing.

The take-home message about massage

Brush aside any thoughts that massage is only a feel-good way to indulge or pamper yourself. To the contrary, massage can be a powerful tool to help you take charge of your health and well-being, whether you have a specific health condition or are just looking for another stress reliever. You can even learn how to do self-massage or how to engage in massage with a partner at home.

Article provided by The Mayo Clinic Newsletter

Use it or Lose it!

Dental Insurance Use It or Lose ItDo you have money left on your annual Dental Insurance Plan? Have you checked it lately? If not, you can check, or you can have us check for you. Most insurance plans are run on a calendar year and if you don’t use all your benefit each year you lose those funds.

So, what does that mean for you? It means that it’s a great time to maximize your dental insurance benefits and make sure that you use your yearly maximum amount allowed according to your plan. If whatever dental work you need to have done is completed before 12/31/17 and billed on or before that date, that work will be applied to this year’s maximum amount that is allowed according to your plan. Most insurance plans cover 2 cleanings per year and cover 100% of any preventative work. You should make sure that you get your full value out of the benefits that you work hard and pay for.

We have openings in our schedule for the rest of the year and are even open three days the week of Christmas. If you have dental work that you need to have done or just want to have your teeth cleaned before the end of the year, give us a call. We will do our best to make sure that your dental insurance coverage is maximized for you and you are able to get the full amount of your plan for the year.

We are also having a Whitening Special in December. Insurance won’t pay for teeth whitening, but if you’d like to have a brighter smile for the holidays, come in and take advantage of this great special. For $150 (normally $200) you will get custom whitening trays and a tube of whitening gel (for up to 6 whitening treatments) to take home. You can whiten your teeth in an hour at your own time and in the privacy of your own home. This special is good until 12/31/17.

Call for an appointment today before we are all booked up through the end of the year: 303-759-0731.

Happy Holidays from the McGlone Dental Team!

Smoking and Your Oral Health

Smoking and Your Oral HealthWhile most people are aware of the impact tobacco use has on their overall health, some might not consider its effects on oral health, including:

  • 50 percent of smoking adults have gum (periodontal) disease.
  • Smokers are about twice as likely to lose their teeth as non-smokers.
  • Cigarette smokers are nearly twice as likely to need root canal treatment.
  • Smoking leads to reduced effectiveness of treatment for gum disease.
  • Smoking increases risk of mouth pain, cavities and gum recession (which can lead to tooth loss).
  • Tobacco reduces the body’s ability to fight infection, including in the mouth and gums. Smoking also limits the growth of blood vessels, slowing the healing of gum tissue after oral surgery or from injury.
  • Smokeless tobacco (snuff or chewing tobacco) is associated with cancers of the cheek, gums and lining of the lips. Users of smokeless tobacco are 50 times more likely to develop these cancers than non-users.
  • Cigars, chewing tobacco, snuff and unprocessed tobacco leaves (used as cigar wrappers) contain tiny particles that are abrasive to teeth. When mixed with saliva and chewed, an abrasive paste is created that wears down teeth over time.
Tobacco Use and Children 

All parents, even those who do not use tobacco, should educate their children about the dangers of smoking:

  • 3,000 children and teens become regular users each day (including chewing tobacco).
  • Nearly one-quarter of all high school students smoke.
  • Some tobacco companies target children with cherry-flavored chewing tobacco sold in colorful containers.
  • Children exposed to tobacco smoke may have delays in the formation of their permanent teeth.
  • Women who smoke may be more likely to have children born with an oral cleft (cleft lip or cleft palate).
What You Can Do

If you are a smoker or a parent with a child or teen who you suspect may be using tobacco, you can start by understanding that tobacco dependence is a nicotine addiction disorder.

There are four aspects to nicotine addiction: physical, sensory, psychological and behavioral. All aspects of nicotine addiction need to be addressed in order to break the habit. This difficulty can mean that tobacco users may need to try several times before they are able to successfully kick the habit.

*Content provided by Delta Dental

No Dental Insurance? We Have the Solution!

No Dental Insurance? We Have the Solution! mcglone dental denverAt McGlone Dental Care, the customer always comes first – and we know that many of our friends and neighbors don’t have dental insurance. We also know that not having dental insurance makes dental care decisions more stressful – How much is a filling going to cost? Can I afford getting a new crown?

We understand, and we want to help. For our friends and neighbors who don’t have dental insurance, we are offering a simplified way to think about dental care – and to help make those tough decisions a little easier – a flat fee of $300 per hour for ALL routine dental work, including fillings, crowns, bridges, periodontal deep-cleanings, extractions and complete and partial dentures.

To put it in perspective, we can usually complete 2 to 3 fillings in ONE HOUR, using highly rated materials and careful techniques.

Of course, some procedures simply take more time – crowns, bridges and full or partial dentures require help from an outside lab.  Together, we will choose the appropriate lab and proper material to be used. We will work with you to establish an accurate cost estimate, and the lab fee will be charged with zero mark-up.

Your dental health is as important as any other health decision you make. And we believe it should be available to ALL our friends and neighbors.

Call us today to find out how simple and affordable your dental care can really be – without all the stress and unknowns. We’re here for you and look forward to visiting with you soon.

Oral Piercing

Key Points

  • Oral piercing of the tongue, lip, cheek, or other soft tissues is a form of body art and self-expression. Oral piercings are more typically seen in adolescents and young adults, and the tongue is considered the most common site for oral-piercing placement.
  • Complications associated with oral piercing include: swelling, bleeding, infection, chipped or damaged teeth, gingival recession, lacerations/scarring, embedded oral jewelry (requiring surgical removal), airway obstruction, hypersalivation, palatal erythema, keloid formation, and purulent or unusual or discharge from the pierced region.
  • Tongue splitting is a less common form of body modification within the oral cavity. By definition, the tongue-splitting process is one in which an individual’s tongue is severed into two pieces using various techniques. The procedure is inherently invasive and dangerous, with significant risks of severe bleeding, infection, inflammation, lingual nerve damage or other complications.
  • The ADA advises against the practices of cosmetic intraoral/perioral piercing and tongue splitting, and views these as invasive procedures with negative health sequelae that outweigh any potential benefit.

Background

Oral piercing is an ancient practice of body modification and self-expression that is also common in modern society.1, 2 Oral piercings may be placed intraorally (most commonly on the tongue) or periorally on the lips, cheeks or a combination of sites.3-5 Oral piercings are more typically seen in adolescents and young adults, and the tongue is considered the most common site for oral-piercing placement.1 There are two primary forms of oral piercing: the term intraoral piercing describes a piercing in which both ends of the oral jewelry (device or apparatus) reside in the oral cavity, as seen with tongue piercings. Similarly, the term perioral piercing describes a piercing in which one end resides in the oral cavity and the other end penetrates the skin surface in the perioral region (e.g., the cheek, upper or lower lip, chin or associated tissues).

Common forms of oral jewelry include studs, barbells, rings and hoops, which are fabricated using a variety of metals, such as stainless steel, gold, titanium and various alloys or synthetic materials.

While some individuals may consider oral piercings to be popular or trendy, numerous studies and case reports have shown that oral piercings can lead to a wide range of oral and systemic complications, including chipped teeth, gingival recession, embedding or aspiration of jewelry and other potentially severe infections, such as Ludwig’s angina6 or infective endocarditis.7

Tongue splitting is another, less common, form of body modification that literally splits, or bifurcates, an individual’s tongue from front to back, creating a “forked” appearance down the anterior midline. Tongue splitting is an invasive and dangerous procedure that directly compromises the intact physical barrier of the tongue surface, rendering it susceptible to severe bleeding and pain, bacterial infection, lingual nerve damage and other adverse effects.8

Complications of Oral Piercing

As with any puncture wound or incision, oral piercings can cause pain,5, 9, 10 swelling,4, 5, 9-11 and infection.9, 10, 12 Other complications of intraoral and perioral piercings include increased salivary flow;10, 13gingival injury or recession;2, 9, 11, 14, 15 damage to teeth, restorations or fixed prostheses;2-4, 10, 11, 15, 16 lingual abscess;17 interference with speech, mastication or deglutition;3, 5, 9 scar tissue and keloid formation;13, 18 and allergic contact dermatitis.19, 20 Because of the tongue’s vascular nature, prolonged bleeding can result if vessels are punctured during the piercing procedure.21 Purulent, unusual and/or colored discharges from oral piercings have also been reported.22

The technique for inserting tongue jewelry may abrade or fracture anterior dentition,3, 4, 10, 16 and digital manipulation of the jewelry can significantly increase the potential for infection.9, 11, 12 Airway obstruction due to pronounced edema4 or aspiration of jewelry poses another risk, and aspirated or ingested jewelry could present a hazard to respiratory or digestive organs.5, 11 Oral jewelry can compromise dental diagnosis by obscuring anatomy and defects in radiographs. There are also reports of the jewelry becoming embedded in surrounding oral tissues, requiring surgical removal.2, 11, 23 Studies have also shown that lip or tongue piercings can harbor periodontopathogenic bacteria,24, 25 and that piercing jewelry made of synthetic materials (e.g., polytetrafluoroethylene or polypropylene), rather than steel or titanium, have lower levels of bacterial colonization.26

Oral piercing complications are relatively common. According to one systematic review, gingival recessions were identified in up to 50% of individuals with lip piercing and in 44% of those with tongue piercing; tooth damage was also seen in 26% of individuals with tongue piercings.27 Complications can arise either during the oral-piercing procedure, immediately after its completion, or over the long term (after initial placement).2

Several case reports in the published literature have described severe or life-threatening complications related to oral piercing.6, 28 In one case, a 25-year-old British woman developed Ludwig’s angina, a rapidly spreading cellulitis involving the submandibular, sublingual and submental fascial spaces bilaterally, four days after receiving a tongue piercing.6 Intubation was necessary to secure the woman’s airway, and when antibiotic therapy failed to resolve the condition, surgical intervention was required to remove the barbell-shaped jewelry and decompress the swelling in the floor of the mouth.

Risks Associated with Tongue Splitting

Like oral piercing, tongue splitting is an invasive, albeit uncommon, procedure with inherent risks of severe bleeding, pain, infection and nerve damage.8 Reports describing the morbidity and mortality associated with tongue splitting are relatively sparse in the research literature, but the risk of complications secondary to surgical procedures (including pain, swelling and infection) is well known.

As a matter of ADA policy, the Association advises against the practices of oral piercing and tongue splitting. The latter practice may be performed using a variety of techniques, which are typically provided in a non-sterile setting (e.g., body-piercing parlor or similar establishment). The practice of tongue splitting entails the deliberate alteration of an individual’s tongue for nonmedical purposes, often without the presence of health professionals and without standard infection control practices, proper sterilization or the provision of safe, appropriate after-care.29 The tongue’s anatomic location, high vascularity and proximity to diverse oral microflora and biofilms present significant potential risks for viral infection or transmission of pathogenic organisms.

Dental Considerations for Patients with Oral Piercing

In the U.S., dentists commonly encounter and treat patients, particularly younger adults, with various forms of oral piercing or oral jewelry (e.g., studs, rings, hoops, barbells) in the intraoral/perioral region. Piercings of the tongue and other oral sites are associated with increased risk of orodental trauma, gingival recession and potentially traumatic lacerations.5 Pierced individuals are also at increased risk of infection due to vast number of bacterial species in the oral cavity.

Individuals who receive oral piercings can expect pain and swelling within the first few days after the procedure.2 Use of an alcohol-free mouthrinse is advised for use after oral piercing to cleanse the mouth and site of the oral piercing.30 After the swelling subsides, the piercee will need to visit their piercer after the piercing procedure to replace the original, longer piece of jewelry with a shorter piece, which should help minimize damage or irritation to oral tissues.31

To reduce risks of oral infection after piercing procedures, pierced individuals should be advised to maintain a standard oral hygiene regimen that includes: twice-daily tooth-brushing using fluoride-containing toothpaste and a soft-bristle toothbrush; regular use of floss or another interdental cleaner; and use of alcohol-free mouthrinse during and after the healing period.30

Dental patients with an oral piercing or split tongue should be advised to keep their piercing site clean, avoid playing with oral-piercing jewelry and monitor their oral cavity for signs of infection, including swelling, pain, tenderness or unusual discharges (particularly those with an offensive odor).30, 32  All forms of intraoral or perioral jewelry (e.g., tongue barbell, lip ring or stud, etc.) should be removed before participating in athletic and other physical activities, particularly contact and collision sports.33

Prepared by: Center for Scientific Information, ADA Science Institute
Reviewed by: Scientific Information Subcommittee, ADA Council on Scientific Affairs
Last Updated: September 18, 2017

Disclaimer: Content on ADA.org is for informational purposes only, is neither intended to and does not establish a standard of care, and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website.

Maximize Your Annual Dental Insurance Benefits

This is our favorite time of the year in Colorado.  The temperature is cooler and you can sleep with your windows open.  The leaves are changing colors and are beautiful with gold and red hues.  It also means that year end is fast approaching and benefits will be resetting come January.

That brings us to the point of this post.  It’s a great time to maximize your benefits and make sure that you use your yearly maximum amount allowed according to your plan.  If whatever dental work you need to have done is completed before 12/31/17 and billed on or before that date, that work will be applied to this year’s maximum amount that is allowed according to your plan.  Most insurance plans cover 2 cleanings per year and cover 100% of any preventative work.  You should make sure that you get your full value out of the benefits that you work hard and pay for.

We have openings over the next few months, so give us a call and we’ll be happy to get you scheduled and take great care of you!

Aging and Dental Health

Key Points

  • The demographic of older adults (i.e., 65 years of age and older) is growing and likely will be an increasingly large part of dental practice in the coming years.
  • Although better than in years past, the typical aging patient’s baseline health state can be complicated by comorbid conditions (e.g., hypertension, diabetes mellitus) and physiologic changes associated with aging.
  • Older adults may regularly use several prescription and/or over-the-counter medications, making them vulnerable to medication errors, drug interactions or adverse drug reactions.
  • Potential physical, sensory, and cognitive impairments associated with aging may make oral health self-care and patient education/communications challenging. 
  • Dental conditions associated with aging include dry mouth (xerostomia), root and coronal caries, and periodontitis; patients may show increased sensitivity to drugs used in dentistry, including local anesthetics and analgesics.

The Federal Interagency Forum on Aging-Related Statistics projects that by the year 2030, the number of U.S. adults 65 years or older will reach 72 million, representing nearly 20% of the total U.S. population; this is an approximate doubling in number as compared to the year 2000.1 Older adults are, therefore, a growing patient demographic for dental practices. Increased numbers of older adults are retaining their natural teeth compared with previous cohorts.2 According to a 1999-2004 National Health and Nutrition Examination Survey (NHANES), approximately 18% of adults aged 65 years or older with retained natural teeth have untreated caries3 while a 2009-2012 NHANES found that 68% of these patients have periodontitis.4 Consideration of the overall clinical and oral health context of aging patients is important in order to provide optimum dental care.

The health status of adults older than age 65 years can be quite variable, ranging from functional independence to frail or cognitively impaired.5-8 According to the U.S. Administration on Aging, over 40% of noninstitutionalized adults aged 65 years or older assessed their health as excellent or very good (compared to 55% for persons aged 45 to 64 years).9 Most older persons have at least one chronic condition and many have multiple conditions.9 In the time period up to and including 2013, the most frequently occurring conditions among older persons were: hypertension (71%), arthritis (49%), heart disease (31%), any cancer (25%), and diabetes (21%).9 A 2015 report by the World Health Organization listed conditions common to older age, including hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia.10, 11

Physiologic changes that are age related include changes to cellular homeostasis, including regulation of body temperature and blood and extracellular fluid volumes; decreases in organ mass; and decline in or loss of body system functional reserves.5, 12 Changes to the gastrointestinal system include decreases in intestinal blood flow and gastric motility and increased gastric pH. Renal, cardiovascular, respiratory, central nervous, and/or immune systems may show decreased function (e.g., decreases in glomerular filtration, cardiac output, lung capacity, sympathetic response, cell-mediated immunity).12 These changes may have an effect on medication absorption and metabolism or an individual’s sensitivity to certain medications (See “Medication Considerations”).13

Physical changes associated with aging include decreased bone and muscle mass.12 Osteoarthritis may result in limitations in mobility.14Visual changes may include age-related macular degeneration, presbyopia, cataracts, glaucoma, or diabetic retinopathy.5, 14 Patients may experience age-related hearing loss, which may affect their ability to communicate.5, 14 Postural reflexes can become dampened, and falls become more common in elderly individuals.5, 12, 13 

Older adults may also demonstrate a spectrum of cognitive acuity, ranging from not at all affected to mild cognitive impairment to frank dementia.5 Dementia is a syndrome characterized by progressive deterioration in multiple cognitive domains, severe enough to interfere with daily functioning.5, 14 Older patients with poor cognitive health will have difficulty managing medications, medical conditions, or other self-care, including dental hygiene.14

According to data from NHANES, 39% of people aged 65 years and older reported using 5 or more prescription drugs (“polypharmacy”) in the prior 30 days during the year 2011 through 2012.15 Ninety percent of people 65 years of age and older reported using any prescription drug in the prior 30 days.15 The high prevalence of polypharmacy among older adults may lead to inappropriate drug use, medication errors, drug interactions or adverse drug reactions.5, 13 The average older adult takes 4 or 5 prescription drugs; in addition, these individuals may also be taking 2 or 3 over-the-counter (OTC) medications.13 A review of older dental patients’ medical history and current medications, both prescription and OTC medications/supplements,16, 17 should be done regularly.5, 13

Drugs most commonly prescribed in elderly patients include “statin” drugs for hypercholesterolemia; antihypertensive agents; analgesics; drugs for endocrine dysfunction, including thyroid and diabetes medications; antiplatelet agents or anticoagulants; drugs for respiratory conditions (e.g., salbutamol); antidepressants; antibiotics; and drugs for gastroesophageal reflux disease and acid reflux.13 The most frequently taken OTC medications by older adults include analgesics, laxatives, vitamins, and minerals.13

Older adults frequently show an exaggerated response to central nervous system drugs, partly resulting from an age-related decline in central nervous system function and partly resulting from increased sensitivity to certain benzodiazepines, general anesthetics, and opioids.13, 18 The American Geriatrics Society has published a 2015 update to the Beers Criteria for potentially inappropriate medication use in older adults.19 Beers Criteria potentially inappropriate medications have been found to be associated with poor health outcomes, including confusion, falls, and mortality. One change of note to the 2015 Beers Criteria includes the addition of opioids to the category of central nervous system medications that should be avoided in individuals with a history of falls or fractures.19

General

Xerostomia affects 30% of patients older than 65 years and up to 40% of patients older than 80 years; this is primarily an adverse effect of medication(s), although it can also result from comorbid conditions such as diabetes, Alzheimer’s disease, or Parkinson’s disease.5, 8, 20Xerostomia, while common among older patients, is more likely to occur in those with an intake of more than 4 daily prescription medications.5 Dry mouth can lead to mucositis, caries, cracked lips, and fissured tongue.8 Recommendations for individuals with dry mouth include drinking or at least sipping regular water throughout the day5, 8and limiting alcoholic beverages and beverages high in sugar or caffeine, such as juices, sodas, teas or coffee (especially sweetened).8 

Older adults are at increased risk for root caries because of both increased gingival recession that exposes root surfaces and increased use of medications that produce xerostomia; approximately 50% of persons aged older than 75 years of age have root caries affecting at least one tooth.2, 21, 22 Ten percent of patients 75 to 84 years of age are affected by secondary coronal caries; this is likely related to the prevalence of restorations in the older population.20 Adoption of good oral hygiene, which includes use of rotating/oscillating toothbrushes, and the use of topical fluoride (i.e., daily mouth rinses, high fluoride toothpaste and regular fluoride varnish application), as well as attention to dietary intake have been recommended in the literature.8, 20, 22

Because cardiovascular disease is common among older individuals, it has been suggested by Ouanounou and Haas that the dose of epinephrine contained in anesthetics should be limited to a maximum of 0.04 mg.13 The authors13 recommend that even without a history of overt cardiovascular disease, the use of epinephrine in older adult patients should be minimized because of the expected effect of aging on the heart. They recommend monitoring blood pressure and heart rate when considering multiple administrations of epinephrine-containing local anesthetic in the older adult population.13

Cognitive Limitations Affecting Dental Care and Self-Care

Patients with severe cognitive impairment, including dementia, are at increased risk for caries, periodontal disease, and oral infection because of decreased ability to engage in self-care.14 Education of the caregiver, as well as the patient, is an important part of the prevention and disease management phase of dental care.5, 14

Communication during the dental appointment may be challenging when the older adult has cognitive impairments. It is recommended that the number of people, distractions, and noise in the operatory be minimized when providing care to a patient with dementia, although a trusted caregiver in the room may provide reassurance to the patient.23 Patients should be approached from the front at eye level and use of nonverbal communication, such as smiling and eye contact, is important.23 The dentist should begin the conversation by introducing himself or herself. Because a patient with cognitive limitations may become overloaded with information easily, instructions should be simple and sentences short, such as, “Please open your mouth.”23

Because cognitive impairment or dementia can affect a patient’s ability to follow instructions following oral surgery, it is recommended that practitioners ensure local hemostasis (i.e., sutures, local hemostatics, socket preservation techniques) prior to dismissal from the dental practice.14

Dentate patients with cognitive limitations should be encouraged to brush their teeth two or more times daily; use of an electric or battery-operated toothbrush should be considered.14 The same oral care routine should be followed consistently, as possible.14 In patients with removable prosthetic devices, the device(s) should be removed, inspected, and cleaned before bed and returned to the mouth in the morning.14

Physical and Sensory Limitations Affecting Dental Care and Self-Care

Patients with Hearing Loss:  Dental care providers should speak slowly, clearly, and loudly when talking with older patients to enhance hearing and understanding.23 It is important to make sure that speaking loudly and slowly does not introduce a patronizing or condescending tone of voice.23 Yellowitz in The ADA Practical Guide to Patients with Medical Conditions14 advises the following in communicating with patients with hearing loss and/or hearing aids:

  • In patients who read lips, face the patient while speaking, speak clearly and naturally; and make sure your lips are visible (remove mask). Be at the same level as the patient.
  • Gain the patient’s attention with a light touch or signal before beginning to speak. Be sure the patient is looking at you when you are speaking and avoid technical terms. Use written instructions and facial expressions.
  • Inform the patient before starting to use dental equipment or when equipment is changed, resulting in an altered experience, e.g., vibrations from a low-speed versus a high-speed handpiece. 
  • In patients with hearing aids, minimize background noise when speaking. Avoid sudden noises and putting your hands close to the hearing aid(s). Patients may want to adjust or turn off the hearing aid(s) during treatment.
  • Written and illustrated materials and websites can be used to help explain dental information, procedures, and postoperative instructions


Patients with Visual Loss:  Age-related visual impairment, such as cataracts, glaucoma or presbyopia, can diminish a person’s ability to process nonverbal conversational cues that frequently are communicated visually.23 Ensure the patient can clearly see demonstrations and read written materials, including appointment cards and instructions.14 The following tools and strategies14 can assist visually impaired older adults in the dental office:

  • Large-print magazines in the waiting room
  • Good lighting throughout the office; add spot/task lighting in areas used for completing forms
  • Large print on prescription bottles
  • Install blinds or shades to reduce glare
  • Use contrasting colors on door handles, towel racks, and stair markers

Patients with Physical Limitations/Loss of Mobility:  Osteoarthritis or rheumatoid arthritis in the hand, fingers, elbow, shoulder, and/or neck can affect a person’s ability to maintain good quality oral health self-care.14 Modification of manual toothbrush handles (e.g., with Velcro® straps or attaching a bicycle handlebar grip) or use of an electronic toothbrush with a wide, grippable handle can help accommodate for lost mobility.14 Floss holders or interdental cleaners/brushes can aid in cleaning between teeth.14Increasing the frequency of dental cleanings and examinations can help promote optimal maintenance of oral hygiene.

Prepared by: Center for Scientific Information, ADA Science Institute
Last Update: June 14, 2017

Disclaimer
Provided by ADA.org – Content on ADA.org is for informational purposes only, is neither intended to and does not establish a standard of care, and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website.

New Artist in Residence Program at McGlone Dental Care

By Meg Benjamin

We moved into our new location in June and the aesthetic of the building is very hip with an open, industrial, modern vibe.  As we started thinking about how we wanted the building to look and were shopping for décor that would match the great vibe we’ve created , we decided instead of purchasing stock art for the walls, we would reach out to local artists to see if we could get any interested in displaying local art on a rotating basis.  That’s how our “Artist in Residence Program” was born!

The response from local artists, after just one post on a local community site, was amazing!  We got more artists interested than we have months left to display art this year.  We are currently booked with artists to display their art on the walls of McGlone Dental Care through October of next year. 

All the artist’s work that is displayed here is for sale.  We have a price list and description of each piece that is hung on our walls.  If a piece sells we only ask that the artist donate 10% of their profit to an animal non-profit organization in Denver.  We really like the Denver Dumb Friend’s League, but if an artist has their own non-profit they like to give to, that’s ok too.

In June when we started the “Artist in Residence Program”, our first artist Brett Cremeens partnered with us to display his art here.  Brett uses acrylic’s, pencil, oil, White Out (Yes! White out that you are used to using for corrections), among other things on all types of surfaces.  He creates art on paper, canvas, exterior and interior walls, denim jackets, and even doors.  Brett painted the tooth logo that is painted prominently on the back of our building.  He has also painted a beautiful, colorful sea turtle on the inside back door of our office.  We have used bright colors mixed with neutrals to make the art pop on our walls. We also have several exposed brick walls that make a great back drop for any art.

July brings us a new artist, Elizabeth Erickson.  She is a photographer that prints her art on metal and standard print material.  Most of her images that are hung in our building are nature inspired.  She doesn’t specialize in one type of photography. She photographs, stills, nature, families, family events, weddings, Bar/Bat Mitzvah’s and more.  Her pieces are currently on display and are all for sale. If you’d like to stop in to take a peek, please do.

Here is our upcoming schedule of artists who will be displaying their art through the rest of the year at McGlone Dental Care:

September & October we will be featuring Jamie Lollback’s art.  She specializes in product, art and portrait photography.  We are excited to see what she comes up with to hang on our walls this fall.  If you’d like a preview click here (link – www.jamiejolollback.com).

November & December we are excited to have Tom Lybeck share his art with us and our patients.  Tom uses oils to paint beautiful, vibrant paintings.  The categories he paints are landscapes, birds, animals, western scenes, predators (the animal kind) and gospel type paintings.  He also produces prints and cards from his art.  For a sneak peek at Tom’s style and art click here http://www.doublevisionart-design.com.

As of now, we have November and December of 2018 open for a local artist to display their art.  If you or someone you know may be interested in partnering with McGlone Dental Care, please give Meg a call at 303-759-0731.  We hope our Artist in Residence Program will be a big hit and a win-win for everyone!

 

Celiac Disease

Celiac Disease’s Toll on Your Teeth

By: Bonnie Schiedel

After Michelle B. was diagnosed with celiac disease in early 2009, she made sure to tuck all nine of her extracted teeth into her handbag when she was referred to the Celiac Disease Center at Columbia University in New York. She wondered if the dental problems with which she had been plagued since her early twenties – repeated cavities, root canals, infections and extractions – could possibly have something to do with celiac disease.

“I kept all my teeth because I just knew something wasn’t right,” explains the 38-year-old resident of Maplewood, New Jersey.

The clinic examined them and found they all had abnormalities associated with celiac disease, like enamel defects, structural defects and calcium deficiency.

“I knew something bigger was wrong than just my teeth, but I was still shocked by the link.”

Celiac disease and teeth? Really? If that’s news to you, you’re not alone – it’s quite possible that your doctor, dentist and hygienist have never heard of that link either. Among celiac disease’s curious mix of symptoms, oral health problems have only recently been shown to be one of them.

The first American study that looked at a connection between celiac disease, dental enamel defects and canker sores was published in The Journal of Clinical Gastroenterology in 2009. Meantime, the very first clinical guidelines for dentists that outlined celiac disease and dental problems was published in 2011, in the Journal of the Canadian Dental Association.

It’s hard to pin down the number of celiac patients affected by oral health issues – the studies have been generally been small – but the 2009 study found that dental enamel defects were found in 87 percent of the children with diagnosed celiac disease compared to 33 percent of non-celiac kids, and that 42 percent of celiac patients, both adults and kids, had frequent bouts of canker sores, versus 22 percent of the non-celiac patients.

Why is it happening?

Just why celiac disease can do a number on your teeth and mouth is, like so much else associated with the frustrating condition, far from clear. “We don’t know what the exact mechanism is, but there are two theories,” says Dr. Peter Green, a gastroenterologist and director of the Celiac Disease Center, who co-authored the 2009 study.

First, because celiac disease means that the body has trouble absorbing key nutrients, including vitamin D and calcium, that could translate to poor tooth enamel formation in childhood.

The second theory points to the immune system: Celiac patients have a substance in the blood known as tTG antibodies, and those antibodies may have some kind of influence on the development of the enamel, he says. (Non-celiac gluten sensitivity and oral health problems have not been studied, says Green.)

Part of the reason why the celiac-oral health connection isn’t on the radar of many health professionals is that dental enamel defects and canker sores – the two most common ways celiac disease affects the mouth – have a number of other causes, too.

“Dental enamel defects could also could be due to excess fluoride, genetics or certain antibiotics [like tetracycline],” explains Alexandra Anca, a Toronto dietitian who co-authored the Canadian clinical guide for dentists, and is scientific adviser for the Canadian Celiac Association’s professional advisory board. “Because of this, I don’t think many dentists are fully aware that celiac disease might be an issue.”

Unfortunately, medical doctors may not yet be in the know either. Even Green, the medical director of a prominent celiac research and treatment center, only recently recognized the connection. “It’s a big step forward for me to develop insight [into this link,]” he admits.

“The mouth, unfortunately, is a bit of a ‘no man’s land’ for physicians. It’s considered to be in the realm of dentists and oral pathologists, and its place in general medicine and gastroenterology has been forgotten.” He adds: “It’s not often you would look in people’s mouths during an exam. Now my group does. We ask about canker sores now, too.”

Greater awareness of the issue may be on the horizon. When Dr. Ted Malahias, a dentist in Groton, Connecticut, who also co-authored the 2009 paper, talks to fellow dental professionals at conferences, he says they are receptive and excited about finding a new piece to the puzzle for patients with stubborn dental issues. “It gets their curiosity going,” he says.

Your Action Plan

Problems like canker sores and atrophic glossitis (see “Watch Your Mouth,” for an explanation of specific celiac-related mouth troubles) are often related to vitamin and mineral deficiencies or immune response, says Malahias, and will likely improve once the celiac disease is addressed with the gluten-free diet.

Likewise, if a child who has dental enamel defects on his or her baby teeth is diagnosed with celiac disease before age 7 (when the enamel is forming on the permanent adult teeth), following a gluten-free diet should mean that dental enamel defects aren’t part of the adult teeth, he says.

However, if you’re an adult with dental enamel defects stemming from long-term, undiagnosed celiac disease, you are stuck with weakened tooth enamel. “The gluten-free diet can’t change the enamel,” he says.

If you have been diagnosed with celiac disease, you are following the gluten-free diet, and your teeth and mouth are fine, you have nothing to worry about, reassures Anca. (If you are diagnosed but cheat on your diet, oral health problems may be in your future, though.)

But if, like Michelle B., you haven’t been diagnosed with celiac disease but have been battling bad teeth, it’s worth a conversation with your doctor, particularly if you have a close family member with celiac disease, or you have any possible celiac symptoms (classic symptoms include abdominal distension and pain, and chronic diarrhea).

This is especially true for kids. “There are many factors that can cause dental enamel defects, but if the medical history indicates there is something else is going on, or there’s a family history of celiac disease, we recommend parents talk to their family doctor about getting their child tested for celiac disease,” says Malahias.

“In kids, the dental enamel defects can be an early warning sign of celiac.” (Michelle B. is keeping a very close eye on her 8-year-old son’s dental visits, but so far all is well.)

Michelle B.’s advice: “You just have to keep on pursuing the truth. My gut, no pun intended, was telling me there was something else going on. If your doctor or dentist doesn’t want to take the time to help you find an answer, you have to find someone who will. Eventually I put the pieces together, but it was a very long road.”

See also: Celiac Disease: Watch Your Mouth

 

*Information courtesy of www.allergiceliving.com

Easing Dental Fear in Adults

What Causes Dental Phobia and Anxiety?

If you fear going to the dentist, you are not alone. Between 9% and 20% of Americans avoid going to the dentist because of anxiety or fear. Indeed, it is a universal phenomenon.

Dental phobia is a more serious condition than anxiety. It leaves people panic-stricken and terrified. People with dental phobia have an awareness that the fear is totally irrational, but are unable to do much about it. They exhibit classic avoidance behavior; that is, they will do everything possible to avoid going to the dentist. People with dental phobia usually go to the dentist only when forced to do so by extreme pain. Pathologic anxiety or phobia may require psychiatric consultation in some cases.

Other signs of dental phobia include:

  • Trouble sleepingthe night before the dental exam
  • Feelings of nervousness that escalate while in the dental office waiting room
  • Crying or feeling physically ill at the very thought of visiting the dentist
  • Intense uneasiness at the thought of, or actually when, objects are placed in your mouth during the dental treatment or suddenly feeling like it is difficult to breathe

Fortunately, there are ways to get people with dental anxiety and dental phobia to the dentist.

What Causes Dental Phobia and Anxiety?

There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include:

  • Fear of pain. Fear of pain is a very common reason for avoiding the dentist. This fear usually stems from an early dental experience that was unpleasant or painful or from dental “pain and horror” stories told by others. Thanks to the many advances in dentistry made over the years, most of today’s dental procedures are considerably less painful or even pain-free.
  • Fear of injections or fear the injection won’t work. Many people are terrified of needles, especially when inserted into their mouth. Beyond this fear, others fear that the anesthesia hasn’t yet taken effect or wasn’t a large enough dose to eliminate any pain before the dental procedure begins.
  • Fear of anesthetic side effects. Some people fear the potential side effects of anesthesia such as dizziness, feeling faint, or nausea. Others don’t like the numbness or “fat lip” associated with local anesthetics.
  • Feelings of helplessness and loss of control. It’s common for people to feel these emotions considering the situation — sitting in a dental chair with your mouth wide open, unable to see what’s going on.
  • Embarrassment and loss of personal space. Many people feel uncomfortable about the physical closeness of the dentist or hygienist to their face. Others may feel self-conscious about the appearance of their teeth or possible mouth odors.
  • The key to coping with dental anxiety is to discuss your fears with your dentist. Once your dentist knows what your fears are, he or she will be better able to work with you to determine the best ways to make you less anxious and more comfortable. If your dentist doesn’t take your fear seriously, find another dentist.
  • If lack of control is one of your main stressors, actively participating in a discussion with your dentist about your treatment can ease your tension. Ask your dentist to explain what’s happening at every stage of the procedure. This way you can mentally prepare for what’s to come. Another helpful strategy is to establish a signal — such as raising your hand — when you want the dentist to immediately stop. Use this signal whenever you are uncomfortable, need to rinse your mouth, or simply need to catch your breath.


* Information courtesy of www.webmd.com/oral-health