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Maintaining oral health is an important factor in overall health and may have an essential role during the COVID-19 pandemic, an expert told Healio Primary Care.

Studies have linked oral health to lung health, including one meta-analysis published in Oral Diseases that found periodontitis was associated with asthma, COPD and pneumonia.

Poor oral health has been associated with a variety of other adverse health outcomes, including increased risks for inflammatory bowel disease, precancerous stomach lesions, coronary heart disease and mortality, and lung and colorectal cancers.

Healio Primary Care spoke with Kami Hoss, DDS, MS, co-founder of The Super Dentists, a large group dental practice in San Diego, to learn more about the relationship between oral health and lung health and its implications during the COVID-19 pandemic.

Q: How is lung health related to oral health?

A: It has long been known that poor oral health is a risk factor in the initiation and/or progression of respiratory infections. Dental plaque can host respiratory pathogens that can be released in saliva and can then be aspirated in the lungs. Pathogens can also enter the bloodstream through bleeding gums in patients with poor oral health and disseminate to the lungs, causing a local infection. In ventilated patients, they can also attach to the endotracheal tube and be aspirated into the respiratory tract.

Q: Why is it important to maintain oral health during the COVID-19 pandemic?

A: We know that COVID-19 affects the young and the healthy differently than [older adults] and those with underlying medical conditions. Oral health impacts overall health in profound ways. The mouth is the opening to the body and pathogens find their way in via the mouth and COVID-19 is no exception.

Q: What signs/symptoms that indicate poor oral health should primary care physicians tell their patients to watch for?

A: Bleeding or swollen gums: Healthy gums should not bleed during routine brushing and flossing. Pain: Dental, gum or jaw pain could be another sign that something’s wrong.

Halitosis: Persistent bad breath that’s not due to something obvious, such as a food source, must be investigated. Sensitivity: Excessive sensitivity to cold or sweet can be due to bone loss and root exposure or cavities. Tooth mobility: In advanced stages of periodontal disease, teeth can get loose and eventually fall out.

Q: How does maintaining good oral hygiene compare with other preventive/mitigative steps?

A: Oral health is another essential piece of the puzzle when it comes to staying healthy. So, as we all put on masks near each other and wash our hands routinely, we should also be paying extra attention to the health of our mouths.

Q: Why is oral health particularly important among nursing home residents during the COVID-19 pandemic?

A: [The] pandemic’s death toll tied to nursing homes has surpassed 50,000. Periodontal disease increases in the older population. In fact, according to CDC, more than 70% of Americans aged 65 and older have periodontal disease. The infection risk is additionally compounded by presence of removal dentures where plaque can accumulate.

This article originally appeared on Healio.com

https://www.healio.com/news/primary-care/20200618/qa-oral-health-a-piece-of-the-puzzle-in-overall-health-during-covid19

For all the time you’ve spent researching the best baby products, tools, and supplies for the nursery that make life easier when your little one is born, it’s likely you’ve considered what type of toothbrush would be best for your child until that first little tooth bud popped through.

If you now find yourself wondering how to go about choosing a toothbrush, you’re in the right place. Whether your child has just started teething or is ready to take on the responsibilities of daily brushing for themselves, there are several things to consider based on your child’s age, development, ability, and preferences.

Dr. Kami Hoss, an orthodontic specialist and dentist in California, thinks finding the right toothbrush is an important first step. “Children should like, even love, their toothbrushes so they’re encouraged to use them,” he told Mom.com. “In fact, more than a third of children brush their teeth less than twice a day. There are a variety of toothbrushes with cool designs, music, and lights to make brushing fun.”

Jamie Reed agrees that making toothbrushing fun for her child is key. “I’ve been trying new things for my toddler when it comes to toothbrushes. We’ve tried electric, and now we’re trying a light-up one,” she told Mom.com

Hoss advises parents to choose carefully when deciding what type of toothbrush is best for their child. “Anything that goes in your child’s mouth needs to be safe and of high quality. Moms need to pay particular attention to the bristles,” he instructed.

When choosing any dental product for yourself or your child, be sure to look for the American Dental Association Seal of Acceptance on the packaging. Companies are required to reapply for the Seal of Acceptance every three years to be able to use it on their packaging. It is an industry-wide designation that dental products like kids’ toothbrushes are safe and effective.

If you’re wondering what type of toothbrush is best, take into consideration your child’s age and development. The following tips should help you find the best toothbrush for your child.

Best baby toothbrush options

Until your infant begins teething, simply wiping your baby’s mouth with a clean, damp, gentle washcloth after feeding will suffice in keeping gums healthy and prevent bacteria buildup. Use a gum toothbrush at nighttime to create an evening routine. As your baby grows, routines will make the bedtime transition easier.

Another option for infants is a soft gum toothbrush that fits on the tip of your finger. These baby toothbrush silicone massagers are designed for infants over the age of two months. Once your child’s first tooth erupts, a visit to the dentist is warranted. Normally this happens when your baby is around 6 months old. This visit will give you a chance to address any concerns you may have with your child’s dentist and is a good way to screen for any potential dental issues that may arise.

Choosing a toothbrush for older kids

The best type of toothbrush
For infants and toddlers, a kids’ toothbrush with a smaller bristle head and ultra-soft bristles is preferable. Children between the ages of 3 and 12 will do well with toothbrushes with a medium-sized bristle area and soft bristles.

Should I buy an electric toothbrush for my child?
According to the American Dental Association (ADA), both manual and electric kids’ toothbrushes effectively remove plaque from your child’s teeth. Often, though, an electric toothbrush may be preferred for those with dexterity problems. “The elderly, people with disabilities, or children — or those who have dental appliances, like braces, may find a powered toothbrush easier to use,” according to the ADA website.

For help choosing the best electric toothbrush for your child, consult the ADA shopping list for toothbrush brands and products that carry the ADA Seal of Acceptance.

Best toothbrush for braces

Kids with braces face additional challenges when trying to keep their teeth clean. You can help instill good dental care habits from the beginning by providing your child with the proper tools.

According to the American Association of Orthodontists (AAO), flossing before brushing your teeth is essential. In a video demonstration, the AAO suggests a reusable floss threader to pull floss underneath each arch-wire of the braces. For braces wearers, the best toothbrush will have soft bristles. Choose a toothbrush with a channel in the center. This allows the shorter bristles to brush the area around the braces while the longer bristles reach the tooth directly.

Mom of four Laura Canada Oneill offered an extra tip. “Get an electric toothbrush and water pick,” she told Mom.com. “For my older boys, the orthodontist included an electric toothbrush with round heads that worked well with braces. The water pick works well for anyone, but especially for those with braces.”

This article was originally posted on Mom.com

https://mom.com/kids/what-type-of-toothbrush-is-best-for-my-child/best-toothbrush-for-braces

The average adult makes 35,000 decisions each day. I’d argue that moms of young children make even more decisions. Ensuring the safety and well-being of our kids is a top priority and often even the seemingly simple decisions, like choosing a toothpaste for kids, can be fraught with challenges.

With a myriad of choices like natural toothpaste options that are sodium lauryl sulfate-free and fluoride-free, or popular brands we all know, finding the best and safest toothpaste for our kids can be difficult. Then there’s the all-important taste factor of whether a child will tolerate a standard minty-fresh taste or prefers a non-mint toothpaste option, like fruit punch, bubble gum, or watermelon.
With all of these choices, figuring out which kids’ toothpaste is the best, safest, and most effective option is hard. This coupled with making sure your child likes the flavor, and that it also fights cavities, makes for a difficult decision. Here we share some background that could help you choose a toothpaste for your kids that checks all of the boxes.

What is in your child’s toothpaste?
Most commonly, fluoride is added to toothpaste to remineralize tooth enamel, which is the case for a wide variety of toothpaste brands on store shelves. Another common toothpaste ingredient is sodium lauryl sulfate. SLS is what gives toothpaste that foamy texture that makes you feel like it’s doing its job. If you’ve ever used an SLS-free baking soda-based toothpaste, you’ll recognize the difference.
According to studies, sodium lauryl sulfate, the detergent and surfactant that causes your toothpaste to foam up, can decrease the efficiency of fluoride. The foaming agent helps remove food debris from the teeth and slough it away. People with sensitive teeth and gums may prefer an SLS-free toothpaste. It has been known to cause inflammation and increased canker sores.
This is the case for Virginia Duan, a mom of four. “I use the DoTerra OnGuard toothpaste. It is the only one that doesn’t make my mouth break out in sores,” she told Mom.com

Dr. Kami Hoss warns against using a toothpaste that contains antibiotics or alcohol. “Some toothpaste and mouthwashes can indiscriminately kill the oral microbiome, disrupting the delicate balance. They may transform beneficial microbes into a pathogenic state or allow new, more opportunistic ones to take hold,” he explained to Mom.com.

What about whitening toothpaste?
If your older tween or teen has expressed an interest in whitening toothpastes or tooth whitening trays, the general consensus is that they are safe to use.
The National Institutes of Health defines whitening toothpastes as those that contain bleaching agents like hydrogen peroxide and silica. These abrasives remove stains to lighten tooth color and may cause temporary gum irritation. For children younger than 14 who may be interested in cosmetically lightening their teeth, baking soda toothpaste may be a more natural toothpaste alternative.

Choose the best kids’ toothpaste
Choosing a child-friendly toothpaste may seem trivial, but to many families, there are myriad factors to consider. I’m fairly vigilant in researching the products I purchase for my youngest child. With research that supports the potential adverse neurological effects of fluoride in drinking water, I choose to go fluoride-free when it comes to dental care so as not to overload his system.
Similarly, for parents whose children have celiac disease or gluten sensitivities, a gluten-free toothpaste is the safest toothpaste choice. There are even traces of milk protein in some types of toothpaste, which can be fatal to those with dairy allergies. As such, anything your child consumes or goes in and around his mouth should be researched carefully. Choosing a safe toothpaste is a decision dependent upon personal experiences, preferences, and of course health concerns.
Dr. Hoss cautions parents from just choosing a random over-the-counter toothpaste and mouthwash. “You should always consult with your dentist to use oral care products that have been customized just for you and your children,” he told Mom.com.

Combat your kids’ cavities
There are other things you can do to keep your children’s teeth free from cavities. An effective cavity-fighting solution, according to the Centers for Disease Control and Prevention, is the application of dental sealants for children between the ages 6 and 11. A thin sealant layer is painted on the surface of the tooth. This prevents decay from forming caries deep in the tooth crevices.
How to prevent cavities
Following these general guidelines also helps prevent cavities and promote good dental habits.
• Dental care should start early. Use a training toothpaste and a soft bristle toothbrush to care for your toddler’s teeth.
• For younger infants and babies, wipe a damp cloth over their gums after meals to clear away bacteria.
• After your child eats fruit snacks or takes gummy vitamins, have them brush. Gummy foods are notorious for causing tooth decay.
• Refrain from offering sugary juice in a bottle.
• Keep regular dental visits to allow your child’s dentist to monitor for potential problems before they become bigger issues.

Read the original article posted on Mom.com

https://mom.com/kids/what-is-the-best-and-safest-toothpaste-for-kids

June 16, 2020, by The Super Dentists

Dental offices responded to COVID-19 lockdowns in much the same way as other medical professions, halting routine visits and only providing emergency care to patients in dire need.

But now that stay-at-home orders are lifting, many dentists are reopening, but with new protocols to limit infection.

Your dental appointment will not be the same, with changes from the waiting room to the dental chair, dentists say.

First off, don’t expect to spend a lot of time lounging in the waiting room, flicking through old magazines.

Many dentists are asking patients to instead wait in their car until their treatment chair inside is ready. Patients text or call to let the office know they’re outside, and use a phone or tablet to fill out paperwork, said Dr. Kami Hoss, an orthodontist in San Diego.

“Our waiting room now starts in the car. We’ve virtualized the waiting room,” he said.

Once inside, patients will be greeted at a screening table where assistants will ask about COVID-19 symptoms and take their temperature, said Dr. Kirk Norbo, co-chairman of an American Dental Association task force that developed a guide to reopening dental offices.

“We’re pretty thorough on the whole screening process at this point,” said Norbo, a dentist in Purcellville, Va.

These screening procedures should make a dental office one of the safest places in medicine to seek treatment, according to Hoss.

“Our goal is to keep this virus outside of our office,” he said. “If a patient has any symptoms that could be a red flag, we reschedule and postpone their appointment.”

You’ll be asked to wear a mask all the way through the office, removing it only when you’ve settled in the dental chair.

You might also notice fewer people in the office. Practices are trying to space out appointments to minimize the number of folks in the building at any given time, Norbo said.

Patients are also being asked to limit the number of people they bring to an appointment. That could mean that parents leave their kids at home with a babysitter, or that parents of older kids might be asked to wait outside while their child is treated, Hoss said.

Dentists will use text or video messaging to communicate what treatment a child is receiving and what the parent needs to know about aftercare, Hoss said.

Once you’re in the chair, many things will look much the same, because dentistry has long focused on infection control to prevent the spread of H1N1 flu, HIV and other dangerous pathogens, Norbo said.

But you are liable to see your dentist and hygienist more fully decked out in personal protective equipment.

“They’re going to see more of that ‘Star Wars’ look,” with staff wearing gowns and face shields and masks, Norbo said.

There also will be some changes in procedure specifically designed to prevent the spread of a respiratory bug like SARS-CoV-2, the new coronavirus that causes COVID-19.

For example, San Francisco-based dentist Dr. Nammy Patel gives her patients a mouthwash containing hydrogen peroxide and salt to kill off any germs that might be lingering in their mouths.

“It’s been documented that the coronavirus is killed by peroxide and saline,” she said.

Don’t expect to be asked to spit, either. Patel said she suctions out the mouthwash, as well as any saliva or water that might build up in your mouth during cleaning or dental work.

“We don’t even give them the opportunity to spit,” she said.

Patel also has invested in an additional vacuum device that remains about 2 feet from the patient’s face to suck up any droplets that might fly out of the mouth.

“There are a lot of unknowns when it comes to COVID,” Patel said. “I’d rather be the helicopter mom and overdo it rather than underdo it.”

Dentists and hygienists working with a patient are being encouraged to choose methods that will reduce the amount of aerosol coming from the mouth as well, Hoss said.

Instead of drilling, a dentist might use chemicals and instruments to remove composite material, he said. Hygienists will use traditional metal hand instruments to remove plaque, rather than newfangled ultrasonic cleaners that tend to create a lot of spray.

Just remember that if you’re trying to see your dentist and you don’t have an appointment, it might be a while before you’re able to get in.

People who missed their cleanings during the two months of lockdown are now trying to reschedule. That, on top of folks already scheduled for dental work and the need to space out dental appointments, is creating a bit of a logjam in some offices, Norbo said.

“I’m amazed at the rebound of the patients,” he said. “We’re slammed right now. We’re getting booked up like it’s pre-COVID days.”

More information

The American Dental Association has more about dentists reopening their offices.

Copyright © 2020 HealthDay. All rights reserved.

Read the original article from U.S. News and World Report here