Beachwood Endodontic Specialists
Feb 20th, 2020
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No Shield From X-Rays: How Science Is Rethinking Lead Aprons
By Mary Chris Jaklevic
JANUARY 15, 2020
CHICAGO — Patients have come to expect a technician to drape their torsos with a heavy lead apron when they get an X-ray, but new thinking among radiologists and medical physicists is upending the decades-old practice of shielding patients from radiation.
Some hospitals are ditching the ritual of covering reproductive organs and fetuses during imaging exams after prominent medical and scientific groups have said it’s a feel-good measure that can impair the quality of diagnostic tests and sometimes inadvertently increase a patient’s radiation exposure.
The about-face is intended to improve care, but it will require a major effort to reassure regulators, health care workers and the public that it’s better not to shield.
Fear of radiation is entrenched in the collective psyche, and many people are surprised to learn that shielding can cause problems. The movement also has yet to gain much traction among dentists, whose offices perform more than half of all X-rays.
“There’s this big psychological component, not only with patients but with staff,” said Rebecca Marsh, a medical physicist at the University of Colorado Anschutz Medical Campus in Aurora, Colorado, who spoke about shielding at a December forum here at the annual meeting of the Radiological Society of North America. “How do you approach something that is so deeply ingrained in the minds of the health care community and the minds of patients?”
Covering testicles and ovaries during X-rays has been recommended since the 1950s, when studies in fruit flies prompted concern that radiation might damage human DNA and cause birth defects. Only in the past decade did radiology professionals start to reassess the practice, based on changes in imaging technology and a better understanding of radiation’s effects.
Lead shields are difficult to position accurately, so they often miss the target area they are supposed to protect. Even when in the right place, they can inadvertently obscure areas of the body a doctor needs to see — the location of a swallowed object, say — resulting in a need to repeat the imaging process, according to the American Association of Physicists in Medicine, which represents physicists who work in hospitals.
Shields can also cause automatic exposure controls on an X-ray machine to increase radiation to all parts of the body being examined in an effort to “see through” the lead.
Moreover, shielding doesn’t protect against the greatest radiation effect: “scatter,” which occurs when radiation ricochets inside the body, including under the shield, and eventually deposits its energy in tissues.
Still, Dr. Cynthia Rigsby, a radiologist at Chicago’s Ann & Robert H. Lurie Children’s Hospital, called the move away from shielding a “pretty substantial” change. “I don’t think it’s going to happen overnight,” she added.
In April, the physicists’ association recommended that shielding of patients be “discontinued as routine practice.” Its statement was endorsed by several groups, including the American College of Radiology and the Image Gently Alliance, which promotes safe pediatric imaging.
In the coming year, the National Council on Radiation Protection and Measurements, which gives guidance to regulatory bodies, is expected to release a statement supporting a halt to patient shielding.
However, experts continue to recommend that health care workers in the imaging area protect themselves with leaded barriers as a matter of occupational safety.
Groups in Canada and Australia have endorsed the change, and a movement to abandon lead shields is underway in Great Britain, according to Marsh.
Marsh, who’s helping direct the educational effort, said perhaps a dozen U.S. hospitals have changed their official policies, but “most hospitals are starting to have the conversation.”
Chicago’s Lurie hospital is launching an “Abandon the Shield” campaign to educate staff, patients and caregivers before it stops shielding across the organization this spring, Rigsby said. Shielding is used for most of the 70,000 X-ray procedures performed annually at Lurie in a variety of settings, from orthopedics to the emergency department.
A few miles away, at the University of Chicago Medicine hospitals, the recommendation to stop shielding “came as kind of a shock,” said Dr. Kate Feinstein, chief of pediatric radiology.
Feinstein said it seems contrary to what radiology professionals are taught, and she’s uncertain how it applies to her department, which already takes steps to reduce the chance that a shield will interfere with an exam. “We apply our shields correctly, and our technologists are incredibly well trained,” she said.
Nevertheless, Feinstein said, her department is weighing a halt to routine shielding.
Some hospitals are concerned about violating state regulations. As of last spring, at least 46 states, including Illinois, required shielding of reproductive organs if they are close to the area being examined, unless shielding would interfere with the diagnostic quality of the exam, according to the medical physicists’ association.
Some states are revising their regulations. In some cases, hospitals have applied for waivers or sidestepped state rules by taking the stance that a shield has the potential to affect diagnostic quality anytime it is used, Marsh said.
No Evidence Of Benefit
The amount of radiation needed for an X-ray is about one-twentieth of what it was in the 1950s, and scientists have found no measurable harm to ovaries and testicles of patients from radiation exposure that comes from diagnostic imaging after decades of looking at data.
“What we know now is that there is likely no [hereditary] risk at all,” said Dr. Donald Frush, a radiologist at Lucile Packard Children’s Hospital Stanford in Palo Alto, California, who chairs the Image Gently Alliance.
There’s also no evidence that fetuses are harmed by even a relatively high amount of radiation exposure, such as that from a CT scan of the abdomen, Marsh said.
Nevertheless, some patients may insist on shielding. The physicists’ group suggested that when hospitals craft their policies they consider that shielding may “calm and comfort.”
“I don’t think any of us are advocating to never use it,” Frush said.
A Need For Outreach
Public confusion might develop if dentists continue to shield while hospitals don’t. An estimated 275 million medical X-ray exams were performed in the U.S. in 2016, but 320 million dental X-rays were done.
Mahadevappa Mahesh, the chief physicist at Johns Hopkins Hospital, said there’s been less outreach to dentists on the topic. “It’s high time we bring them into the discussion,” he said.
The American Dental Association states abdominal shielding “may not be necessary” but has continued to recommend using lead collars to shield the thyroid “whenever possible.”
But Mahesh, who’s on the board of the physicists’ association, cautioned that lead collars to protect the thyroid may not be helpful and could obscure images taken by newer 3D dental imaging machines.
Contacted for a response, the dental association said its guidance on shielding is under review.
Technologists especially will need support in educating patients and families “so they are not feeling like they are walking into a disastrous conversation,” said Marsh, the medical physicist.
She is doing her part. At the radiology conference, Marsh strummed a banjo and sang her version of the Woody Guthrie ballad “So Long, It’s Been Good to Know Yuh,” with lyrics like: “To get rid of shielding at first may seem strange, but the time is upon us to embrace this change.”
Read the original article from Kaiser Health News HERE
Jan 16th, 2020
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Suffering from dental problems? Sugar-free chewing gum may help prevent tooth decay
PTI|Nov 20, 2019, 06.05 PM IST
LONDON: Chewing sugar-free gum may help reduce the deterioration of cavities of the teeth, according to a study which analysed research published over the last 50 years on dental caries.
The review, published in the Journal of Dental Research: Clinical & Translational Research, revealed that sugar-free gum could reduce the advancement of dental caries, and may be used as a viable preventative agent, compared to non-chewing control strategies like oral health education and supervising toothbrushing programmes.
The researchers, including those from King’s College London in the UK, analysed 12 studies published in the past 50 years which explored the impact and intervention outcome of chewing sugarfree gum on oral health conditions.
The study noted that sugar-free gum reduced the risk of deterioration of dental cavities by 28 per cent.
“There is a considerable degree of variability in the effect from the published data and the trials included were generally of moderate quality,” said study lead author Avijit Banerjee from King’s College London.
However, the researchers said there was a need to update and refresh existing knowledge about sugar-free gum and its effect on oral health.
“We are planning further research to determine the acceptability and feasibility of using this method in public health,” Banerjee said.
The study said that chewing sugar-free gum has recently emerged as a possible supplement to existing prevention strategies in stopping the development of dental caries.
“Both the stimulation of saliva which can act as a natural barrier to protect teeth, and the mechanical plaque control that results from the act of chewing, can contribute to the prevention of dental caries,” Banerjee added.
He said sugar-free gum can also act as a carrier for antibacterial ingredients such as xylitol and sorbitol.
“No recent conclusive evidence existed prior to this review that showed the relationship between slowing the development of caries and chewing sugar-free gum,” Banerjee said.
Click HERE for the full article from The Economic Times.
Nov 21st, 2019
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Keeping Your Toothbrush for Too Long
Did you know the average life of a toothbrush is 3-4 months? Make a resolution to change your toothbrush with every season this year. Frayed and broken bristles won’t keep your teeth clean—these are signs it’s time to let go. When you’re shopping, look for one with the ADA Seal of Acceptance.
Not Brushing Long Enough
Speed demons, listen up! Your teeth should be brushed for a full two minutes, twice per day. Most of us fall short —the average time most people spend brushing is 45 seconds. If you’re racing through cleaning, try setting a timer. Or distract yourself by humming your favorite tune!
Brushing Too Hard
Be gentle with your teeth. You may think brushing harder will remove more leftover food and the bacteria that love to eat it, but a gentle brushing is all that’s needed. Too much pressure may wear down the hard outer shell on your teeth and damage your gums.
Brushing Right After Eating
If you feel the need to clean your teeth after eating or drinking, wait at least 30 minutes before brushing—especially if you have had something acidic like lemons, grapefruit or soda. Drink water or chew sugarless gum with the ADA Seal of Acceptance to help clean your mouth while you are waiting to brush.
Storing Your Brush Improperly
When you’re done brushing, keep your toothbrush upright and let it air dry in the open. Don’t keep your toothbrush in a closed container, where germs have more opportunity to grow, and if your toothbrush is in a holder next to another, keep them separated like the photo above.
Using a Brush with Hard Bristles
Soft bristles are the way to go. You don’t want to use medium or hard bristles because these may wear down the outer shell of your teeth and may cause sensitivity when eating or drinking cold food and beverages.
Get your best brush with these steps: First, place your toothbrush at a 45-degree angle to the gums. Then, gently move the brush back and forth in short (tooth-wide) strokes. Next, brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth. Finally, To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.
Using a Brush That’s Not the Best Fit for You
There are many toothbrushes that can leave your teeth fresh and clean, including manual and power brushes that carry the ADA Seal of Acceptance. Both get the job done. Try different types until you find one you’re comfortable with. For example, a power brush can be easier to hold and does some of the work for you if you have trouble brushing. No matter which you choose remember that it’s not all about the brush—a clean mouth is really up to the brusher!
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Jan 2nd, 2018
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Step 1: Have a Plan
Once you’ve made up your mind to quit smoking and set the date, develop a plan. There are free tools online at smokefree.gov and a toll-free number, 1-800-QUIT-NOW, to help you succeed. Download an app to track your progress.
Step 2: Don’t Go It Alone
It will be easier to quit smoking if you have support from family and friends. Let them know you’ve decided to quit, ask for their support, and tell them specifically what they can do to help. Spend time with people who want you to succeed. Talk to friends who have quit and ask for their advice.
Step 3: Stay Busy
Replace your smoking habit with a healthy habit like exercise. Make plans for dinner or a movie with non-smoking friends. Instead of smoking, chew sugarless gum — it keeps your mouth busy and helps prevent cavities, too. Choose one with the ADA Seal of Acceptance.
Step 4: Avoid Smoking Triggers
Stay away from people, places and things that tempt you to smoke. Some common triggers include stress, alcohol, coffee, and hanging out with people who smoke. Throw out cigarettes, e-cigarettes, vaporizers, lighters and ashtrays, and go to places where smoking isn’t allowed.
Step 5: Avoid Other Tobacco Products
Other tobacco products like e-cigarettes won’t help you stop smoking. Smokers who used e-cigarettes to help them quit were 59% less likely to stop than those who didn’t. There are also no regulations on how many contaminants they can contain, there is a risk of e-cigarette explosions and fires, and more studies are needed to see how they affect your health. Hookahs are also hazardous. One session is the same as smoking 100 cigarettes. Talk to your dentist or doctor about safe and effective quitting options.
Step 6: Reward Your Accomplishments
Quitting is hard. And, every hour or day you go without a cigarette is an achievement. Take it hour by hour, and reward yourself for small successes. With all the money you save on cigarettes, you can treat yourself to a stress-relieving massage or a pedicure!
Visit https://tobaccofreelife.org/ for more help!
Nov 16th, 2017
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With Halloween comes ghosts, goblins and goodies—and the sugar in those treats can play some unwanted tricks on your teeth if you’re not careful.
Here’s why: The bacteria in your mouth are probably more excited to eat Halloween candy than you are. When the bacteria eat the sugar and leftover food in your mouth, a weak acid is produced. That acid is what can contribute to cavities.
But don’t hang up your costume just yet. “Halloween is about candy, dressing up and having fun,” says ADA dentist Dr. Ana Paula Ferraz-Dougherty. “It’s OK to eat that candy on Halloween as a splurge as long as you’re brushing twice a day and flossing once a day all year long.”
To help you sort through the trick-or-treat bag loot, we have a rundown of some common candies and their impact on your teeth:
Chocolate is probably your best bet, which is good because it’s also one of the most popular kinds of candy handed out on Halloween. “Chocolate is one of the better candies because it washes off your teeth easier than other types of candy,” Dr. Ferraz- Dougherty says. “Dark chocolate also has less sugar than milk chocolate.”
Sticky and Gummy Candies
Be picky if it’s sticky. These are some of the worst candies for your teeth. “This candy is harder to remove and may stay longer on your teeth, which gives that cavity-causing bacteria more time to work,” Dr. Ferraz-Dougherty says.
Hard candies are also ones to watch on Halloween. “They can actually break your teeth if you’re not careful,” Dr. Ferraz- Dougherty says. “You also tend to keep these kinds of candies in your mouth for longer periods of time so the sugar is getting in your saliva and washing over your teeth.”
You might want to pass on things that make you pucker – especially if they are sticky and coated in sugar. “Sour candy can be very acidic,” says Dr. Ferraz-Dougherty. “And that acidity can weaken and damage the hard outer shell of your teeth, making your teeth more vulnerable to cavities.”
Have some floss handy if you’re enjoying one of these fall favorites. “Kernels can get stuck in-between your teeth,” Dr. Ferraz-Dougherty says. “They are also sticky, sugary and can be hard.”
Oct 26th, 2017
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Last month, more than 100 Cleveland public high school football players received free, custom-made mouthguards, all because of the Safe Smiles program founded by Dr. Katz and Dr. Coreno in 2015. With grants from the Greater Cleveland Dental Society Foundation and volunteers from Case Western Reserve University School of Dental Medicine, the Safe Smiles program has been able to provide high-quality custom-fitted mouthguards to underserved athletes in Cleveland. A custom-fitted mouthguard makes a huge difference in reducing force to the head and impact to the teeth and jaw. A custom mouthguard is more comfortable for the athlete to wear and is more likely to stay in place when a blow to the head is received, providing more protection.
Check out these videos from the Safe Smiles event this year:
Imagine what it would be like if you suddenly lost one or two of your front teeth. Smiling, talking, eating—everything would suddenly be affected. Knowing how to prevent injuries to your mouth and face is especially important if you participate in organized sports or other recreational activities.
Mouthguards, also called mouth protectors, help cushion a blow to the face, minimizing the risk of broken teeth and injuries to your lips, tongue, face or jaw. They typically cover the upper teeth and are a great way to protect the soft tissues of your tongue, lips and cheek lining. “Your top teeth take the brunt of trauma because they stick out more,” says Dr. Thomas Long, a private practice dentist and team dentist for the Carolina Hurricanes professional hockey team. “Your bottom teeth are a little more protected because they are further back.”
When Should You Wear a Mouthguard?
When it comes to protecting your mouth, a mouthguard is an essential piece of athletic gear that should be part of your standard equipment from an early age.
While collision and contact sports, such as boxing, are higher-risk sports for the mouth, any athlete may experience a dental injury in non-contact activities too, such as gymnastics and skating.
Types of Mouthguards
The best mouthguard is one that has been custom made for your mouth by your dentist. However, if you can’t afford a custom-made mouthguard, you should still wear a stock mouthguard or a boil-and-bite mouthguard from the drugstore. Learn more about each option:
- Custom-made: These are made by your dentist for you personally. They are more expensive than the other versions because they are individually created for fit and comfort.
- Boil and bite: These mouth protectors can be bought at many sporting goods stores and drugstores and may offer a better fit than stock mouth protectors. They are first softened in water (boiled), then inserted and allowed to adapt to the shape of your mouth. Always follow the manufacturers’ instructions. CustMbite MVP and CustMbite Pro are a boil and bite mouthguards that have earned the ADA Seal of Acceptance.
- Stock: These are inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and can make breathing and talking difficult.
Protecting Your Braces
A properly fitted mouthguard may be especially important for people who wear braces or have fixed bridge work. A blow to the face could damage the brackets or other fixed orthodontic appliances. A mouthguard also provides a barrier between the braces and your cheek or lips, which will help you avoid injuries to your gums and cheeks.
Talk to your dentist or orthodontist about selecting a mouthguard that will provide the right protection. Although some mouthguards only cover the upper teeth, your dentist or orthodontist may suggest that you use a mouthguard on the lower teeth if you have braces on these teeth.
If you have a retainer or other removable appliance, do not wear it during any contact sports.
Mouthguard Care and Replacement
Talk to your dentist about when is the right time to replace your mouthguard, but replace it immediately if it shows sign of wear, is damaged or ill fitting. Teens and children may need to replace their mouthguards more often because their mouths are still growing and changing.
- Between games, it’s important to keep your mouthguard clean and dry. Here are some tips for making sure your mouthguard is always ready to go:
- Rinse before and after each use or brush with a toothbrush and toothpaste.
- Regularly clean the mouthguard in cool, soapy water. Then, rinse it thoroughly.
- During your regular dental checkups, bring your mouthguard for an evaluation. Your dentist may also be able to give it a thorough cleaning.
- Store and transport the mouthguard in a sturdy container that has vents so it can dry and keep bacteria from growing.
- Never leave the mouthguard in the sun or in hot water.
- Check fit and for signs of wear and tear to see if it needs replacing.
- Some mouthguards have fallen victim to family pets, who see them as chew toys. Store your mouthguard and case somewhere your pet cannot get to it.
Sep 26th, 2017
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They help you chew, speak and smile, but how much do you really know about your teeth? Here are some of the “tooth truths” that prove your teeth really are remarkable.
1. People have been caring for their teeth for centuries.
Did you know the first toothbrushes were actually twigs our ancestors chewed on, using the frayed ends to cleanse their teeth? Around 5,000 B.C., the Egyptians used crushed eggshells and ground animal hooves to clean and polish their teeth. By the 1700s, a British inventor had adapted a design first seen in China – a bone handle with boar bristles inserted into small holes and secured with wire. Modern toothbrushes with nylon bristles arrived in the late 1930s, and the first electric toothbrush was introduced in 1954.
2. Teeth can tell stories about you.
Scientists can tell a great deal about us just by examining our teeth. Did you realize that our teeth reveal how old we are, what we eat and drink — even where on Earth we may have lived? Our teeth also carry significant clues about our overall health, including periods of stress or illness we’ve endured. In short, teeth are a lasting record of our personal history
3. Every tooth is unique.
Whether we’re talking about the 20 “baby teeth” that serve us in childhood or the 32 permanent teeth we have in our adult years, no two teeth are exactly the same shape and size. Each tooth in your mouth has its own unique profile, and teeth also vary widely from person to person. So your smile really is a true mark of your individuality!
4. The blueprint for your teeth is present the day you’re born.
When babies arrive, the crowns of their first 20 teeth are already in place under the gums, waiting for the right time to break through – starting sometime between 3 to 6 months of age. Throughout childhood, the crowns and roots of adult teeth are already forming under those baby teeth, waiting until it’s time to begin pushing them out of the way. And here’s one more fun fact: In 1950, the average gift from the Tooth Fairy was just 25 cents. Today’s kids get about $2.00 per tooth.
5. Cleaning between your teeth is just as important as brushing the parts you see.
When we brush, we’re able to easily reach the tops and sides of our teeth. But the surfaces between – which make up a significant part of our tooth enamel – need proper cleaning, too. This is why it’s best to clean between your teeth daily to remove food and bacteria and promote healthy gums.
And don’t forget to visit your dentist regularly for cleanings and checkups. Your teeth are already amazing, and your ADA dentist and their team can help keep them that way.
Aug 24th, 2017
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By Jennifer Garvin
Rockville, Md. — Primary teeth from children with autism spectrum disorders contain less of the essential nutrients zinc and manganese and more of the neurotoxin lead compared to those from children without ASD, according to a new study published June 1 in the journal Nature Communications.
In the study, researchers from the Icahn School of Medicine at Mount Sinai in New York and the Karolinska Institutet in Sweden used tooth biomarkers to analyze primary teeth collected from 32 pairs of twins and 12 individual twins enrolled in the Roots of Autism and Attention Deficit Hyperactivity Disorder Twin Study in Sweden, according to a Mount Sinainews release.
“The differences in metal uptake between children with and without [ASD] were especially notable during the months just before and after the children were born,” according to the National Institute of Environmental Health Sciences, part of the National Institutes of Health, which funded the study.
NIEHS said the scientists determined this by “using lasers to map the growth rings in baby teeth generated during different developmental periods.”
“We found significant divergences in metal uptake between ASD-affected children and their healthy siblings, but only during discrete developmental periods,” said Dr. Manish Arora, Ph.D., an environmental scientist and dentist at Mount Sinai. “Specifically, the siblings with ASD had higher uptake of the neurotoxin lead, and reduced uptake of the essential elements manganese and zinc, during late pregnancy and the first few months after birth, as evidenced through analysis of their baby teeth. Furthermore, metal levels at three months after birth were shown to be predictive of the severity of ASD eight to ten years later in life.”
NIEHS said researchers also observed lower uptake of manganese in children with ASD, both before and after birth; children with ASD also had lower zinc levels earlier in the womb, but the levels then increased after birth, compared to children without ASD.
NIEHS noted that prior studies relating toxic metals and essential nutrients to autism have faced “key limitations, such as estimating exposure based on blood levels after autism diagnosis rather than before, or not being able to control for differences that could be due to genetic factors.”
“A lot of studies have compared current lead levels in kids that are already diagnosed,” said Cindy Lawler, Ph.D., head of the NIEHS Genes, Environment and Health Branch. “Being able to measure something the children were exposed to long before diagnosis is a major advantage.”
The researchers noted that larger studies are needed to confirm the connection between metal exposure and uptake and ASD.
Jul 14th, 2017
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Summer sun brings summer fun! While warm months are perfect for spending time together, summer vacation can also throw off your usual dental routine. Here are three ways to prevent summertime tooth decay:
STAY ON A ROUTINE
Whether your kids are staying up to catch fireflies or a fireworks show, resist the temptation to skip brushing before a late bedtime—or let it slide when they sleep in the next morning. “Don’t forget about your smile over the summer,” says ADA pediatric dentist Dr. Mary Hayes. “It’s important for families to consistently brush and floss, which keeps kids on track for healthy back-to-school dental visits.”
No matter how eventful the upcoming months become, supervise that they are brushing twice a day for 2 minutes with fluoride toothpaste. Simple things like brushing calendars can help everyone stay on track over the summer. Plus, it’s a chance to spend more time together. Brushing alongside your children for 2 minutes, twice a day for the three months of summer gives you 6 extra hours together, so make the most of them!
And don’t forget to clean between those teeth once a day. “Your children should be flossing between any two teeth that touch,” Dr. Hayes says. “However, many kids don’t have motor skills to floss until they are over 10 years old.” If your child needs help, try different types of interdental cleaners or put your hands over theirs to guide them and get the job done at the same time.
SAY NO TO SUGARY DRINKS AND SNACKS
As the temperature rises, it’s common for families to sip and snack during sports tournaments, festivals or nearly any community event. “Watch your family’s intake of lemonade, juice and soda,” says Dr. Hayes. “Consider sugary drinks treats to enjoy once in a while, and not often.” Instead, offer water (even better if it has fluoride) to beat the heat, or milk to drink with meals. And, don’t let summertime grazing damage your child’s smile. “Taking a break from snacking is healthy for your teeth,” says Dr. Hayes. “It allows time for saliva to bathe the teeth, wash away leftover food and get stronger.”
If you find yourself spending more time at home, snack smarter, and let your children tell you when they’re hungry instead of offering snacks throughout the day. “They’re not afraid to let you know when they want something to eat!” she says.
MAKE YOUR BACK-TO-SCHOOL DENTAL VISIT EARLY
Some schools require back-to-school dental visits for certain grades, and these checkups can be a good way to be sure your child’s teeth stayed healthy. It is a good idea to make your child’s back-to-school appointment early in the summer to avoid the August rush and help insure you get the appointment time that works best for you. “We can help spot and take care of any issues, so your child doesn’t have to miss class once school starts,” Dr. Hayes says. “Visiting the dentist regularly can help your child’s smile stay healthy all year long.”
Jun 13th, 2017
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