[Shirdent]

Yes, Dr. Kutsch mentioned caries being a pH disease at the last World Congress of Minimally Invasive Dentistry this summer. The confusion for me is that early gnotobiotic rat studies showed a strong correlation between strep and lesions. The germ free rats didn’t get holes in their teeth. So right now I’m thinking we need to test saliva for pH and for strep to let us know how often the pH is low. Strep love low pH.

Shirley Gutkowski, RDH, BSDH, FACE

        

[Shirdent]

ahluwaliatony wrote:

Dear colleague I am working in a govt. institute and we have about 6 dental hygienists working here. They perform a number of tasks according to the requirement like taking x-rays, oral prophylaxis and patient management. Sometimes they can also help as chairside assistants. So they have many roles to play.

Devinder Preet Singh

I just read an article about the shortage of health care workers in India. Dental hygienists was listed as one of the catagories where more people were needed. How many schools are there?
We have an over abundance of dental hygienists in the states. We have over 300 dental hygiene schools, graduating about 25 per class once a year. Contrast that to about 50 dental schools.
Dental hygienists can only work under a dentist’s supervision in the US. There is some variation on that in some states but for the most part that’s how it is.
What’s it like for dental hygiene in India?

        

[Shirdent]

Yes, Dr. Kutsch mentioned caries being a pH disease at the last World Congress of Minimally Invasive Dentistry this summer. The confusion for me is that early gnotobiotic rat studies showed a strong correlation between strep and lesions. The germ free rats didn’t get holes in their teeth. So right now I’m thinking we need to test saliva for pH and for strep to let us know how often the pH is low. Strep love low pH.

Shirley Gutkowski, RDH, BSDH, FACE

        

[Shirdent]

There are a few things to remember or do to keep yourself safe.

1. Lock the outside door while you’re working on a patient if you and your assistant are the only two in the building.

2. Keep the place lit as if there was a party going on.

3. Have a third person available if possible, like the front desk person.

4. Employ a dental hygienist so you’ll have a fourth person. The more people, the less likely someone will try something.

Shirley Gutkowski, RDH, BSDH, FACE
http://www.careerfusion.net

        

[Shirdent]

Veerendra Darakh wrote:

what is the brand name of xylitol in USA.

veeren

The brand name that fits the best with the variety of products, has world wide distribution, and a good relationship with researchers is Spry. http://www.xlear.com or http://www.sprydental.com.

Shirley Gutkowski, RDH, BSDH, FACE

        

[Shirdent]

I’ve found the best way to explain this to patients is to sit them up. At least here in the US it’s important to speak to a patient at equal eye level. I hit on three main components:
1. It’s a difficult to control infection and I’ll have to detoxify the area between their teeth and gums.
2. The infection produces compounds that break down collagen and elastin, two main components in youthful skin.
3. Other compounds produced by the infectious nature of the disease increases their risk for heart attack, stroke and other cardiovasular events.

Shirley Gutkowski, RDH, BSDH, FACE

        

[Shirdent]

Int J Paediatr Dent. 2009 Jul;19(4):263-73. Epub 2009 Mar 23.

Oral health programme for preschool children: a prospective, controlled study.

Meurman P, Pienihäkkinen K, Eriksson AL, Alanen P.

University of Turku, Institute of Dentistry, Turku, Finland.

BACKGROUND: New perspectives are needed for oral health programmes (OHPs). The aim was to evaluate the preventive effect of a risk-based OHP in comparison with a traditional programme. DESIGN: An age cohort of 794 Finnish children, 446 in the intervention group and 348 in the control group, was followed from 18 months to 5 years of age. The children were screened for mutans streptococci (MS) in the dental biofilm. The main outcome measure was the proportion of children with dental caries (decayed, missing, or filled primary teeth > 0) at the age of 5 years. The intervention, targeted to MS-positive subjects in the intervention group only, was based on repeated health education to the caretakers and xylitol lozenges for the child. Dental hygienists carried out the programme. RESULTS: OHP was effective in white-collar families [numbers needed to treat (NNT) = 3, 95% CI 2-11]. Factors significantly associated with caries at 5 years were MS colonization at 18 months, occupation of caretaker, but also gender when incipient carious lesions were included in the index. CONCLUSION: Early risk-based OHP, targeted to the families of MS-positive children, can reduce the risk for caries in white-collar families. For blue-collar families, different kinds of methods in caries prevention and support are needed.

Publication Types:

* Research Support, Non-U.S. Gov’t

PMID: 19320915 [PubMed – in process]

        

[Shirdent]

Top reasons for legal tangles include mis-diagnosis and non treatment of dental infections.

For instance:
1. Patient has heart attack, and untreated undiagnosed periodontal disease
Potential malpractice

2. Patient has new decay after radiation treatment of the parotid and salivary concerns are not addressed, only fluoride is advised. OR dentist never even tests for saliva attributes.
Potential Malpractice

Shirley Gutkowski, RDH, BSDH, FACE

        

[Shirdent]

Xylitol is a 5 carbon sugar, polyol come from plant material particularly hard woods and pulpy plants.

Indications
caries infections
perio infections
Sinus infections
ear infections
chronic wounds – biofilm infections

Mode of action
penetrates biofilm
affects the cell wall of gram negative
Inability of strep family to metabolize
increases salivay pH

Applications
caries infections
in gum 5 to 10 total applications per day
in mints 5 to 10 total applications per day
in toothpaste or other vehicles
sinus infections
saline nasal spray prn
chronic wound – biofilm infections
apply as a paste prn
ear infections
combination of oral and nasal applications
in small children nasal spray in each nostril at each diaper change
Periodontal disease
see caries infections

Shirley Gutkowski, RDH, BSDH, FACE

        

[Shirdent]

If you’re willing to come to the USA we’re having an excellent broad spectrum perio meeting in November in Scottsdale, Arizona.
Here is the link to the Web site with all of the information.

http://www.acescottsdale2009.com/

Shirley Gutkowski, RDH, BSDH, FACE

        

[Author]

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