Brain Injury and Oral Health

Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain. TBI can occur as a result of  impact to the head with an object or when an object pierces the skull and enters brain tissue. Brain injury can be mild, moderate, or severe.

A concussion is also classified as a traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. It can happen to anyone! So protect yourself and take the proper precautions.

Concussions are common, particularly if you play a contact sport, such as football or hockey. But every concussion injures your brain to some extent. To heal properly this injury needs time and rest. Most concussive traumatic brain injuries are mild, and people usually recover fully, sometimes people don’t even realize that they had a concussion if loss of consciousness doesn’t occur.

Signs & Symptoms of a Concussion

Signs and symptoms of a concussion may not be immediately apparent and can be delayed for several hours or even days. They can also be very subtle, but may persist for days, weeks or longer!

Most common symptom after a concussion are headaches and possible memory loss or confusion.

Signs and Symptoms may include:

• Headache
• Confusion
• Temporary loss of consciousness
• Slurred speech
• Delayed responsiveness
• Amnesia
• Dizziness
• Ringing in the ears
• Nausea/Vomiting
• Fatigue

Always see a doctor within 1-2 days after injury. Do not return to any sport or strenuous activity while any of the symptoms persist.

There has always been the debate of whether a mouthguard will help prevent a concussion.

Regulations have changed just this year in hockey, no longer requiring the use of a mouthguard. I personally think that is ridiculous. The more protection one can take against injury, the better. An ounce of prevention is worth a pound of cure! An independent dental hygienist or dentist can make a professional custom fit mouthguard, that offers superior protection. They fit better, it is easier to breath and speak with them in, and players are more compliant to wear them!

Here is a great link to a current article that studied  custom made mouthguards vrs. store bought http://www.sciencedaily.com/releases/2014/05/140501101133.htm

The Canadian Dental Hygienists Association has lots of supportive information on the importance of mouthguards. Check out the following link.

http://www.cdha.ca/AM/Template.cfm?Section=Home&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=15993

Moderate or Severe Brain Injury

Depending on the severity of the brain injury a person with a moderate or severe injury may have difficulty with adhering to their daily home care routine, and special oral hygiene care may be required from a caregiver. These caregivers  ensure their loved ones receive proper oral care  which is important for their comfort, general health and quality of life.

Bacteria from oral infections can enter the blood stream or airways and travel to other parts of the body, increasing the risk for other health problems such as stroke, heart disease, and respiratory disorders such as pneumonia and lung disease. So maintaining good oral health for the patient with a brain injury is important.

The person may be able to brush their teeth on their own and should be encouraged. An electric toothbrush may be easier for the patient or caregiver but can be too stimulating for some individuals and may not be tolerated.

Tips For The Caregiver

Make sure to communicate what you are doing in a gentle tone of voice to reduce any anxiety.  Tell the person what is going to be done and how it will feel and then show them. Routine alleviates stress too, so try and use the same technique at the same time and place.

• Brush teeth 2x day using a soft bristle toothbrush, an electric toothbrush maybe easier, if tolerated. Make sure to clean at the gum line (base of teeth) a common area where plaque is missed.
• Use a pea sized amount of fluoridated toothpaste, make sure they don’t swallow it.
• Clean in between the teeth daily. Flossing may be difficult so try using a proxabrush (small interdental brush), or  floss wand with a longer handle.
• If experiencing a dry mouth avoid sugar gum or mints, try xylitol mints or gum instead. There is also special products for dry mouth such as mouth wash and toothpaste etc.

Dental visits at an office can also be a challenge.  Arrange for a professional dental hygiene assessment and cleaning from a mobile dental hygienist. This will make it easier for the person with the brain injury since they are in a familiar and comfortable environment.

http://www.odha.on.ca/drupal/system/files/pdf/CaregiversNewFactSheet.pdf

http://depts.washington.edu/sodent2/wordpress/wp-content/media/sp_need_pdfs/TBI-Adult.pdf

Ministerial Message – National Dental Hygienists Week – April 6-12, 2014.

This is an article from www.dentalbuzz.com

This is polyethylene: 

Did you know that polyethylene is the most common plastic in the world? It is used primarily for containers and packaging, such as these bottles and plastic grocery bags, and has been a concern for the environment because polyethylene lasts practically forever and isn’t biodegradable. It only breaks down into smaller and smaller particles until you can’t see it anymore. That’s why a couple of states are trying to ban it in body scrubs and dental products.

This is also polyethylene:

Well, not all of it. Most of it is toothpaste. But do you see those blue specks? That’s plastic. This is the suggested pea-sized amount that you should use when you brush your teeth. Yes, there is plastic in this toothpaste.

Want to see how many pieces of plastic are in this exact sample?

Not that I’m counting the bits but that seriously looks like A LOT of plastic… err…high density polyethylene. That’s what plastic trash cans are made from! If you throw away the box like most people do, the ingredients aren’t actually listed on the tube (sneaky, sneaky, Procter & Gamble!) However, I was able to track down the box here at this link. We’re not talking about polyethylene glycol, which is soluble in water. This stuff won’t dissolve in water, or even acetone or alcohol for that matter. How do I know it won’t dissolve? Because I put on my little scientist hat and tested it.

Like many of you, we often let our daughter pick out her own toothpaste at the store. She liked the tween vibe of this particular product so much that she chose it twice, but eventually the squeezed-out tubes ended up in the back of her toothpaste drawer.

When I first got wind that plastic was in some toothpastes, it was kind of exciting to realize that we had some on hand! And a bit concerning, because, after all, this is in my own home, used by my own child. Able to confirm that, sure enough, there was polyethylene in this toothpaste, I squirted out a pea-sized sample, mixed it up with some water, strained out the undissolved particles and let them dry on a paper towel. Oh, and I used a hair dryer to speed things up because I’m impatient. Then I shook approximately half of the sample into each of two pyrex bowls and added some household solvents:

They didn’t dissolve in the acetone, (nail polish remover) or in the alcohol either. I even left the samples in the solutions overnight, then re-hydrated them. No change in the particles.

So it has been established here that polyethylene will not dissolve in the mouth, or even in household products. It is an inert substance, which means that it doesn’t change at all. You know, that’s pretty good in some ways, because at least it’s probably not morphing into big blobs of plastic evil cancer bait.

Here’s where the story gets scary, though.

You see, I’m not just a concerned mom. I’m also a dental hygienist. And I’m seeing these same bits of blue plastic stuck in my patients’ mouths almost every day.

Around our teeth we have these little channels in our gums, sort of like the cuticles around our fingernails. The gum channel is called a sulcus, and it’s where diseases like gingivitis get their start. A healthy sulcus is no deeper than about 3 millimeters, so when you have hundreds of pieces of plastic being scrubbed into your gums each day that are even smaller than a millimeter, many of them are getting trapped.

The thing about a sulcus is that it’s vulnerable. Your dental hygienist spends most of their time cleaning every sulcus in your mouth, because if the band of tissue around your tooth isn’t healthy, then you’re not healthy. You can start to see why having bits of plastic in your sulcus may be a real problem, sort of like when popcorn hulls find their way into these same areas. Ouch, right?

Like I said, I’ve been seeing these blue particles flush out of patients’ gums for several months now. So has the co-hygienist in our office. So have many dental hygienists throughout the United States and Canada who have consulted with each other and realized that we have a major concern on our hands.

This is what an actual polyethylene speck looks like when it’s embedded within the sulcus, under the gumline:

I am not saying that polyethylene is causing gum problems. I’d be jumping too soon to that conclusion without scientific proof.  But what I am saying definitively is that plastic is in your toothpaste, and that some of it is left behind even after you’re finished brushing and rinsing with it.

Do you want plastic in your toothpaste? So far the only mention of polyethylene on the Official Crest website at this link is that it is added to your paste for color, not as an aid in helping to clean your teeth or to disperse important anti-plaque or anti-cavity ingredients.

Polyethylene plastic is in your toothpaste for decorative purposes only.

This is unacceptable not only to me, but to many, many hygienists nationwide. We are informing our patients. We are doing research separately and comparing notes. And until Procter & Gamble gives us a better reason as to why there is plastic in your toothpaste, we would like you to consider discontinuing the use of these products.

Here are some of the brands (click each to see their ingredient list and labeling) that we currently are aware of which contain polyethylene:

What you can do

At this point, it’s probably best if you leave your flaming torches back in the barn. We’re not going after witches or Frankenstein here; you’re using your power as a consumer to send a message that you do NOT want plastic in your toothpaste. Heck, you might even be worrying about what may happen if you or your children swallow some of it.

1. If you’ve already purchased one of these toothpastes you can take it back to the retailer where you bought it, make sure that the manufacturer knows why you’re returning it, and ask for a refund.

2. Lodge a Crest consumer complaint at (800) 959-6586 and report an adverse health effect, namely, that you’re concerned that plastic pieces may be getting trapped in your mouth.

3. Click here to send an email to Procter & Gamble, the makers of Crest.

4. Share this! Let your friends and family know that you are also concerned about the plastic in their toothpaste by clicking on your favorite social media link below and getting the word out.

Response to criticism

Procter & Gamble’s current party line? “We will discontinue our use of PE micro plastic beads in skin exfoliating personal care products and toothpastes as soon as alternatives are qualified.”

And your response then may be, “I will discontinue MY use of Crest toothpaste until there are no more decorative microplastics entering my mouth.”

References and acknowledgements

Plastic Trades Industry: http://www.plasticsindustry.org/AboutPlastics
US National Library of Medicine: http://dailymed.nlm.nih.gov/crest
HygieneTown: http://www.hygienetown.com/blue-dots-in-patients-mouths

And a HUGE thank you goes out to my friend and colleague Erika B. Feltham, RDH for bringing this problem to our attention and for her extensive research. Erika is dedicated to providing the best possible care for her patients. She has been active inthe dental profession for over 30 years, is a recipient of the 2008 American Dental Hygiene Association/Johnson and Johnson Hygiene Hero Award, the 2010 RDH Sunstar Americas (GUM Dental)Award of Distinction, lectures extensively about the harmful effects of sour candies, energy and sports drinks, and along with her San Diego component, she is responsible for presenting the resolution on sour candy labeling at the 2009 CDHA House of Delegates.

via DentalBuzz – a jolt of current.

Pearly Whites Mobile Dental Hygiene Services is excited to be a participant in The Gift From the Heart this Saturday February 8th 2014. We will be treating clients who cannot truly afford dental care from 9am – 3pm, providing them with free dental hygiene services. Unfortunately due to the overwhelming number of inquires our day is full. But we look forward to participate again next year.  We will keep you updated with photo’s from the event. Listen to MyFm 104.9 tomorrow morning to hear our interview.

The Bridal Event 2014 this Sunday February the 2nd 1:30 pm – 3:30pm at The Germania Hall in Pembroke

Stop by our booth and check out our whitening specials for the bride and her bridal party. An easy way to add some sparkle on that special day! The poster below is from last year. Still free entry and great prizes to be won.