Author: Adam Thomas

On Thursday, September 24th, 2020, The FDA (Food and Drug Administration) issued a statement titled “FDA Issues Recommendations for Certain High-Risk Groups Regarding Mercury-Containing Dental Amalgam.” In their statement they issue “updated recommendations concerning dental amalgam and potential risks to certain high-risk individuals that may be associated with these mercury-containing fillings used to restore the missing structure and surfaces of a decayed tooth.”

The groups that the FDA states “may be” at a greater risk of negative health effects are:

• Pregnant women and their developing fetuses;
• Women who are planning to become pregnant;
• Nursing women and their newborns and infants;
• Children, especially those younger than six years of age;
• People with pre-existing neurological disease such as multiple sclerosis, Alzheimer’s disease or Parkinson’s disease
• People with impaired kidney function; and
• People with known heightened sensitivity (allergy) to mercury or other components of dental amalgam.

Although the FDA defines these groups as ‘maybe’ having a higher-risk of negative health effects from dental amalgam, they don’t appear to provide any new evidence of this being the case. In fact, after the FDA released their statement, the ADA (American Dental Association) released their own press release reaffirming its position on dental amalgam.

The ADA’s press release did acknowledge that they agreed with the FDA’s recommendation of the patient discussing all treatment options with their dental provider, but pointed out that there is “little to no information” on whether or not anyone in these specific groups were at greater risk of negative health effects from the use of dental amalgam. The ADA stands by their assessment that “dental amalgam is a durable, safe and effective cavity-filling option.

Apparently there are some people who’ve taken to the social media platform, TikTok, and posted videos of themselves using a fingernail file to grind down their own teeth. One girl who had a chipped tooth filed down her two front teeth so that the lengths were the same. The tooth filing-trend started gaining so much attention that dental hygiene professionals began responded in an effort to debunk them.

There’s no doubt that some of these TikTok users should leave the dental work to professionals. Although some appear to be doing it as a joke there  are several who are grinding off some parts of  their permanent teeth. Doing this could leave some of these social media socialites with irreparable damage and tremendous pain.

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The United States Centers for Disease Control and Prevention continues to recommend the wearing of masks while in public to help curb the spread of the COVID-19 virus.  But you may be experiencing some negative side effects from wearing a face mask for an extended period of time.

Some experts suggest that the increased use of masks due to the coronavirus has left some patients with gum disease and bad breath. One dentist and co-founder of One Manhattan Dental, Dr. Rob Ramondi, said around 50 per cent of his patients are being impacted by the use of face masks. He also stated that wearing masks for extended periods of time can cause dry mouth, which leads to a decrease in saliva – and saliva is what fights bacteria and cleanses your teeth.

Decisionsindentistry.com writes in The Truth Behind Mask Mouth:

“Wearing a mask is not new for dental and medical professionals; however, the extended wear time is. And with supplies of personal protective equipment (PPE) low in some regions, many healthcare providers are keeping the same mask on instead of donning a new one after each patient, further extending the wear time of masks.²

In one study, nurses were tested and surveyed while wearing their masks over the course of two 12-hour shifts.³ Over the two days, 22% of the nurses removed their masks at some point due to discomfort and a perceived shortness of air with complaints of headaches and lightheadedness as well.

More recently, a study was conducted specifically related to headaches and their association with PPE such as N95 masks and protective eyewear.⁴ This study found that out of 128 participants with no preexisting headache condition, 81% reported PPE-associated headaches. Additionally, out of the 46 participants with a pre-existing headache diagnosis, 91.3% reported an exacerbation of their headache condition after the extended use of PPE.

Headaches can be a symptom of dehydration.⁵ Extended mask wearing may inhibit the consumption of enough fluids throughout the day. This could, in turn, lead to xerostomia, which opens the door for potential oral complications.

Xerostomia has been associated with an increased risk of caries, fungal infections, oral malodor, and periodontal diseases,⁶ which may be why we have started hearing the phrase “mask mouth.” Since masks are now required in many public settings, we need to discuss these potential complications with our patients, as they too are wearing masks for extended periods. Combatting xerostomia as a side effect of mask usage can be as simple as reminding our patients to drink enough water throughout the day. Additionally, chewing gum with xylitol can help stimulate salivary flow and prevent caries.^7″

In addition to headaches and dehydration, some say that wearing the PPE for an extensive amount of time can lead to difficulty breathing, profuse sweating and skin irritation.

CDA.org writes in Side effects of PPE: Tips to relieve physical and emotional exhaustion:

“Some dental professionals are facing a new set of challenges from wearing additional personal protective equipment as they adapt to providing care in the COVID-19 era.

A recent survey of more than 2,500 dentists, hygienists, dental assistants and business administrators on the impact of current PPE protocols found that dental professionals of all ages are experiencing increased levels of physical and emotional discomfort since resuming routine care.

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Dental professionals who are now wearing multiple layers at one time, including a surgical mask, face shield and respirator mask, have also reported challenges with breathing. According to the survey, participants said they are having a hard time breathing nearly 50% of the time while wearing the current recommended respiratory PPE.

Dental professionals are also wearing their PPE for an extensive amount of time, which can lead to profuse sweating — another side effect that was reported among more than half of survey participants. According to an article in Dentistry IQ, 62% of health care workers report only removing their PPE during their lunch break, while another 7% say they never remove their PPE during their entire work shifts.

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If you’re experiencing more breakouts and irritation on your face lately, you’re not alone. In the survey, 43% of respondents reported an increase in facial acne while another 35% reported facial skin soreness due to face masks. The constant rubbing of the masks against the skin causes micro-tears, allowing easier entry for bacteria and dirt to clog the pores.

Health care workers are most at risk because their masks are tighter-fitting and workers are wearing them longer. According to a research letter published in the Journal of the American Academy of Dermatology in May, at least 83% of health care workers in Hubei, China, suffered skin problems on their face due to enhanced infection-control measures.”

To combat some of the side effects of prolonged mask usage, it is important to stay hydrated by drinking plenty of water. If you remain hydrated throughout the day, it is less likely you will experience dry mouth, bad breath and headaches.

If you’re experiencing skin irritation, experts recommend simplifying your skin care routine and using a gentle non-soap cleanser and a mild, fragrance-free moisturizer. It is also advised to avoid thick skin care creams and opt for a more lightweight water-based product to wear underneath your mask.

And if you’re looking for a solution to any of your dental lab management issues, please check out Evolution from ABS.

The American Dental Association (ADA) has issued a statement saying that they “respectfully yet strongly disagree with the World Health Organization’s (WHO) recommendation to delay “routine” dental care in certain situations due to COVID-19″

On August 3rd, 2020, The WHO released “Considerations for the provision of essential oral health services in the context of COVID-19” interim guidance, which states:

“WHO advises that routine non-essential oral health care – which usually includes oral health check-ups, dental cleanings and preventive care – be delayed until there has been sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases or according to official recommendations at national, sub-national or local level. The same applies to aesthetic dental treatments.”

The ADA has taken issue with the WHO’s definition of “non-essential oral health care,” with the association’s president, Chad P. Gehani, D.D.S., stating:

“Oral health is integral to overall health — staying well depends on having access to health care, which includes dental treatment.”

He added:

“Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health.”

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