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Keep your team happy for the long haul

Here's how to get those perfect team members to stay with your practice for the long haul. Dr. Roger Levin believes there's a lot to be said for keeping employees happy. Every CEO and business owner knows that holding on to great team members is a critical success factor. Of course, practices will have turnover from time to time, but that can be managed with well-documented systems, step-by-step instructions, and scripting. However, one of the best ways to improve staff performance is to maintain a long-term team of high-performing members. Let’s look at five ways you can hold on to great staff members and increase longevity of staff. Create and promote the practice vision Unfortunately, dental practices don’t offer much opportunity for advancement or upward mobility. It’s highly unlikely that most dental assistants will move into other positions, and the same is true for the rest of the team. So, how can you motivate your team?You can create a practice vision. People like to belong to something bigger than themselves, and they don’t come to work every day just to do the same thing over and over. Creating a vision for the future and discussing it often gives your team members an understanding of what they belong to, where the practice is going, and how they can contribute. When a team is galvanized around a common goal, this creates a better team and people become more committed, which means they are more likely to stay. Demonstrate high levels of appreciation The first way to show appreciation to your team is, of course, monetarily. In fact, many offices have found that a highly compensated staff often results in the need for one less team member, as team members perform at such a high level that someone becomes superfluous. In addition to proper monetary compensation, having regular out-of-office activities, surprises such as days off, tickets to key events, or a trip or dinner to celebrate the practice’s five-, 10-, or 15-year anniversary are all great ways to keep the team motivated and on board. Daily compliments are also very beneficial to demonstrate appreciation for a job well done. Provide opportunities for team members to improve in their jobs Continuing education is just as important for the dental team as it is for dentist. While CE is mandatory for maintaining a dental license, it should also be mandatory for practices that want to keep their teams long-term. If you have the right team members, they will enjoy learning and growing. Providing them with those opportunities will stimulate them, which will contribute to their desire to remain with the practice. Create a fun environment Levin Group has consulted with thousands of practices and the easiest ones to work with are those that are having a good time. You walk in the door and you get a sense of energy, positive attitude, and fun vibe. You also get a sense that the staff really wants to be there, really likes the patients, and enjoys the interpersonal interaction. Those practices are truly fun and very successful. Make friends Finally, don’t be afraid to develop friendships with your team. I fully believe that it’s possible to manage a person and be their friend at the same time. This may be one of the best ways to keep your team on board. Refer link: https://www.dentistryiq.com/practice-management/staffing/article/14200777/how-to-increase-dental-staff-longevity

9th April, 2021

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Demystifying private equity

Is your goal to own multiple dental practices? There's a whole language associated with it, and a lot to learn. Dr. Chris Salierno provides some terrific first steps. Angel investors, term sheets, up rounds . . . this is the language of venture capital. If you’re an aspiring owner of multiple practices, you would do well to start learning the concepts and speaking the lingo. We definitely didn’t learn this stuff in dental school. For example, Tend, a startup in urban-based, technology-focused dental practices, recently completed a successful Series C round of investments. If you check out the history of their funding rounds on Crunchbase, you’ll see a case study in how this process is supposed to work for a young and successful company. If your enterprise were ever to seek private equity funding, this is the kind of trajectory you would want. But if those numbers and terms are foreign to you, then I’d like to introduce you to the resources that helped me. First, I’m a huge fan of Khan Academy, which you may be familiar with as a free, online educational platform for a variety of topics. Founder Sal Khan has an MBA from Harvard, and his lessons on finance and capital markets are outstanding. Check out this introduction to startup financing, and you’ll start going down the rabbit hole. Next, when you’re ready to take a deeper dive, then I strongly recommend the book Venture Deals by Brad Feld and Jason Mendelson. Some books on start-ups and investments are too academic, but this one is quite readable while still being comprehensive. Finally, take a look at Startup Evolution Curve by Donatas Jonikas, PhD. This serves more as a workbook, helping you flesh out your ideas, apply best business practices, and consider how external funding can help scale. Enjoy the journey! Refer link: https://www.dentistryiq.com/practice-management/dsos-and-corporate-dentistry/article/14201485/demystifying-private-equity

17th April, 2021

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What’s right for you? Dental service organization or private practice?

It's one of the biggest decisions dentists will make: opening their own practice, or joining a dental service organization. Both have risks and advantages. Which one is for you? The emergence of dental service organizations and their desire to grow, combined with the hardships of the COVID-19 pandemic, has created a shift in dentists’ attitude toward “selling out.” Who wouldn’t want to capitalize on the increased security and comfort of a large organization backing them up—securing the payroll through hard times, marketing to patients, and helping to alleviate the cost of unforeseen issues? That seems like an easier decision during an age of uncertainty. Does it make more sense for some than for others to pull the trigger? Of course, and you might be more equipped to flourish on your own. But this depends on the individual skills and preferences of the owner. For the record, I am not going to tell readers which option is better as that is completely arbitrary and depends on the person. I’ll only offer some tactical information to present a factual and complete analysis of each scenario. I sat down with David Rice DDS, founder of Ignite DDS and a pillar of dental industry knowledge and experience and came away with several interesting considerations. Some of his insights: “They both have advantages and shortcomings depending on the person. One’s level of personal responsibility, income level, and quality of life can all be better or worse according to preference. It definitely comes down to an important choice; how much are you willing to deviate from the old adage of ‘focusing on the dentistry?’” DSO advantages DSO ownership can offer many advantages to a practice owner. There is essentially a corporate management system that takes over operations. This means help with payroll, supply distribution, and repair/maintenance issues. You’ll also probably enjoy perks such as drastically reduced repair bills and quicker service response. Large DSOs have the power to negotiate prices based on volume, so the larger they are the better the perks become. Operations isn’t the only thing that gets a boost; your new affiliation will offer inclusion in nationwide marketing campaigns, with more patient visibility through multiple website channels. In a world where the pandemic literally shut down almost everything, that can be a huge boost when trying to convince your patient base (who isn’t leaving the house much) that the dentist’s office is one of the safest public places to be. Speaking of your patient base, if you’re just starting out in practice this is a big plus—you don’t have to wait to build your client base; the DSO will have been marketing for you since before day one. Other perks will most likely include access to training and continuing education opportunities that you and your staff might not have known about or had access to otherwise. One thing about DSOs is that they prefer uniformity. This could result in the uniform decision to replace equipment that doesn’t hold up to their standard. You could suddenly be replacing dental chairs that are more than 10 years old or moving to CAD/CAM or CBCT if you haven’t already done so. The benefits of new equipment are obvious, and hopefully your team will be excited about the new learning opportunities. Guidelines are the key to success for them, and you’ll have to keep your team in the progress loop. Because of this, you’ll also learn a lot about running a successful dental business, something that will be invaluable should you decide to open your own office someday. Large companies hire successful, experienced executives to lead their (and your) teams so that only best practices are brought into the business. DSO disadvantages The drawback of the disadvantages might depend only on your interest in avoiding them, but profit would be at the top. You stand to make only a portion of what you would make as an owner, but the tradeoff is everything I discussed above. Because of the standards and uniformity, you’ll have little room for negotiation at the practice level, and other doctors and team members will be paid accordingly. Profits may take priority in corporate ownership, so you would be leaning into decisions you might not normally make under alternative leadership. You also stand to lose some decision-making power. More specifically, additional treatment could be the norm when in doubt (perhaps against your own intuition), and associates working on scale might be in competition for the high-dollar procedures. Production goals will also be in place, so if others are sending the business, you’ll be held to capitalizing on those opportunities. It’s also wise to find out everything about the contract you sign; some may include a restrictive covenant that would prohibit you from practicing within a certain distance of your current practice to prevent competition. Advantages of private practice On the flip side, private practice offers high-risk, high-rewards for those with dreams and perseverance. In reality, doesn’t everything worth doing carry risk? Obviously, overhead is the major discerning factor here, as all costs—from startup to maintenance—are solely your responsibility. Private practice also offers complete autonomy, with no location restrictions or restrictive covenants and complete control over capital investments, personnel, and other major decisions. It helps if you know something about business, and there are many articles available about what they don’t teach in dental school. Small offices are more personally affected by each employee, so you’ll need to create influence by being a strong mentor and helping your team members grow. One way to do this is by exposing them to new technology and procedures and developing their skills. The investments you make in your team will pay off exponentially with less absence and turnover. Also, human resources decisions are left up to you. If you do things right, you can minimize payroll with smart choices and multifunctional team members. You don’t have to seek approval to hire someone outside of your initial price range with exceptional skills. All major equipment investments, while seemingly pricey, will pay for themselves with a quick return on investment and will be attractive when it’s time to retire. I’ve often said that dental equipment upgrades are never a bad decision, and any dental transition broker will tell you that buyer dentists will consider offices with upgrades and good equipment a much better investment than something they must sink money into immediately. Furthermore, a private practice that is well kept is a very attractive opportunity should the owner want to take on a partner. Private practice challenges Some challenges a new private practice might face are the same as starting any other business. Startup costs in building or purchasing can be burdensome, and loans can put pressure on a new business. A consistent patient base can take years to develop, so a first impression is important. The current technology and a fresh, clean office are a must to lure new patients away from their current offices. Marketing is important, and while there are several programs that you can use with third parties, a good employee with a marketing background will help you manage that as well as a strong social media presence. Obviously, slow days in your practice mean less income to cover expenses, whereas working for someone else might not affect your daily rate. You’re also solely responsible for keeping up on all of your HIPPA requirements and security and failing to do so can mean consequences to you personally. Ultimately, there are ups and downs at both ends of the ownership spectrum. My goal in this article is not to pick a winner, only to illuminate the fact that one’s ambition, desire for income potential, or need for autonomy would make one choice easier than the other. Depending on one’s abilities, means, and outlook on life, either one offers benefits and downsides, but switching between the two will take time and research. Before you make the decision, it’s wise to consider all factors, do your due diligence, and understand the restrictions of each. There are many resources available to advise on the cost/benefit spectrum, but no one else can tell you what’s right for you. If you value work/life balance and don’t put a premium on income, you might opt for less responsibility and focusing on the dentistry. If you want the chance to build something in your own name, you might want to take more control and reach for the brass ring. Good luck! Refer link: https://www.dentistryiq.com/practice-management/dsos-and-corporate-dentistry/article/14201480/dentists-whats-right-for-you-dso-or-private-practice

16th April, 2021

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Antiplatelets & Anticoagulation Drugs: Dental Implications

Abstract Many patients with cardiovascular disorder, including coronary heart disease, cerebrovascular disease, atrial fibrillation and venous throm-boembolic disease, take antiplatelet and/or anticoagulant drugs. Over the last five decades warfarin has been the oral anticoagulant of choice and has been considered as mainstay of treatment. However, the frequent requirement for monitoring and multiple drug and food interactions have fuelled the need for development of newer oral anticoagulants. As a direct result of this, a new generation of oral anticoagulants has been developed to treat and prevent thromboembolic disorders, the direct thrombin inhibitors and the factor Xa inhibitors. They require no monitoring; exhibit predictable pharmacokinetics, have limited food and drug interactions, and a rapid onset of action and a short half-life. However, they lack a specific reversal agent. Complementary medicines, including fish oil, garlic, ginger, green tea and glucosamine, have a weak antiplatelet effect, but this is usually not clinically significant. This paper describes the importance and implications of these drugs in the dental management. Introduction Many dental patients are taking “blood thinners” medications to prevent the formation of potentially harmful blood clots for various medical conditions involving the arterial system e.g.: stroke, heart attack and the venous system e.g. deep vein thrombosis (DVT) or pulmonary embolism (PE). However, these medications interfere with the body’s normal clotting mechanism to stop blood flow at a site of tissue injury, which is of concern to dentists for procedures that cause bleeding. There are two main processes by which the body normally forms a blood clot. The first involves platelets, which clump, together at wound site to form a platelet plug, which slows the flow of blood through the vessel and forms a matrix. The antiplatelet drugs inhibit clumping. The next phase is coagulation when proteins in the blood interact with each other to fill in the spaces between the platelets, stabilize the clot, and make it more solid until bleeding stops. The anticoagulants drugs inhibit the activation of these proteins. Antiplatelets: Aspirin inhibits the metabolism of arachadonic acid by irreversibly inhibiting cycloxygenase enzymes, preventing the production of prostaglandins. By inhibiting cycloxygenase 2 (COX2), aspirin prevents the production of prostaglandins responsible for mediating pain and inflammation, therefore, acting as an anti-inflammatory, antipyretic, and an analgesic. However, due to its non-specific mechanism, aspirin also inhibits cyclooxygenase 1 (COX1) which produces physiologically important prostaglandins responsible for platelet aggregation, the protective function of the stomach lining and maintains kidney function. By inhibiting COX1, aspirin irreversibly blocks the formation of Thromboxane A2 in platelets producing an inhibitory effect on platelet aggregation during the lifetime of the affected platelet (7-10 days). Low dose aspirin (75mg daily) is indicated in patients at risk of myocardial infarction and ischaemic stroke, especially in those who have undergone cardiac procedures. Aspirin does not usually cause significant bleeding from extraction wounds. For dentoalveolar surgery (including extractions), there is no indication to temporarily cease prescribed regular aspirin. Patients are warned of having higher chance of bruising if aspirin is not ceased, but the risk is minor compared with the risk of embolism if aspirin is not ceased. Local measures are sufficient to achieve haemostasis, including infiltration of adrenaline containing local anaesthetic, insertion of oxidised cellulose and suturing. Clopidogrel (Plavix) and Prasugrel is antiplatelet medication used in patients following myocardial infarction, ischaemic stroke and ischaemic vascular disease. They are commonly used with aspirin to prevent stent thrombosis for up to one year after coronary stent placement. They are also used in patients who had ischaemic events despite treatment with aspirin or who cannot tolerate aspirin (Chart 1). Acute coronary syndromes are usually treated with dual antiplatelet therapy (aspirin and clopidogrel). Clopidogrel and Prasugrel irreversibly inhibits platelets aggregation and cross linking of platelets by fibrin by activating cytochrome P450 in liver. The half-life is approximately eight hours at an optimal daily dose of 75mg. Premature discontinuation of dual antiplatelet therapy after placement of coronary stent markedly increases the risk of stent thrombosis, by 15%, which frequently leads to myocardial infarction 14. Do not stop Clopidogrel or prasugrel without expert advice. Current available information suggests that the risk of bleeding in patients undergoing invasive dental procedures (for example extraction) is low, provided that local hemostatic measures (suturing, gelatine sponge, gauze soaked 5% tranexamic acid, tranexamic mouth rinse) are used (Table 1). Anticoagulants: Warfarin (a coumarin derivative) is the most widely used anticoagulant in the world. It is a vitamin K antagonist and inhibits vitamin K- dependent synthesis of clotting factors (VIII, IX, X and prothrombin II) affecting the formation of fibrin clot. These factors are synthesised in the liver in precursor form and activated by carboxylation of specific glutamic residues, which require vitamin K in its reduced form as a cofactor. In the UK it is estimated that at least 1% of the population and 8% of those over 80 are tak-ing it regularly. It was first used in 1955 to treat American President Dwight D Eisenhower for a coronary event. It is currently used in: 1. Prevention of venous thrombosis and embolism in rheumatic heart disease and atrial fibrillation (AF) 2. Treatment and prophylaxis of deep vein thrombosis (DVT) and pulmonary embolism (PE) 3. Stroke prophylaxis 4. AF and valvular heart disease (International Normalised Ratio) (INR target 2.5-3) 5. Mechanical heart valves (INR target 4) The maximum anticoagulant effect of warfarin takes 48 to 72 hours to develop, with an estimated duration of action of two to five days and a reported half-life of two and half days. It is important that both the patient and their medical practitioner understand how the patient’s warfarin treatment should be managed in relation to tooth extraction. It is not uncommon for patients to reduce their warfarin dose without consultation or, alternatively, to consult with their medical practitioner who may unnecessarily suggest the traditional course of ceasing anticoagulants for minor surgical procedures. Owing to the risk of potentially fatal thromboembolism, cessation of warfarin therapy prior to dental treatment is not recommended. Instead, an INR should be taken 24 to 48 hours pre-operatively to establish the degree of anticoagulation. In general, it is safe to proceed with an invasive dental procedure (including administration of local anaesthesia, periodontal or endodontic surgery and routine/surgical extractions) if the INR is less than 2.2. If the INR is greater than 2.2 to 4, the dentist should liaise with the treating physician in order to safely reduce warfarin dosage. Local measures are necessary to achieve haemostasis including tranexamic acid mouthwash. Due to warfarin’s long half-life, a period of three to five days is required for reduction in the level of anticoagulation, as reflected in a reduce INR . Finally, all dentists should be cognisant of the potential interaction between warfarin and other drugs commonly used in dentistry, including azole antifungals, macrolide antibiotics, and NSAIDs (Table 1). Refer link: https://www.dentalnews.com/2018/07/05/antiplatelets-anticoagulation-drugs-dental-implications/

5th April, 2021

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Inflammation and biofilm: Which comes first?

Does dysbiosis initiate inflammation or vice versa? Dr. Richard Nagelberg looks at how what we understand impacts periodontal disease treatment. We understand that periodontal pathogens in oral biofilm mobilize the inflammatory response, which in turn causes periodontal tissue destruction through the various inflammatory mediators. We also recently understand that it is actually inflammation that selects for the species of bacteria in biofilm, causing dysbiosis. So, which comes first? Is this a chicken-and-egg question? Historically, the development of periodontal disease has been illustrated in a linear manner—meaning that one event leads to the next, which leads to the next, and so on. In this model, there is no chicken-and-egg question as the process starts with biofilm. The human body is so complex that a linear disease development process does not commonly occur. The immune system is continuously monitoring and addressing a myriad of insults to the body, such as microbiota, ultraviolet (UV) radiation from the sun, pollen, air, water, and foodborne pathogens and irritants, among many others. But what if the development of periodontal disease is not linear, but rather cyclical? What if it is an ongoing continuum in which both processes are occurring simultaneously, creating a delicate balance that can be perturbed by a number of factors? Disease is caused by reciprocally reinforced interactions between polymicrobial communities and the host inflammatory response. Thus, the chicken-and-egg question—whether dysbiosis initiates inflammation or vice versa—is bypassed. In this model, there is an emphasis on the continuous cyclic process in which dysbiosis and inflammation are reciprocally reinforced and constitute the actual driver of periodontitis.1 In other words, both events are occurring simultaneously in a feed-forward loop. How does this information impact the treatment of periodontal disease? The traditional antibacterial approach of scaling and root planing (SRP) along with home care has not worked out very well. A novel treatment that breaks the destructive cycle likely by targeting the inflammatory response seems logical, because the antimicrobial approach to biofilm has had only limited success and apparently does not interrupt the cycle as evidenced by the high prevalence of periodontal disease. Hopefully it will not be long until we have a truly effective way to reduce the incidence of periodontal disease, finally. Refer link: https://www.dentistryiq.com/dentistry/oral-systemic-health/article/14201481/inflammation-and-biofilm-which-comes-first

16th April, 2021

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10 causes of periodontitis that go beyond oral hygiene

You're brushing your teeth, so why do you have gum disease? Knowing the various causes can help with prevention and gum disease treatment. As a dental professional, I sometimes have to tell patients unpleasant facts about their teeth and gums. When patients swear they practice good oral hygiene, it’s difficult to advise them that they have gum disease, an infection of the gums that hold our teeth in place. But there are many reasons for these types of gum infections since  periodontal disease is caused by much more than poor oral hygiene. Here’s a look at some of the other factors that can contribute, as well as at gum disease treatment. Genetics Gum disease can run in families. A family history could make you more susceptible to this oral bacterial infection. If you think you could be genetically predisposed, diligent oral hygiene, again, becomes more crucial. Aggressive bacteria Some patients acquire virulent bacteria that are more destructive to gums and bone support for teeth. This can cause bleeding and bone loss with tooth mobility, without the patient experiencing telltale pain. Patients with this type of gum disease need treatment since oral hygiene alone is ineffective. Medications A multitude of medications can lead to bleeding issues or enlarged gum tissue. Some medications can result in “dry mouth,” which lets bacteria spread faster. Long-term use of many liquid medications, antacids, and cough drops that have been sweetened with sugar can make oral hygiene even more important. Smoking It’s not just cigarettes that are a problem when it comes to oral health. Tobacco use in any form—including cigars, pipes, chewing tobacco, e-cigarettes, and vaping—put people at two to three times greater risk of getting gum disease. Smoking slows the natural tissue healing process in the mouth and makes it more prone to infection. The more and longer someone smokes are both factors that increase the risk of gum disease. The Centers for Disease Control and Prevention (CDC) reports that periodontal disease (severe gum disease) is more prevalent in men (56.4%) than women (38.4%) and even more so in smokers (64.2%).  Pregnancy and hormonal shifts Patients may need to practice greater oral hygiene if they’re expecting or even during menstrual cycles. Hormonal fluctuations can make gums more prone to gum disease. Active periodontal disease in pregnant women has been linked to complications such as low birth weight and premature birth. Nutritional deficiencies Bleeding gums can point to gingivitis, which is the early stage of gum disease. But bleeding can also indicate a deficiency in nutrients like Vitamin C. Adding healthy foods like carrots, sweet potatoes, and oranges may help. Poor nutrition in general can negatively affect the body’s immune system. Age According to the CDC, more than 64 million adults over age 30 in the U.S. have some form of periodontal disease. And the risk increases with age, much like our risk for other medical disorders. Statistics from the American Academy of Periodontology show that the risk for periodontal disease, the most serious form of gum disease, increases to over 70% in adults over age 65. Poor brushing techniques Some patients brush only once a day, and those people tend to do so in the mornings. Once a day brushing simply isn’t enough. Skipping nighttime brushing allows plaque to grow and multiply, undisturbed. Reduced saliva flow at night means teeth are even more susceptible to bacteria from the tiny food particles stuck in the teeth during the day. Bad “morning” breath is only one consequence.  Brushing too hard is also an issue. It can lead to gum recession, which causes “pockets” where bacteria can more easily build up. And many patients simply aren’t spending enough time brushing—two minutes seems to be a good norm—or they’re not brushing correctly. A lack of flossing A few years back, flossing made the news when a sensational Harris Poll survey conducted online on behalf of the American Academy of Periodontology showed that more than a quarter of Americans lie to their dentists about flossing. Daily flossing is important—it reaches pockets that brushing or even mouthwash can’t tackle. Even if you see blood when you floss, you should continue the daily practice. And we recommend you use dental floss, not picks, if possible, to reach down into the cracks between your teeth. Overall health issues Heart disease, diabetes, and rheumatoid arthritis are three examples of systemic diseases that cause inflammation that can worsen gums’ condition. And numerous studies in the last few decades concurrently link gum disease to an increase in those same diseases. Harmful bacteria in the mouth are thought to travel from the mouth into the bloodstream and lungs.  Gum disease treatment Today’s periodontal offices offer many nonsurgical treatment options including two-part deep cleaning known as scaling and root planing. LANAP® laser therapy is minimally invasive and safely “vaporizes” diseased gum tissue while leaving behind healthy tissue. It’s especially recommended for patients on blood thinners, or those with diabetes and other long-term conditions. Talk to your dentist or periodontist to obtain a diagnosis and discuss gum disease treatment options. Most offices will educate patients about proper brushing and flossing techniques. Regardless of why you have gum disease, now’s the time to treat it.  Refer link: https://www.dentistryiq.com/personal-wellness/article/14200659/10-causes-of-periodontitis-that-go-beyond-oral-hygiene

14th April, 2021

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The top 5 reasons why people get canker sores

Canker sores do not have surefire causes, but there are several common factors. Here's what you can do help prevent these painful ulcers. Canker sores can happen to anyone, at any age. Although simple canker sores are mostly common in the age group of 10 to 20, complex canker sores can happen at any age. Complex canker sores are rare but people with a history of simple canker sores are prone to them. Scientifically, there is still an open and unsettled debate as to what precisely causes canker sores. Unlike most other dental or oral problems, canker sores do not have a surefire specific cause. There are many arguments and speculations. While there can be some rare factors for an individual, these five reasons are the most common and widespread causes of canker sores among all and sundry. 1. Vitamin deficiency Most problems of the skin and outermost layers of the human body in areas such as the inside of the mouth are owing to vitamin deficiencies. In case of canker sores, the specific vitamin is B-12. Kids require more vitamins than adults because they are consistently growing and the body keeps demanding more vitamins. Also, kids are the most averse to vitamins. Fruits and vegetables are not typically a dear favorite of the young guns. Thus, vitamin B-12 deficiency is rather common among kids. If this is the cause of canker sores, then taking vitamin capsules or applying the contents of vitamin B-12 capsules directly to areas where sores have developed can offer quick and painless results. 2. Nutritional deficiency It has been noted in several studies that canker sores are either caused or triggered further when there is a deficiency of folic acid, zinc, or iron in the human body. Deficiencies of calcium can also cause canker sores, but more than causing them, calcium deficiency can worsen the situation. Healthy eating is the best solution to such a nutritional deficiency. 3. Stress/injury Stress on the tissues or any type of injury in the mouth can cause canker sores. Since the sores are actually tiny ulcers, they can be caused by any kind of hard brushing or eating something that can cause bruises or lead to tissue inflammation in the mouth. Also, many people suffer from injuries from dental equipment such as braces. Using harsh mouthwashes or oral products that can damage the outermost layering of the mouth can also lead to canker sores. Poorly fitted dentures, brushing too roughly, not keeping the mouth clean, or using any harsh product can lead to stress or injury of the tissues and that may cause canker sores! 4. Fruits and vegetables Ironically, some fruits that are considered to be very healthy due to their nutrients are actually not desirable when one has canker sores. Many citrus fruits are highly acidic and can cause or worsen canker sores. While it is not entirely accurate to state that fruits such as oranges, lemons, or pineapples can in and of themselves cause canker sores, they can when there is already some stress on the tissues and the surfaces inside the mouth are prone to burn or react to the acidic nature of the fruits. Strawberries, figs, tomatoes, and apples are some of the foods that should be avoided if one has canker sores. 5. Poor immune system People who have a poor immune system are more prone to canker sores. It is difficult to find a specific correlation of immune system with canker sores and pinpoint what exactly is in one’s immunity that triggers canker sores, but the fact that the immune system cannot prevent or repair it quickly is reason enough to consider it to be a contributing factor. Besides, there is evidence that gastrointestinal problems and other diseases contribute to or cause canker sores. Refer link: https://www.dentistryiq.com/personal-wellness/article/16354767/the-top-5-reasons-why-people-get-canker-sores

14th April, 2021

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Don't ignore these new oral symptoms of Covid-19

The deadly coronavirus has caused an unprecedented pandemic around the world. The disease produced by the novel coronavirus and its consequences have posed a challenge for health authorities worldwide. Transmission through direct contact and saliva in the form of small drops and through aerosols have caused the rapid spread worldwide. Day by day, scientists are learning more about the different new symptoms of this deadly virus infection with the hopes of eventually being able to treat it. According to the latest report of the National Institute of Health, half of the coronavirus patients suffer oral symptoms during the infection. Here are the known oral symptoms identified by the researchers: Xerostomia (Dry Mouth) Dry mouth refers to a condition in which the salivary glands in your mouth don't make enough saliva to keep your mouth wet. Dry mouth can have causes that aren't due to underlying disease. Examples include not drinking enough fluids, sleeping with mouth open, dry hot weather, eating dry foods or medication side effects. Lesions An oral lesion is an ulcer that occurs on the mucous membrane of the oral cavity. This happens when the virus attacks your muscle fibres, oral linings. They are very common, occurring in association with many diseases and by many different mechanisms. COVID tongue In this condition, your tongue may start to appear white and patchy, according to scientists. In the COVID tongue, your body fails to produce saliva that protects your mouth from bad bacteria. People with this symptom may also find it difficult to chew food and to speak. Covid tongue could also be accompanied by a change to the tongue's sensation, as well as muscle pain while chewing and persistent ulcers. However, it's not entirely clear what specifically causes Covid tongue. Source:https://www.wionews.com/world/dont-ignore-these-new-oral-symptoms-of-covid-19-377054

14th April, 2021

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