Anaesthesia | Antibiotic Prophylaxis | Amalgams | Infection Control |Latex Allergy | Medication | Water Quality | X-Rays

Anaesthesia
For infomation about anaesthesia click here.

Antibiotic Prophylaxis
Some people take antibiotics before dental procedures for various reasons such as a weakened immune system (from disease or other condition) and would like to minimise infection risks; others simply do so out of fear, which in most cases, is unfounded.

Oral bacteria can enter your bloodstream any time there is bleeding in the mouth. In healthy people, the immune system usually destroys such bacteria creating no need for concern.

People with certain heart conditions however, may be at risk if they are exposed to these kinds of bacteria. For example, the bacteria may settle on malformed heart valves or muscle tissue that has been weakened by an existing heart problem or heart surgery. In these cases, the bacteria can cause a serious inflammation of the heart valves or tissues. This condition is known as bacterial endocarditis.

To reduce the risk of bacterial endocarditis, people with certain heart conditions may be given one dose of an antibiotic to take approximately one hour before dental procedures that are likely to cause oral bleeding.

It is important to tell your dentist that you have any heart condition before undertaking a dental procedure, including a simple exam. The Heart Association has developed some guidelines on whether you could benefit from antibiotic prophylaxis.

If you have a heart murmur which is not a life-threatening condition, you may not have to take an oral antibiotic prior to a dental procedure. Not everyone who has a heart murmur is at risk for bacterial endocarditis.
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Are amalgams safe?
We discuss this issue under fillings in the oral health section.
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Infection Control
Many people experience unwarranted anxiety about visiting the dentist. The AIDS epidemic that began in the early 90’s and continues today has many people concerned about the possibility of contracting HIV via medical procedures.

Dentists today practice stringent infection control precautions that virtually eliminate any possibility of being exposed to HIV. Many patients unfamiliar with technology and medical procedures may not be aware that sterilisation and other infection control precautions are taking place in the dentist’s office, because many of these procedures occur out of view.

Infection control is the procedures medical and health professional practice to ensure that patients as well as dentists and their staff are protected against the spread of germs. Dentists often come in contact with saliva and blood particles, all of which can carry bacteria and viruses that can spread from instruments and equipment.

In 1986, less than 30 percent of dentists wore gloves, masks or gowns. Because of improved procedures and heightened awareness to the dangers of infection, infection control tools are required in all dental practices today. To fight the spread of diseases such as HIV, Hepatitis B (HBV), syphilis, and herpes viruses, our office has strict infection control procedures.

You may have heard a term called ‘universal precautions’. These are an exhaustive set of important guidelines promulgated by the NH&MRC. These precautions require all dental staff involved in patient care to use appropriate protective garb such as gloves, masks and eyewear. After each patient visit, the gloves are thrown away, hands are washed, and a new pair of gloves is used for the next patient.

Much of what a dentist and dental assistant uses during your treatment are thrown away after each patient. This includes gloves, masks, paper drapes, scalpel blades, and needles. In addition, dentists sterilise hand pieces and other instruments to prevent the transmission of diseases after exams and procedures. Most dental instruments are sterilised in special machines that expose them to chemicals or steam, destroying harmful germs and bacteria.

When you visit the dentist office and are welcomed into an exam room, you can be confident that all surfaces, such as the chair, drawer handles, lights, and countertops have been disinfected. To sterilise equipment that can not be moved, such as X-ray units and countertops, disinfectant is applied after each patient to ensure a sterile environment. Sharp items and anything contaminated with blood or saliva are disposed of in special containers with safety lids.

Taking into consideration all of the various ways dentist’s practice infection control in their office, hand washing is probably the simplest and most effective means to protect. Hands are washed at the start of the day, before gloving, after removal of gloves, and after touching any contaminated surface. Different kinds of protective gloves are used in the office. Latex or vinyl gloves are used for patient exams and procedures, and are worn when skin is in contact with body fluids. Between patients, the gloves are thrown away, the hands washed, and a new set of gloves is used to treat the next patient. For cleaning and sterilising instruments, heavy rubber utility gloves are used.

Things to look for to ensure a safe dentist office:

• Are the dental staff helpful and willing to answer your questions?
• Do the dentist and staff wear gloves and other appropriate protective gear during all actual patient treatment?
• Do the dentist and staff wash their hands prior to donning a clean pair of gloves?
• Do all surfaces and equipment in the treatment room appear clean?
• Are needles and other sharp items disposed of in special puncture-resistant containers?
• Is everything that is used in the patient’s mouth either heat sterilized or disposable?
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Latex Allergy
In recent years, there has been a rise in the incidence of health care workers and patients developing allergic reactions to latex. The scientific community has linked the source of these reactions in the human immune response system to proteins in naturally occurring latex.

The incidence of latex allergy, which now approaches twenty-five percent for health care workers (physicians, nurses, dentists, dental hygienists, and dental assistants) and two percent of non-health care workers, increased dramatically since the 1980’s. This happened because there was a dramatic increase in the use of latex gloves to protect workers and patients from the AIDS and Hepatitis virus.

Many don’t realise, but latex can be found in many common household items, including baby bottle nipples, balloons, some bandages, condoms, diaphragms, elastics in garments and socks, erasers, hoses, makeup, rubber bands, stretch textiles, and many toys.

People who already have allergic conditions such as hay fever, reactions to animal dander and eczema, are more susceptible to additional allergies such as those involving latex.

Symptoms of latex allergy include:

• Dry skin
• Hives
• Tingling sensations
• Nausea
• Low blood pressure
• Respiratory arrest

The most serious result of latex allergy is anaphylactic shock, which mimics the reaction that people who are allergic to bee stings and penicillin receive.

People who are continually exposed to latex, have spina bifida, or have had multiple surgeries are at a higher risk of developing an allergy to latex.

Some people contract latex allergy if they are constantly exposed to the airborne particles released from the powders inside the gloves. The powder contains latex protein (the allergen) and can remain suspended in the air for up to twelve hours. If you suspect that you are allergic to latex, inform your dentist before treatment. Gloves made from other materials are available. If you are not aware that you have the allergy (which many people are not) and you suffer symptoms following a dental procedure or from contact with any latex products, seek treatment immediately, and inform your dentist.
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Medication that affects your mouth
Some patients have asked me if the use of medications can affect their teeth.

Yes, some medications used long-term can have detrimental effects on your teeth, mouth, and gums. It is best to consult first with your primary care doctor about medication she or he prescribes. It also is important to let your dentist know about any medications that you are taking, including over-the-counter or non-prescriptive medications.

Some medications such as antihistamines, decongestants, pain killers and diuretics can cause a dental condition called dry mouth. Some of the common problems associated with dry mouth include a persistent sore throat, burning sensation, speech problems, difficulty swallowing, hoarseness or dry nasal passages. Dry mouth can damage your teeth if it is left untreated.

Without adequate saliva in your mouth to rinse away food and neutralize the acids produced by plaque, you can be more vulnerable to cavities. I can recommend various methods to provide more moisture in your mouth, including artificial saliva and oral rinses. Some people chew sugarless gum or suck on sugar-free candy to stimulate the flow of saliva in their mouths.
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Water Quality and Bio-films
Many patients wonder if the water used in a dentist’s office is safe and free of germs. Scientific reports have not linked illness with water passing through dental water lines. If you are concerned about the water quality, ask my office about it. Our office follows the infection control guidelines of the NH&MRC.

In today’s world, many patients are concerned with the spread of infection during medical treatments. You may have heard of bio-films.  These are microscopic communities that consist primarily of naturally occurring water bacteria and fungi.

Bio-films form thin layers on virtually all surfaces, including dental instruments such as the thin tubes used to deliver water during treatment. These common microbes or germs also accumulate inside objects around your home, such as like showerheads and taps. Scientific reports have not linked illness to water passing through dental water lines.

When an individual’s immune system is compromised because of age, smoking, heavy drinking, being a transplant or cancer patient, or as a result of HIV infection, he or she may have more difficulty fighting off germs.

For this reason, the American Dental Association encourages patients who have weak or compromised immune systems to notify their dentist prior to seeking treatment.
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X-Rays
For more information on x-rays, go to the oral technology page in the oral health section.
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