This is a catch all area
  Years ago, I remember hearing that the plaque, now biofilm, was mainly full of anaerobic bacteria. I had invested in an ozone machine and had an idea of using a modified bleaching tray or similar to apply the ozone via the Healozone machine. You'll be relieved to hear I went and asked for advice. The conversation went on with a Periodontist to oxygenating the pocket. I may have been carrying it out to a minimal extent through using diluted hypochlorous acid in my cavitron. I had invested in a Sterilox machine because of the recent worry regarding legionella. (The conclusion in the long paper is interesting, and we went down the same route with dishwashers for CJD. The interesting part about legionella was the research published about aerosols in 2000.) The conversation with the specialist drifted to using a hypochlorite rinse. What was a safe concentration to use? The answer from the expert was nobody knows, as its too cheap for any company to fund the research. We have some idea now. This is from the article published in late 2019 The trial was it was not sponsored, and based in India were Chlorhexidine is more expensive. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906904/ This was recently on my mind as there was a post about allergic reactions to chlorhexidine, and I sometimes wonder with rubber dam With the current pandemic, there is talk about mouthwashes. So I asked an expert about using 0.2% hypochlorite. You may be interested as this applies to mouthwashes in general. Historically with mouthwashes in vitro may work, in vivo don't. Some mouthwashes are relatively ineffective in a mouth and don't reduce the bacteria or virus in sufficient numbers to be effective. Possibly due to the mouthwash becoming inactive by binding to salivary proteins, and some natural resistance by the bacteria, and after coughing any virus or bacteria will be protected by mucus. As the virus infects the URT and salivary glands, there is a continuous supply of the virus which may be accelerated by a mouth rinse. The mouth rinse does not travel up a salivary duct, and hopefully, the user should keep clear of the URT. For balance, this is an article from California about five years ago. It was the source of my initial interest. Being in the USA they tested Prisoners, and a similar group-dental students. https://www.rdhmag.com/career-professio ... ch-rinsing Often when using my ultrasonic my mind may drift. At nine seconds per tooth, hopefully four minutes relaxation for me. Generally, I would do enough to disrupt the biofilm, and if any sign of bleeding refer to our hygienist. This is the kind of thing I would think, do you? The average size of a pulp chamber by volume is 0.02cc. Your average 1.8 ml syringe is having enough by volume for 90 pulps. The average amount of saliva by volume in the mouth is 1 ml. If all the hypochlorite from the pulp chamber escapes into the oral cavity, it would have a concentration of .02%. The Mouthwash concentration of this trial was 0.2%. Now I know the taste of hypochlorite isn't great, but then when it comes to taste everyone is different. Some prefer beer or wine or spirits etc. Generally, they have the same effect but all can be fatal with the wrong volume or dose. When I had some patients trapped in my chair, I would ask for their professional advice on many occasions. My favourite was for the more elderly, happy, healthy patients their secret to a long and happy life. It was golf, and a whiskey of an evening. Over the years, it changed from whiskey to red wine. If you can't play golf, get a dog.
To get some insight into how the public are let down in many ways, this is a great start. But get a drink first. Ben Glodacre's BAD PHARMA-How medicine is broken, and how we can fix it.
Great news about the vaccine though, its not all bad.
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When you fill in your medical records, do you face the patient? Can they see your face?
While IT has made it possible to write copious notes, even with a youngsters ability not to require cutting and pasting, it's unlikely to save you from a clever lawyer with a disgruntled patient. While IT improves and develops at an alarming rate, the good news is both the patient and our own individual psychological responses when engaging one another are still primitive. Do you take full advantage of this? At work, we generally don't have time to have long drawn out introductions, but the evidence points out that as little as an extra three minutes chat can markedly reduce your likelihood of being sued. The psychology of "thin-slicing" maintains people judge one another within a short period of time, and as with speed dating, three minutes may be long enough. My advice would be to read a lot of books such as Blink by Michael Gladwell or start an online course on NLP, preferably with CPD. In the interim, try out these tips in no particular order which I'm happy to recommend after my 38-years experience as a GDP.
This was my template. Dear The Donald, Following your appointment today. These are your scores. BPE 11112 BEWE 010111 Download our free teeth4life dental App available on the App Store and Google Play. Press SQUEEZE ME on the tube of toothpaste on the front page to see how the App works for you. Personalise the App in the My Teeth section, add your scores and risk factors, then view your scorecard. Set appropriate reminders to help improve habits. Type in our postcode BS9 1JB to find me, my contact details, and further details of specific procedures I carry out at the practice. This animation explains how oral health is directly linked to general health. Keeping your scores in the green may well help maintain your immunity, as well as a healthy smile. https://youtu.be/9Tbp6zi7wnc Please look at this animation video on Oral Cancer as you need to monitor yourself for this largely preventable, and deadly disease. There is a shorter self-monitoring clinical video in the App. https://youtu.be/9IzyuFDpHUY Set a monthly reminder in the My Teeth, scorecard section. Please share the App link with family and friends from the social media icons on the front page. Help save a life SHARE teeth4life. Stay Safe, Regards, Dr Antony Smith B.D.S D.P.D.S Customise the teeth4life App for yourself via the care4teeth.co.uk website. Remember to add your practice postcode, and chose your own favourite YouTube videos for procedures you want to promote. By sending them their BPE, and advise on reminder settings to help improve their OH you help protect yourself against periodontal litigation. The data will be permanently retained on your practice software. Can anyone help with a brief 160 page T&Cs attachment to help you sleep better of a night, and spend more quality time with friends and family? Agree on concise clinical records appropriate for scrutiny from your GDP peers in both the NHS and private, and not the copious notes demanded by self-serving litigation lawyers. I came across this text recently on an Open University site, and it got me thinking.
When I qualified in 1982, I wondered should I be called Mr Smith, or a few years later, Dr Smith. Now nearly everyone calls me Tony. I'm now saying goodbye, and I reflect on how our relationship has changed. When I qualified, my patients were 100% NHS. I didn't do any posterior white fillings, tooth whitening, implants, or any orthodontics that took more than two months. As I retire, my old practice is about 33% NHS, and the rest is private revenue. A lot of the practice income is hygienist therapy and elective procedures such as whitening, Invisalign, Implant work, Botox. The term client implies the individual to be aware of their responsibility to maintain their health. If they want an elective cosmetic service, they obtain that as a client. If they have a disease, then the relationship changes to that of a patient. With the demands of the NHS we need to reinforce the individual's responsibility for societies health. To avoid seeing patients, I have have made a free App promoting public prevention in oral health. You can create a good client base through prevention and promote your services by customising the teeth4life App. For more advice on prevention and MID we have made a website teeth4life.org.uk. It will be updated by some of us senior dentists to collaborate with our experience to help your career. All the business coaches maintain that motivated "clients" buy your services. You don't need to sell. Hi, Can you direct me to someone in your marketing department? I have made an App which allows the dentist to customise it for themselves. I made a video yesterday to engage the public and the profession on social media. https://vimeo.com/454981557 I have been asked to help with Fds next year and make a video on my experience and how to engage other health professionals. This is it. Hi I've made a video on my experiences over 38 years. When I started, we had no gloves or keyboards. This is how I may be able to help you now I have retired. https://vimeo.com/453115506 Please download the App, remember to add your postcode. And share it with your young colleagues and us older ones. To be free for the public and dentists it will need some sponsorship. Can you help? Dental litigation is a problem. It seems to have taken off around the millennium. One of the bigger firms began which is two years after dental specialist register started. Perhaps we ought to consider why we try to improve our skills when so many of the public can no longer afford them? It seems to me that we try to improve our skills to maintain our interest to what for many has become a routine job. The university and academics benefit from our fees, but do the public at large. My finals case presentation was of a two part denture. It was checked by an oral surgeon who fortunately couldn't get it out no matter how hard he pulled. We need specialists for the 10% who can afford them, but we need these expert witnesses to check other disciplines. That would be fairer for the public and dentists at large who have a far better skill set for the public at large. |
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June 2023
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