The Importance of Oral Health in COVID-19 Era
Are you overdue for your dental wellness exam and cleaning? Have you been too preoccupied to schedule an appointment? While we understand that everyone is doing their best in this unprecedented time, you may want to rethink putting off scheduling or postponing your appointment.
A case study published on January 18, 2021 by the Journal of Clinical Periodontology on the Association between periodontitis and severity of COVID-19 infection concluded that “periodontitis was associated with higher risk of ICU admission, need for assisted ventilation and death of COVID-19 patients, and with increased blood levels of biomarkers linked to worse disease outcomes.”
The aim of the study was to investigate the association of periodontitis (gum disease) with COVID-19 complications and showed that the risk of COVID-19 complications were significantly higher among patients with moderate-to-severe gum disease compared to those with milder or no gum disease.
Specifically, the study found that “COVID-19 patients with gum disease were 3.5 times more likely to be admitted to intensive care, 4.5 times more likely to need assisted breathing (ventilator), and close to 9 times more likely to die compared to COVID-19 patients without gum disease.”
Periodontitis shares common risk factors with most chronic inflammatory diseases known to influence COVID-19 severity, and has been shown to affect systemic health systems including cardiovascular diseases, diabetes, hypertension, chronic renal disease, pneumonia, cancer, and increases the risk or mortality. Additionally, the study revealed that the oral cavity and/or periodontal pockets of those with gum disease could act as a viral reservoir (basically incubating the virus)!
It is crucial, now more than ever, that we do everything necessary to reduce risk, and this includes oral care. If you’re overdue for your wellness exam with your dentist, we are advising you to come in as soon as possible to have your gums evaluated. Call us for an appointment (773)631-6060.
“Mask Mouth” is real! Increased carbon dioxide and decreased oxygen promotes anaerobic bacteria which is the most destructive type of pathogen for periodontal disease and cavities. When the oral pH is low, from GERD, for example, it’s twice as bad. Since hindsight is 2020 let’s revisit some basics heading into 2021. The buildup of bacteria and inflammation of gum tissue, thanks to the mouth breathing that we do inside of masks can be controlled. Drink more water to keep your mouth moist, reduce your consumption of caffeine, scraping your tongue regularly, and not smoking really helps. If you don’t have hot water radiant heat, using a humidifier is also helpful. Instead of using alcoholic mouthwashes, we recommend AO Gel as our favorite brushing and flossing add-on.
With all of the mask options available, you might wonder what is an effective mask, and what is the best way to take care of your non disposable mask. ACS Nano published a paper that tested the effectiveness of cloth masks and found that high thread count cotton (600 thread count or higher per inch) filters out 79% of particles smaller than 0.3 microns. (SARS-CoV-2 particles are 0.125 microns in diameter.) They also found that when you layer a high thread count cotton with either polyester, or with two layers of natural silk or chiffon, these “hybrid” masks are 94-97% effective. Single layer or low thread count cotton masks are found to be largely ineffective; 80 thread per inch cotton was found to filter out less than 10% of sub 0.3 microns particles. While HEPA filters are extremely effective, they should never be worn in a mask because they are made with microscopic glass or acrylic fibers which are harmful to the lungs. Please help protect the environment by wearing washable masks, “Wash One, Wear One.” The best way to clean your reusable mask is to wash it in hot water using laundry detergent. Never use bleach because if inhaled, it can damage the respiratory tract. Additionally, it can damage the fabric of the face mask, reducing its effectiveness.
Disposable masks vary in effectiveness and increase waste. Single use masks that have three or preferably four layers with a metal strip at the top to secure the mask around the bridge of your nose. The most effective masks have at least three pleats to enable a good fit around the nose, mouth, and chin. Please dispose of these types of masks after use. These cannot be washed. Be careful with N95s, although they filter 95% of particles 0.3 microns in size, they can be hard to breath in if you are not used to wearing them. KN95 is the Chinese equivalent of these, which is similar, however, much harder to determine authenticity.
Nupro Freedom Cordless Prophy System
Safety is our top priority! We want all of our grateful patients to know about our safety measures. We are proud to have the Nupro Freedom Prophy System, the safest method to polish teeth in our industry!
The CDC guidelines state that “dental handpieces and associated attachments should always be heat sterilized between patients.” The Nupro Freedom is designed to completely comply with the CDC standards for infection prevention. The inner module is protected from debris by disposable polyethylene barriers. The autoclavable outer sheath prevents contamination of the inner module, and the elimination of seams and entrapments areas where bacteria and contaminants can build up greatly reduces the production of aerosols compared to other coronal polishing systems.
In addition to the hygienic design, the Nupro Freedom is also lightweight and cordless, offering enhanced control and more convenience. It operates with SmartMode® Technology, allowing a quiet output of 25% more speed and power, delivering a consistent and splatter-free performance.
We are grateful to our patients that have been in to see us during the last 6 months. We thank you for your loyalty, which enabled us to fully staff our office. While the cost to obtain personal protective equipment (PPE) is still 5-10 times greater than before the pandemic, we have decided to include the cost for PPE into our standard fees. Starting September 4th, we will no longer be charging a separate $20 PPE fee.
As we continue to monitor CDC and IDPH guidelines to ensure that we comply with all their recommended precautions. These include:
Personal Protective Equipment (PPE):
- All staff are required to wear the appropriate PPE for each patient. This PPE may include scrubs, surgical caps, N95 or level 3 surgical masks, eye protection, gloves, surgical gowns, and face shields.
- In accordance with state regulations, we require all patients and visitors over two years of age to wear masks when entering our building. Patients may only take off their mask during their procedure.
- We have limited the number of patients and visitors allowed in our office.
- We ask that only one caregiver or family member accompany a minor in the building at a time and have provided an outdoor waiting area.
- Our waiting area is now a screening area and we are asking patients to wait in their car until we call you in for your appointment.
- We screen all visitors and staff for symptoms, high risk behavior, contactless temperature checks, and ask everyone to use hand sanitizer upon entry.
- We have implemented ultraviolet sanitizing bags and sanitize your belongings upon entry. Anything too big for our UV bag will be ziplocked prior to entering the operating theatre.
Enhanced Cleaning Protocol:
- We disinfect all surfaces in our operatories as well as all high touch surfaces with products that exceed EPA and CDC criteria for use against SARS-CoV-2, the virus that causes COVID-19.
- All high touch surfaces areas are also deep cleaned throughout our day and at the end of each day by members of our team.
- Our cleaning doesn’t stop at disinfecting surfaces! We have implemented a Surgically Clean Jade Air purifier that removes bio-aerosols, viruses, molds, allergens, pollutants, dust particles, pollen, and cleaning chemicals from the air. Information about our Jade air unit can be found here: https://scadental.com/core-technologies/
- We have installed an ultraviolet HVAC filter and are able to purify our office space 24 hours a day, leaving our office with cleaning, purified air.
We thank you again for putting your trust in us and making us your safe dental home.
Grateful Update: 08/05/2020
To help guard against viruses, you know about diligent hand-washing. But it is also wise to follow a natural immune-boosting regimen that includes plenty of sleep (seven to eight hours a night), a healthful diet (with lots of vitamin C-rich citrus fruits and berries), exercise, and low levels of stress. Dr. Wittmus also recommends these supplements that have been found to help prevent viral illness:
Vitamin D: Adults with low levels of vitamin D (below 10 ng/mL) who took a vitamin D supplement daily or weekly had half the risk of developing an acute respiratory infection, such as the flu or cold, according to research published by the BMJ. Get your vitamin D levels tested, and if low, take a 2,000 to 4,000 international units (IU) daily.
Zinc and Glycyrrhizin (from licorice root): These supplements may reduce risk for coronavirus. Drinking Licorice tea each morning with raw organic honey and taking 10-30mg of zinc a day makes your body less hospitable to viruses. In studies on 2003 SARS coronavirus, zinc killed the virus on contact. Dr. Wittmus likes zinc lozenges with elderberry as another line of defense.
Grateful Update: 07/19/2020
The SARS COV-2 virus continues to spread in our nation. Please wash your hands often and social distance, “be sweet, stay 6 feet.” Wear a face mask whenever possible and if you do not have access to clean facemasks, we will provide you with a new washable mask. Disposable masks are not good for the environment. Grateful Dental continues to work hard to reduce our carbon footprint and help curb global warming. We have always laundered our scrubs and surgical gowns on site. We change gowns for every patient. We wear autoclavable shoes instead of disposable booties and washable surgical caps instead of disposable caps. We try to use plastic disposables such as suction tips that are made from renewable fossil-free recyclable raw materials like bamboo or sugarcane. The cost of masks, gloves, disposable gowns, and supplies to ensure our Grateful patients’ safety have increased 5 to 10 times more than in February 2020. Our PPE fee of $20 will continue per patient per visit until costs become more reasonable. Safety for our patients is our top priority.
Grateful Update: 06/30/2020
There is a new procedure upon arrival for your appointment. Payment for your estimated portion is due prior to your procedure. Payments may be made by phone before your appointment or during check-in. Your mask, method of payment, keys, glasses, and phone will be sterilized using a UV sterilizer bag upon arrival. You will be given a complimentary breathable, washable Grateful Dental mask to wear and to take home. *Please try to avoid bringing large purses, backpacks, and luggage. Questions about your estimated portion should be discussed prior to arrival via phone, text, or email.
Grateful update 6-8-20:
Our Grateful patient community has been through a lot this spring. While many things have changed, our commitment to safety has never changed. Infection control remains our top priority for our grateful family. We want to continue to update you about the infection control procedures that will keep our patients and staff safe. In addition to our Jade Air Purifier we now have an aerosols evacuation unit called the “Aerosol Annihilator.” Our operatories have been remodeled to prepare for SARS Cov-2 and all future pathogens which may or may not present in the future.
Changes you will see on your next visit include a screening process prior to your entrance to our office. A tele-dentistry zoom conference is now necessary for emergencies and new patients. Patients without access to zoom can still be screened in their cars or our new outdoor waiting area. No one without an appointment will be allowed in our office. We are allowing greater time between patients to allow for additional protocols in the office. We are limiting the number of patients in our office to a maximum of two at any given time. This may greatly reduce appointment availability. If you had your appointment rescheduled due to the pandemic, you are top of our patient list and we will contact you soon. Thank you for being grateful patients. We value your trust and loyalty. If you currently have a scheduled appointment in June, please contact us. Phone (773) 631-6060, text (773) 631-1624, or email [email protected].
Update: April 28, 2020: To further safeguard our team and patients, we have implemented a Surgically Clean Air purifier. This air filtration system has a multi-air purifying approach using HEPA-Rx and carbon filters, germicidal UV bulbs-C+ bulbs, a hydroxyl radical reactivity chamber, and a negative ion chamber. These technologies work together to capture bio-aerosols, viruses, mold, allergens, pollutants, dust particles, pollen, and cleaning chemicals. Our unit cleans 1000 sq feet of air space every 5 minutes. In conjunction with our ultraviolet HVAC filter, we are able to purify our office space 24 hours a day, leaving our office with cleaner, healthier purified air.
Update April 15, 2020: The safety of our patients and team are of utmost importance therefore we are taking extra measures to ensure the safety of everyone that enters our office. We have added an ultraviolet filter to clean our air. Our team will be protected with personal protective equipment (PPE) including N95 and level 3 face masks, surgical caps and gowns, gloves, eye goggles, face shields, and autoclavable shoes. Additionally, the protocols for entering our office have now changed. Only one patient may enter our office at a time; no waiting room is available. Patients are asked to wait in their car or our backyard seating area, weather permitting, and to notify us once they have arrived. When the room is ready, we will ask patients to enter. Upon entry, each patient will have their temperature taken and will be asked to wash their hands and rinse with hydrogen peroxide. Once an appointment is completed and a patient has left, we use the most powerful compounds available to sterilize our office before the arrival of the next patient. Dr. Wittmus will begin seeing emergency patients on May 4th.
Update April 1, 2020: Due to the extension of the shelter in place order to April 30th by the State of Illinois we are asking patients who have appointments scheduled for Hygiene or Elective treatments in April to reschedule for June. Any scheduled appointments in May to reschedule for July. Please contact our office with any painful emergencies or urgent dental issues. Do not go to the ER, Intermediate care center or other medical facility with dental issues! We continue to always be available via phone, text or email [email protected] 7 days a week.
Update: The Covid-19 order to shelter in place has been extended by the state of Illinois until April 30th.
There have been shortages of PPE in the medical community. We at Grateful Dental have chosen to donate some of our PPE to the facilities in need. We expect to get more PPE in May to safely conduct hygiene visits. Until then, all elective and hygiene appointments have been cancelled.
Please do not go to the ER, doctors office, or intermediate care centers with dental emergencies. We are always available by phone, text, or email to get you to the appropriate provider. We will begin seeing emergency patients in our office on April 21st. Until then, Dr. Anthony Spina (847-268-3910) and Dr. Brett Gilbert (847-588-7890) are among the dozen providers available 7 days a week for painful emergencies and dental infections for all our patients.
Please call our office at (773)631-6060 to reschedule your elective and hygiene appointments. Please refer to our website, www.gratefuldental.com, for updates. Thank you, and stay safe.