Better Health - August 2020

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Better Health D

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“I truly believe we prevented at least 1,000 people from going to the emergency room in pain, allowing physicians and nurses to invest their time in the life and death situation of keeping COVID-19 patients alive.”

Dr. Kevin Coughlin of Ascent Dental Care

By Keith O’Connor

and did not return to work. alive,” Coughlin said.

“That has made it difficult The area dentist noted they When the AIDS epidemic for some practice owners, removed close to 600 teeth, broke out some 40 years ago, completed 150 root canals, because if they don’t have it forever changed the dental and saw at least 300 emerpatients in their chairs, then industry requiring dentists to gencies from other offices they are not making money. wear gloves, goggles and face from March through June And, if they were cash poor during the shutdown. masks. to begin with and didn’t have Now in the face of the dead“I had no problem working, several months of reserves, ly, highly-contagious corobut other dentists may not then that severely impacted navirus known as COVID-19, have felt comfortable and had some dentists. I can tell you dentists, as well as many family at home or elderly that about some young doctors others in the healthcare prothey were taking care of to who wanted to start their own fession, are once again chalconsider. I was fortunate to dental practices and invested lenged to step up their safety have 16 employees, including heavily in building them up practices as they reopen their four doctors, who came to from scratch. These same doors to patients. work each day from 7:30 a.m. dentists, many of whom also “I think for dentists it will to 8 p.m. and kept us open were burdened with student have an everlasting impact on to provide emergency care,” loans, lost their practices. their overhead. The addiCoughlin said.

And, that has happened quite tional safety procedures and From a staff standpoint, a bit across the country,” clinical protocols may slow as in many other businessHanlon said. es, some workers have been dentists down and cost more So, what is the future of to follow, but dentists want to making out better on unemdentistry in the new world of ployment, especially with the COVID-19? adhere to them and reassure extra $600 stimulus monies, patients that they are safe “We still have patients who when visiting their practices,” said Dr. Mary Jane Hanlon, president of the Massachusetts Dental Association and associate dean of Clinical Affairs at Tufts University School of Dental Medicine in Boston.

Not all dentists initially closed their doors when the pandemic broke out, but when the shutdown occurred, 99 percent were closed except for those who were allowed only to stay open for emergency procedures, Hanlon noted.

Dr. Kevin Coughlin of Ascent Dental Care, with two practices in East Longmeadow and one in Longmeadow, is one of the few dentists who remained open in Massachusetts.

“Every dental office is different. Some don’t do dental extractions or root canals and emergency procedures or hospital care. I’ve been practicing general dentistry since 1983 and am fortunate to offer all of those services. I truly believe we prevented at least 1,000 people from going to the emergency room in pain, allowing physicians and nurses to invest their time in Top: Dr. Kevin Coughlin of Ascent Dental Care in East the life and death situation of Longmeadow. Above: The lobby at Ascent Dental. keeping COVID-19 patients Special To The Republican

(HOANG ‘LEON’ NGUYEN / THE REPUBLICAN)

aren’t comfortable coming in for routine care. If they are not in pain, they don’t consider it worth the risk of being exposed. Then, there is the economics. There are still millions of people out of work, and if it comes to paying a dental bill or putting food on the table, then they’re going to put food on the table,” Coughlin said.

The dentist noted he doesn’t see things changing anytime soon.

“To my knowledge, and it is not my area of expertise, there has never been a vaccine for a coronavirus. This would be extraordinary to have our first vaccine and extraordinary in the time frame they are predicting. God-willing I hope both will occur, but for the foreseeable future, these situations are desperate,”

Coughlin said.

As far as personal protective equipment is concerned, Coughlin noted he has required staff to wear PPE for decades, and as a dentist he has been ahead of the curve.

“Most changes were not major for us. But one thing that is different now is our filtration system in the office, which hooks up to heat and air conditioning and filters the air to decrease any potential bacteria or virus. Of course, we’ve always wiped down and disinfected our rooms just like operating rooms after their use. But, now we also have a cleaning company that comes in and sprays the entire office, ceilings, walls, floors and table tops, and that is an additional cost to our overhead,” he said.

The economics of dentistry

12 Signs

You Need to See a Dentist Some dentists recommend having a cleaning and checkup twice a year, but there is no “golden rule” and will vary depending on your oral health and other factors that your dentist will consider in establishing a plan that’s right for you. The American Dental Association offers 12 reasons you need to visit your dentist: 1. You Have Pain 2. Your Gums Are Acting Up - puffy and bleeding 3. You Try to Hide Your Smile - a missing tooth 4. You’ve Had Work Done - fillings, crowns, implants, dentures, see your dentist regularly to make sure everything is in great shape 5. You Have Ongoing Medical Issues diabetes, cardiovascular disease, HIV positive, or are having treatments such as radiation or chemotherapy 6. You’re Pregnant 7. You’re Having Trouble Eating - difficult chewing or swallowing 8. You Have Dry Mouth 9. You Use Any Kind of Tobacco 10. You’re Having Jaw Pain 11. Your Mouth Has Spots and Sores 12. It’s Time For Your Checkup

also plays a role in possible survival for dentists in the era of COVID-19.

“In reality almost no business in a capitalist society does another entity dictate what you charge for goods and services. But in healthcare, including dentistry, your dental plan tells me what I can charge for a cleaning, a crown, or a root canal, for example.

So, even if your overhead costs are more because of added safety measures because of COVID-19, you can’t raise those fees to offset the increase,” Coughlin said.

“From an efficiency standpoint, we are having patients wait in their cars, then call them in, so there is nobody else in the waiting room when they come in. They fill out a screening form and have their temperature taken, and if they have been exposed or out of state, we ask them to reschedule and that means more lost revenue,” he added.

Despite the pandemic, while the country is not experiencing a shortage of dentists, that is not the case for western Massachusetts, Hanlon noted.

“Many young dentists gravitate to big cities like Boston where their friends might also be working and living. But COVID-19 might change that because living in a busy city might not be the healthiest choice today for a dentist and his family. The hope is more doctors will consider the quality of life offered by western Massachusetts for a dentist and his family and will consider moving west of Worcester to practice” she said.

Hanlon offered some advice on finding a dentist who is right for you.

“Get feedback from family and friends about their dentists and look at reviews online. Just remember that one negative review does not necessarily indicate a bad office. Some patients are just ‘bad’ patients and complain about every little thing,” she said.

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D2 | SUNDAY, AUGUST 23, 2020

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How to

clean & sanitize

Make the

dentist a fun experience for kids

V

isits to the dentist for periodic cleanings and checkups are an important component of oral hygiene. Dentists also may be the first people to identify potential issues that can affect health elsewhere in the body.

Many people are unaware that children should visit the dentist early in their lives.

The American Academy of Pediatric Dentistry recommends that a child should visit the dentist by age one or within six months of the eruption of his or her first tooth.

However, many parents wait until much later - age two or three - to take kids to the dentist, offers Delta Dental Plans.

Hesitance to visit the dentist may stem from personal fears or perceived reactions by children.

Primary teeth may eventually fall out, but they shouldn’t be ignored. They save space for permanent teeth and serve other functions. Therefore, parents should begin to acclimate children to the dentist at a

young age to make the experience fun and even enjoyable.

Lead by example

Children who witness their parents putting off going to the dentist or being apprehensive about visiting the dentist may develop their own fears. Always paint the dentist in a positive light and keep appointments.

make the process much easier for everyone involved. The dentist may be able to also give a test ride on the exam chair, moving it up and down, as well as showing off the water fountain and oral irrigator.

Avoid giving false hope

Focus on the good aspects

Talk up all the benefits of going to the dentist, such as having a squeaky clean and fresh mouth. Many hygienists will hand out small toys after a successful visit, or at the very least a great new toothbrush and other fun products to try.

Get a tour of the office

Ask the staff if your child can get a special tour of the office with explanations of all the tools and equipment.

Understanding what to expect the next time around in a no-pressure situation can

Do not tell a child that “everything will be OK” at the dentist’s office. If a child needs treatment that may be uncomfortable, he or she may not trust you the next time a dental visit is scheduled, according to Joel H. Berg, D.D.S., M.S., Director of the Department of Dentistry at Seattle Children’s Hospital.

Avoid words like “shots,” “pain,” “hurt,” or even “cavities.” Dentists, particularly pediatric dentists, may have their own vocabulary that can assuage fears and seem less alarming to kids.

Over time, dental visits can become an easy routine with children, setting them up for a lifetime of healthy mouths and teeth.

backpacks

Backpacks are useful the backpack, including all of more quickly outdoors, but the pockets. If necessary, use avoid direct sunlight, which tools for students can compromise the integrity a vacuum to get crumbs out of the fabric or discolor the of the backpack. and adults alike.

From hiking supplies 2. Check the care label backpack.

6. Do not store or use the to see if there are washing to school books to instructions. This will deter- backpack until it is completesports equipment, mine if you should wash it by ly dry. backpacks can store hand or if it can be put in the 7. Sometimes a backpack just about anything. machine. may need to be disinfected to 3. If the bag can be prevent the growth of fungus As veritable machine-washed, turn or bacteria. Athlete’s foot workhorses, they’re it inside out first or place it fungus can easily transfer in a pillowcase so that the from socks and shoes to the bound to get dirty straps and zippers will not if gym clothes are and can benefit from be caught. Then wash it on a backpack left in the bag. The Spruce gentle setting with a mild de- says to skip chlorine bleach periodic cleaning.

While it may be tempting to simply throw a backpack into the washing machine, it is important to check the care instructions first. Some canvas, nylon and fabric backpacks can go in the wash, but those made of leather or those with intricate details should not.

Backpack manufacturers also advise against putting backpacks in a dryer.

Here are steps to cleaning a backpack: 1. To get started, begin by removing any items from

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tergent and lukewarm water.

If the bag should be handwashed, use lukewarm water and a soft sponge or a gentle bristle brush. The outdoor retailer REI says you do not want to harm any protective coatings on the pack.

4. Zippers need occasional cleaning to remove dirt, sand or crumbs. Many zippers have water-resistant coatings so do not scrub them. Use a lubricant made for zippers to help them slide smoothly.

5. Hang the bag to air dry upside down. It likely will dry

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and use a pine oil or phenolic disinfectant or a disinfectant wipe, such as Pine Sol or Spicn-Span. Lysol brand disinfectant also can be used and is available in liquid formula or spray.

If a backpack is waterproof, only wash it once or twice per year; otherwise, you may reduce the pack’s ability to repel water. Use cleansing wipes to spot clean when necessary.

Backpacks can get grimy quickly. Routine washing can freshen them right up.

N

ature can inspire a sense of awe and wonder, and in such situations it can be easy to overlook safety. That’s a potentially dangerous mistake but one that is easily avoided.

Nature enthusiasts accustomed to spending long hours in the great outdoors are vulnerable to a host of potentially dangerous conditions, including dehydration.

during hot weather are at risk of dehydration if they do not drink enough fluids while outside. The risk of dehydration on hot days is higher because people are more likely to sweat a lot when the temperature rises. If those fluids are not replenished, and replenished often, dehydration can occur.

In addition, the USNLM notes that outdoor exercise during hot days increases the What is dehydration? risk of dehydration. Outdoor According to the U.S. Naactivities that are physically tional Library of Medicine, challenging, such as hiking, dehydration occurs when the rock climbing and kayaking, body loses more fluids than it are a form of exercise that is taking in. When that hapcan make participants more pens, the body does not have vulnerable to dehydration. enough fluids to function What are the symptoms properly.

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of dehydration?

The Mayo Clinic notes that thirst is not always a reliable Numerous things can cause indicator that the body needs someone to become dehywater. Older adults are more drated, including not drinkvulnerable to dehydration ing enough fluids. Diarrhea, than others because they vomiting, sweating too much, naturally have a lower voland urinating too much are ume of water in their bodies. some other factors that can Aging men and women also cause someone to become don’t typically feel thirsty dehydrated. until they’re already dehydrated. So it benefits people Why are outdoors of all ages, and especially the enthusiasts at risk of elderly, to learn these sympdehydration? toms of dehydration.

Outdoor enthusiasts who · Extreme thirst spend ample time outdoors · Less frequent urination

· Dark-colored urine · Dry mouth · Less frequent sweating · Feeling tired · Dizziness · Dry skin Parents should know that infants and children may exhibit symptoms of dehydration that differ from those experienced by adults. Such symptoms may include: · Dry mouth and tongue · Crying without tears · No wet diaper for three hours or more · High fever · Being unusually sleepy or drowsy · Irritability · Eyes that appear sunken

Can dehydration be prevented?

Ensuring sufficient fluid intake can help people avoid dehydration. Drinking enough water each day and avoiding outdoor physical activity on hot days are some other ways to reduce dehydration risk. In addition, avoid sugary and/or caffeinated beverages to reduce risk for dehydration.

A perfect day outdoors involves drinking enough fluids to stay hydrated.