Treating Common Gum Condition Could Limit Heart Attacks for Some Patients

Treating Common Gum Condition Could Limit Heart Attacks for Some Patients

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There’s an easy adjustment that could be made to aid people with chronic kidney disease. Treating a common gum condition in chronic kidney disease patients could lower their risk of potentially fatal heart disease by a large margin, according to Aston University researchers.

More than 10 percent of the adult population has CKD, which generally results in poor health. The disease gradually inhibits kidney function while raising blood pressure. It can also cause progressive vascular injury and heart disease.

New research indicates that a higher mortality rate in people with CKD stems from inflammatory conditions like gum inflammation, loss of bone that supports teeth and tooth loss. Studies in the past have shown that 85 percent of people with CKD have inflammatory gum problems, which result from poor removal of dental plaque.

Aston University in England is leading many of the studies on these issues. The research could prove to be pivotal for people who suffer from CKD.

The next study will include 80 people, 60 of whom have CKD. Some will also have periodontitis while others will not. There will be a group of 20 people with CKD and periodontitis who will be randomly treated for the gum problem during a one-year period. These people will have their information analyzed at three monthly intervals to look for signs of cardiovascular disease.The project is part of a collaboration between Dr. Irundika Dias and Professor Helen Griffiths of Aston’s School of Health and Life Sciences, Professor Iain Chapple, Head of Periodontology at the University of Birmingham, and Professor Paul Cockwell, Consultant Nephrologist at University Hospitals Birmingham NHS Foundation Trust. This partnership has provided Dias with the ability to secure samples from patients with and without periodontitis in Birmingham hospitals.

Dental Student Detects A-Fib

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Jack Morris, a 59-year-old patient, has been receiving oral health care at the University of Michigan School of Dentistry for the past year. But when third-year dental studentBrandon Churchman detected an irregular heartbeat during a routine blood pressure check at the school’s 2 Green Clinic in July, he suspected something could be wrong.

“As dental students, a blood pressure check of each patient is a standard part of the care we provide. That helps us to identify any possible irregularities before we begin a treatment session,” said Churchman, who also is a certified physician’s assistant and a paramedic. “When I saw Mr. Morris’ reading, I knew right away that something wasn’t right. I was pretty sure it was A-fib (atrial fibrillation).”

“This was the first time a healthcare provider told me that something wasn’t right,” said Morris. “I thought something wasn’t right for a couple of years. Brandon told me he suspected I had atrial fibrillation and that he would not be treating me that day.”

Churchman then walked Morris to an electrocardiogram (EKG) unit at the school’s department of oral and maxillofacial surgery just down the hall. The EKG confirmed the student’s suspicions. Morris then was admitted to the University of Michigan Hospital and was observed for 2 days before being discharged.

A-fib is an irregular and sometimes rapid heartbeat that results in poor blood flow throughout the body. Patients sometimes are unaware of their condition until it’s detected during an exam. Symptoms include heart palpitations, weakness, and shortness of breath, sometimes requiring emergency treatment. A-fib also can lead to a stroke.

“I am grateful to use that education and training I received to help Mr. Morris when he was here at the school of dentistry,” said Churchman.

“I appreciate what Brandon did for me,” said Morris. “Because of his training, he confirmed what I had suspected all along—that something wasn’t right.”

Trends Evolve in Dental School Admissions

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The demographics of the dental school landscape continue to evolve. Research from the University of Virginia School of Medicine and the American Dental Education Association (ADEA) shows how the latest incoming classes differ significantly from when more seasoned dentists entered school.

Since 2010, for example, there has been a gradual decline in the number of people taking the Dental Admission Test (DAT). Also, the number of applicants has remained relatively flat, though the number of first-year dental students has continuously increased. As a result, there is an increasing rate of enrollment among applicants.

Since 2010, the number of first-time, first-year enrollees increased by 945 to 2014’s total of 5,892. In 2014, 47% of all applicants ultimately enrolled in dental school, and in 2015, 50% of all applicants enrolled. The researchers attribute the steady increase in enrollment to new schools, expanding class sizes at existing schools, and new evaluation methods.

“One explanation for the increased share of applicants gaining admission to dentalschool is that many schools have moved to holistic admissions where personal attributes and experiences are considered in addition to grades and test scores,” said Bryan J. Cook, PhD, senior vice president of educational research and analysis at the ADEA.

“This allows dental schools to admit many highly qualified candidates who might otherwise be overlooked to a narrow focus on numbers only as the criterion for developing a dental school class,” Cook said.

In fact, 93% dental schools now use some aspect of a holistic admissions process, which helps universities “consider a broad range of factors reflecting the applicant’s academic readiness, contribution to the incoming class, and potential for success both in schooland later as a professional,” according to the Urban Universities of Health.

DAT scores and grade point averages (GPAs) still matter though, and they’re rising too. Since 2000, average science GPAs among applicants have increased from 3.08 to 3.26, and average total GPAs have increased from 3.20 to 3.38. DAT academic averages among applicants have gone from 17.8 to 18.9, DAT perceptual ability averages have risen from 17.1 to 19.3, and DAT total science averages went from 17.5 to 18.7.

The number of women applying and enrolling is growing too. In 2000, men made up 59.7% and women made up 40.3% of applicants. In 2014, men accounted for 50.4% and women were 48.4% of applicants. In 2000, 1,504 more men applied than women. By 2014, though, only 239 more men than women applied.

“With the exception of the most recent year, since 2010 the percent of female applicants has increased as the actual number of male applicants has fluctuated. This means the number of female applicants is increasing faster and more consistently than male applicants. Despite the decrease in male applicants in 2014, since 2004 the number of male applicants to dental school is actually up 12%,” said Cook.

“This follows broader trends in higher education, where the number of women graduates earning bachelor’s degrees has grown at a more rapid rate than that of men. From 2012 to 2013, 34% more women graduated with bachelor’s degrees from postsecondary institutions than men,” Cook said.

The researchers examined data on race and ethnicity as well. Among underrepresented minorities, there remains a low number of applicants and a lower than average enrollment rate. The largest ethnic group among applicants and enrollees was white, followed by Asian, making up 75% of applicants and 77% of enrollees combined in 2014.

Meanwhile, the number of underrepresented minority applicants remains low, with a lower than average enrollment rate. Black or African American, Hispanic/Latino, American Indian/Alaska native, and native Hawaiian/Pacific islander constituted 14% of applicants and 13% of enrollees in 2014. Remaining applicants and enrollees reported 2 or more races, were unknown/unreported, or were nonresident aliens.

“Increasing the racial and ethnic diversity of the applicant pool is going to require a multipronged approach, and it requires time to make a measurable difference. The most widely used best practices include more targeted recruitment and outreach efforts to encourage these candidates to apply to dental school,” Cook said.

“This targeted recruitment involves creating more middle and high school programs that offer both academic and career experiences that will not only expose them to a dentalcareer but also support their dental career preparation. These efforts also need to be paired with overall mission-based policies that make creating a diverse environment a priority,” Cook said.

And, the data revealed which schools got the most applicants in the 2013 to 2014 cycle: The New York University College of Dentistry had the most with 4,581, followed by Boston University Henry M. Goldman School of Dental Medicine at 4,118, and Tufts University School of Dental Medicine at 3,662.

Also in 2014, 11,745 applicants submitted 114,924 applications to the 65 dental schools in the United States, for an average of 10 applications per applicant. Schools varied in the number of applicants per enrollee, ranging from 8 to 43.

Data was drawn from the ADEA’s Associated American Dental Schools Application Service, which is the centralized application service for all US and selected Canadian dental schools, and its 2013 to 2014 application cycle. The study, “U.S. Dental SchoolApplicants and Enrollees, 2014 Entering Class,” was published by the Journal of DentalEducation.

“Mindful” Techniques Reduce Dental Student Stress

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Mindfulness is the skill of learning to pay attention to one’s present experience without judgment. It boosts wellbeing by significantly reducing anxiety and stress while improving mood. Now, students at the University of Kentucky College of Dentistry (UKCD) are practicing mindfulness too.

When the school launched a pilot program for first-year students in the fall of 2014, 75% of its participants used mindfulness techniques during the following semester. They described increased focus and attention in addition to less stress.

Also, the students studied more effectively, regulated their emotions better, and saw a decrease in negative physiological reactions to stress. Specifically, students who had moderate to high levels of anxiety before starting the program showed a decrease in anxiety levels later.

“Because I have personally utilized mindfulness and know the benefits, I will most definitely, as a future dentist, use and introduce this to my patients,” said UKCD student Bethany Burton.”

After the pilot program, assistant dean of student affairs and adjunct faculty Christine Harper and Dr. Pam Stein VanArsdall, UKCD professor of oral health science, began instructor training in the Koru mindfulness method. Targeting college students and other emerging adults, Koru offers mind-body skills such as abdominal breathing and guided imagery, as well as insight meditation practice, that quickly reduce distress and build motivation to practice stress management.

“Our students have a massive amount of information to absorb, as well as the difficult task of learning and perfecting their hand skills to perform a variety of oral surgeries and procedures. It’s very challenging, and we try to find ways to help students manage their anxiety and stress,” said VanArsdall.

“Using an evidence-based practice, such as mindfulness, can help improve their quality of life while they are at UKCD,” VanArsdall said. “It’s truly a life skill they can use after graduation to help manage the stress and challenges of being a practicing dentist as well.”

UKCD now offers its students an elective 4-week mindful meditation course. In groups of 10 to 12, students meet once a week for 75 minutes to discuss assigned reading and learn and practice mindfulness techniques. They also are asked to practice techniques for 10 minutes each day and keep a journal.

During the course’s first session, students are asked why they are taking it. Common responses include the desire to relax between classes, the need to manage anxiety before tests, and a longing for help in balancing everything. TED talks on meditation also inspired some students to try the class, which is growing in popularity.

“I’m very glad that I participated in the mindfulness course and have already recommended it to my classmates, especially if they are dealing with stress, poor sleeping habits, jumbling thoughts, or any other problem,” said UKCD student Austin Delpont.

“To get the full benefit of mindfulness exercised, you have to buy in completely,” said UKCD student Troy Miller. “But if you fully immerse yourself in it, it will make a difference in your daily life.”

Cognitive Behavioral Therapy Can Ease Dental Anxiety

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Dental anxiety prevents many people from seeking the care they need. They have poor oral health because they avoid the dentist, and when they finally do make an appointment, they require sedation to get through it. According to a study from King’s College London, cognitive behavioral therapy (CBT) may alleviate this anxiety and improve their care without sedation.

The researchers surveyed 130 patients (99 women and 31 men) attending psychologist-led CBT at the King’s College London Dental Institute Health Psychology Service at Guy’s and St. Thomas’ National Health Service Foundation Trust. The patients were asked about their levels of dental anxiety, general anxiety, depression, suicidal thoughts, alcohol use, and quality of life related to oral health.

About 77% scored 19 or higher on the Modified Dental Anxiety Scale (MDAS), indicating dental phobia. The rest all scored high on one or more items, suggesting a specific fear of some aspect of dentistry. Fear of injections and the drill were the most common high-scoring items on the MDAS. Also, 94% reported that the problems with their teeth, gums, and mouth affected their daily living and quality of life.

Furthermore, 37% had high levels of general anxiety and 12% had clinically significant levels of depression. Suicidal thoughts were reported by 12% of patients, with 4 of the 130 surveyed admitting a recent attempt to commit suicide. These individuals were referred to support services via their general practitioner with immediate action taken based on local service guidelines.

Of all the patients, 79% eventually had dental treatment without sedation, with 6% requiring sedation. The average number of CBT appointments required before a patient received dental treatment without sedation was 5. Generally, CBT lasts 6 to 10 sessions when used to treat psychological problems such as depression and anxiety-related disorders.

“People with dental phobia are most commonly given sedation to allow them to become relaxed enough for a short period of time to have their dental treatment performed. However, this does not help them to overcome their fear in the long term. The primary goal of our CBT service is to enable patients to receive dental treatment without the need for sedation. Our study shows that after on average 5 CBT sessions, most people can go on to be treated by the dentist without the need to be sedated,” said professor Tim Newton of the Dental Institute at King’s College.

“However, there is a need for people with dental phobia to be carefully assessed by trained CBT practitioners working with dental health professionals. Some of the patients referred to us were found to be experiencing additional psychological difficulties and needed further referral and management. CBT provides a way of reducing the need for sedation because they require urgent dental treatment or they are having particularly invasive treatments,” Newton said.

“Our service should be viewed as complementing sedation services rather than as an alternative, the 2 together providing a comprehensive care pathway for the ultimate benefit of patients,” said Newton.

Suicide and Dentistry: Myths, Realities, and Prevention

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Dentistry is more than stressful. It also has a grim reputation. Many people believe more dentists commit suicide than other professionals. Studies have cast doubt on these assumptions, but misperceptions and risks remain.

“There are many myths surrounding suicide in general,” said Wendy LiKamWa McIntosh, MPH, an author of a Centers for Disease Control and Prevention (CDC) study that examined suicide rates by occupational group in 17 states. “It is likely that some mix of media, including social media, and misinformation in general, perpetuate these myths.”

According to the CDC, 40,000 suicides were reported in the United States in 2012, making suicide the 10th leading cause of death for people older than the age of 16 years. That’s a 21.1% increase since 2000’s rate of 13.3 per 100,000 to 16.1. Yet there were variations in rates among people categorized by different occupational groups.

The construction and extraction industries saw the most suicides, with 1,324, or 10.8% of these deaths in 2012, followed by management at 1,049 (8.5%) and production at 953 (7.7%). Healthcare practitioners and technical workers were 11th on the CDC’s list of 30 professions, with 450 deaths (3.7%), though the CDC did not have breakout information on how many of those workers were dentists.

A 2010 review of the literature found that while the suicide rate among dentists appeared higher than other professions, previous studies lacked the correct scientific weight. The review also concluded that new studies were required to examine a number of factors that previous research had not considered.

Though the numbers are murky, some dangers are clear. The CDC says that professions with high suicide rates may see greater risks because of job-related isolation and demands, stressful work environments, and work-home imbalance, all of which many dentists can relate to. Other factors include financial pressures and access to lethal means, which dentists also may experience.

Warning signs, according to the National Suicide Prevention Lifeline, include:

  • Talking about wanting to die or stating the intent to kill oneself;
  • Looking for a way to kill oneself, such as searching online or buying a gun;
  • Talking about feeling hopeless or having no reason to live;
  • Talking about feeling trapped or in unbearable pain;
  • Talking about being a burden to others;
  • Increasing the use of alcohol or drugs;
  • Acting anxious or agitated, or behaving recklessly;
  • Sleeping too little or too much;
  • Withdrawing or feeling isolated;
  • Showing rage or talking about seeking revenge;
  • Displaying extreme mood swings.

Professionals who see these signs in themselves can take steps to get help, beginning with the National Suicide Prevention Lifeline at (800) 273-TALK (8255). Skilled and trained counselors at the program’s crisis centers are available anytime in both English and Spanish. An online chat option is available as well at suicidepreventionlifeline.org.

Meanwhile, practices can manage risks by instituting options such as employee assistance programs for access to behavioral health treatment. Wellness education programs also can provide education and training for supervisors and staff to recognize warning signs. Technology is available for online mental health tools and screenings as well.

Additionally, professionals who see warning signs in their colleagues can take action. For example, managers can make their employees aware of the National Suicide Prevention Lifeline or call it themselves. They also can implement the National Action Alliance for Suicide Prevention Workplace Task Force’s Blueprint for Suicide Prevention. Plus, there always is direct contact.

“Ideally, the person would talk to the person they are concerned about and ask them if they are suicidal,” said McIntosh. “If they say yes, they should show caring and compassion and persuade them to get help and help them in getting that support.”

The Three Easiest Ways to Break Through Dentistry’s Stress

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Are you finding yourself a little anxious about everything dental lately? Staff stressing you out? Wondering where all your time has gone? Experiencing relentless physical pain? Feeling so exhausted by the end of the day after running around, micromanaging like crazy? 

Tired of the daily grind of dentistry and wondering when the books will finally be filled? It’s neverending. That was me. Nine years ago, I bought my first dental clinic and suffered my first panic attack shortly thereafter. This was a blessing in disguise.

I had been so stressed with doing, doing, doing that my body broke down. I was in pain all the time, having Botox in my face for headaches and cortisone injections in my shoulder to continue working.

I realised that it all came down to me. I decided that I wanted to be at the cause, not at the effect, of my life.

So I set out on a mission to transform myself—my mind and body. Amazingly, when I changed, everything changed around me.

Suddenly I was able to cut my dental days from six down to two and still double my profits.  But what that really bought me was my freedom. 

The first step to freedom is conquering your stress. 

How would it feel to be calm and centred in yourself even when there is a tornado in your world? To trust yourself so that no matter what happened, you will always find a way through?

Stress plays havoc on your body and mind by producing cortisol and adrenaline. Your body focuses on cortisol instead of its other systems because it is in survival mode. So, everything else like rest, digestion, and immunity and optimal brain function are put on hold.

You cannot think and operate clearly on chronic stress. But when you can break through the stress, anything is possible. Here are my top three ways to do so.

Remember to Breathe

Imagine you’re working with your assistant. She’s taking out 10 times more composite than needed and keeps overfilling the bond. Now she’s dropping your curing light, and, oops, there goes the suction on the floor again. 

You’re running late too. 

And the worst thing is that you’ve told her all this before—five times.

Before you continue to stare daggers at her and open your mouth to reprimand her through clenched teeth, stop.

Breathe.

Take long, deep, full breaths. Down to your stomach.

At least 10 of them.

When you’re holding your breath, contracting your body, and your thoughts are jumbled, you most likely will say something you regret.  

Welcome to the nervous system’s flight or fight mode! 

In this state, you have a propensity to snowball and make a mountain out of a molehill.  You’re in survival mode and can’t think clearly. We’ve all been there.

By breathing deeply and fully, you actually shift the way your nervous system is working and you can then act from a place of calmness, patience, and clarity. 

So, keep breathing. You will think more rationally and wisely. You will make better decisions. Your work will become more purposeful and precise rather than frantic.

It’s a win-win for everyone involved! 

Patients will feel this and be reassured they are in the right place. 

Reframe 

So in your mind, your assistant isn’t really listening to you. In the dialogue in your head, you’re getting more and more frustrated with her.

The reality is that even though you have explained things to her in a way you thought was clear and concise, she has filtered your instructions through her mind according to her map of the world.

That’s when you need to step up and take 100% responsibility for your communication. 

I know, that’s a tough one to swallow. 

You might find you “seek first to understand” and put yourself in her shoes. You may even realize why she doesn’t understand you and find some empathy for her.

By reframing the situation, you will always see another potential reality, rather than the negative one you’re used to focusing on.

For instance, instead of thinking she is not listening to you, reframe and think “she must be trying so hard to please me and is becoming so nervous around me, that must be why she is dropping everything,” rather than “she is so clumsy.”

Once you assume good intent, then you can actually start to empathize and see any “bad” situation in a new light. 

This will save you a lot of gut lining. When you start to feel that the universe is working for you, not against you, you will feel so much less stress. 

Change Your State 

Back to your assistant situation. 

You’re sitting there, peeved with your assistant. The breathing and the reframing still aren’t working for you. 

Where is your focus? Is it on all the “wrong” things that she is doing?

What is your physiology like? Is your whole body clenched? Holding your breath? Frowning?

What is your language like? Are you asking yourself things like, “What the hell is she doing? Why doesn’t she listen? Why is she so lazy?”

These three areas—focus, physiology, and language—make up your overall state. The good news is that you can always change your state by changing these three elements. 

So in the middle of wanting to strangle your assistant, or any other tense situation, how can you change your state?

  • Focus: Consider how much she must be trying and how nervous she must be.
  • Physiology: Wiggle out your body, breathe, sit up straight, let your neck be free, smile, and shake your booty behind your patient.
  • Language: Give her a couple of compliments about what she is doing right. 

So, there you have it.

One minute of stress can use so much of your precious energy that it reduces your immune system for four or five hours! You are only poisoning yourself. Stress less, and watch your life change. 

59,000 Pediatric Extractions Prompt Calls for Better Prevention

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The British Dental Association (BDA) is urging the government to tackle oral health inequities that have left young children in deprived parts of England more than five times more likely to face hospital dental extractions under a general anesthetic than the national average.

Public Health England (PHE) reports that more than 59,000 patients age 19 and under had dental extractions under a general anesthetic in 2017 and 2018, representing 7% of all hospital procedures performed on children. Two-thirds of these procedures were primarily due to tooth decay, and 84% of extractions with decay as the primary diagnosis were performed on patients age 10 and under.

The worst affected areas include Rotherham, Sheffield, Preston, and Blackpool. Doncaster has England’s highest rates of extractions, with nearly 600 in total. That’s more than five times the national average for 6- to 10-year-olds undergoing the procedure, or an average of one in every classroom. Overall, hospital extractions result in at least 60,000 missed school days each year. 

“Children’s oral health shouldn’t be a postcode lottery, but these figures show just how wide the oral health gap between rich and poor has become,” said Mick Armstrong, BDA chair.

The BDA points to PHE’s own modelling showing that interventions in deprived areas could yield significant returns on investment. Each £1 spent on supervised tooth brushing programs in nursery and primary schools would yield a £3.06 return in five years, rising to £3.66 in 10 years as a result of reduced treatment costs.

Scotland’s Childsmile and Wales’ Designed to Smile national intervention programs have saved the National Health Service millions in treatment costs, the BDA reports. Meanwhile, England’s Starting Well program has no new funding attached and is only operating in a handful of local authorities, says the BDA, which backs a properly resourced national program for England.

“While Wales and Scotland have national programs making real inroads, in England, ministers are yet to commit a penny of new money to this challenge. This poverty of ambition is costing our NHS millions, even though tried and tested policies would pay for themselves,” Armstrong said.

The BDA further notes that official extraction figures likely understate the true scale of the problem, owing to data gaps and coding inconsistencies. Pediatric hospital extractions are estimated to have cost the National Health Service at least £200 million since 2012, the BDA says.

“The government’s own figures show a pound spent on prevention can yield over three back in savings on treatment. If ministers won’t heed the advice of health professionals, they might want to speak to an accountant,” Armstrong said. 

Prevention should be at the heart of any effective healthcare strategy, the BDA says. Tooth decay, an almost entirely preventable condition, remains the leading cause of hospital admissions among children in the United Kingdom, adds the BDA, which advocates six steps toward improving oral health:

  • A national program focused on preventing tooth decay among children
  • A National Health Service contract system that rewards prevention
  • A fair funding settlement that makes National Health Service dentistry viable
  • A guarantee of stability and sustainability for dentistry as the UK leaves the European Union
  • Ensuring the Soft Drinks Industry Levy marks the beginning and not the end of action on sugar
  • Fixing a broken system of regulation that has failed patients and practitioners 

PHE, meanwhile, is asking parents and caregivers to do their part by limiting sugar intake among their children and encouraging proper oral hygiene habits. According to PHE, children still consume about 8 sugar cubes more than the recommended daily limit, often eating 11 grams of sugar during breakfast alone. 

PHE’s Change4Life campaign encourages parents to choose lower-sugar alternatives to sugary drinks, yogurts, and cereals when they shop. It also urges parents to limit fruit juice and smoothies to a total of 150 ml each day and only serve them with meals, counting them as a maximum of one portion towards the suggested “5 A Day” limit.

“Parents can help reduce their children’s sugar intake by making simple swaps when shopping and making sure their children’s teeth are brushed twice a day with fluoride toothpaste,” said Dr. Sandra White, dental lead for PHE. “Small, consistent changes like these can have the biggest impact on children’s teeth.”

BDA Wants to Use Sugar Tax Revenue to Fight Tooth Decay

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Now that it has been in effect for about a year, the Local Government Association reports that England’s sugar levy has produced about £250 million in revenue, and the British Dental Association (BDA) wants to put that money to use in fighting childhood tooth decay. 

None of the levy revenue has been earmarked for tooth decay programs yet, but the BDA says that just 2% of the larger-than-expected revenues would be enough to bring supervised tooth-brushing programs to 5-year-old children in the greatest need. 

The BDA says that every £1 spent in the most deprived communities would generate up to £3.66 in return on investment (ROI). Targeting the most deprived quintile of 5-year-olds would generate expected savings after five years of nearly £10 million, with £7.5 million saved in hospital treatment costs alone, with a total ROI of nearly £2 saved for every £1 spent. 

Further, the £5 million plan would break even in its first year, the BDA says. It also would prevent more than 60,000 school absences and 25,000 working days lost to parents taking their children to dental appointments.

The BDA notes that Scotland and Wales have national oral health programs for children that operate in nursery and primary schools built around supervised tooth brushing. England’s equivalent Starting Well program operates in just 13 local authorities, with no new money attached. 

Meanwhile, the BDA reports an 18% increase in the number of pediatric extractions in hospitals since 2012, costing the National Health Service (NHS) £205 million. In 2017 and 2018, more than 59,000 patients age 19 and under had an extraction under general anesthetic in a hospital. 

Changes to how the sugar levy operates will come into effect this financial year with no Capital Fund available, so revenues raised may blur into the daily budgets of schools and used for other costs like maintenance and repairs with very little oversight, the BDA reports. Instead, the organization is calling for revenue to be set aside specifically for oral health programs. 

“Sugar is fueling an epidemic of decay, and it’s only right some of this windfall is used to make good on the damage. A tiny fraction of this revenue could transform the oral health of children in our most deprived communities,” said BDA chair Mick Armstrong. 

“We shouldn’t be spending millions on extractions when tried and tested policies can make a lasting difference. Supervised toothbrushing is a winning investment that the government’s own models show will yield clear returns for our children’s health and an overstretched NHS,” Armstrong said. 

“The levy proceeds were meant to be put to work on prevention. Dentists have seen what works, and the funds are at hand. All that’s required now is the political will,” Armstrong said.

Take Control of Your Dental Day With One Simple Routine

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Do you ever wake up and the first thing you start to think about is your work? Stressing over a staff member? Or replaying that bad surgical case? You sleep with the phone behind you and wake up to its alarm clock, only to see some messages come in from the team.

Someone’s running a bit late.

Someone’s had gastro during the night and won’t be coming in. 

Maybe someone also quit over the phone.

And while you’re there, you quickly rummage through your email, just in case.

Before you know it, you’re sucked into the vortex of technology. 

You’re feeling frantic, moving at a million miles an hour, reacting to every message, email, and call. 

You message your other staff members to make sure they’re aware you’re short staffed today. 

You start replying to all your emails, just a quick one here and there. 

You check your social media. Who’s been active on your Facebook page lately? Any more likes?

There might be a few comments there, so you quickly reply to them because if you don’t, you might forget. 

You’re already ticking off your “to do” list, and your feet haven’t even touched the floor yet!

And so, despite being in the spiral of technology, you wolf down some food and coffee and speed off to work.

Time to rifle through the appointment books. 

You see that a patient has cancelled and straight away you start thinking about how you could fill that gap today. 

You click through the appointment book for the rest of the week and notice there are quite a few gaps! Why did that patient cancel his crowns? You thought he was convinced! 

Your stress levels are rising. 

You start barking at your team. 

“Who’s this!?”

“Why didn’t this person call?”

“Why has this person cancelled?”

Before you know it, the day is looking chaotic. 

Staff left, right, and center. Patients in the waiting room. You’ve started late.

Now your whole day looks like it’s going to run late, and you’ll be constantly trying to make up time. You’re exhausted even before you start your work day.

Before you go any further, stop. It does not have to be like this.

What if you could start your day on time? Not just on time, but refreshed, revitalized. 

What if there were a few little habits you could put in place that would completely transform your day?  

What would happen for you if you could implement these few simple things that would give you back total control of your day? 

It starts off with not sleeping with your phone! Swap it for an alarm clock.

The problem with sleeping with your phone, apart from all of the electromagnetic toxins that it creates around your body, is that it gets you sucked into the technology first thing and you’re wired straight away!

In fact, start to turn off all screens at least one hour before you go to sleep, as blue light interferes with your sleep and stops you from moving into deep rest states that are critical for your body’s repair.

Start your day by hydrating yourself. Drink two glasses of body temperature water as soon as you get out of bed. This replenishes your body and invigorates colon action, so you can release the waste in your body! 

Next, create a simple 10-minute morning routine. I call this a ritual, as it is “me” time. 

This will have a profound impact on your day because you’re just starting to clear all this excess “thinking” energy out of your brain.

If you allow it, the brain will run wild and get wrapped up in all sorts of stories. The body doesn’t differentiate between a real or perceived threat, so the stressful thoughts you tell yourself release the same chemicals such as adrenaline and cortisol in your body as if you were there in that stressful situation. 

This body is then primed to fight, flight, or freeze. And it won’t allow rational thinking! 

So, to stop worrying about work, it’s time to condition the body and brain differently. 

Start by moving your body in some way shape or form. 

Five minutes of easy movement, dancing however you are feeling, to music you love.

Then, five minutes of sitting. Just doing nothing. Meditation has huge health benefits alongside the fact that the brain is malleable and can change itself. Regular meditation has been shown to shrink the amygdala region—the fight, flight, or freeze center—so it doesn’t have to control your life. 

If you’ve never done this before, just sit and use a timer so you can fully relax. No special postures, no lotus poses necessary to start. Just five minutes of sitting and watching your brain.

Start off small so that you can build the habit. 

Make it so hard for you not to start. 

Sit and breathe and visualize.

“What does my day look like?”

“How do I want to show up?” 

“What do I need to call in for myself?”

“How do I want to feel?”

See yourself moving through your day as the best possible version of yourself!

See it already being done. When you set the intention for the day, you start to create your day, rather than be controlled by whatever comes your way.

And feel in your body three things you are grateful for. There are always three things you can be grateful for: your warm bed, your loyal staff, the fact that you’re a dentist and in a privileged position. This will release dehydroepiandrosterone (DHEA) into your bloodstream—the antidote to stress.

So, your 10-minute routine consists of five minutes of movement and five minutes of mindfulness.

When you arrive at work, create the same ritual with your team. This will have a huge impact on how your clinical day starts. 

Get the staff together and run them through something that keeps them mindful and in the moment and something that gets their body moving. 

You don’t have to be an expert at yoga or meditation. It could just be dancing or squats or planking.

Then, have the staff visualize their intention for the day.

What do they need to call in for themselves? How do they want to feel?

This is the most efficient way to get all your staff together and starting the day right! This will absolutely give you back control of your day. 

I challenge you to try this for the next week, and you will see your day completely transform!

You’ll love it so much you’ll begin to wake up earlier to be able to incorporate your morning ritual.

But beware. This might even grow to be about 30 minutes or so, not just 10 minutes.

Don’t have time, you say? 

You’re going to enjoy this so much that you’ll make time for it! 

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