I started working with seniors and patients with special health care needs last year. This was a result of my general practice residency, during which I learned how to care for patients with more complex needs. Finding care for many of these patients is especially difficult. Some patients are restricted because of resources or their support systems; others are limited by a disability from leaving their home and getting the dental care they need. At Enable Dental, we are able to provide fully functional portable dental services to our patients in their homes, thereby eliminating frequently encountered barriers in accessing care.

I often get questions from friends, family and colleagues on what exactly I do in “portable dentistry.” To be completely clear, we do not have a dental van with chairs in it that patients get to use. We mobilize all dental equipment and take it into our patients’ homes or assisted/independent living centers.

Here are some of the highlights and challenges associated with working in portable dentistry:

1. We have long commutes.

Since we go see our patients at assisted living centers or their homes, we often have to drive long distances. Most of the time we drive together in a single vehicle and split driving among each other. Long commutes mean long days. I often get home after 6 p.m. on such days. Those are days I do not cook dinner.

2. We do dentistry standing up, bending or occasionally sitting down.

Recently I had a patient sitting in her arm chair and prepped for a few extractions. Unfortunately, I didn’t have the foresight to move her into a chair without thick arm rests beforehand. After a lot of changes to my positioning and sweating/sighing, I ultimately sat on the floor and extracted Nos. 12 and 13. Afterwards, my assistant said, “Congratulations, you just delivered two boys!” That cracked me up, and the whole room, including our patient, erupted in giggles.

3. I wear excellent loupes because I have to.

I recently made the decision to buy an ergonomic set of loupes. They have been a godsend. The loupes have prevented me from worsening my upper back and neck. Especially with the work I do, having a nonergonomic set of loupes would have made life miserable.

Ergonomic loupes have a slight bend in them, which means the loupes do the bending for you, instead of your neck. You can stand and look straight ahead and still see everything you need to in a patient’s mouth. The power at which I use my loupes gave me no headaches and did not require any time getting used to.

4. We provide a ‘good and better’ plan for patients.

Most of our patients are above the age of 75. It may not always be reasonable for us to plan extensive care for them. Many are looking for palliative care and regular hygiene appointments only. Most are looking for someone to talk to for an hour. It’s an honor for me to feel included in my patients’ lives and listen to their stories during these times. Our treatment plan is based on what is realistic for us to achieve given their medications and complex needs. This can be very different from what we are traditionally able to achieve in a regular dental clinic environment. We always provide one to two alternatives to all treatment plans.

5. We address complex medical histories.

I have to admit that after residency, complicated medications and medical histories do not scare me as much as they used to. My general practice residency prepared us for the most medically complex conditions. If you are a dental student and not considering a residency, let this post make you reconsider.

When it comes to our patients, it is important to put their diet, medications, preference and dental needs in a neat bow and come up with the right plan. There are several patients for whom I have to regularly contact physicians, endocrinologists or cardiologists to have an educated conversation about test results and next steps. A dentist can be an important person to alert the care team on things that are amiss. We need to remember that patients see their dentists more often than their physicians. I usually set aside a half day for these consultations. I’ve also found that having phone conversations about important topics is much better than requesting a standard medical clearance that comes back saying “patient cleared for dental treatment.”

There was a patient we saw in residency with an abnormally high blood sugar level that needed full-mouth extractions and dentures. We declined to do the extractions until his blood sugar is under better control because of postoperative healing considerations. This prompted his care team to start the patient on insulin. The patient may not have gotten the needed care and medications had it not been for our team creating this alert.

6. We have a committed, motivated team.

It is hard to be in a job like this and not be committed to our work. Our assistants lug heavy equipment to and from every patient’s home and then commit 100% to their treatment plan and care. The nature of our work and patients we see also makes it easy for us to love our jobs. Before I started doing this, I used to think pediatric dentists probably have the most fun jobs in the world. Seeing adorable small kids all day — how cute! However, now I think treating seniors is just as fun (or even more).

7. Our patients are amazing.

We are often the last resort for our patients, and that becomes very evident when we meet them. Most are very happy to see us and thankful for a dental team that can come to their doorstep to care for them. We also, of course, have patients who are less than overjoyed to see us. Those are the patients whose children are scheduling dental treatments for them. There are also patients who may be confused by our presence. This could be because of advancing dementia or other neurological conditions.

8. I was able to work longer while pregnant.

I worked through nearly 35 weeks of pregnancy in this job. Had it been a traditional brick-and-mortar space, the size of my belly would have probably impeded my ability to practice beyond 25 weeks, the way it does most clinicians. Since I stand while I do most treatments, I was able to perform dentistry much longer. My caring team also took extra steps to make sure I was more comfortable during this time, and my patients gave my child many, many blessings. The constant moving around also helped me stay active throughout pregnancy.

All patient interactions have taught me significant lessons about society, the aging process, the importance of family and support systems, patience, compassion, and different cultures. These are lessons I would not find in any other job. I hope this post inspires other new dentists to work with seniors and patients with special health care needs. Getting anxious about treating these populations is only natural; however, with time and proper education via residency or dedicated continuing education, it will become easier.

via New Dentist Blog https://ift.tt/Jeau9s2

As dentists, it is important for us to understand mental health illnesses are on a continuum, from mild or none to moderate or severe, and they are diagnosable and treatable health conditions. Everyone has a state of mental health and wellness, which can be good or poor or somewhere in between. Mental health and wellness can vary or change at different ages and phases and changes in life. Not having a mental illness does not guarantee good mental health, and similarly, having mental illness does not guarantee poor mental health.

Recently, I was reminded of this through meditation and my spirituality. I underwent events at work that caused a downturn in my well-being, and I decided to refocus through meditation and church.  During the meditation, the instructor said to think of events and challenges as waves in the ocean.  There will be ups and downs and times when things are rough, but there will also be times where the sea is calm.

As I work towards more optimal mental health, I have found that it is helpful to track my well-being over time. One of the initiatives from the ADA Wellness Ambassador Program was a pilot of the Well-Being Index from Mayo Clinic. The index is an anonymous self-assessment tool that was created to measure distress, well-being, quality of life, fatigue and provider burnout.

The ADA’s Council on Dental Practice and Dental Team Wellness Advisory Committee have been advocating for mental health and wellness for oral health care providers. The ADA created the Wellness Ambassador Program and hosted a Health and Well-Being Summit in September 2023. At the summit, each wellness ambassador was able to share their work in progressing mental health and well-being.

Through my wellness journey, I was able to be a part of the Well-Being Index pilot program and take monthly self-assessments. When I took my first assessment, I realized I had fallen below average and was able to change my path through my habits at home and work. I have found the monthly assessments also keep my wellness on track even when I am not in a state of poor mental health, as I have feedback about where I am as a health care professional.

Recently, the ADA made the index available to all members of the organization, including dental students. The assessment only takes a minute to complete, provides immediate ADA and some state-specific resources to participants, and allows them to track their progress over time.

Personally, the index has been a wonderful resource, not just when times have been challenging for me, but also at times when I am well. I would encourage all members to utilize the index, as our bodies and minds are our greatest resources in our journey of life.

For additional wellness resources, visit ADA.org/wellness.

via New Dentist Blog https://ift.tt/ZJy2rpF

Running is a simple yet rewarding activity requiring minimal equipment, but having the right gear can significantly improve a runner’s comfort, performance, and overall experience. Whether you’re a beginner or a seasoned runner, here’s a comprehensive guide to essential items that should be part of every runner’s kit:

1. Running Shoes: Investing in high-quality running shoes is paramount. Choose shoes with proper support, cushioning, and stability for your foot type and running style. Regularly replace worn-out shoes to prevent injuries and maintain optimal performance.
2. Moisture-Wicking Apparel: Opt for moisture-wicking, breathable clothing made from technical fabrics that help manage sweat and keep you dry and comfortable during runs. Wear moisture-wicking tops, shorts, or leggings suitable for different weather conditions.
3. Technical Socks: Select socks designed for running, preferably made from moisture-wicking materials that prevent blisters and provide cushioning and support. Proper running socks can significantly enhance comfort and reduce the risk of foot-related issues.
4. GPS Running Watch or Smartphone App: A GPS running watch or smartphone app can track distance, pace, route, heart rate, and other essential metrics. These devices help monitor performance, set goals, and track progress during training sessions.
5. Hydration Gear: Hydrate during runs by carrying a handheld water bottle, hydration belt, or hydration pack. Ensure you have access to water or electrolyte beverages, especially during longer runs in hot conditions.
6. Reflective Gear and Lights: For running in low-light conditions or at night, wear reflective clothing or accessories to enhance visibility to vehicles and other runners. Consider using a headlamp or a clip-on light for added safety.
7. Running Hat or Visor: Protect yourself from the sun and keep sweat out of your eyes with a lightweight, breathable running hat or visor. Choose one that offers sun protection and allows for ventilation.
8. Recovery Tools: Include recovery tools such as foam rollers, massage balls, or compression gear in your kit. These aids help alleviate muscle soreness, improve recovery, and prevent injury by promoting better circulation and muscle relaxation.
9. Sunscreen and Sunglasses: Apply sunscreen before running to protect your skin from harmful UV rays. Wear UV-protective sunglasses to shield your eyes and improve visibility in bright conditions.
10. First Aid Kit: Carry a small kit containing essentials like adhesive bandages, antiseptic wipes, blister pads, and pain relief medication for minor injuries or discomfort during runs.

via Jeremy Blacquier | Sports https://ift.tt/JeVSYx3

Dental implants have revolutionized dentistry, offering a permanent solution for replacing missing teeth and restoring functionality and aesthetics. Understanding the various types of dental implants and their respective benefits is crucial for individuals seeking to regain their smiles. Let’s explore the different types of dental implants and the advantages they offer:

1. Endosteal Implants: Endosteal implants are the most commonly used type of dental implants. These implants are surgically placed directly into the jawbone, acting as artificial tooth roots. Once the implant fuses with the bone during the healing process (osseointegration), a connector called an abutment is attached, onto which the artificial tooth or crown is placed. Endosteal implants are versatile, suitable for most patients, and offer a robust and stable foundation for replacement teeth.

Benefits: Strong and durable foundation. Support for single or multiple teeth replacements. Long-lasting solution with proper care and maintenance. It preserves jawbone density and prevents bone loss.

2. Subperiosteal Implants: Subperiosteal implants are placed on or above the jawbone but beneath the gum tissue. These implants consist of a metal framework atop the jawbone, with posts protruding through the gums to hold the artificial teeth securely. Subperiosteal implants are often recommended for patients with insufficient jawbone density or those unable to undergo bone grafting procedures.

Benefits: Suitable for patients with reduced bone density. Minimally invasive compared to bone grafting. Supports the placement of prosthetic teeth without extensive surgery.

3. All-on-4 Implants: All-on-4 implants offer a comprehensive solution for patients missing an entire arch of teeth. This technique involves the placement of four implants per arch strategically positioned to support a complete set of fixed prosthetic teeth. All-on-4 implants provide stability, functionality, and aesthetics similar to natural teeth, often eliminating the need for bone grafting in some instances.

Benefits: Immediate restoration of a complete arch of teeth. We have reduced the need for bone grafting. It improved chewing ability and speech. It enhanced aesthetics and confidence.

4. Zygomatic Implants: Zygomatic implants are advanced dental implants used in cases where patients have severe bone loss in the upper jaw. These implants are anchored into the cheekbone (zygomatic bone) rather than the maxillary bone, providing stability and support for fixed prosthetic teeth.

Benefits: Ideal for patients with extensive bone loss in the upper jaw. Avoids the need for bone grafting procedures. Offers a reliable solution for fixed teeth restoration.

Understanding the different types of dental implants and their benefits allows individuals to make informed decisions about their dental restoration journey. Consulting with a qualified dental professional is essential to determine the most suitable implant type based on individual needs, ensuring successful and long-lasting results in restoring a natural-looking smile and improving oral health.

via Jeremy Blacquier | Professional Overview https://ift.tt/37sxJZf