The COVID19 pandemic has seen daily life grind to a halt for many and as we continue to fight the spread of this disease, we must be vigilant and careful about how we move around and interact with each other.
Within dentistry we are all trained on the concept of ‘Universal Cross Infection Control’, a method of working that promotes the safest environment for our patients. Infectious diseases are nothing new, they are a factor that we must consider for any public service. The barber has to disinfect their combs between clients, restaurants must ensure their cutlery is safe for the next diner, hotels change their linen before the next resident, the bowling alley sprays their shoes before the next customer, the list goes on and and on…
Everything is an effort to ensure that equipment is safe when passed from person to person and any infection is stopped in its tracks.
Dentistry works in much the same way; except we take this to the nth degree. After every appointment we do what is called ‘the breakdown’:
- All equipment that has been used on the last patient is either:
(a) Disposed of in designated medical waste containers
(b) Processed through our sterilisation facilities where the equipment goes through an autoclave and is returned to storage sterilised in sealed packaging
- All surfaces within the surgery are wiped down with disinfectant to return the room to a condition that allows us to bring our next patient through.
Personal Protective Equipment has seen a lot of news coverage of late, within the dental profession this has long been a standard part of our working day. We are experts in hand hygiene, we have always used face masks, gloves are changed between every patient, a key role for the nurse is their expert use of high-volume suction to reduce aerosol production. Our diligent adherence to Universal Cross Infection Control ensures a safe environment for us and our patients.
With that in mind I would like to talk about why it is essential to see the dentist regularly. Dental disease is unlike most other ailments, things literally never get better if we just ‘wait and see’. Damage to the teeth and gums should be seen as a cumulative destruction of these structures, incremental injury piled upon incremental injury leading to tooth decay or gum disease.
Teeth cannot heal themselves and gum disease cannot be reversed. As such when a caries develops or when periodontitis begins, if left untreated, holes get bigger and the gums recede further.
A tooth begins to decay, caries has broken through the enamel and is now spreading through dentine, millimetre by millimetre the defect grows until it reaches the nerve, what was a sensitive tooth now starts to become outright painful, the nerve tissue cannot cope with the bacteria that has now invaded the pulp chamber, the pulp succumbs to the infection and dies off, infection now begins to spread around the tooth’s supporting structures, sporadic toothache now gives way to constant agony, an abscess has formed.
If the dentist had intervened at the first sign of decay this tooth could have been rendered disease free with a simple filling, having allowed the disease to progress however this tooth now requires either a Root Canal Treatment or an extraction. All dental disease follows this path and it is the job of dental professionals to prevent this progression through timely intervention and health promotion ie your ‘check-up and clean’.
‘A stitch in time saves nine’