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The following patient information is provided by the BC Dental Association (BCDA) based on information from the College of Dental Surgeons of BC (College) and the Provincial Health Officer. Learn more at the College COVID-19 information page at cdsbc.org/Pages/covid-19-info.aspx.

1.Where can I get answers to my questions about
COVID-19?
British Columbians can reach service representatives
seven days a week, from 7:30am to 8pm, by calling
1-888-COVID19. Information is available in more than
110 languages.

2. I went to the dentist the week after the dental
conference, do I need to self-isolate?
No. Advice from the Office of the Provincial Health
Officer indicates that only the dentists and dental staff
who attended the dental conference need to self-isolate
until Sunday, March 22.

3. How do dentists ensure that patients are protected
from being infected?
Dental clinics are like mi-hospitals and are
required to follow strict infection and exposure controls
on an ongoing basis. Dentists comply with Infection
Control Standards set by the College. The BCDA has
also provided dentists with an Exposure Control Plan that
outlines requirements for Personal Protection Equipment
(PPE) as a standard practice for managing all patients –
all the time. Both of these documents are posted on the
BCDA website under COVID-19.

4. If dental offices are so safe, why has elective and
non-essential dental treatment been suspended
indefinitely?
This was a prudent decision to adhere to the requirement
for social distancing and mitigate unnecessary patient
contact. On March 17, the Provincial Health Officer
declared a “Public Health Emergency” which means
that all elective medical and dental procedures are
suspended until further notice. Suspending these
services ensures that protective equipment and essential
human resources can be directed to critical care areas
until the crisis has passed.

5. If dentists are responsible to treat dental emergencies,
such as uncontrolled bleeding, infection, swelling or
trauma/accident. How do I know I’m safe?
Dentists follow Infection Control and Exposure Control
guidelines as a regular course of practice. With the focus
of containing the COVID-19 virus, until March 22, dentists
who attended the dental conference are required to
manage emergencies by phone first (prescribe antibiotics
or pain relief as required). Dentists who did not attend the
conference can provide essential as well as emergency care
in their office now. After March 22, all dentists can provide
essential as well as emergency care in their office following
standard protocols if the patient does not have symptoms.
If the patient has cold or flu symptoms, the dentist can treat
the patient in their practice or refer the patient to a clinic or
hospital with required Personal Protective Equipment (PPE) in
place.

As regulated health care professionals, dentists share
the primary responsibility to keep patients and staff safe.
They are committed to lessen the burden on overtaxed
hospitals by treating dental patients in their clinics within the
guidelines provided.

6. What should I do if I think I have COVID-19?
The Public Health Agency of Canada has provided
instructions for the steps you are expected to take in a
fact sheet called Coronavirus disease (COVID-19): How to
isolate at home when you have COVID-19. A new COVID-19
assessment tool is also available at covid19.thrive.health/.

7. What is the difference between “self-isolate”,
“self-monitor” and “quarantine”?
Please refer to a very helpful resource from the Public
Health Agency of Canada titled Know the Difference: Self-monitoring, self-isolation, and isolation for COVID-19.

* E-cigarettes with sweet flavors can increase the risk of cavities, according to the ADA Foundation Volpe Research Center. A study investigating changes in cariogenic potential when tooth surfaces are exposed to certain e-cigarette aerosols in a controlled environment has found that the combination of the viscosity of e-cigarette liquids and some classes of chemicals in sweet flavors contribute to the increased risk.
The study suggests that the complex impact of e-cigarettes on human health goes beyond respiratory and cardiac systems and may have significant implications on oral health.
The Food and Drug Administration (FDA) has found that e-cigarette use is not benign despite marketing efforts to make it seem less harmful than combustible tobacco and that it has its own effects on health.
The study, “Cariogenic Potential of Sweet Flavors in Electronic-Cigarette Liquids,” was published by PloS One.

*Excerption from September issue of Dentistry today

Published by Columbia University College of Dental Medicine

1.What it is
Some teeth have cracks that are too small to show up on X-rays. Sometimes the cracks are under the gum. These small cracks are known as “cracked tooth syndrome.”
Cracked tooth syndrome is most common in lower back teeth (molars). That’s because these teeth absorb most of the forces of chewing. Some people grind or clench their teeth. These people may be more likely to have cracked tooth syndrome. Sometimes, the way a person’s teeth come together can put too much pressure on one tooth. This can cause the teeth to crack. Teeth with large fillings may be more likely to crack. Teeth that have undergone root canal treatment are weaker than other teeth and also may be more likely to crack. People with one cracked tooth are more likely to have others, either at the same time or in the future.

2.Symptoms
The tooth may hurt sometimes when you bite or chew. The sensitivity or pain can be mild or intense. It may last a brief time or a long time. It may be painful only when you eat certain foods or when you bite in a specific way. You will not feel a constant ache, as you would if you had a cavity or abscess. The tooth may be more sensitive to cold temperatures. If the crack gets bigger, a piece of the tooth may break off. You may also develop an infection. This can happen in the gum around the fractured tooth. You may notice a pimple-like bump on the gum near the tooth. Pus may drain from the pimple. This is known as a fistula. Many people with cracked tooth syndrome have symptoms for months. Cracked tooth syndrome is one of the most difficult dental problems to diagnose because the pain is not predictable. Your dentist may refer you to an endodontist (root canal specialist).

3.Diagnosis
Your dentist will examine your mouth and teeth, focusing on the tooth in question. He or she may use a sharp instrument called an explorer to feel for cracks in the tooth. Your dentist also will look at the gums around the tooth. You may have X-rays taken. But X-rays often do not show the crack.
Your dentist may use special tools to test the tooth. One tool looks like a toothbrush without bristles. It fits over one part of the tooth at a time as you bite down. If you feel pain, the part of the tooth being tested most likely has a crack in it. Your dentist may shine a very bright light on the tooth. He or she may stain it with a special dye. If the tooth already has a filling or crown, your dentist may remove it in order to see the tooth better.

4.Expected Duration
How long symptoms last depends on how quickly a cracked tooth can be diagnosed. Even after a crack is found, treatment may not completely relieve the symptoms.

5.Prevention
If you grind or clench your teeth, talk to your dentist about treatment. Grinding can increase your risk of cracked tooth syndrome.

6.Treatment
Treatments for cracked tooth syndrome do not always relieve the symptoms.
Treatment depends on:
Where the crack is
How deep it is
How large it is
Sometimes a crack affects one or more cusps of a tooth. These are the highest points of the tooth. In this case, the tooth may be fixed with a crown, also known as a cap. Some cracks affect the pulp: the center of the tooth, where the nerves and blood vessels are. In that case, the tooth will need root canal treatment. About 20% of teeth with cracked tooth syndrome will need root canals. After a root canal, the tooth will no longer be sensitive to temperature, but it still will respond to pressure. If you felt pain before the root canal, you may still feel some pain afterward. It probably will not be as intense or as frequent, but it may still occur. In some cases, the tooth may need to be removed. Some cracks affect the root of the tooth in the jaw. There’s no way to fix this type of crack. If your tooth is removed, you can have it replaced with an implant or a bridge. Your dentist can make a night guard (a plastic bite piece) to prevent you from grinding your teeth. This will relieve the pain from grinding. For some people it can stop tooth sensitivity. The night guard can be worn during sleep. It also can be worn at other times if clenching or grinding happens during waking hours.

7.When To Call a Professional
If you feel pain when you bite or chew, contact your dental office.

8.Prognosis
Treatment of cracked tooth syndrome is not always successful. Your dentist should talk with you about what might happen. In some people, a crown will fix the problem. In others, root canal treatment solves the problem. Some people continue to have occasional symptoms after treatment. They may need to have the tooth taken out.

“The results of the Fluoride Varnishes for dental health generally support the use of professionally applied topical fluoride varnish for the prevention and reversal of dental caries, remineralization of white spot lesion and dental caries lesions, and decreased of dentin sensitivity” the CADTH (Canadian Agency for Drugs and Technologies in Health) says.

We regret to inform that parking here is now paid parking. Management company recently installed parking meters and parking rate is $1 for an hour. Meter takes either coins or credit cards. Once you pay for the parking, you can tear the parking permit in the middle, leaving the left side on the dashboard and bring the right side ( it’s written “RECEIPT”) with you. The parking fee will be reimbursed to you. If you have any problems with parking meters, please call us for further assistance. Please kindly remind to bring the parking receipt for our records.

Thank you for your understanding!