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dytabytes · 2 days ago

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As a dentist, I have to slide in here with some notes:

1) If you want to keep your teeth healthy, vaping is actually, unfortunately, a really bad option. The carriers used for most vape juice are often some kind of vegetable glycerin, which will stick to the teeth, significantly weaken your tooth enamel and promote bacteria growth, which leads to cavities. It might not stain them as much, but if you want to protect the look of your teeth, vaping is definitely not the way to go.

2) Marijuana use affects the effectiveness of lidocaine, which is one of the most commonly used dental anaesthetics in North America. This means that, if you want to be numb in the dental chair, I recommend trying to take a break on use for at least a week, if not more, before going for treatment. That said, if you really need some help calming down (and I know a lot of people do), tell your dentist so that they can change their treatment plan! Depending on the patient, sometimes I'll give a double dose of anaesthetic right off the bat, or I'll switch what I'm using altogether for something that's not as affected by marijuana use! Your dentist wants you to be numb just as much as you do, believe me!

3) Night grinding is often related to a sleep breathing issue. If you're a clencher or grinder and/or you snore, I'd strongly recommend speaking to your doctor about a sleep test before having a nightguard made, because treating the sleep issue might negate the need for the nightguard altogether! This would either be because you won't be grinding anymore, or because the doctor might put you into a specialized kind of nightguard made to treat sleep breathing problems. If you've already have a nightguard made and you find you can't sleep with it, or you're taking it out at night because it's uncomfortable, that is also a sign that you might have a sleep breathing issue. A normal nightguard takes up just a little more space in the mouth, which decreases your airway size, and if you already have an airway that is too small, your body will respond by saying "I don't like this".

4) Xylitol is actually more than a saliva stimulation item! It's what we call a "cariostatic" sugar; the bacteria in your mouth can't process it, so it slows down their growth. Because of that, I actually also recommend people use it if, say, you have trouble brushing regularly because of mental illness or sensation trouble, or if just get cavities a lot. That said, be careful with how much you eat! The bacteria in your mouth can't process xylitol, but neither can the bacteria in your gut. If you have too much, you might end up with bloating or other tummy trouble. Everything in moderation! 5) Last tip! A lot of people out there have trouble affording dental care. If this is an issue for you, I strongly recommend searching out if you have a dental school or hygiene college near you. Students are watched over super carefully, so the work you get done at those institutions will be very thorough, and schools often give steep discounts on price to encourage people to come. You will, however, likely be paying for your treatment with time, instead of money. It's been a while, but as an example, when I was in school a root canal at a dental office would have taken an 60-90 minutes and cost over $1000. In school, the same root canal would be 6 hours, split into 2 appointments... but would have only cost $75. Stay healthy, friends c:

STUFF NOBODY EVER TOLD YOU ABOUT TEETH (and how to take care of them if you are poor and/or depressed)

Contrary to what the US health industry would have you believe, your teeth are NOT luxury face bones. You need them. Healthy teeth are a cornerstone of good health in general for a lot of reasons. You can’t eat well without them. You need them to speak. And tooth bias is real.

This makes me very sad because I love teeth. I am not a dentist. I’m a biological anthropologist whose expertise is oral disease and the evolutionary anatomy of teeth. My dad’s an oral surgeon and I worked in his office from the tender and illegal age of 8 to the ripe old age of 18, which is when I went to college. At 12, I was assisting with the disposal of biowaste, aka packaging up the teeth to send them to dental schools. I live, breathe, sleep, and occasionally eat teeth. I found a human incisor on my floor this morning and wasn’t even surprised. I study how teeth go bad partly so that I can help living people protect the teeth they’ve got. It’s my goal with this post to teach you about a couple of different types of procedures and oral injuries, as well as what you can do to help keep your teeth functional. So in this post, what I am going to do is outline a few common things that can go wrong with your teeth, how they happen, and how to catch them before they get bad. A lot of the advice in this post is for people who maybe can’t get to the dentist for a cleaning and checkup every six months. This post is also gonna be LONG AS HELL and there is going to be a separate post called “luxury face bone hacks for the busy/broke/b’mentally ill” or something like that, so like. If you don’t like super long posts, just hit this one with a like and actually read through that one.

First, let’s talk about dental anatomy.

What Are Teeth?

Teeth are extremely cool. They’re these amazing little packages of dentin pulp, protected by enamel, nestled into the jaw like truffles in a box of chocolates, held in place with a teeny tiny ligament. They’re gorgeous– enamel is a beautiful substance, translucent and opalescent. Teeth are also extremely weird when you think about them. You have these weird not-bone things emerging from holes in your jawbones. They’re snapped into place with a biological bunjy cord and you can actually SPRAIN THEM if you put too much pressure on them.

Here are some important things to know about teeth!

First, the nerves in your teeth were never meant to be exposed to the air. They only process stimulus one way: pain. This means that when you get a cavity or do anything else that exposes the nerve, it is going to hurt like a bitch.

Your teeth may come loose! Usually they stay put and go back to normal in a day or two. Don’t panic. This is usually the result of you spraining your dental ligament that holds the tooth in place.

Root canals suck but they can prevent dental abscesses. Dental abscesses can kill you. If they spread and get into your sinuses, they can cross the blood/brain barrier and you will die. This doesn’t happen much any more, but in rare cases… it can.

The phrase “like pulling teeth” is a misnomer. Pulling teeth is extremely easy if you know what you’re doing. Extractions are usually a very simple procedure. What’s complicated is things like root canals and setting up implants, which, in the case of implants is the literal opposite of pulling teeth.

Pregnancy will fuck up your teeth because a.) the fetus is leaching your vital essence and other nutrients and b.) your hormones are telling a lot of ligaments in your body to loosen up to get ready to give birth. Sometimes wires get crossed and other ligaments at non-mobile joints get the loosen up message, too. Just be sure to keep up your dental hygiene regimen during pregnancy and you’ll be fine.

Your gum tissue isn’t just weird wet skin. It’s a mucous membrane that protects the mouth. It can get diseased and inflamed, so pay attention to it! Also, there’s a lot of blood vessels so if you poke yourself with something, you’ll bleed like a stuck pig for a minute. The kind of bleeding you should be worried about is prolonged bleeding, where you see blood welling up around your teeth for no apparent reason.

Now that you’ve been equipped with some fun facts, lets talk about diseases and procedures.

Braces: if you’re reading this, you probably don’t need them

First: Pediatric orthodontia is largely a scam. People who put standard braces on their child before that child has lost all of their baby teeth are stupid and causing their child needless pain because those teeth are going to fall out anyways and the alignment of the adult teeth was decided long, long ago. The kids who NEED orthodontic intervention are kids with bad crossbites/underbites/overbites. This requires specialized headgear most of the time and is more intense than the standard braces because they are made to solve a much bigger problem. The standard bracket-and-wire braces? Don’t put those on a child. They won’t help. Also, your kid doesn’t have their third molars yet, and those are the molars most likely to come in twisted anyways.

As an adult, you may want braces for cosmetic reasons or for comfort reasons. This is a CHOICE that is YOURS TO MAKE. If your dentist suggests you need braces, ask why. You don’t have to get them. Now,If you have certain kinds of dental overlap- like, your lateral incisors have been pushed behind your frontals- then yeah, you should get braces. But is it the end of the world if you don’t get braces? No.

Wisdom tooth removal: you might not need it

The human jaw is in a state of evolutionary mismatch right now. Basically, our last molar, the third molar, doesn’t come in until we’re an adult. Unfortunately, thanks to ten thousand years of agriculture, give or take a few millennia, we have much more gracile jaws than our ancestors. There’s not always enough room for it. Now, this isn’t true for everyone, because no two skulls are identical and all, but sometimes there is a condition where you really should get those suckers out. If they are impacted, or coming in sideways, they can push your other teeth out of alignment and cause jaw issues down the line. If they come up straight, don’t worry about it.

Cavities: you need to get these taken care of

Cavities are a pain in the ass and are honestly the main reason you should go to the dentist for checkups, so that they can take the x-ray of your mouth and see how any potential trouble zones are progressing. You should call a dentist and seek help if you notice pain that persists over three days, as that’s an indicator of something more serious than just a sprain.

Tooth Grinding: this is a problem

If you grind your teeth, your dentist may recommend a night guard. Actually listen to them about this. Grinding your teeth can cause major jaw alignment problems that are a pain to fix, so just bite the silicone and suck it up. Also maybe talk to a therapist if you can, because grinding can be a result of stress/anxiety.

Whitening your teeth: bad idea

First off, your teeth ain’t supposed to be white. Enamel is not white. Enamel is translucent and pearlescent, so its actual color is very hard to pin down. Your teeth are naturally going to look more ivory-colored over time. That’s just part of being human and having teeth. Embrace it. You are a badass omnivore with thirty-two gorgeous enamel teeth. They weren’t put in your mouth to look pretty, they were put in your mouth to feed you.

Second: Whitening your teeth weakens your enamel. Once your enamel’s gone, it ain’t coming back, baby. There are some gentler whitening methods, like whitening toothpaste, but these are only going to give you about one to two shades worth of improvement. If you have extremely stained teeth and you want to whiten them, make sure you talk to your dentist about all the risks. Unfortunately, there is no truly safe and effective home-style (read: not a million gotdang dollars) remedy for whitening teeth.

There are a few that are kicking around, but seriously, some of them are dangerous. Do NOT rub wood ash on your teeth. That’s lye. Don’t put that in your mouth. Do NOT use actual bleach, hair dye developer, or non-dental peroxide gel. They are poisonous. DO NOT PUT ACETONE ON YOUR TEETH i have seen this exactly once and the person came into my dad’s office with chemical burns on their gums and lips. I do NOT want to see this again.

It is a misconception that brushing your teeth keeps them looking white. Brushing your teeth removes plaque and biofilm, but those buildups don’t actually stain the enamel itself. Instead, really the only way to keep your teeth looking light is to pay attention to what you’re putting in your mouth. If you’re a tobacco user, vape! Tar is a major staining agent. Coffee’s also a major stainer, and the big trick there is to put a little milk in it. See, enamel staining doesn’t come from the color of the food. It comes from chemical properties. Acidic foods stain because acid damages enamel. Food with high levels of tannins, like coffee or tea, stain because the tannins change the PH of the mouth. So what you should do to avoid staining is balance your mouth PH by eating something basic after eating something acidic. Add a lil milk to your coffee or tea to weaken its acidity just a bit. Swish with water afterwards to help clear the acid. Don’t eat lemons or any other acidic food after drinking coffee. Why would you want to eat lemons after drinking coffee, anyways? Seems like a weird flavor combo to me.

And while we’re on the subject…

MOUTH CHEMISTRY

What’s in your mouth? Your teeth, your gums, your tongue, your spit… yeah, your spit. Saliva’s important. It’s probably THE most important thing in protecting your teeth because salivary production constantly washes the teeth, clearing off as much bad bacteria as possible. If you have an issue with saliva production, you should drink as much water as you can throughout the day, and get a bottle of dry mouth tabs for nighttime. Or daytime, if they don’t bother you. This is really important because dry mouth is a major side effect for a lot of drugs, like anti-depressants. This is actually a huge part of my research- the population I study used a natural painkiller, but in the end its use caused them more pain because the way it works, it decreases the efficacy of the salivary glands. They stop making sufficient saliva, the teeth dry out, the mouth PH changes, and the bacteria that destroy enamel go buckwild. If you can’t make your own spit, store bought is fine. Water for the day, tabs for the night.

Now, you might think that ok, acid isn’t great, let’s eat more basic foods to balance that out. You can, but it… isn’t great. Your saliva is naturally acidic for a reason, and if you neutralize it completely, that ALSO messes with your teeth. You should be drinking plain water as much as possible.

Seltzer and Soda

Some people think seltzer may hurt your teeth, but it really won’t… unless it’s citrus-flavored. Reason: citrus seltzer uses citric acid as a flavoring agent, and that messes with your teeth. So if you want to drink citrus seltzer, drink it with a meal or with food. Don’t sip it slow over the day.

Soda, on the other hand is a goddamn nightmare. The acid’s kind of a problem but the sugar… dear god the sugar. So. your teeth are covered in a bacterial biofilm. Some of these bacteria excrete acid, and that’s what gives you cavities. This is another part of my research- looking at how cavity prevalence changes as sweetening agents and sugar availability changes. As different carbohydrates enter the diet, populations’ disease responses change. I know more about this than probably anybody else in the world, and here is what I know: the best thing you can do for your teeth is stop drinking American soda.

It’s the corn, you guys. The chemical compounds in corn make the cavity-causing bacteria kick into overdrive. Sodas sweetened with high fructose corn syrup create the perfect environment for these dudes to excrete out a storm. Sugary beverages in general promote cavities, but NOTHING does it like sodas sweetened with high fructose corn syrup or any other corn byproduct. Try to limit your soda and juice consumption and if you can, make sure that when you do have them, you’re getting some food,too.

Other Acids

Ok this next part is going to deal with eating disorders. I’m going to be talking about some of the side effects of bulimia, what they can do to your teeth, and how you can take care of them. Eating disorders are serious business and I hope if you need this section you are in supportive recovery and have the love and support and resources you need. If you don’t want to read about what this can do to your teeth, scroll real quick until you seen the big green text.

If your teeth are in frequent contact with stomach acid, acid etching can be a real problem. Your enamel is tough but stomach acid is gnarly, and your gums don’t have that same protection. If you find yourself vomiting frequently, for whatever reason, try to swish water around in your mouth afterwards to help clean it out. I know that’s not the thing that’s likely on your mind after that, but a lot of what we’re doing here is damage control. I’m not here to judge you in the slightest. I’m just here to help you with your teeth.

Do not brush your teeth immediately after vomiting. The enamel is weaker, and you can cause even more damage by brushing too hard. Wait for at least an hour until after you’ve rinsed your mouth to avoid spreading the acid around.

You can also add some (1-2 tsp) baking soda to the water you rinse with, if you feel ok with doing that. It will taste gross and salty but it will help neutralize the acid. You just rinse with this, you don’t swallow.

ok that part is over

TOOTH HACKS

This is the funnest part, I get to tell you good ways to take care of your teeth that require very few spoons and very little money!

Brush ‘em twice a day. Once when you get up to clear out whatever happened the night before, and once before you fall asleep. You can brush more but you don’t have to. Use a soft-bristled brush and whatever toothpaste you like. If you hate mint, kid toothpaste that tastes like bubblegum or berries is totally fine!

Don’t want to get out of bed? totally fine. Use a finger toothbrush! these are designed for babies which is actually great because they are SUPER soft. If you have sensitive gums, these are going to be really helpful.

Don’t have access to a finger toothbrush? honest to god you can just dip your finger in water (though a mix of water and baking soda or water and salt is better) and brush your teeth with just your finger. The point of this isn’t to freshen your breath or anything, it’s just to get the biofilm off of your teeth and protect them.

Floss. This gets the biofilm out from between your teeth and promotes good gum health. Don’t just run it between the teeth- you need to floss below the gumline a little bit to help clean out plaque.

If you don’t have the spoons to do your whole mouth, floss between your molars if you can.

There’s lots of products that are great for people who can’t go through the whole flossing routine. Pre-threaded flossers are ideal because they’re designed for minimal effort and maximum gain. These are also killer for people with physical disabilities that affect hand dexterity.

If flossing hurts because you have sensitive gums, a water flosser can really help. This is more expensive but will last a very long time.

You can also get topical numbing gel that you can smear on your gums when flossing. Just be careful that you’re not flossing too hard because you can’t feel it. This brand is kind of expensive but it has a nice minty flavor. If you have a dollar and a way to get there, I saw Orajel at Dollar Tree yesterday… when I was buying a bunch of those pre-threaded flossers to throw in my car. I oughta do a Dollar Tree field trip to show you like, what products are available at the absolute cheapest in the US. Dollar Tree has a LOT of good dental options.

There’s a tiktok that says you can use a strand of hair to floss. This is a bad idea. A single strand of hair is likely to break and can cut into your gums. If you want to use hair as floss, you need to use a couple of strands twisted together. Go slow and gentle if you’re using hair. Obviously actual floss is better but this isn’t “perfect dental tips for perfect people,” this is “life sucks but your teeth don’t gotta.”

If you can’t floss or can’t brush, gargle. Put two tsp of baking soda in a glass of warm water. Swish it around, spit it out. If you can do that, you’ve helped clear out biofilm and bacterial waste.

Prioritize your teeth. You only get two sets and you lose the first one by the time you’re twelve. If you can only do one hygiene thing today, make it be your teeth.

Eat some pineapple. Bromelain, which is only found in pineapple, is super good at protecting enamel.

That’s… all I got for you now. Take care of your teeth!

#teeth #dentistry #dental health #healthcare #health

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thoughtportal · 9 months ago

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Opinion Here’s how to get free Paxlovid as many times as you need it

When the public health emergency around covid-19 ended, vaccines and treatments became commercial products, meaning companies could charge for them as they do other pharmaceuticals. Paxlovid, the highly effective antiviral pill that can prevent covid from becoming severe, now has a list price of nearly $1,400 for a five-day treatment course.

Thanks to an innovative agreement between the Biden administration and the drug’s manufacturer, Pfizer, Americans can still access the medication free or at very low cost through a program called Paxcess. The problem is that too few people — including pharmacists — are aware of it.

I learned of Paxcess only after readers wrote that pharmacies were charging them hundreds of dollars — or even the full list price — to fill their Paxlovid prescription. This shouldn’t be happening. A representative from Pfizer, which runs the program, explained to me that patients on Medicare and Medicaid or who are uninsured should get free Paxlovid. They need to sign up by going to paxlovid.iassist.com or by calling 877-219-7225. “We wanted to make enrollment as easy and as quick as possible,” the representative said.

Indeed, the process is straightforward. I clicked through the web form myself, and there are only three sets of information required. Patients first enter their name, date of birth and address. They then input their prescriber’s name and address and select their insurance type.

All this should take less than five minutes and can be done at home or at the pharmacy. A physician or pharmacist can fill it out on behalf of the patient, too. Importantly, this form does not ask for medical history, proof of a positive coronavirus test, income verification, citizenship status or other potentially sensitive and time-consuming information.

But there is one key requirement people need to be aware of: Patients must have a prescription for Paxlovid to start the enrollment process. It is not possible to pre-enroll. (Though, in a sense, people on Medicare or Medicaid are already pre-enrolled.)

Once the questionnaire is complete, the website generates a voucher within seconds. People can print it or email it themselves, and then they can exchange it for a free course of Paxlovid at most pharmacies.

Pfizer’s representative tells me that more than 57,000 pharmacies are contracted to participate in this program, including major chain drugstores such as CVS and Walgreens and large retail chains such as Walmart, Kroger and Costco. For those unable to go in person, a mail-order option is available, too.

The program works a little differently for patients with commercial insurance. Some insurance plans already cover Paxlovid without a co-pay. Anyone who is told there will be a charge should sign up for Paxcess, which would further bring down their co-pay and might even cover the entire cost.

Several readers have attested that Paxcess’s process was fast and seamless. I was also glad to learn that there is basically no limit to the number of times someone could use it. A person who contracts the coronavirus three times in a year could access Paxlovid free or at low cost each time.

Unfortunately, readers informed me of one major glitch: Though the Paxcess voucher is honored when presented, some pharmacies are not offering the program proactively. As a result, many patients are still being charged high co-pays even if they could have gotten the medication at no cost.

This is incredibly frustrating. However, after interviewing multiple people involved in the process, including representatives of major pharmacy chains and Biden administration officials, I believe everyone is sincere in trying to make things right. As we saw in the early days of the coronavirus vaccine rollout, it’s hard to get a new program off the ground. Policies that look good on paper run into multiple barriers during implementation.

Those involved are actively identifying and addressing these problems. For instance, a Walgreens representative explained to me that in addition to educating pharmacists and pharmacy techs about the program, the company learned it also had to make system changes to account for a different workflow. Normally, when pharmacists process a prescription, they inform patients of the co-pay and dispense the medication. But with Paxlovid, the system needs to stop them if there is a co-pay, so they can prompt patients to sign up for Paxcess.

Here is where patients and consumers must take a proactive role. That might not feel fair; after all, if someone is ill, people expect that the system will work to help them. But that’s not our reality. While pharmacies work to fix their system glitches, patients need to be their own best advocates. That means signing up for Paxcess as soon as they receive a Paxlovid prescription and helping spread the word so that others can get the antiviral at little or no cost, too.

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#article #washington post #Paxlovid #covid #pandemic #health

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