The opioid epidemic has been fueled by soaring numbers of prescriptions written for pain medication. And often, those prescriptions are written by dentists.
“We’re in the pain business,” says Paul Moore, a dentist and pharmacologist at University of Pittsburgh School of Dental Medicine. “People come to see us when they’re in pain. Or after we’ve treated them, they leave in pain.”
Indeed, 12 percent of prescriptions for immediate-release opioids are written by dentists. In 2012, dentists ranked fourth among medical specialties for their opioid prescribing rates, according to data from QuintilesIMS. It has made dentists targets for people “doctor shopping” in order to get opioids.
Massachusetts has taken the lead in trying to reduce opioid prescription abuse. Last year, Gov. Charlie Baker’s office passed a law to prevent drug misuse. Dental schools in the state are also required to teach a set of core competencies that their students are required to meet before graduating. Students will have to demonstrate that they know how to consider nonopioid treatment options.
Photo: Jessica Cheung/NPR Caption: Third-year students at the Harvard School of Dental Medicine learn how to trim crowns and prep a tooth for a crown. They’re also learning to deal with the aftereffects, studying alternatives to opioids for pain relief.
To anyone getting wisdom tooth surgery:
From my experience, here’s what I reccomend.
-Choose the person who accompanies you to your appointment wisely! They are going to be taking care of you for a few hours and you need someone who is compassionate and willing to help you.
-Milk! Once you are able to drink again, I recommend drinking lots of chocolate milk! If you don’t like chocolate, try strawberry or vanilla! (Yes vanilla milk exists) Flavored milks have lots of calories, which you need to heal (especially since your diet is restricted from the surgery). If you can’t drink lactose try almond, soy, goat or any other milk substitute. Just make sure it has those calories and tastes yummy! You’ll want that yummy taste to help you feel better after the surgery.
-Don’t use too much cotton. Once you pull the cotton swab out and its not completely soaked in blood, you don’t need to replace it again. The surgical site might ooze blood for up to 24-48 hours so if you taste a little blood, don’t freak. Although if you’re profusely bleeding after three or more gauzes, call your doctor or dentist.
-DONT DRINK FROM STRAWS OR BOTTLES! The suction will cause the blood clot to come out and will cause you to bleed more. If that does happen, call the dentist and follow their instructions.
-Eat soft, mushy, lukewarm or cold foods. Avoid spicy, super salty or acidic foods. I know, that’s not much fun, but here’s some stuff I like: Eggs (cooked any way), Potatoes (again, most ways are fine), cooked veggies (so they’re soft), pasta with butter (no tomato sauce), pierogis, raviolis (again, no red sauce), soup. Remember, all your cooked foods must be cooled down before you eat them. Ice cream, yogurt, pudding, jello, milkshakes, smoothies (try to avoid having seeds in your smoothies, you don’t want them to get lodged in your surgical wound), soft fruit (peaches, mango, plum, grapes, melons, etc.), cheese, soft un-toasted breads. Overall, keep it bland and not at an extreme temperature.
-Check your mouth using a mirror and a light for extreme bleeding or anything unusual, if you see anything that looks not good, call your dentist or doctor.
-TAKE YOUR MEDS ON TIME AND CORRECRLY! Trust me, these medicines are friends, they will keep your pain at bay. They may not get rid of all the pain, but they will subdue most of it.
-A little swelling and bruising is normal. To avoid major swelling, for the first 24 hours after surgery, place ice to the outside of your cheek where the surgery was performed on for 15 minutes and off for 15 minutes. After 24 hours, switch to heat.
-Sleep and lay down with your head elevated, it will stop blood loss.
-Don’t be worried if you’re still numb for a few hours. The Novocain processes different in everybody’s body. Sometimes it wears off in a half hour, sometimes it takes a few hours. But if you get really worried, call your dentist.
-Don’t exercise for two to three days after surgery, you risk unlodging the blood clot.
-Your mouth might have limited movement range after surgery, totally okay.
-If you get IV anaesthesia, you may be nauseas or have a headache after, this happens sometimes, just tell your surgeon and he’ll tell you what to do.
-Do something nice for yourself, take a soothing bath, get into your comfiest clothes, watch your favorite movie/TV show. TREAT YO SELF.
BUT REMEMBER! I AM NOT A PROFESSIONAL! CHECK EVERYTHING WITH YOUR DENTIST/SURGEON! It’s better to be safe than sorry. Okay? Now take care of yourself, love you babies!
I just saw your post about homemade toothpaste being unhealthy so I'm just wondering ow bad are the abrasive properties of baking soda and do you know a zero-waste alternative??
Sorry for the delay, Anon, I just got this message today!
Minerals are given a hardness rating using something called the Mohs hardness scale, which goes from 1 (talc) and 10 (diamond). The harder a substance is, the more difficult it is to scratch. Tooth enamel is around 5, and baking soda is 2.5; a lot of zero waste and natural health sites have used this fact to say that baking soda is not capable of scratching teeth.
However, softer substances can scratch harder ones. For a non-dental example: iron and steel have a hardness of approximately 4 while glass is 5–despite being harder, glass is easily scratched by iron, it’s just that the iron is damaged more than the glass is in the exchange.
Baking soda crystals are less abrasive than steel, obviously, but have been shown to cause small abrasions over long-term use, which is why a number of medical professionals caution against brushing with baking soda. These tiny grooves provide the perfect habitat for bacteria to grow, and can make you more susceptible to cavities further down the line.
On the other side of the coin, a number of commercial toothpastes contain silica (hardness 7), and have been known for at least a decade to abrade enamel, the results of which are worsened by regularly drinking acidic beverages (this study has a lot of good information for those interested in reading more about the above).
The take home message of the dental literature I’ve read (disclaimer: I’m not a dentist nor a doctor, not giving anyone medical/dental advice) is that baking soda is less abrasive than some commercial toothpastes, but still too abrasive to be using on a daily basis. It has been shown to be good at removing plaque, but this is a once a month rather than daily type of requirement.
What I do personally is brush with water daily, and dissolve baking soda in a glass of water to make a mouthwash. This gives you the pH-balancing action of the baking soda while getting rid of the abrasion. I do brush with baking soda, but only once a month to once per two months, depending on whether or not I see plaque buildup. This is actually how old-fashioned tooth powders were used a century ago, on an as-needed basis. They have become popular again, but people have forgotten how to use them (and there are plenty of 1950′s and before patents and papers demonstrating their effectiveness when used in this fashion).
So my tooth pain has gotten to a point where I can’t deal with it at all. It keeps coming back, with smaller and smaller periods of reprieve. So from this point forward I’m opening commissions explicitly to get to a dentist and take care of the agony in my mouth. I probably have more than one cavity, and I desperately need funds. Even donations. Please help me. What money I’ve made from commissions thus far is not enough to get me the help I need.
Can you develop an STD without catching it from someone else?
Someone asked us:
Can you develop a std/sti without “catching” it, or having it passed down?
No, you can’t get an STD without catching it from someone. STDs are communicable infections. That’s a fancy way of saying they’re spread from one person to another, kind of like a cold.
Sex — including vaginal, anal, and oral sex — is the main way STDs travel from one person to another. That’s why using condoms and dental dams every time you have sex is a good idea. These barriers literally block germs from getting through.
But some STDs can be spread other ways, too. For example, HIV and Hepatitis B can both be spread from one person to another by sharing needles. HIV can also be spread to a baby during pregnancy, birth, or breastfeeding. Scabies and public lice can be passed from one person to another from non-sexual behavior too, like sharing a towel or bed sheets with someone who has it.
Sex isn’t the only way STDs happen, but all STDs are passed from one person to another somehow. They don’t just pop up out of nowhere.
Maintaining good dental hygiene is important, but due to sensory issues and executive dysfunction it can be difficult for many autistic people. Here’s some tips, feel free to add your in the comments.
- If the way toothpaste foams in your mouth makes brushing a painful sensory experience, try a more natural toothpaste like Kingfisher, or brush with baking soda. - If you really can’t stand having stuff in your mouth, it’s better to brush with just water than not to brush at all. - Flossing can be fun! I like to floss whilst watching videos because having something to do with my hands helps me concentrate. - Use a fluoride mouthwash - you can dilute it if the taste is too strong! - If you don’t like the taste of mint, there are many other flavours of toothpaste, including clove, strawberry and fennel. - If you really can’t manage to brush your teeth, chew gum. Make sure it’s sugar-free! - If you get excited about trying new things, buy yourself a new toothbrush or toothpaste - you’ll look forward to using them. - Experiment with different toothbrushes until you find one that feels good in your mouth. - Make sure you drink water after eating, so that the acid in your mouth is reduced, so if you aren’t able to brush your teeth in the evening it won’t be as damaging. - Eat sugar-free sweets instead of sugary ones where you can - xylitol is a healthy sweetener which is good for your teeth. - Don’t forget to go to the dentist :)
I’ve never had any gay sex-ed. What are some lesbian safer sex basics?
Someone asked us:
I’m a lesbian teenager who is not currently sexually active. However, I’ve never really had any exposure to gay sex-ed, and was wondering what the basics are for when I do become sexually active?
It’s truly excellent that you’re the be-prepared type. And yes, a lot of sex ed out there is deeply heteronormative and cissexist — which are big words for “not relevant for people who are LGBTQ.”
As you know, everyone — regardless of gender or sexual orientation — needs to protect themselves from STDs if they’re sexually active. Sex between people with vaginas isn’t very likely to pass HIV, but there are plenty of other STDs to watch out for. Infections like herpes, genital warts, chlamydia, gonorrhea, and syphilis can be spread from sexual skin-to-skin contact (like a mouth on a vulva, penis, or anus, or bare genital rubbing), and through exposure to each other’s vaginal fluids. Using a Sheer Glyde dam for oral sex, and condoms on any sex toys you share will help prevent STDs. Some people also use rubber gloves to protect their hands and avoid passing genital fluids. And sexually active folks should be tested for STDs at least once a year (but note that Pap tests don’t screen for STDs — if you want to be tested, make sure to ask).
If there are both penises and vaginas involved in the sex you’re having, you gotta think about protecting yourselves from unintended pregnancy, as well as STDs. Condoms are a great way to do both, but we also recommend using a second form of birth control along with condoms for the best possible protection against pregnancy. It’s important to note that trans folks’ Hormone Replacement Therapy (HRT) can affect their fertility, but it varies person-to-person and shouldn’t be considered a reliable form of birth control.
Now onto butts: Never put anything in a vagina, like fingers or sex toys, that’s been in the back door, because anal germs can cause vaginal infections. You should also ALWAYS use lube for anal action — the anus doesn’t self-lubricate the way the vagina does, and anal penetration with fingers or toys can cause irritation and tears that may increase your STD risk. And you should never put anything in your butt that doesn’t have a flared (wider) base that stops it from slipping all the way in — sex toys can get lost in rectums, unlike in vaginas. Now might also be a good time to remind you and any potential partners to wash your hands before and after touching each other’s genitals.
And you know, being safety-conscious starts with having open dialogue with your partner(s). It may seem a little awkward to ask a new partner about their STD status, when they were last tested, if you need to be concerned about pregnancy, what protection they want to use, etc., but it’s all just a part of being a safe and responsible sexually active person. And really — if you’re going to get naked with someone, how hard can having a convo about health be? A lot of people never ask, roll the dice, and hope for the best. Don’t be that gal. Talking openly protects you AND your partners.
While this is a pretty solid start to safe lesbian sex, remember that being sexually active isn’t just about avoiding STDs. Good sex is about pleasure, consent, and learning about your body, so keep reading and keep asking questions. It’ll come in handy whenever you decide you’re ready!
maybe i’m just fucking paranoid, but I hear so many stories about dentists lying about problems with people’s teeth, just so they can make money off of it.
and you know what you can’t know one way or another whether or not they’re telling the truth unless you get second and third opinions. and you can’t fucking get second and third opinions when you’re a poor person on medicaid.
This is absolutely why dental care and health is so important.
Both photos are of the teeth located in the lower right quadrant of a dog.
The top photo shows healthy premolar teeth. The tooth roots are solidly attached to the surrounding bone by the periodontal ligaments, there are no cracks to the crown, and there is no lucency at the apex of the teeth.
The bottom photo shows severe dental disease. The tooth roots look mottled, there are large apical abscesses, and the bone has completely eroded away leaving the jaw exceptionally fragile.
When we ignore dental health, plaque begins to accumulate on the teeth. Plaque is a soft film that is full of millions of bacteria. If left on the teeth, plaque eventually hardens into calculus. Calculus sits on the teeth at the gum line and will cause gingival recession and eventually infection will travel down the tooth root, loosening the periodontal ligaments and causing the tooth to become mobile. Once infection continues down the tooth root, it can cause large abscesses at the base of the root which will cause bone degradation.
Animals absolutely require dental care, and regular brushing like we do can prevent issues like this from becoming this bad. Imagine what our teeth would look like if we didn’t brush!
There are other options if you are unable to brush your pet’s teeth like water additives, chews (NOT BONE OR ANTLER), and professional cleanings that will improve your pet’s oral health. It is recommended that you get your pet’s teeth professionally cleaned under anesthesia to prevent these issues. Non-anesthetic cleanings are not effective and do not improve your pet’s oral health.