Do Bugs Always Need Drugs?

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It’s flu season and the line up in the pharmacy for antibiotics is getting long.  We all would like a quick recovery and end the misery of lethargy, runny nose and cough by popping a pill.   Antibiotic use is; therefore, becoming more common, even in viruses induced illnesses such as a cold or the flu.  But is antibiotics the correct way to go when it kills bacteria not viruses?   Using antibiotics too often, which does not even help viral infection anyways, can lead to antibiotic resistance.  Bacteria resistance to antibiotics can happen naturally and on it’s own, although frequent use of antibiotics can increase its chance.  Bacteria gets accustomed to the exposure of antibiotics in its surroundings and it can mutate or learn to build an immunity against it.  Doctors are running out of options worldwide in finding treatment for serious diseases, like pneumonia or skin and gastrointestinal infection caused by superbugs such as methicillin-resistant Staphylococcus aureus (MRSA) and  Vancomycin resistance Enterococci (VRE).  Sometimes these superbugs are not only resistant to one but multiple kind of antibiotics.

Fortunately, there is something you can do to prevent bacteria resistance to antibiotics.   Antibiotics should only be used when they are prescribed to you by your doctor; when he or she can confirm with testing or has reasonable suspicion that your illness will be beneficial to the use of antibiotics.  Finishing the entire amount of the prescription is vital and never share antibiotics with anyone.   Washing and sanitizing hands sounds awfully simple but it is very effective in preventing the spread of bacteria.  Cough and sneeze into your sleeves or tissues and not your hands.  Avoiding touching moist areas of your face such as the mouth, eyes, and nose because it is an easy entry for microorganisms into your body.    

Please don’t be disappointed when your dentist did not give you a prescription of antibiotics.  From a dental perspective, clean wound related to trauma on a healthy individual may not need to be treated by antibiotics.   If a child has acute pain because of cavity infecting the nerve of the tooth, providing immediate treatment for the offending tooth (ie, pulpotomy, pulpectomy, or extraction) would be better than taking antibiotics.   Antibiotic therapy usually is not needed if the dental infection is contained within the immediate surrounding tissue and the child does not show signs of a spreading infection.  Antibiotic use should be reserved for a child who is suffering from high fever, facial swelling or a child who is immunocompromised.  

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Dental visits made easy for children with autism

Dr. Phoebe Tsang and her research team would like to extend a big thank you to all participants in her study, focused on helping children with autism cope with their dental visit, at BC Children’s Hospital (BCCH).  She was also very grateful for the opportunity to collaborate with BCCH psychologist, Dr. Janet Mah in the last few years.  Their hard work has been recently published in the Journal of Clinical Pediatric Dentistry.

Here is the abstract of the study for those who are interested.  You can find the full article in with the following citation:   Journal of Clinical Pediatric Dentistry Volume 40, Number 5/2016.

autism awareness

Visual Schedule System in Dental Care for Patients with Autism: A Pilot Study

Objectives:  A pilot study to test whether a visual schedule system using picture communication symbols can help children with autism have successful routine dental cleaning visits.

Study Design: 14 boys with autism between three- to eight-years-old presented to the dental clinic for four weekly consecutive dental appointments. Patients were randomly assigned to either the control group who received the tell-show-do method (i.e., standard of care), or the test group who received the tell-show-do method plus the visual schedule system.

Results: Patients in the test group completed an average of 1.38 more steps, at 35.52 seconds per step faster, and with 18.7% lower levels of behavioral distress than those in the control group.

Conclusion: The use of a visual schedule system, along with repeated weekly visits, showed some promise in helping children with autism successfully complete more steps, progress at a quicker rate, and exhibit lower levels of behavioral distress within a dental appointment, compared to a traditional tell-show-do approach.

Visual Schedule for dental visit

How to maximize happiness at the Happiest Place on Earth: A Disney Guide

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I had the opportunity to attend a continuing education course in Anaheim, California recently.  Being a mother of a 3 year old, I have a good reason to also visit the happiest place on earth (but I have to admit, it is for my own amusement as well J).   For my son to enjoy his first time in Disneyland, I had to do some “strategic planning”: which park to hit, rides that are most suitable for my son’s age and interests, Fastpasses, the quietest time of year, plane tickets, food, hotels; the list seems never ending.   I am sure there are many moms out there doing the same – so why reinvent the wheels?  Let me share some of my experience which you may find helpful in planning ahead of time.

The biggest key is to allow yourself time to plan before the trip. A few months in advance can be extremely helpful, considering that there are so many things to think of.  You most likely already have a park in mind, but do consider that Disney World has 4 parks and 2 water parks and is immensely bigger than Disneyland, which only has 2 (for now – they are building a 3rd one). With small children, walking from hotel to park, and trying to hit every park in a week at Disney World may be challenging and not so enjoyable for the little one’s so Disneyland may be more attainable for young first timer.

It is also important to do research on when you want to go.   Some of the least busy times to go to Disney World are the middle of January to the middle of February; late August; and the week after American Thanksgiving to the middle of December. The least busy times at Disneyland are the week after Easter Sunday until the middle of May; after Labour Day to mid October; and after American Thanksgiving to the middle of December. The busiest times are obviously weekends, winter and spring break, summer, and all major holidays.   It is more memorable to go in October when there is a Halloween theme and other special attractions that only happen this time of year but you can also add more personalized touch by signing up for events like dining with characters.  It is better to book these special events in advance online. The Disney Website has its own planner called My Disney Experience, and you can use it to plan hotels, food, attractions and whatever else you are curious about. Calling a Disney representative is also helpful as they can give you ideas and save you time finding out the info on the website.

Mickey

Finding a place to stay in or around the Disney area is overwhelming, as there are so many options for this as well. Staying in the park is convenient, because you walk out of your nicely themed hotel and you are already in the park, but they are usually more expensive.  Also, if you are with older or no children, this can be a bit too much Disney for you, and the off-park hotels can give you a break from the crazy hustle and bustle. Hotels around Disney area often provide shuttle services so you can minimize walking as you will be doing all day in the Park!

Line up is no fun for anyone, especially small little ones so Fastpasses are blessings! Fastpasses are essentially tickets with a return time so you can pass through lineups and get right onto the ride.  It works differently for each park – for Disney World, you have to get them beforehand, but at Disneyland you go right to the popular attractions and grab the Fastpass ticket at the ride.  Bear in mind that there are also Fastpasses for meeting some of the favourite characters – for examples, nowadays, with Princess Anna, Elsa and Olaf.   There is also an app that tells you the wait time at each ride and food lines, which is very convenient if you are debating walking across the park. Disney World has wifi built throughout the entire park which makes the app more accessible if you’re from out of country or do not have data.

When you arrive at the park, you can tell Guest Relations if it is your birthday, first visit, or anniversary, you will be given a button to wear which gets the cast’s attention to give you an extra special hello.   There is a disability card that can be provided for those who can’t wait in the long lines due to a disability, which you can also get at Guest Relations. There are strollers to rent in the park for littler children, and if you plan on renting one for more than a day, let the park know and they will give you a discount. Another fun tip, is that if you buy a coffee in the park and keep your receipt, you can take it into any food shop and get it refilled for free (you don’t even need your cup). You can also ask the photographers if they can add special effects to your photos with characters. Make sure you don’t forget an autograph book for the little one’s when they meet the celebrity characters.  You can purchase in the park, or just buy a more affordable Disney themed one at the dollar store at home. It is a good keepsake for children (I still have mine from my first visit to the park).

Being organized and having everything planned beforehand takes away the stress one might have at the beginning of the trip, and allow everything to flow smoothly.   Hope all these tips help you enjoy your time in the park.   Have fun!

 

Vaping teenagers

In the past few years, there have been an increase in popularity of electronic cigarettes among adults and teenagers. These devices are advertised to help cigarette addicts to overcome their cravings in a gradual and helpful way; but, they have quickly become a growing trend among youth.

What is e-Cigarette?

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An e-cigarette is an instrument that uses a coil to turn liquid nicotine into vapour for the user to inhale. It uses no tobacco, and it has different levels of nicotine to give each individual a personalized experience. The liquid or “juice” used in these devices are often flavoured, and have sweet and candy-like tastes that users do not usually have while smoking a regular cigarette. This variety of flavours are why it is becoming so popular with adolescents.  There are over 8,000 flavours to choose from;  for example, strawberry, bubblegum, cream, hazelnut and kiwi and new websites and “vape shops” have been rapidly launching around North America. The phenomenon has been so popular, that even tobacco companies have been creating their own style of e-cigarettes and selling them, alongside normal cigarettes. Even though vapes may be an alternative for quitting smoking, the long-term effects of these products are not unknown.

What are the potential health problems with e-cigarettes?

e-cigarette

Health concerns with electronic cigarettes are not well researched, mostly because they have only been around for such a short time.   Since vape has not yet been regulated by  FDA nor Health Canada and with so many brands and vendors to choose from,  the true ingredients (and its detrimental effects)  in the products are questionable.  In 2014, Health Canada randomly tested some of the products claimed to be  “nicotine free”, and found at least over half the products actually containing nicotine.  Some contains solvents which may be harmful to your body.    

On the other hand, a ten millilitres e-cigarette cartridge is equivalent to 200 cigarettes.  Users often subconsciously consumed way more nicotine as one of these 10ml e-cigarette cartridges can easily be consumed completely in 2 hours!  

ecig flavours

Nicotine, even in small doses, can become highly addictive, and can be detrimental to a growing child’s brain.  Even though young children may not be vaping like a teenager, they may accidentally ingest the liquid, as they are drawn to the “juices” by their different attractive flavours.  Calls to poison control centres related to e-cigarettes liquid poisoning in young children have sky rocketed since e-cigarettes introduction in recent years.  

Though e-cigarettes have been considered by many as a good way to stop smoking, the research for its efficacy and safety for smoking cessation has not been established. Nicotine patches, gum, or lozenges are still the mainstream for smoking substitutes. The more exposure e-cigarettes have, the more chance it will fall into children’s hands, leading them to become addicted to nicotine and even become future smokers.  The idea of E-cigarettes as a smoking alternative may just be illusive and cloudy as the vape as it produces.   

Do you know what is in your toothpaste?

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The options of toothpaste currently available on the market today are endless: ranging from whitening, desensitizing, antiplaque, and multi beneficial. There is even toothpaste focusing on individuals who have dry mouth. White, healthy teeth have been desired in society since the archaic age, and continue to be a trend in today’s general population. The first toothbrush was invented in China in the early 1700’s, but the toothpaste tube was not invented until the late 1800’s. Until then, most used dentifrices supplied in jars that the entire family shared. Some saw this as a health hazard, and didn’t use toothpaste until the tube was actually invented.

The most common ingredients in toothpaste are abrasives (a substance used for cleaning), detergents, and fluorides. Other, less significant, components include humectants (helps reduce the loss of moisture), water, binders to avert separation, and flavours or sweeteners to give the dentifrices a likeable taste. Arguably, the most important reason why we use tooth paste is because of its fluoride.  Fluoride strengthens tooth enamel and makes teeth less susceptible to decay. Different types of fluoride include stannous fluoride, sodium monofluorophosphate, sodium fluoride, and amine fluoride, each has a different intention, or purpose. The amount of fluoride needed to protect the teeth is very minimal so most of the toothpaste’s fluoride concentration is kept low in order it to be sold over the counter in the supermarket.

Expectations have climbed over the years for how many benefits can be squeezed in one small tube of dentifrice. It is not only expected to provide general mouth health and the prevention of tooth decay, but now it must fight gum disease, rid plaque, clear tartar, and have a whitening component. Producers also need to provide to certain groups of individuals, as in customers with tooth sensitivity, dry mouths, smokers, and those who want more natural products in their toothpaste. Anti-tartar products have high levels of pyrophosphates that are combined with sodium fluorides to reduce the buildup of tartar, but cannot take away the already hardened deposits on the tooth. Whitening toothpastes is very appealing with its claims of stain removal and teeth brightening, while being used frequently. However, ingredients in the whitening toothpastes have very short life span so it is questionable how much it will give the teeth a glistening and bright look. Actual whitening of the tooth requires bleach, which is more safely done in an office procedure or dental recommended gel. Anti-sensitivity toothpaste ingredients have remained the same since it was first created, containing strontium chloride, potassium nitrate, and sodium citrate. Anti sensitivity toothpaste seem to work well and it can be combined with other toothpaste ingredients, such as anti-tartar.
It is recommended that all children should use fluoridated toothpaste. Children 3 years or older should use no larger than a pea sized amount. Children 3 or younger can use the toothpaste as well, but no larger than the size of a grain of rice. Using fluoride toothpaste can prevent tooth decay and the side effect is minimal if its use is supervised to ensure correct amount and proper brushing techniques.

There is a wide assortment of toothpastes available on the market, and with each one comes a different proposition or promise. It is up to each individual and their needs to determine which toothpaste is most suitable for them. Talk to your dentist about what is best for one’s oral care needs.