Monday, December 7, 2020

How to use ventilation and air filtration to prevent the spread of coronavirus indoors

The vast majority of SARS-CoV-2 transmission occurs indoors, most of it from the inhalation of airborne particles that contain the coronavirus. The best way to prevent the virus from spreading in a home or business would be to simply keep infected people away. But this is hard to do when an estimated 40% of cases are asymptomatic and asymptomatic people can still spread the coronavirus to others.

Masks do a decent job at keeping the virus from spreading into the environment, but if an infected person is inside a building, inevitably some virus will escape into the air. 

Once the virus escapes into the air inside a building, you have two options: bring in fresh air from outside or remove the virus from the air inside the building.

 

All of the air in a room should be replaced with fresh, outside air at least six times per hour if there are a few people inside.

 

It’s all about fresh, outside air

 

The safest indoor space is one that constantly has lots of outside air replacing the stale air inside. 

In commercial buildings, outside air is usually pumped in through heating, ventilating, and air-conditioning (HVAC) systems. In homes, outside air gets in through open windows and doors, in addition to seeping in through various nooks and crannies.

 

Simply put, more fresh outside air inside a building. Bringing in this air dilutes any contaminant in a building, whether a virus or a something else, and reduces the exposure of anyone inside. Environmental engineers quantify how much outside air is getting into a building using a measure called the air exchange rate. This number quantifies the number of times the air inside a building gets replaced with air from outside in an hour.

While the exact rate depends on the number of people and size of the room, most experts consider roughly six air changes an hour to be good for a 10-foot-by-10-foot room with three to four people in it. In a pandemic this should be higher, with one study from 2016 suggesting that an exchange rate of nine times per hour reduced the spread of SARS, MERS and H1N1 in a Hong Kong hospital. 

Many buildings in the U.S., especially schools, do not meet recommended ventilation rates. Thankfully, it can be easy to get more outside air into a building. Keeping windows and doors open is a good start. Putting a box fan in a window blowing out can greatly increase air exchange too. In buildings that do not have operable windows, you can change the mechanical ventilation system to increase how much air it is pumping. But in any room, the more people inside, the faster the air should be replaced. 

 

Air cleaners

If you are in a room that cannot get enough outside air for dilution, consider an air cleaner, also commonly called air purifiers. These machines remove particles from the air, usually using a filter made of tightly woven fibers. They can capture particles containing bacteria and viruses and can help reduce disease transmission.

The U.S. Environmental Protection Agency says that air cleaners can do this for the coronavirus, but not all air cleaners are equal. Before you go out and buy one, there are few things to keep in mind.

The first thing to consider is how effective an air cleaner filter is. Your best option is a cleaner that uses a high-efficiency particulate air (HEPA) filter, as these remove more than 99.97% of all particle sizes.

The second thing to consider is how powerful the cleaner is. The bigger the room – or the more people in it – the more air needs to be cleaned.

The last thing to consider is the validity of the claims made by the company producing the air cleaner.

The Association of Home Appliance Manufacturers certifies air cleaners, so the AHAM Verified seal is a good place to start. Additionally, the California Air Resources Board has a list of air cleaners that are certified as safe and effective, though not all of them use HEPA filters.

 

Keep air fresh or get outside

Both the World Health Organization and the U.S Center for the Disease Control and Prevention say that poor ventilation increases the risk of transmitting the coronavirus. 

If you are in control of your indoor environment, make sure you are getting enough fresh air from outside circulating into the building. A CO2 monitor can help give you a clue if there is enough ventilation, and if CO2 levels start going up, open some windows and take a break outside. If you cannot get enough fresh air into a room, an air cleaner might be a good idea. If you do get an air cleaner, be aware that they do not remove CO2, so even though the air might be safer, CO2 levels could still be high in the room. 

If you walk into a building and it feels hot, stuffy, and crowded, chances are that there is not enough ventilation. Turn around and leave. 

By paying attention to air circulation and filtration, improving them where you can and staying away from places where you cannot, you can add another powerful tool to your anti-coronavirus toolkit.

 

Thursday, October 8, 2020

HOW TO CARE FOR YOUR MOUTH.

Nobody thinks of oral hygiene as luxe self-care. Brushing and flossing feels more like a chore, a habit you have adopted since the days of footsie pajamas. But since the mouth is a portal for taking in all kinds of things, including the coronavirus, oral care is essential right now.

Not only does good dental hygiene keep the bacteria in the mouth to a minimum, it can be, as The Mayo Clinic suggested, a window to your overall health. Oral conditions may impact infection in other parts of the body, especially in people with a compromised immune system.

To keep that microbiome in check and keep you from an emergency dental visit during quarantine do the following.

 

Brush, floss, rinse, repeat.

Preventative measures like brushing and flossing are a must, as it might be a while until your next dental appointment.

An electric or ultrasonic toothbrush is the best option for removing bacteria and keeping teeth and gums healthy. And when it comes to toothpaste, natural is not always better. Make sure your toothpaste contains fluoride to prevent cavities. Charcoal paste might be trending, but you might end up with more holes in your mouth.

Contrary to common belief, over-the-counter mouthwashes do not contain a high enough concentration of alcohol to kill most bacteria and viruses.

When a mouthwash bottle claims, ‘kills 99.99% of bacteria,’ it is referring to the bacteria found around the gumline called tartar and plaque. Instead, we recommend gargling with a hydrogen peroxide solution if you are getting over a cold or flu. Use a 3% concentration of hydrogen peroxide (the ones most found in homes are 3%). Anything stronger is likely to cause irritation. Mix two parts water with one-part hydrogen peroxide. Limit this practice to a few times a week and only during times of minor irritation or recovering from strep, cold or flu. Overuse can damage the normal flora and bio ecosystem of the mouth and allow the opportunity for fungal infections to appear.

 

Clean and replace your toothbrush often.

The bristles of your toothbrush can be a breeding ground for bacteria.

Fungi, like candida, can live on a toothbrush. Because people are on high alert right now, a good tip is to rinse your brush with hydrogen peroxide every day to keep the bristles clean.

If you are using an electric toothbrush, your best bet is to store it in the charger, with the head cover on for added protection. And you will want to keep your toothbrush in a clean area to dry, preferably away from your toilet, which can spray fecal matter when it’s flushed.

A good toothbrush has flexible bristles, and they should have rounded ends. Toothbrushes should be replaced when the bristles become bent or frayed. Do not go longer than three months without changing the head or replacing your handheld brush.

 

Stop sharing oral hygiene products.

If you are sharing oral hygiene products with anyone in your family, stop immediately. Periodontal disease, a common septic condition caused by poor hygiene and candidiasis, an oral yeast infection also called thrush, can be spread easily via toothbrush. So, can viruses such as streptococcus mutans, which can cause MRSA infections as well as Herpes simplex and HPV, a virus linked to esophageal, oral, and cervical cancers. Plus, bleeding gums can spread a bloodborne illness.

To minimize the transference of germs, keep your own roll of floss and even your own tube of toothpaste. Because we are during a viral outbreak, to avoid cross contamination, anything you handle with your hands prior to putting in your mouth should not be shared.

Keep your aligners, mouth guards, or retainers bacteria free.

Clear aligners, mouth guards and retainers can collect bacteria and viruses. To clean them, rinse them with cold or room temperature water (never hot! as the plastic may melt or deform). Then use mild antibacterial soap. Another option is to soak aligners in one tablespoon of white vinegar and cold water for 15 minutes. Do not soak longer than 15 minutes, as this may damage your aligners, and dry them well before storing them in the holding case.

Limit sweets and avoid biting into hard foods.

Sweets are acidic, which can, make your mouth more prone to cavities. This does not mean you have to swear off sugar during quarantine, but you should limit sugary foods to one time per day and brush your teeth within one hour of consumption. Also avoid hard bread, popcorn, hard candy, and anything that can crack the tooth, causing an emergency visit. And do not use your teeth as tools right now.

Do not pick chapped lips.

It might be tempting to pick at dry, chapped lips, but this, may irritate and infect oral areas. Stay hydrated, consider using a humidifier and moisturize lips with a gentle product. Resist licking, as this exacerbates dry skin.

Try tongue scraping.

You might find it satisfying to scrape away colonies of bacteria that live on your tongue. A 2004 study indicated that tongue scraping is more effective than tongue brushing for a squeaky-clean mouth.

Debris, bacteria, and dead cells can build up on your tongue over time, can lead to bad breath and have a negative impact on your overall oral health. Using a tongue scraper can help remove this buildup and help with overall hygiene. So, go ahead and balance the body’s microbiome, boost immunity, and have a little fun with this final step in your oral hygiene routine.

 

Wednesday, August 26, 2020

WHAT TO KNOW ABOUT MORNING BREATH

Morning breath is the term that people commonly use to describe breath that smells bad when a person wakes up. It is a very common problem.

The Academy of General Dentistry have estimated that 80 million people in the United States experience chronic bad breath. However, there are many straightforward ways to treat morning breath.

What is morning breath?

Good oral hygiene can help prevent morning breath.

Morning breath is a type of bad breath that affects people when they wake up. The medical term for bad breath is halitosis, which describes chronic bad breath that does not go away.

Causes of morning breath

According to the American Dental Association (ADA), morning breath occurs due to a buildup of bacteria in the mouth overnight.

Food particles

During the night, the enzymes in saliva will break down food particles remaining in between teeth, on the tongue, or around the gumline. This breakdown releases volatile sulfur compounds (VSCs), which give off a bad smell.

The specific foods that a person eats can also influence how their breath smells. The list of foods that can cause bad breath is very long and includes:

*       garlic

*       onions

*       coffee

*       spices

Smoking

Smoking can also cause bad breath. A person may not be aware of the effect that smoking can have on their breath odor because smoking dampens the sense of smell.

Dry mouth

A person may experience morning breath if they have a dry mouth. Saliva helps the mouth clear out bacteria that build up over the day and night. If the mouth is not producing enough saliva, bacteria will be able to build up more often. As a result, the release of VSCs overnight may be higher, potentially causing morning breath.

One study that investigated the effect of water on morning breath found that drinking water or rinsing the mouth with water in the morning reduced VSCs by 30–50%, leading to an overall improvement in morning breath.

Breathing through the mouth can also dry it out. People who sleep with their mouth open or snore heavily may have a drier mouth and be more likely to have bad breath in the morning.

Poor oral hygiene

Poor oral hygiene is a common cause of morning breath. Proper brushing and flossing remove bacteria and food particles that cause bad breath.

If a person does not regularly and effectively clean their teeth, they could also develop tooth cavities and gum disease. Gingivitis and periodontitis are types of gum disease that can cause bad breath.

Tooth cavities resulting from bacteria that produce plaque can trap more bacteria in the mouth, as can the deep pockets that gum disease causes. A person can then find it hard to clean the bacteria away when they brush their teeth.

Underlying medical conditions that cause morning breath

The cause of morning breath can be as simple as poor dental hygiene, especially if it leads to complications. Tooth decay or a “dead tooth” can cause bad breath that may be even worse in the morning.

However, certain underlying chronic conditions that are not directly related to the mouth can sometimes be responsible for an unpleasant breath odor.

For instance, untreated diabetes can be a cause of bad breath. Some infections — such as tonsillitis, sinusitis, and bronchitis — and fungal infections of the mouth, lips, and tongue can also have an adverse effect on the breath.

In some cases, liver or kidney disease may result in bad breath.

A person will experience other symptoms alongside bad breath if an underlying condition is the cause.

Treatment and remedies

People can often improve their morning breath by doing the following:

Keeping the mouth clean

A person can treat morning breath or longer lasting halitosis by improving their dental hygiene.

Brushing the teeth twice a day and cleaning in between them with dental floss or interdental brushes can keep mouth bacteria under control. A person can also use mouthwash to help clear bacteria out of the mouth.

One study on the effectiveness of mouthwash against morning breath found that the daily use of mouthwash significantly reduced the number of bacteria in the saliva. Flossing and mouthwash can also ensure that no food remains in the mouth overnight.

A person can also use a tongue scraper as part of their brushing routine to remove bacteria from the tongue. Tongue scraping is a gentle technique, but some people may find it uncomfortable because it can trigger the gag reflex.

Anyone who wears removable dentures should take them out at night and clean them thoroughly before wearing them again the next day.

It is also important to make regular visits to the dentist to help maintain oral hygiene.

Drinking more water

A person may find that increasing their water intake and reducing how much caffeine and alcohol they consume leads to an improvement in their breath odor.

Staying well-hydrated by drinking water can increase the amount of saliva that the mouth produces, which will help keep mouth bacteria under control.

Caffeine, alcohol, and smoking can dry out the mouth. Certain types of medication can also have this effect.

When to see a dentist

Usually, there is no need to worry about waking up with morning breath.

However, if a person finds that their morning breath is not going away with conventional treatments, such as improving dental hygiene and keeping their mouth from becoming dry, they may need to seek advice from a dentist.

A person should see a dentist if:

*       they have a constant bad taste or smell in their mouth

*       they are experiencing other new symptoms along with bad breath

*       they spit blood when they brush their teeth

Blood in the saliva after brushing the teeth can be a sign of gum disease and requires medical treatment. If the dentist finds that the odor is not due to oral factors, they may advise the person to consult a doctor.

A person may experience poor mental health and self-esteem if they are aware that they have morning breath or halitosis. They may feel constantly stressed about having bad breath, which might adversely affect their social life and relationships.

If a person is very worried about morning breath or halitosis, a psychiatrist may be able to help them overcome their anxiety around this issue.

Summary

Morning breath is very common among the general population, and it does not usually last long into the day.

A person can improve their breath odor by brushing the teeth thoroughly, using mouthwash and dental floss, and staying hydrated to stop their mouth from becoming dry.

A person should seek medical advice if their bad breath does not go away or if they are experiencing symptoms of an underlying condition that may also be causing bad breath.

*        

Monday, March 9, 2020

What Vaping, Smoking Do to Your Mouth’s Microbiome — and How That Affects Your Health


  • Researchers say they’ve discovered that vaping and smoking cause changes in the mouth’s microbiome.
  • Those changes can lead to an increased risk of infection, inflammation, and gum disease.
  • It’s the latest research that links oral health to the overall health of the body.
Vaping e-cigarettes could induce changes to the composition of the mouth’s microbiome, leading to increased risks of inflammation, gum disease, and infection.
That’s the conclusion of a study published today from the New York University College of Dentistry.
Researchers looked at a group of more than 100 cigarette smokers, e-cigarette users, and nonsmokers.
They found that smokers and e-cigarette users had significantly higher rates of gum disease and infection — 73 percent and 43 percent, respectively —than nonsmokers, who had a 28 percent rate of disease.
The researchers then used saliva samples from study participants to investigate what was driving these rates of disease and infection.
They found that smoking and e-cigarette use led to bacterial changes in the mouth, including increased levels of two different types of bacteria in e-cigarette users known to cause periodontal disease.
Just like in the gut, the composition of the microbiome in your mouth affects your propensity for infection and other diseases.
In general, healthier bacteria leads to healthier outcomes.
The bacterial changes among vapers indicate that there will be a favorable environment for opportunistic pathogens to grow more in the mouth much faster, as compared to the good bacteria [normally there] and change the whole microenvironment, which may be which may further lead to other complications.
 The pathogens that are known to be the most aggressive are all anaerobic, which means they thrive in an oral environment without the presence of oxygen. The dry oral environment and presence of nicotine, which reduces blood supply and oxygen levels, help create an environment that allows these bacteria to proliferate at an increased rate.
The mouth’s health is a leading indicator of other health complications.
Essentially, vaping creates and promotes an environment that allows the impact of these bacteria to be exacerbated and further promote complications associated with poor periodontal health such as increased risk for cardiovascular disease, Alzheimer’s, dementia, stroke, heart attacks, respiratory infections that can lead to pneumonia, osteopenia, rheumatoid arthritis, uncontrolled diabetes, and even preterm or low birth weight babies as well as exposing the fetus to infections.
The reality, is that the microbiome changes might not just be happening in the mouth — it’s simply harder to test the microbiome of the lungs, for instance — but equally possible these changes are happening elsewhere.
This may be happening down the respiratory tract or the GI tract, which we don’t know because there is no data available. Anybody who is planning to start using e-cigarettes, use with the caution that this can happen in the mouth. This can happen in the lungs. This can happen in the skin or nostrils or other places also.
According to the new study, traditional cigarette smokers still had significantly higher levels of infection and inflammation than vapers, but nothing beats stopping smoking altogether for oral health.
While some people vape as a way to smoke less frequently or smoke “healthier,” that assumption of lower health risks has been thrown into contention as more studies into the health effects of vaping surface.
Recent research shows negative health consequences of vaping may include cell dysfunction, damage to DNA, and compromised cardiovascular health.
In addition, most of those studies pre-date the appearance of a mysterious vaping-related respiratory illness that emerged last year.
Part of this is simply because e-cigarettes have not been on the market long, so scientists don’t have a full understanding of all their effects, Saxena said.
Research has shown how interconnected the mouth and the rest of the body are.
The oral bacteria that cause gum disease have been found in the clots of both stroke and heart attack victims, showing they enter the bloodstream from diseased gum tissue and cause damage elsewhere in the body.
Because it is so common, the infection and inflammation from untreated gum disease is one of the most studied connections between poor oral and overall health risks.
Experts say if you want to have a healthier oral microbiome and better overall health, there is a simple solution: Stop smoking, whether that’s vaping or cigarettes.
The microbiome is reversible. So, if you stop now and the cells are not in stress and there is a good saliva production, the oral ecology will become normal again.


Thursday, March 5, 2020

What is trismus?


Trismus, or lockjaw, is a painful condition in which the jaws do not open fully. As well as causing pain, trismus can lead to problems with eating, speaking, and oral hygiene.
Trismus occurs when a person is unable to open their mouth more than 35 millimeters (mm). It can occur as a result of trauma to the jaw, oral surgery, infection, cancer, or radiation treatment for cancers of the head and throat.
Most cases of trismus are temporary, typically lasting for less than 2 weeks, but some may be permanent.
In this article, we explore the causes and symptoms of trismus. We also look at the current treatment options for this condition.
Trauma and inflammation are possible causes of trismus.
There are many possible causes of trismus, including the following:
Trauma
Injury or damage to the jaw can lead to trismus. Examples of such trauma include fractured jawbones or tissue damage following dental surgery.
Others include:
  • contusion of the temporomandibular joint (TMJ)
  • hematoma, which is a collection of blood outside of blood vessels
  • injury to the muscles of mastication, which people use when chewing
Inflammation
Some medical conditions that cause inflammation in the mouth may cause trismus. One example is pericoronitis, which is inflammation of the soft tissue around a tooth, potentially leading to an impacted molar.
Others include:
  • arthritis in the jawbones
  • scleroderma, which is an autoimmune disease that affects connective tissue
  • soft tissue fibrosis, which occurs when excess fibrous connective tissue forms
Dental surgery
Oral surgery, including wisdom tooth extraction, may cause inflammation in the mouth, which can lead to trismus.
Hyperextension, which is having to open the mouth wider than its usual range of motion, during surgery may also lead to lockjaw.
Infection
Infections can contribute to trismus in some cases.
Types of infections that may do this include:
  • mumps
  • tetanus
  • tonsillitis
  • peritonsillar abscess
  • other types of abscess
Cancer or cancer treatment
Cancerous tumors in the head or throat can affect the function of the jaw.
Radiation treatment for these tumors can also cause trismus.
According to a small 2016 study consisting of 30 participants with oral cancer, trismus affected 53.3% of them at the time of diagnosis.
This number increased to 86.7% after surgery and 85.7% after radiotherapy.

While anyone can develop trismus, some factors may increase the chance of developing it.
These include:
  • having head or neck cancer
  • undergoing radiation treatment for head or neck cancer
  • recent oral surgery to remove a wisdom tooth
  • recent trauma to the mouth or jaw
  • having certain types of mouth infection
The defining symptom of trismus is the jaw not opening fully or opening to 35 mm or less.
Other symptoms include:
  • jaw pain and cramping
  • difficulty biting, chewing, or brushing the teeth
  • inability to swallow some foods
  • headaches
  • earache
Typically, treating the underlying condition should resolve many cases of trismus.
Generally, the earlier a person seeks treatment, the better the outcome.
Treatment options include:
Medication
It may be necessary to take medication to reduce pain and relax the jaw muscles. Common medications for trismus include muscle relaxers and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
Depending on the severity of the symptoms, a doctor may prescribe oral medications or drugs that require injection into the jaw.
Some forms of NSAIDs are also available over the counter.
Jaw-stretching devices
A doctor or physical therapist may recommend the use of a jaw-stretching device.
In a 2014 study, people who used such a device when performing specific mouth exercises had an average increase in mouth opening of 5.5–7.2 mm.
Dietary changes
Individuals may need to make dietary changes until the condition improves.
For most people, moving to a soft foods diet is helpful because it is possible to eat these foods without opening the mouth too much.
Examples of soft foods include:
  • soup
  • smoothies
  • yogurt
  • mashed potatoes
  • oatmeal
  • beans
  • steamed vegetables
  • stewed fruits
  • cheese
  • fish
  • scrambled eggs
Until trismus resolves, it may be beneficial to avoid foods that are hard, crunchy, or chewy, such as candy bars, uncooked apples, and tough meats.
A doctor will carry out a physical examination and take a person’s medical history to diagnose trismus.
They may ask about recent injuries or dental work and look for signs of cancer or abnormalities in the bones or tissues of the jaw.
A doctor may use one or more of the following tests to help them diagnose or rule out trismus:
  • a measurement of the mouth opening
  • a CT scan
  • an MRI scan
Trismus may cause a variety of complications that can affect a person’s quality of life, including:
Oral hygiene problems
If a person cannot open their mouth fully, this makes maintaining oral hygiene more difficult.
Poor oral hygiene can lead to:
  • bad breath (halitosis)
  • dental caries (cavities)
  • infection
Trismus may also make it challenging for those wearing dentures to insert the dentures or remove them for cleaning.
Difficulty eating
If people cannot bite, chew, or swallow properly, there is a chance of malnutrition and dehydration.
Temporarily moving to a predominantly liquid and soft foods diet may help reduce these risks.
Many of the infectious and traumatic causes of trismus may also have associated complications. For example, an odontogenic infection that causes trismus may lead to further infection with facial cellulitis or mandibular osteomyelitis.
Infection
If an infection is the cause of trismus, there may be associated complications, such as cellulitis.
Cellulitis is skin inflammation that is often due to infection. The symptoms include:
  • edema, or swelling
  • reddening of the skin
  • warmth emanating from the infection site
  • pain
Trismus is a painful condition involving a reduction in the size of the mouth opening between the jaws.
Most cases are temporary, and medications, physical therapy, and other treatments can often effectively alleviate trismus and reduce or prevent complications. Early treatment typically provides the best outcomes.
Individuals who have concerns about trismus or their risk of developing it should speak to their doctor or dentist.