Gar N. Chan, DDS, INC

Yes, absolutely because dental visits will help keep you and your baby safe.

Although your life becomes busy with trips to your obstetrician, baby showers, and decorating the nursery, your regular cleanings and dental exams become even more critical once you are pregnant because your oral health impact your overall health and the health of your baby.

Table of Contents

• Safety Concerns
• What Additional Measures Does the Practice Take to Ensure Safety?
• What Dental Work Should Be Considered During Pregnancy?
• What Anesthetics Are Safe During Pregnancy?
• Are X-rays Safe During Pregnancy?
• How Does Dental Health Impact Pregnancy
• What Oral Health Problems Can Develop During Pregnancy?
  • Gingivitis
  • Stained teeth
  • Dysgeusia
  • Ptyalism
  • Diabetes
  • Food cravings
• When Is the Best Time To Have A Dental Visit While Pregnant?
• Conclusion

Safety Concerns

If you are reading this, you probably already realize the importance of oral care, but is it safe to go to the dentist while pregnant during coronavirus

A study released by the ADA reported that less than 1% of dentists were positive for COVID-19. Although this report surprised many because experts assumed positivity rates would be higher in dental offices, this good news was expected by those in the profession.

Dentists have always practiced impeccable infection controls, even before the pandemic. For years our office staff have worn gloves, masks, and personal protective equipment (PPE), used disposables, sterilized all instruments using multi-parameter indicators, disinfected countertops/surfaces, and employed patient safety glasses.

Although all facilities upped their sanitation practices to comply with COVID mandates, in general even before the pandemic, dental offices practiced optimal infection and safety controls and the low transmission rates reflect this.

Learn more about how our practice handles infection control

What Additional Measures Does the Practice Take to Ensure Safety?

 

Now with the pandemic, dental visits to our office are a little different. Rest assured that the same level of care, skill, compassion, and level of expertise are still present

Dr. Chan and his staff strive to keep patients safe. That is why our office has extra precautions in place to help stop the spread

When you arrive at our office, we ask you to wait in your car to limit the number of patients inside at a time. We request you wear a mask until seated in the dental chair.

All patients must pass a temperature check and respond to a COVID-19 screening before their appointment. Also, we provide hand sanitizer and ask you to wash your hands frequently.

Our staff will be wearing additional personal protection equipment, such as face shields, hair covers. For certain procedures, high volume air filtration and suction HEPA and Ulta units will be utilized to filter out airborne contaminants. You may notice one in the reception room.

Pandemic or not, Dr. Chan wants to make sure you always have a beautiful, healthy smile. Whether you have a specific concern or just want to schedule dental prophylaxis (cleaning), our entire staff will go above and beyond to keep you safe and comfortable at all times.

What Dental Work Should Be Considered During Pregnancy?

During pregnancy dental services can be categorized into three main treatment types:

1. Routine care: Examples include regular check ups and prophylaxis. If you’re getting an x-ray, let your dentist and staff know you are pregnant. They will use a lead apron to protect your developing fetus and your thyroid.
2. Fillings and extractions: There is no risk to these procedures. Local anesthetics are safe in pregnancy.
3. Considerable dental work: It is probably best to do it in the second or third trimester when you aren’t experiencing as much nausea, vomiting or gag reflex.

Dr. Chan will explain and help you to differentiate which cateogory your needs fall into and what will be best for you.

What Anesthetics Are Safe During Pregnancy?

Most local anesthetics are safe for both you and your baby. If there are compromising medical co-factors, ie. high blood pressure, history of allergic reactions, hypertension, anxiety, etc., then Dr. Chan will consider those conditions prior to your appointment and choose the appropriate anesthetic to administer

Mepivicaine HCl 3% with or without vasoconstrictor, is often used for pregnant patients because it is short-acting.

Whenever a pregnant patient presents with the need for dental treatment including providing local anesthesia, Dr. Chan always assesses the individual’s current physiological and psychological status prior to proceeding.

Are X-rays Safe During Pregnancy?

Yes, x-rays are safe during pregnancy, especially since we utilize digital low dose equipment and employ the use of a lead apron to screen out any scatter radiation; however, when we are aware that a patient is expecting, we usually defer taking a full mouth set of radiographs until after delivery.

Instead, we take only one or two single radiographs to further minimize any exposure to the developing fetus.

As has been Dr. Chan’s philosophy throughout his dental career, he is conservative and conscientious in practice.

How Does Dental Health Impact Pregnancy

Preventative check-ups, including exams and prophylaxis are essential during pregnancy, especially if you are struggling to keep up with your oral hygiene regimen at home due to morning sickness and a more sensitive gag reflex.

Infections in the mother, such as tooth decay and gum disease, can pose a risk to your baby’s health. Current research shows an undeniably strong correlation between the existence of gum disease and inducing early labor, premature births, and underweight babies.

What Oral Health Problems Can Develop During Pregnancy?

 

Several oral health issues may develop or worsen throughout your pregnancy. Continuing with and/or increasing your visits and/or dental prophylaxis can alleviate many of these problems and allow you and your dentist and dental hygienist to work together to treat any concerns early.

Gingivitis

During pregnancy hormone levels increase and can lead to an escalation in plaque levels, resulting in your gums becoming inflamed, tender, and bleeding easily. This condition is known as pregnancy gingivitis.

Untreated, this can progress to more severe forms of periodontal disease and can potentially result in permanently losing both supportive bone and gum tissue around teeth, in tooth decay, and eventual tooth loss.

Fortunately, regular brushing, flossing, dental check-ups, and possibly more frequent visits during pregnancy can help you manage this condition.

Stained teeth

During pregnancy, several products are known to cause staining on the new mother’s teeth or the later on the baby’s newly erupted teeth. They include iron supplements, chlorhexidine mouthwash, and tetracycline antibiotics.

• Although Iron supplements help to support your growing baby, these supplements can cause dark spots on your teeth. Instead, drinking the liquid form through a straw or mixing it with water or fruit juice, or taking it in pill form will help keep the supplement staining your teeth.
• Chlorhexidine mouthwash is typically prescribed to treat gum disease but can cause brown stains. Avoid consuming other dark foods and beverages while using this mouthwash
• Tetracycline, a commonly used antibiotic, is absorbed through the placenta to the developing fetus. It can affect developing baby’s teeth and cause permanent dark grey or brown staining when the baby’s teeth erupt later

Dysgeusia

Dysgeusia is a state of impaired taste. Occasionally pregnant women express having a metallic taste in their mouths

The condition is temporary and is linked to changing hormones and water retention which affect your taste buds.

You may find it helpful to chew sugarless gum or suck on sugarless sweets to help with any metallic aftertaste you are experiencing. If you like spicy foods, the spiciness often offsets the metallic taste.

Ptyalism

Ptyalism is excessive production of saliva or hypersalivation. This condition is common in women experiencing severe morning sickness.

While the links between pregnancy and ptyalism are still unclear, there are several things you can do to ease any discomfort, including regularly sipping on water, eating a balanced diet, and reducing meal size.

Other ways to alleviate excess saliva include, increasing meal frequency, chewing sugar-free gum, and continuing to follow a dental health regimen.

Diabetes

Research has shown that people with diabetes are more susceptible to gum disease. This is due to higher blood sugar levels in those with diabetes, which feed the plaque-building bacteria.

In other studies those with diabetes have been shown to have a genetic predisposition to gum disease.

Since pregnancy can lead to an increased risk of gingivitis, careful monitoring of your oral health is particularly crucial if you have diabetes and are, or considering becoming, pregnant.

Food cravings

The increasing frequency of eating and drinking due to food cravings may lead to cavities and gum disease unless you continue to brush twice daily and floss every day.

When Is the Best Time To Have A Dental Visit While Pregnant?

The second trisemester is the most optimal time to schedule your dental appointment(s)

Conclusion

Pregnancy is a time for many healthcare visits. While it is tempting to skip the dentist, that is one appointment you should not put off. It is safe and beneficial for you to keep your dental visits while pregnant.

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on June 11, 2021 at 9:43 AM hosted by Stan Bunger. The following information was prepared by Natalia Gurevich. This blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

Ask An Expert

Summer is going by fast, and the state’s reopening next week is sure to rev things up even more.

For those who are still in school or have children still in school, it’s still unclear what the fall semester is going to look like.

Dr. Monica Gandhi, professor of medicine at UCSF and Associate Division Chief of the Division of HIV, Infectious Diseases and Global Medicine at San Francisco General Hospital, offered her take on the dilemma. “Fortunately, children are less likely to be exposed as more and more people get vaccinated,” Dr. Gandhi told KCBS Radio’s “Ask An Expert” on Thursday. “Like a child who is less than 12, they are protected by the low rates of community transmission and everyone else’s immunity around them.”

Dr. Gandhi herself has an 11-year-old, she added, and in the city at least she hasn’t been too worried. “We do a lot of swabbing here in San Francisco, and there were 12 cases a day at the most, with a very low test-positivity rate.”

With returning to school, Dr. Gandhi acknowledged that there is a lot up in the air. With more and more vaccinations happening, numbers get adjusted.

“All the past openings, surges and subsequent closings wouldn’t happen now, she said, with all these high rates of community immunity. “When you open schools in the fall, if our community transmission and hospitalization rates stay low,” she said. “Then the way a child is protected is through that.”

Other countries, such as the United Kingdom, that reopened schools where children aren’t masked at all, there was no increase in cases among children, she added.

Overall, Dr. Gandhi is excited for the next steps the state is taking.

“We are standing in a very wonderful position because we have these vaccines and we’re very lucky,” said Dr. Gandhi. “June 15 is going to be a great day, I think it’s an important day to say that the state is opening.”

But we aren’t out of the woods yet.

“I think we still need some residual clarity around masking, which is confusing at the moment,” she said.

Globally, COVID-19 vaccine distribution is still far behind in low-income countries, she added. Dr. Gandhi hopes to turn her attention there.

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on March 2nd, 2021 at 9:20 AM hosted by Stan Bunger. The following information was prepared by Jessica Yi. This blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

Ask An Expert

The FDA granted an emergency use authorization to the Johnson & Johnson vaccine over the weekend after experts concluded that the vaccine is highly effective. But reports of just how well the vaccine works have varied from 66 percent to 72 percent to 85 percent, causing some confusion.
“They had several different endpoints and they had studies going on in different countries. So think of it as a kind of table,” explained Dr. George Rutherford, Director of the Prevention and Public Health Group at UC San Francisco.

Johnson & Johnson tracked how well its vaccine worked at preventing asymptomatic infection, mild to moderate disease, critical and severe disease and death, as well as the results in the U.S. versus worldwide.

“So that’s why you’re seeing so many different percentages,” he said.

The vaccine was found to be 66 percent effective at preventing moderate to severe cases of COVID-19 across the world, and 72 percent effective in the U.S. When looking at severe cases only, it was 85 percent effective.

Importantly, no one in the clinical trial who received the Johnson & Johnson vaccine has died from the virus.

“I tend to think of this as being between 80 percent to 85 percent effective, and that kind of gives us the benefit of the doubt for looking just at the U.S. data,” said Dr. Rutherford. “Because they recruited a lot of patients in South Africa where these other variants are.

Dr. Rutherford added that people should not worry too much about the varying levels of efficacy reported between the Johnson & Johnson, Pfizer and Moderna vaccines.

“You don’t know it until you put them out there together and really race head to head, and so these vaccines were NOT compared head to head,” he explained.

For example, the Johnson & Johnson vaccine trial was somewhat later in the pandemic after variants started to become more prominent.

He said as the vaccine is distributed widely, more data will be compiled to look at how the vaccines perform under the same conditions.

Many public health experts have said that all three vaccines available in the U.S. will significantly reduce your risk of becoming hospitalized or dying because of COVID-19, and people should take whichever vaccine becomes available to them.

For more information, please contact Gar N. Chan, D.D.S., Inc. at Office of Gar N. Chan, D.D.S., Inc. Phone Number 408-847-1234 today!

For the past several weeks  visitors to our office may have noticed a slight humming noise emanating from a white box sitting on our reception room floor.  This unit is known as the Air Doctor and it helps to remove and filter the following:

• Smoke  (0.1-1 microns)
• Bacteria (.02-0.2 microns)
• Viruses (0.1-1 microns)
• Pollen (10-20 microns)
• Mold (10 microns)
• Dust Mite (50 microns)

AirDoctor’s UltraHEPA™ Filter

is 100 times more effective than ordinary HEPA filters, capturing 100% of some of the most dangerous ultra fine particles as small as .003 microns in size.  

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on January 11th, 2021 at 9:20 AM hosted by Stan Bunger. The following information was prepared by Jessica Yi. This blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

Ask An Expert

While the FDA has approved both Pfizer and Moderna’s COVID-19 vaccines for widespread use, neither were testing in individuals who are immunocompromised, a normal practice in clinical trials for new drugs.

“Efficacy is the big question,” in deciding whether or not immunocompromised patients should still get the vaccine, explained Dr. David Cohn, chief medical officer at the Ohio State University Comprehensive Cancer Center.

Dr. Cohn told KCBS Radio’s “Ask An Expert” the issue is not whether or not the vaccine is safe for these patients, but if their immune system will mount a response to the vaccine in the intended way.

“It’s that level of immune response that’s going to protect somebody from developing this severe infection if they were exposed to the virus,” he said.

“But here’s the important point: we know that patients that have COVID-19 and cancer or who’ve been treated do develop an immune response. That means that these patients will still develop some level of immunity or protection from the virus.

“What Dr. Fauci has stated – and many have followed – is that some level of protection is better than none.

Patients who are taking medications that impact their immune system in some way should consult their doctors about when to schedule their vaccines.

“We want to time a vaccination, if it’s possible, at a place where somebody has the highest possibility of an immune response,” Dr. Cohn explained.

There are always some risks associated with getting a vaccine, particularly for those with a history of severe allergic reactions, and patients who are on other medications should consult their doctor before getting vaccinated.

However, he said the advice in most cases will be to get the shot.

“There’s very few conditions in which we would not recommend that somebody be vaccinated against COVID-19, and I would just make the comment that this is certainly a time of hope where we can begin seeing some light at the end of what’s become a very, very long tunnel.”

Every two years dental professionals are required to be certified in CPR as part of their licensure renewal. This year Dr. Chan requested the American Heart Association’s Basic Life Support (BLS) course be taught on site in our office to all staff members to build consistency, coordination and teamwork. After passing our on-line coursework, Eric Colfer, HeartShare Instructor, observed us as we practiced CPR on AMA approved manikins in both adult and infant sizes with electronic feedback to ensure that we achieved the correct depth and rate of chest compressions for effective CPR.

Saving Lives

What Is CPR?
CPR is short for cardiopulmonary resuscitation. Everyday CPR saves lives and it can be learned by anybody.
In cases of drowning, choking, heart attack and other instances where a person’s blood supply to the brain is interrupted because of the inability to breathe or when the heart stops pumping every second counts and CPR can afford a person those seconds to keep permanent brain damage from setting in.

Why Would You Need To USE CPR In A Dental Setting??
Those who work in dental offices will rarely (if ever) have to deal with life-threatening emergencies. But sometimes, at-risk patients such as the elderly and those medically compromised will undergo procedures that will aggravate pre-existing conditions, or will have adverse reactions to anesthesia. Among the possible emergencies that a dental staff may encounter, sudden cardiac arrest (SCA) is the among the most likely to result in the death of a patient.

Treating sudden cardiac arrest will require a coordinated effort on the part of staff in order to effectively activate the “Chain of Survival” required to afford the victim the best chance of recovery. For the first responder, this will include rapid activation of EMS personnel, rapid defibrillation, and early application of effective CPR. These steps must be initiated as quickly as possible, and thus requires premium, frequent training for the entire office staff. This means keeping everyone up-to-date on their CPR certifications, and training the staff as a cohesive unit, rather than everyone learning separately.

What Is An AED?
AED stands for Automatic External Defibrillator, an electronic device used for monitoring abnormal heart rhythms or arrhythmias. It helps in checking heart activity and it can also be used as “defibrillator”.to help restore a normal heart rhythm.

Our office has an AED unit. Our wonderful staff keeps it charged in the event it is needed. Fortunately, throughout the years, we have never had to employ it.

We did it!

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on January 21st, 2021 at 9:20 AM hosted by Stan Bunger. The following information was prepared by Jessica Yi. This blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

Ask An Expert

It has been over a month since COVID-19 vaccines became available, and more than 15 million Americans have now received at least their first dose.

With vaccination rates slowly but steadily rising, is it safe for people who have been vaccinated to gather with one another?

“This is a very complicated topic just because there is so much uncertainty around it,” said Dr. Angela Rasmussen, a virologist at the Georgetown Center for Global Health Science and Security on KCBS Radio’s “Ask An Expert” program.

While clinical trials have shown that both Pfizer and Moderna’s COVID-19 vaccines are about 95 percent effective at preventing symptomatic cases, the trials did not regularly test all of their participants, so it is not proven that the vaccine protects you from getting infected at all.

“We think that probably transmission will be reduced in vaccinated individuals, but we don’t know for sure,” said Dr. Rasmussen. That also means that there is no data to show that the vaccine can stop people from infecting others.

“My suspicion is that that potential for transmission will be greatly reduced, and that’s based on some limited data we have from clinical trials as well as data that has been obtained from pre-clinical trials in non-human primates, or monkeys.”

This is why people who receive vaccines are still supposed to follow the same safety precautions as the general public, including wearing masks in public and avoiding gatherings.

Additionally, the vaccine does not reach its full efficacy until sometime after the second dose and is not 100 percent effective.

But Dr. Rasmussen said because the vaccine greatly reduces risk, it may be relatively safe for vaccinated people to gather in small groups if everyone has received both doses and there is no contact with unvaccinated people.

“If everybody’s vaccinated, we do know that these vaccines are highly efficacious at reducing disease,” she said. “You can probably start dipping your toes into the pool of resuming normal social interactions again, as long as everybody’s vaccinated and you’re in a sequestered environment…if you haven’t seen your parents in months and you’re all vaccinated and it’s been two weeks since your second shot, it’s probably okay to get together.”

“What I think would be bad advice at this time would be to suggest that vaccinated people can get together with a group of their vaccinated friends and go bar hopping or go out into the public space not wearing a mask.”

Dr. Rasmussen added people who have been vaccinated should still follow normal safety precautions anytime they could come into contact with someone who is not vaccinated.