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IMPORTANT HEALTH AND SAFETY NOTICE REGARDING COVID-19

J. Peter St. Clair, DMD Blog

HOW HAVE YOU BEEN SLEEPING?

May 26, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 4:28 pm

Dental hygiene appointments will be allowed to start at the beginning of Phase 2 Monday, June 8th. Dentists have been allowed to see “emergent and likely to become emergent” patients since last week. Many of us have struggled to understand what that means exactly, but I think we are getting closer to “the new normal”.

Many people I have talked to have noticed a change in their sleep patterns in the past couple of months. Staying up later and getting up later has been the trend. Your body needs sleep and really needs consistent quality sleep. If you are going to bed later and getting up at the same time, meaning your total sleep time is less, has this impacted the way you feel the next day?

There are many reasons for poor quality sleep. Everything from a poor mattress, poor pillow, sleep position, medical issues, diet, alcohol consumption, work schedule, or a noisy bed partner can have an impact on the quality of sleep that we get. Although some people can notice subtle changes in sleep quality, many others do not realize that some of the issues they have routinely can be caused by poor sleep quality.

Sleep plays a vital role in good health and well-being throughout our lives. The way you feel while you’re awake depends in part on what happens while you’re sleeping.

Sleep helps your brain work properly. Studies show that a good night’s sleep improves learning. Studies also show that sleep deficiency may cause you to have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change.

Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, stroke, sexual dysfunction, ADHD, obesity and depression.

Sleep issues can affect the young, the old, and everyone in between. The many changes that take place in our bodies as we age can increase the risk of sleep disorders.

Sleep apnea is one of many sleep disorders. It is a serious, potentially life-threatening sleep disorder that affects at least 18 million Americans. It comes from the Greek meaning of apnea which means “want of breath”. People with sleep apnea have episodes in which they stop breathing for 10 seconds or more during sleep.

People with sleep apnea usually do not remember waking up during the night. Some of the potential problems may include morning headaches, excessive daytime sleepiness, irritability and impaired mental or emotional functioning, excessive snoring, choking/gasping during sleep, insomnia, or awakening with a dry mouth or throat.

Have you been told that you snore? Do you often feel tired, fatigued, or sleepy during the daytime? Has anyone ever witnessed you stop breathing while you are asleep, or have you ever awoken with a gasp? Do you have high blood pressure, or are you on medication to control high blood pressure? Is your body mass index greater than 28? Are you a male with a neck circumference greater than 17 inches or a female greater 16 inches? (Note: anyone of any size can have sleep apnea)

If you answered yes to more than two of these questions, or if there is anything else in this column that makes you believe you may not be getting the quality of sleep you would like, maybe your new normal should be better sleep. A good first step would be to talk with your physician or sleep-minded dentist.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

WHERE’S THE LIGHT IN THE TUNNEL?

May 19, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 12:35 pm

As I write this, New Hampshire dental offices have opened their doors for routine dental care, while Massachusetts still struggles to be any more than vague on our plan for re-opening; good thing the virus doesn’t cross state lines. We must still be vigilant in protecting the most vulnerable at this time, but we also need to be mindful that the economy is suffering every hour we are shut down. Hopefully there is a well laid out plan in place to get this State going by the time you read this.


You know that feeling you get when you’ve missed one of your regular workouts, or are used to getting your hair cut or styled every 6 weeks? It’s a great feeling when you knock it off your list; both mentally and physically. I’ve heard from many of my patients who are overdue for their dental hygiene appointments by one, two, or three months, and can’t wait to get in to the office. Do you get that feeling about your dental health?

If you don’t, why not? Everyone has their reasons for not doing things that are good for them, and/or they know that they SHOULD do. I would bet that if you are not a regular dental goer, your reason falls into one of these 5 categories:


Money – Although you may think that money would be the number one reason people avoid ideal dental treatment, it is not. I’m talking about “normal” times, not pandemic times.

Each of us gets to choose what we do with the money we have. Many people will use lack of insurance as an excuse for not visiting the dentist. What that really means is that you just choose to spend the money you have on something other than your dental health. Dental insurance is not insurance; never has been. More on that another time.

If a dental office doesn’t offer payment plans through third party carriers, or offer in-house payment options for basic dental care, find another office. A good dental office, and we have many in this area, are very willing to work with you so that you can get the care you want.


Time – Time is just another excuse. We all use time as an excuse for many of the things in our lives we want to avoid. I use lack of time as an excuse constantly for not exercising. The reality is, however, if we place something high enough in our value system, there is always time for it. Moving something higher up in your value system has to come from your desire to want it enough to make the time for it. This is the most common reason people don’t get the care they need.

Lack of concern – It is easy to ignore things for many reasons. Absence of pain is one. Most people with dental pain go to the dentist. Gum disease and cavities, however, don’t hurt, until it’s a BIG problem. That’s why gum disease and other “silent” dental problems are such a problem for so many patients as years progress. Most problems are avoidable.

Fear – Some people have fear of going to the dentist….and for good reason, due to bad past experiences or bad information. However, dentistry today should be a comfortable experience most of the time. For those who are still fearful, some dental offices provide treatment under sedation.

Trust – The last barrier to ideal treatment, and the least common for why people don’t get ideal dental care, is trust. A strong doctor-patient relationship is essential. If there is a lack of trust, that’s an easy one to fix; it’s time to move on.

If it’s been awhile, please consider making your dental health a priority after we get through this very difficult time. It may become a habit you just can’t break.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

THE SAFER DENTAL OFFICE

May 12, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:10 pm

Unless things have changed, we will start to see signs of routine life this coming Monday, May 18th. Among other retail stores and services, dental offices will be allowed to see patients for routine care under guidelines from the Centers for Disease Control (CDC) Occupational Safety and Health Administration (OSHA)l and Prevention, the American Dental Association (ADA), and the Massachusetts Dental Society.

Many dentists, like myself, will be having a “soft opening” for at least the first couple of weeks, as this virus becomes less prevalent, patients get more relaxed with entering the dental setting, dental offices wait for supplies for personal protection equipment (PPE) to ease, and we get used to the short and long-term changes we are faced with in running a dental business.

The dental environment may never be the safest place on earth for dental providers, but it is going to be safer than it ever has been before for patients. Some of the basic things we will all be doing is to communicate with our patients before their appointments to ask some screening questions. You’ll then be asked the same questions when you enter the office. These simple questions are the first key to creating a safe environment for everyone.

Until further notice, you will be asked to don a face covering before entering the office, and leave it on except during treatment….obviously. You will be asked to use provided hand sanitizer when you enter the office as well. Dental offices will have hand sanitizer available throughout the office. You may also have your temperature recorded with a non-touch infrared thermometer.

You won’t see any magazines, children’s toys or books in the reception area. If your dental office has a large reception area, the seats will be spaced out at least 6 feet. Offices with smaller reception areas may have you call when you have arrived at the office, and then either call or text you when they can bring you right into the treatment room. Many offices will also be spacing appointments out further to help with time needed to clean and disinfect.

I would imagine that these basic steps, along with the added PPE, will continue until at least the summer. We may see them come back as recommendations are issued prior to the new flu season. It may even become a seasonal thing.

Many dental offices will be taking steps beyond the recent recommendations to increase Universal Precautions for the long-haul. Although all dental offices have been treating the water lines in dental chairs for years to keep water safe for patients, this pandemic has made many of us more conscious about making the air quality in the office better.

I can tell you this; your dentist, dental hygienist, dental assistant, and other dental support staff are going to be so happy to see you. We have been spending a lot of time gathering information, training, and getting excited about bringing you dental care in a safer environment than ever before.

Moving Forward!

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

THE COVID-19 CHRONICLES

May 4, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 2:56 pm

There are states in this country where dental offices are returning to providing routine dental care. That is not the case here in Massachusetts. At the time of this writing (Wednesday April 29th), the State of Massachusetts has extended its stay-at-home advisory through May 18, 2020. Dental offices will continue to remain closed for non-emergent care at least until then.

In Stewart Lytle’s column last week entitled “Businesses hanging in”, he mentioned that I had a list of 27 things that I wanted to change in my office. It is going to be very important for any business that has been closed for 2 months to have a plan in place for re-opening. My list of 27 things has changed many times over the past weeks, and it will be refined in the weeks to come.

Stewart mentioned that I was “getting rid of plants and stuff on the counters that may catch viruses”. As I discussed a couple of weeks ago, the dental operatory produces aerosols from motorized handpieces. Plants in the dental operatory cannot be wiped down following a procedure. While I’m not concerned with the plants “catching a virus”, they will likely find a new home within the office. After a procedure, the room should be able to be cleaned thoroughly. Keeping counters free of anything not needed for a specific procedure is common sense practice.

Dental offices are required to take a course in infection control every two years. Many offices also use a paid consultant to help structure and implement an infection control protocol in the office. Universal Precautions is how dentists and staff have been trained in infection control since the 1980’s. This means to treat every person as if they are infectious.

So, what is going to change in the dental office because of this pandemic? There will be some changes that are short-term and other long-term changes. An example of a short-term change might be spreading patient visits out more. Another one might be to have patients wait in their car and to text them to come in when the office is ready to bring them directly to the treatment room.

Some of my dental colleagues have already decided to make expensive purchases in response to this pandemic. Stewart mentioned in his column that I was considering negative pressure rooms to change the air in the room on a continual basis. This is an expensive proposition and there is no indication that dentists will be required to take action to that level. However, cleaning the air does seem like something that we may hear about more of as time goes on.

Some dental offices will change very little and some will change many things. While we all must do what we are recommended to do by organizations such as the CDC, ADA and Mass Dental Society, what level it is taken to will vary between offices.

If you have concerns about returning to your dental office for routine care, my suggestion would be to have a direct conversation with your dentist and/or dental hygienist. They will be able to give you information about the specific steps they are taking and can address your individual concerns.

I’m looking forward to writing a column on something other than COVID-19.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

SUPPORT YOUR LOCAL BUSINESSES

April 27, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 2:13 pm

There’s a lot more to consider with regards to the steps needed to provide a safe environment when we return to our routine medical and dental appointments following this global pandemic. Unfortunately, it seems there is plenty of time left to discuss these. We are all waiting for more guidelines from the CDC and other professional organizations on any necessary changes that need to occur before and upon opening to patient care.

Many of us have not been affected directly by the virus, other than watching the numbers, following reports, and grieving for those who have been plagued by its wrath. Most of us however, have been affected indirectly in some way or other.

The effects this tiny virus has had is mindboggling. Small businesses have been hit hard. Many businesses are not sure whether they will ever be able to re-open. Others are struggling to get by with government payroll protection loans. Will this money last long enough to keep the businesses afloat? There are many unanswered questions.

While we are all ready to get back to ‘normal’, we are also aware that this will be some new kind of normal. Is it a temporary new normal or a permanent new normal? We just want to know now!…. so we can get on with our lives. Many of us are going stir-crazy…..if you can’t tell!

Will our restaurants be a half or a third full to comply with new guidelines? How long will that last? Would any small business be able to operate on a half to a third of the income?

Will the barber shop have a virtual waiting room in the parking lot where people are called on their cell phone to come in after the chair has been disinfected? And is your barber now gowned in PPE , looking like he’s on the next rocket to the moon? You can barely understand him trying to have his ‘usual’ conversation through his N95 mask. He can’t understand you either through your mask. He gives you a buzz cut. I hope it doesn’t come to that, or at least to that degree.

We must continue to follow the guidelines we are given. At the time of this writing, our state is peaking in cases, which hopefully means the downslope is right around the corner. We are all sick and tired of this, but we must continue to be patient and be vigilant about protecting ourselves and others.

In this spare time that many of us have, may I suggest doing some Google research on the many services that each of us use and find indispensable? Have you ever Googled your car mechanic, restaurant or barber shop to see what kind of content they have on their website?

Does your local pharmacist, hair stylist or local brewery have a Facebook page that you could connect with and follow? Have you looked around your dentist’s website and read the biography of your favorite hygienist or dental assistant?

While you’re exploring and learning more about the people and places that you miss, I am sure they would LOVE for you to leave a nice review for them. Reviews are important to these small businesses from a marketing perspective ,and I am sure they all would appreciate kind words during this difficult time.

There are many platforms to leave reviews. One of the more valuable at this time is Google Reviews. If you are a gmail user it is easy to leave a Google Review. Get typing and support your favorite local businesses.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

THE BUBBLE DENTIST

April 21, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 12:26 pm

Last week, the title of this column was a Jon Bon Jovi reference from the 80’s hit Livin’ on a Prayer, hoping that “We’re Halfway There” when it comes to getting back to ‘normal’. As I was thinking of a title this week, the first thing that jumped into my mind was a story I remember about “the boy in the bubble”.

When David Vetter was born in 1971 with severe combined immunodeficiency (SCID), an experiment to keep him alive made him famous. Vetter became known as “The Bubble Boy” after he was placed in a germ-free plastic bubble that he lived in for 12 years.

David was protected during that period of time from all the bad things in the air by this plastic enclosure. The air within the bubble was kept clean so that his severely immunocompromised system could survive. Sadly, David died from an unsuccessful bone marrow transplant. Children born today with this disease have better treatments available in helping them to lead more normal and productive lives.

The dental operatory is a bubble. It is a small, crowded space. Add to that a high-speed turbine in a person’s mouth, creating an aerosol that is spraying all over the room. This is nothing new.

In the 1970’s and 80’s, dentists were not wearing gloves, masks or eye protection, and many were smoking cigarettes during procedures. Since then, the dental office has become a much safer place for both patients and dental personnel. 

Has the coronavirus changed that? Are we doing enough? What more can we do? Can we really create a ‘bubble dentist’? Who and when is someone going to tell dental offices what to do? What are the financial implications? These, and many more questions, are at the forefront of many conversations going on in the dental community.

I listened to a webinar this week presented to a group of dentists by a company called Surgically Clean Air. They have been around for about 10 years, starting in the dental field, but have branched out into other industries including professional sports and retail. 

With their system, they claim to filter and ‘sterilize’ the air within a dental operatory every 5-8 minutes. I thought the presentation was very good and convincing. However, these are units that sit on the floor in the dental operatory and filter the air in the room. The critics would question the effectiveness of protecting the patient, dentist and dental assistant from the immediate aerosol being produced during a procedure. They also come with a very high price tag.

I also did some google research on capture systems for dental aerosols. These types of systems claim to effectively capture airborne contaminants via a 5-foot evacuation hose that is positioned 6-12” from the patient’s mouth during a procedure. The air is cleaned in a 3-stage process including HEPA filtration. These units can also be set up to be exhausted outside to create a negative pressure within the room……closer to being in a bubble.

It will be interesting to see what happens. I will report what I learn along the way. It is a topic that should not and cannot be ignored. And, until we have a vaccine, I think careful consideration needs to be given to allow dentists to provide the 5-minute COVID-19 tests available to keep people safer.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

How Can I Keep My Toothbrush Clean?

April 15, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 4:21 pm
yellow toothbrush with toothpaste on it

Because of the COVID-19 outbreak, people are worried about cleanliness more than ever before. The worry of keeping everything clean enough should also extend to your toothbrush. You might be wondering “how can I keep my toothbrush clean” in the age of the coronavirus. That’s why, in today’s blog post, we have written about how to deep clean your toothbrush to keep it as germ-free as possible.

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WE’RE HALFWAY THERE

April 9, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 2:53 pm

Hopefully you were singing the 1986 hit by Bon Jovi when you read that title. Anything to put a smile on your face these days. The funny, and not-so-funny thing about that title is that I hope we are halfway there. The new “projected” date to resume “normal” business is May 4th. That would put us at about halfway there. Whatever the date is that we go back to work, it still won’t be “normal”.

Think back to just the end of February. If someone told you that within a month schools would be closed, many business would close, not knowing if they could weather the storm, millions of people would be out of work, filing for unemployment for the first time, people would be standing in lines 6 feet apart wearing masks ,waiting to get into the grocery store, airplanes would be flying around almost empty, the stock market would plunge, our government would be whipping together the largest economic stimulus plan in history, and countless other things that have changed the world forever……..you might think they were crazy.

Is this a once-in-a-lifetime chance to make changes in things, to make the world a better and safer place, or is it something that will prove to be a burden on a brighter future? We’ll have to see how that plays out, but I’m banking on choice A.

I think it’s well-accepted that there will be a new normal. I’m not sure what all the changes will be for your routine visits to places like a dental office, but it is something we will all need to be ready for.

For example, the guidelines for treating emergency dental patients right now is very strict. Dental procedures in general would put many people at risk if an infected person was involved in the procedure. Many of these protective measures for both patients and dental personnel will carry over to become the new normal. Those will be discussed in a future column.

Of the many webinars I’ve been watching during this work hiatus, I have one coming up that I’m a little more excited about, versus the ones that explain how to apply for government help and other ways to survive the pandemic. It is being presented by a company called Surgically Clean Air.

The company, founded in 2009, makes air filtration equipment for many different industries, ranging from professional sports teams to Walmart. They claim that their dental units decrease air pollutants in the dental operatory by not only filtering the air but sterilizing it as well. “We diminish everything in the air: bio-aerosols, odors, gasses, disinfectants, particulates, molds, viruses, bacteria and fungus”, their website says.

Could this be a new standard in the dental office? That might be the topic next week.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

Video Update from Dr. St. Clair

April 3, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 5:31 pm

KILLING TIME….AND THE VIRUS

April 2, 2020

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:55 pm

Here we are again, another week into the viral pandemic that just doesn’t seem to want to go away. Our return to normal seems to keep getting pushed out further into the future. We will be able to see each other again one day, just not for another “few” weeks.

Aside from the numerous webinars and Zoom meetings I’ve been watching specific to dental practices and small businesses, two things I have seen this past week that have had the most impact on me have nothing to do with my profession or my business.

A couple people had recommended that I watch a YouTube video that was an hour long. My first reaction was to dismiss it because it was so long, and then I was gently reminded by myself that I have plenty of time on my hands.

The video was a replay of a recorded Zoom meeting with Dr. David Price (a critical care pulmonologist at Weill Cornell Hospital in NYC) and a group of family and friends. He was addressing them and answering questions about being on the “front line” in New York.

A couple of times he got emotional and said it was not because he was scared, but because he had learned enough about the virus that he is now not scared. His presentation to his family and friends was a breath of fresh air that we will get past this. He did offer a few key suggestions to avoid getting the virus. These are probably things you have heard numerous times, but I don’t think anyone will argue that this stuff cannot be said enough.

  1. Always know where your hands are. Don’t touch your face!
  2. Clean your hands frequently.
  3. Distance yourself from others.
  4. Shrink your social circle.

Dr. Price said that this virus is spread and contracted 99% of the time by touching your hands to your eyes, nose or mouth. He said that it may be possible to get it from the air with sustained close contact of an infected person, but that these cases are few and far between.

He said that wearing a mask is most helpful to just remind yourself to keep your hands away from your face. You don’t have to be scared of your neighbor. You can’t get the virus by looking at someone.

On a completely different level, I’ve been watching some television that I would not “normally” be watching.  Since there are no Bruins, Red Sox or March Madness, I’ve sat in on some TV surfing with my family.
Yesterday I watched an episode of “Too Cute” on Animal Planet. This is a narrated show about puppies and their trials and tribulations growing up. Is it a complete time waster and ridiculous? Yes. Would I watch it again? I’m not going to say no. It put a smile on my face and made me feel good.

Wash those hands, keep them away from your face, distance yourself from others in public, shrink your social circle……..and find something simple to put a smile on your face.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

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