O Higienista Oral

Novo endereço

2016-08-28T10:42:00.003+02:00

Caros leitores,

E verdade o blog tem vindo a crescer cada vez mais e isso traz mudanças...
Agora temos o nosso próprio domínio e mudamos tudo...

Visitem-nos em http://ohigienistaoral.com...

Passar Fio ou não passar?

2016-08-22T19:01:00.001+02:00

Devemos passar fio dentário?
Grande parte da comunidade Dentária comentou sobre o recente relatório da Associated Press questionando a eficácia do uso do fio dentário. Ao menos este estudo trouxe o tema do fio dentário às discussões do dia-a-dia sendo uma grande oportunidade para ter uma c
onversa com os seus pacientes, amigos e família!

Fio dentário.
Isto é como eu olho para a questão. Há surpreendentemente poucos estudos bem controlados que suportam uso do fio dentário. Podemode perguntar “Mas porquê?” A resposta é fácil. A doença periodontal, na maioria dos casos, é uma doença de progressão lenta que pode levar anos a manifestar-se. Uma vez que ela se manifesta, o dano é irreversível.
Como conseguimols estudar isso?Teriamos de padronizar uma técnica de escovação, controlar tantas variáveis quanto possível, coisas como tabagismo, dieta, hábitos, consumo de álcool, as questões sociais, etc. Depois teríamos metade do grupo a usar fio e a outra metade não usar . O estudo iria durar anos ou, pelo menos, até ver uma tendência. Até então, uma certa quantidade de destruição irreversível teria acontecido. Nuncaa poderiamos ter um estudo como esse aprovado e se fosse, não seria ético.
Então, como podemos responder a estes opositores do fio? Bem, há vários pontos que gostaria de fazer:
O controlo de placa bacteriana não é um absoluto. Há “níveis” de controlo de placa e existem “níveis” de susceptibilidade à doença. Não precisamos remover toda a placa, apenas o suficiente para ficar abaixo do limiar da doença. Uso do fio dentário remove a placa interproximal, mas não toda, há concavidades que o fio dentário não vai tocar, mas consegue retirar a maior parte dela. Um ponto a seu favor para se manter saudável.
Uso do fio dentário não é um grande compromisso de tempo e, certamente, não cria uma dificuldade financeira. Então porque não colocamos as cartas no nosso lado da mesa?
É uma boa sensação depois de passar o fio. Eu, por exemplo, não consigo ficar com restos de alimentos presos entre os dentes e eu duvido que as outras pessoas gostam de ver um pouco de alface preso entre os dentes dos outros.
Aposto que muitos dos leitores concordam nestes pontos. Então – Eu, por exemplo, vou continuar a usar o fio dentário até que alguém prove que é realmente prejudicial!

Aspirador/Espelho da ClasenUno - Mirror and Aspirator

2016-08-04T08:56:00.000+02:00

Boas,

Como alguns de vocês devem saber, o Congresso Internacional dos Higienistas Orais, ISDH, foi no final de junho em Basileia e muitas foram as novidades que encontrei lá.
Uma delas foi um Aspirador que ao mesmo tempo serve de espelho e que recebeu o Design Award 2016.
E ainda por cima esterilizável a 134°C.
Em teoria é uma excelente ideia e na práctica?
Eu tive o prazer de o testar durante 1 mês inteiro e agora já vos posso dar a minha opinião...

Quando trabalhamos sozinhos torna-se muito práctico, sobretudo quando utilizado com o airflow. A qualidade de imagem é incrível e bastante resistência, (tanto durante o trabalho como durante a esterização).

Contudo, é muito largo e quando trabalhamos em bocas pequenas ou em pacientes que têm dificuldade em abrir a boca, torna-se difícil.

Resumindo, se trabalham sozinhos é uma excelente aquisição, pois vai ajudar bastante, (como disse, sobretudo com o airflow ou com o Ultra-sons de 13-23 por palatino), mas com bocas mais pequenas será complicada a sua utilização.

Deixo-vos um vídeo:

Demora

2016-07-30T00:07:00.000+02:00

Caros leitores,

Peço iiiiiiiiiiimensa desculpa pela demora nos meus últimos posts, mas estes últimos meses foram ricos em mudanças.

Pois é verdade casei-me, mudei de emprego, mudei de casa e não faltaram novos projectos com que me ocupar... Mas agora voltei com novas ideias, novos posts e alguns desses novos projectos. Tentarei dentro do possível fazer no mínimo 2 posts por semana, pois não falta o que escrever e fiquem atentos porque estão preparadas algumas surpresas...

UM ATÉ JÁ

Celso

9 Exercises you can do to help prevent carpal tunnel syndrome

2015-11-08T09:05:00.001+01:00

9 Exercises You Can Do To Help Prevent Carpal Tunnel Syndrome

By Angel Chang
Have you experienced a numb, tingling sensation either through your fingers or in the area between your neck and shoulders? If you have been observing a persistent pain, you should probably learn about carpal tunnel syndrome.
This medical condition could be caused by a variety of factors — including diabetes, pregnancy, hypothyroidism, and obesity — but it’s generally experienced when the median nerve is compressed and pinched.
In an exclusive guide below, we outline some of the best exercises you can try if you’re looking to prevent pain in your hands, wrist, shoulders, and arms. While these exercises should never replace the advice of a medical professional, they’re a good way to keep your joints and muscles limber — like these stretches that could help to prevent bunions.
Compiled from physical therapy experts like Chad Madden, and from organizations like Palo Medical and Healthline, these exercises help stretch the median nerve.
Scroll further to see the steps for each exercise, and let us know what you think in the comments below!

First, let's understand where the pain is coming from...

LittleThings/Maya Borenstein

When you have carpal tunnel syndrome, it means that there is something problematic with your median nerve. This is the nerve that provides feeling for the thumb, the index finger, middle finger, and half of the ring finger.
In your body, the nerve starts traveling from the space between the top of your neck and the collar bone. It moves down your arm, through the front of the elbow, and into the hand.
The “carpal” is the grouping of the eight bones in your wrist, and is located at the base of your palm. The median nerve travels through the carpal, underneath a little sheath.
When this nerve becomes pinched — usually from highly repetitive tasks, like working with vibrating tools, or typing frequently away at the computer — you may start to feel pain in the flesh area beneath the thumb and through the fingers. But you could also feel pressure in your neck, above the shoulders, and through your arm.
Longtime CTS can lead to permanent nerve damage, and atrophy of the muscles, so it’s important to make this condition a priority.
If you are experiencing numbness or tingling in any of these body parts, try out some of the helpful stretch exercises below to stretch the median nerve.

Exercise #1: Spiders Doing Pushups On A Mirror

LittleThings/Maya Borenstein

First, put your hands in a “prayer” position.
Spread your fingers as far apart as you can, and push your palms away from each other, starting with the thumbs and pinkies.
Keep your fingers together. Repeat for a couple of minutes.

Exercise #2: The Full Arm Stretch

LittleThings/Maya Borenstein

Stretch out one arm in front of you. Keep your elbow straight, extend your wrist, and have the fingers face the floor.
Spread your fingers slightly. Use the other hand to apply gentle pressure to the downward facing hand.
Stretch your wrist and fingers as far as possible.
Hold this position for about 20 seconds.
Switch hands and repeat for a couple of times.

Exercise #3: The Chicken Dance Pose

LittleThings/Maya Borenstein

Extend your arms beside the body, and bend the elbows.
Wriggle your wrists into your armpits, and have the palms facing away from the body. Have the fingers point downwards.
Straighten your back and lift your chest. You should feel the stretch in the back of your hands.
Hold for 20 seconds, and repeat. This can be done either standing or seated.

Exercise #4: Single Wrist Pulls

LittleThings/Maya Borenstein

Reach one arm in front of you, keeping the hand parallel to the ground.
Flex the wrist back, with the palm facing forward. Spread your fingers wide, and gently pull on the thumb.
Repeat with all your fingers, and hold each for a few seconds. This can be done either standing or seated.

Exercise #5: The Downward Stretch

LittleThings/Maya Borenstein

Simply bend one wrist downwards, with your fingers pointing to the ground.
Use your other hand to apply pressure to the hand, as if you’re “pushing” on it.
Repeat each tug for 20 seconds, and switch to the other hand.

Exercise #6: The Fist Bend

LittleThings/Maya Borenstein

Extend both of your arms, and straighten both wrists. Relax the fingers.
Make a tight fist with both hands.
Bend both wrists downwards, and hold for five seconds.
Afterward, straighten both wrists and relax the fingers. Hold for five seconds, and repeat the exercise.

Exercise #7: Pushing Away From The Wall

LittleThings/Maya Borenstein

Stretch out one arm, keeping the elbow straight and the palm facing upwards.
Move your head away from your hand, and lean your ear to the opposite shoulder.
Hold for 30 seconds, and repeat three times. You can also try leaning your palm flat against a wall.

Exercise #8: The Puppet Hand

LittleThings/Maya Borenstein

Stretch our one arm in front of you, and make a fist. Hold for five seconds.
Next, flatten our your palm, and hold for five seconds.
Then, make a “C” shape with your hand, and hold for another five seconds.
Turn your palm upward and hold for five seconds.

Exercise #9: The Rib Stretch

LittleThings/Maya Borenstein

Lay a towel on you first rib — the area closer to your neck than to your shoulders.
Grasp the front of the towel with one arm, and the back with the other.
Pull down on the towel, and lean your head to the other side.
Hold for 30 seconds, and repeat with the other side.

Do you suffer from carpal tunnel syndrome? Did you learn any new useful exercises to try out?
Let us know if you’ll be trying these out when you have a spare moment, and please SHARE these tips with family and friends!

Mulher com medo do Dentista utiliza super-cola durante 10 anos para colar os seus dentes

2015-06-25T15:40:00.000+02:00

Angie Barlow, 48 anos, perdeu 90% do osso do maxilar, depois de, durante 10 anos, colar os seus próprios dentes com super-cola.
Esta senhora afirma ter medo do dentista devido a ter sido diagnosticado à sua mãe, durante uma visita ao dentista, cancro da faringe e que levou à sua morte, na altura com apenas 34 anos.
A senhora afirma, que não tinha confiança nela e sentia-se desconfortável com a sua aparência.

"When the tooth comes out, I just put a little bit of glue and try and hold it in place to keep it, so I don’t have a gap in my teeth. I used glue on the top of the tooth, and then I put it back in place until the glue is set. I just feel so self-conscious that I don’t go anywhere really. Even going in the shop, I feel embarrassed. Even in front of my son I’m embarrassed to sit and have a conversation with him.”

Depois de resolvidos os problemas e de ter gasto todas as suas poupanças aqui fica uma foto da sua aparência agora.

Espero que se tenha acabado a super-cola... Nesta área não há espaço para o DIY....

options to replacing missing teeth

2015-06-23T10:04:00.000+02:00

The tongue

2015-06-22T10:02:00.000+02:00

Teeth Grinding

2015-06-21T10:01:00.000+02:00

Baby's teeth health

2015-06-20T09:59:00.000+02:00

GUMS

2015-06-19T09:58:00.000+02:00

'Do-It-Yourself Dental Braces' Ridiculous trend and why it should be avoided | NEWSPH

2015-06-19T09:24:00.001+02:00

Follow the link
'Do-It-Yourself Dental Braces' Ridiculous trend and why it should be avoided | NEWSPH

What every dental patient should know

2015-06-18T09:57:00.000+02:00

Body posture depends on teeth - http://starecta.com/book/

2015-03-22T14:29:00.000+01:00

Body posture depends on teeth

Why teeth are so important for the posture? The skull is the heaviest part of our body and it is supported at the top, on the last cervical vertebra (atlas). To ensure that our head, which weighs on average 4 kg, remains at the top with the least expenditure of energy, Mother Nature has devised a very ingenious “bio-mechanical system of levers”.

The question that we must ask is: “What or who is holding the skull on the last cervical vertebra?”

We will try to give you a picture of the situation.

Until a few decades ago people believed that the skull was simply supported by the neck muscles operated by our willingness to stand upright. Over time and with the birth of gnathology science, clinical trials have shown a functional-anatomic and physiopathological link between skull-mandible (CMD) and skull-cervical dysfunctions, aggregating various areas of the body in a single tonic-postural system: the skull-cervical-mandible joint.

In short, scientific literature, or rather some pioneers in this new sector, has started to understand the role of the mandible in the human postural system, and that consequently neck and back problems are caused by skull-cervical-mandible disorders.

Having established that, we can realize that in this bio-mechanism that keeps sustained our head on top of the first cervical vertebra, the “jaw” has a vital role in supporting the skull.

It is a matter of fact that these medical-science pioneers have managed to understand, more or less, the bio-mechanism and how to act on it with the use of a bite in order to alleviate people health problems, but they have always proceeded by trial and error without ever being able to develop a proper relationship between correct body posture, jaw and teeth.

Despite this important scientific progress, no one has yet managed to truly solve the classic postural problems (scoliosis, lordosis, kyphosis). In fact, these scientists have been trying to test many different roads for years, in order to solve these problems. They have tried the most diverse methods, yet none of these have really focused on the issue. That is why this matter is still more of academic than practical interest. Even some gnathologists assert that there is no proof of any relationship between occlusion and posture due to a lack of convincing scientific evidence.

You can solve a postural problem only if you know “precisely” how the bio-mechanism works and therefore the exact relationship between teeth, occlusion and posture.

The second question to ask is: “How does this postural bio-mechanism work?”

The first thing we do know is that the skull always leans on the first cervical vertebra and that it is supported only by the neck muscles.

The second thing we can notice is that the jaw is suspended between the hyoid bone and the skull and it is equipped with a movable articulation: the TMJ (temporo-mandibular joint), a joint which provides a movement along three planes of space. Considering these peculiarity of the jaw, it is difficult to think that the skull can find support on teeth and lower jaw. And it is even more difficult to understand how a dysfunction in this district can produce such remarkable changes in the whole body.

The answer is in the fact that the lower jaw becomes a stable structure and has a carrier function only at the time of occlusion or during the occlusal contact. More precisely the highest stability is produced during the swallowing phase.

The support given by the jaw to the skull, through the occlusal contact, becomes even more stable during a stronger closure of the jaw thanks to the various muscles involved.

In fact, during the swallowing act all the muscles of the stomatognatic system start working and it is exactly at this time that the jaw becomes a solid structure, just like a sailing boat mast supported by cables.

During this process both the raising and lowering muscles of the jaw contract at the same time. When these muscles work together, from opposite points, they become like tie-beam giving a stabilizing effect to the jaw.

It is exactly during the swallowing act that the forces generated by the contact between the teeth are transmitted to the underlying structures.

Let’s try to progress in steps in order to fully understand this bio-mechanism.

Next questions might be: how this whole system can compromise body posture? How is a correct posture determined? How do back diseases generate? How can you fix scoliosis, and stop the deterioration of lordosis and kyphosis?

The answer to all these questions lies in the “teeth”. We have seen how the skull is supported by the cervical vertebra and we have understood the role of the jaw. We also know that teeth are located between skull and mandible. Sometimes teeth may not be completely extruded in the premolar and molar area for various reasons. In this case there may be several factors that can cause a dental arch inclination. In most cases these problems are related to birth defects, and mainly attributable to jaw bone dysmorphoses (lower bone thickness) or lack of teeth extrusion on thin and porous bones.

Other causes not related to birth defects may be a teeth collapse or bad dental work. Nonetheless, it must be said that stress can be a trigger for the lowering of the tooth thickness. A body under high tension leads all muscles to work harder. Among them there are also those muscles in the mouth that constantly biting, especially on molars and premolars, can cause their collapsing.

Now, let’s get to the heart of the matter.

Let’s see in profile what happens to the posture of a skeleton looking at it from the sagittal plane. Let’s see if these premolar and molar teeth are not completely extruded or have collapsed over the years.

We note that the skull changes inclination with respect to the jaw then compressing all the cervical area. The skull changes inclination until it is re-established a good occlusal contact. A collapse of the teeth can occur in the years due to an excessive dental consumption or due to a heavy stress that can destabilize an already precarious situation.

Next step will be the consequent change in shape of the entire spine. The spinal column will be forced to stay in a smaller space while maintaining anatomically its length. For this reason, you will have an increase of the curves such as the cervical and lumbar lordosis as well as the kyphosis.

In the image on the side we can see in seconds what happens in years or even in a few months of postural decay (due to strong psycho-physical stress).

It is now clear that the collapsing or the lack of extrusion of molars and premolars over the years can make the skull incline and how this structural change passes on to the underlying structures.

In practice, as you can always see in the image on the side, the skull collapses until the upper teeth do not find contact with the lower ones.

The temporal masseter muscles etc etc. will force the skull to incline pulling it down.

From here on, the skull will lose its center of gravity and the body will perform a series of bio-mechanical changes such as the shortening of its natural physiological curves such as cervical and lumbar lordosis and kyphosis.

In the lower diagram you can clearly see this process broken into four phases.

This article aims to explain the bio-mechanism in a more simplified way.

If you want to know more about this, all information can be found in my book.

Carrying on with the reading we can observe the same mechanism of decay or postural imbalance on the frontal plane.

Just to sum it up, we analyzed the postural bio-mechanism on the sagittal plane observing a skeleton profile with lack of height in the premolar and molar dental area.

Now let’s see what happens to our skeleton on the frontal plane.

In the event that there is a lack of dental arch height as the left side of you may see on the picture on the side, the upper teeth will try to find occlusal contact with the bottom.

These are just examples, because, in reality, as already written before, the reasons for this asymmetry are connected to birth defects or bad dental work.

At this point, the skull will lean on the left side and the left masseter will shorten causing a stretching effect on that on the right side.

We also know that a short muscle is also much stronger, while the lengthened opposite side will be weaker.

The skull is pulled to the left side and all the muscles of the body to that side will begin to shorten.

A subsequent actions chain throughout the body will involve the development and worsening of the musculoskeletal asymmetry with abnormal curves of the spine or the origin of muscular imbalances.

The body or better the musculoskeletal structure will go through various stages until they find a new balance, or to be more precise, we could say a new “unbalanced equilibrium”.

There may be different types of unbalance according to the type of cranio-mandibular joint disorder (i.e. different types of imbalance that vary from person to person).

If you want you can download the free e-book and fully understand this theory: http://starecta.com/book/

Os Efeitos das Metafetaminas

2014-11-11T12:00:00.000+01:00

Como sabem, as metafetaminas têm efeitos nefastos na nossa saúde incluíndo nos nossos dentes.
Aqui estão algumas imagens do Antes e Depois:

Oral Health and Pregnancy

2014-11-10T14:15:00.000+01:00

Dental loupes

2014-11-10T08:19:00.001+01:00

Já faz algum tempo que utilizo este equipamento e estou muito satisfeito. Traz muitas vantagens e permite economizar-em um pouco fisicamente, sobretudo costas e olhos.

Vantagens:

-postura correcta;

-melhor visualização;

-melhor trabalho em boca;

-melhor eficácia;

A verdadeira desvantagem é o preço deste equipamento: entre os 150€ e os 1600€.

Mas é com toda a certeza um bom investimento para os profissionais de saúde dentária.

Keep Calm and Work Hard

2014-10-28T07:56:00.001+01:00

Faculdade de Medicina Dentária fecha clinica externa - triste. notíciajornal "Sol"

2014-10-04T17:53:00.001+02:00

Faculdade de Medicina Dentária fecha clínica devido a acusações de tribunal

Foto: Shutterstock

A Clínica Externa da Faculdade de Medicina Dentária de Lisboa vai fechar a 31 de Outubro, na sequência "de irregularidades" encontradas por uma auditoria do Tribunal de Contas, disse à Lusa o director do estabelecimento de ensino.

O anúncio foi feito hoje pelo director da Faculdade de Medicina Dentária, João Aquino Marques, depois de um relatório do Tribunal de Contas, no qual é referido que a existência daquela unidade não está prevista nos estatutos da faculdade e não tem licença da Administração Regional de Saúde de Lisboa e Vale do Tejo ou de qualquer outra entidade para funcionar.

Embora o Tribunal de Contas considere "não estar em causa a qualidade dos serviços prestados" e reconheça a "função social prestada a estratos desfavorecidos da população", sublinha que a clínica deve "observar as normas e boas práticas aplicáveis às entidades públicas e às actividades prosseguidas".

Para João Aquino Marques, a Clínica Externa faz parte "da orgânica da Faculdade", não a considerando uma "unidade privada" que requeira licenciamento por parte do regulador da Saúde, e sublinhando que a mesma tem funcionado ao longo dos últimos 10 anos como "extensão do serviço da universidade", opinião partilhada pelo secretário-coordenador, Dário Vilela.

"As instituições procuram meios de financiamento e, na altura, pareceu-nos uma boa ideia abrir a faculdade à população geral. A clínica externa ou integrada é um serviço hospitalar com médicos, depende da faculdade, utiliza as suas instalações e é uma fonte de receitas", explicou o director da Faculdade de Medicina Dentária da Universidade de Lisboa, João Aquino Marques.

Por seu turno, Dário Vilela sublinhou que a clínica é responsável por cerca de 20 mil consultas anuais e que o seu fecho irá acabar com a "única consulta no sector público para adultos com necessidades especiais".

Tendo em conta as restrições adoptadas pelo Governo para as contratações de funcionários por entidades públicas, João Aquino Marques considerou que não tem grandes alternativas a não ser o fecho da clínica, já que não pode fazer contratos de prestação de serviços, nem de avença.

"Pedem que sejamos criativos. Não queremos fechar a consulta externa, mas as alternativas legais passam por criar uma clínica privada, com abertura de um concurso às quais as clínicas privadas podem concorrer. Isso não nos interessa, já que queremos seguir a nossa filosofia de ensino", explicou.

João Aquino Marques vai mais longe ao afirmar que essa opção seria "emprestar o nome da faculdade a terceiros, o que daria um reconhecimento de "laboratório de boas práticas clínicas".

De acordo com o responsável, a dotação do Estado para a faculdade ronda os 1,8 milhões de euros anuais, sendo os salários de docentes e não docentes chega aos 3,8 milhões de euros.

"Quando o Tribunal de Contas diz que a clínica não prova que somos auto-suficientes, a prova é que nunca pagámos dos nossos bolsos os salários. E gastamos 400 mil euros em material clínico. Temos de fazer das tripas coração para isto. Cometemos esta ilegalidade que o TC aponta e somos penalizados por isso", retorquiu.

Segundo o mesmo responsável, a clínica externa funciona há cerca de dez anos, dá emprego a 60 pessoas, das quais 42 médicos dentistas, e atende cerca de 20 mil pessoas, sendo responsável por um acréscimo de 50% às 45 mil consultas realizadas pela faculdade. Do valor pago na consulta pelos doentes, 40 % é para os médicos dentistas, 60% para a faculdade.

Lusa/SOL

Brush your teeth

2014-07-11T17:06:00.001+02:00

Como 20 mil escovas de dentes e caixas de DVD fizeram uma casa

2014-07-10T18:11:00.001+02:00

A “Waste House” é considerada como “o primeiro edifício permanente do Reino Unido construído a partir de lixo”. Ganga, caixas de DVD, escovas de dentes e pedaços de carpetes são alguns dos materiais usados

Um grupo de estudantes da Universidade de Brighton, na Inglaterra, e o arquitecto Duncan Baker-Brown construíram uma casa quase inteiramente a partir de lixo. Demoraram um ano a terminar o projecto e da lista de materiais fazem parte, por exemplo, 20 mil escovas de dentes e centenas de caixas de DVD e VHS.

A "Waste House” foi construída nos terrenos da universidade e a ideia é provar que os materiais desperdiçados podem ter um fim diferente. “É um facto deprimente que, por cada cinco casas construídas no Reino Unido, o equivalente a uma casa em materiais desperdiçados vá para um aterro”,disse o arquitecto ao “The Guardian”.

É, de acordo com o também professor universitário, “o primeiro edifício permanente do Reino Unido construído a explicou ao site de arquitectura Dezeen. “Houve uma série de outros projectos onde as pessoas construíram abrigos ou coisas temporárias a partir do lixo, mas este é o primeiro a obter os regulamentos de construção e aprovação de planeamento”, sublinhou ao mesmo site.

Duncan Baker-Brown e os seus alunos usaram dois mil pedaços de carpetes, provenientes de um edifício de escritórios da zona, que iriam acabar no lixo. Pendurados com a face à prova de água para o exterior, foram cortados e reposicionados para funcionarem na fachada do edifício, com dois andares. Para que seja possível ver de que são feitas as paredes, o revestimento tem secções transparentes que revelam os materiais reutilizados.

“Todas as lojas de aluguer de vídeo parecem ter fechado enquanto a obra decorria”, brinca Baker-Brown, o que resultou na utilização de caixas de DVD e VHS para isolamento da casa. Já as escovas de dentes — 20 mil, ao todo —, são provenientes de uma empresa de limpeza de aviões. Também é possível ver disquetes e pilhas de ganga (cerca de duas toneladas), importadas da China para uma fábrica de confecção de “jeans”.

“Tem que haver uma forma de armazenar e re-utilizar todos os excedentes, em vez de os atirar para um aterro”, defende o arquitecto.

Além dos estudantes da Universidade de Brighton, a construção da “Waste of House” contou ainda com a participação de estagiários da empresa Mears e voluntários e estudantes da City College Brighton & Hove. O edifício vai ser usado por estudantes do curso de Design Sustentável daquela universidade e vai estar disponível para a realização de workshops e eventos.

Fonte: Jornal "Público"

Scaling and exercise strategies to prevent hand, wrist, and arm injuries - RDH

2014-05-20T22:44:00.001+02:00

Scaling and exercise strategies to prevent hand, wrist, and arm injuries

Imagine working as a dental hygienist and never being concerned about work-related hand or arm pain. Certainly with all the available literature on neutral ergonomic hand, wrist, and arm positions, preventive scaling techniques, and healthy stretching exercises, practicing pain free should be simple, right? This is wishful thinking. Having available literature and knowledge is only beneficial if it's implemented routinely. How can a different result be expected if knowledge isn't translated into action?

Unfortunately, evidence shows that work-related musculoskeletal disorders (MSD) are recognized as a considerable problem for the dental hygiene profession, with a majority of the professionals reporting musculoskeletal pain.¹ While practicing, a dental hygienist must have a conscious awareness of instrument grasp, pinch force, finger rest positions, fulcrum pivoting, intraoral and extraoral fulcrum rest positions, and neutral hand, wrist, and arm positions in order to employ productive and preventive techniques while scaling.

The dominant hand must work as a unit with the instrument in order to enhance precision and stability. Orchestrating these skills can be a challenge depending on learned techniques in dental hygiene school. The risk factors associated with carpal tunnel syndrome and other hand disorders include repetitive hand motions, forceful pinching or gripping, sustained awkward wrist postures, and vibration.² Attention must be given to these fundamentals since dental hygienists are predisposed to hand, wrist, and arm injuries.

Musculoskeletal disorders (MSD) have been reported among registered dental hygienists and dental hygiene students (DHS), adversely impacting their daily performance and career longevity. RDHs and DHS have reported pain in the following areas -- neck,1,3-5 shoulder,1,3-5 lower back,1,3,4 forearm,1 wrist/hand,3 and upper back.³ RDHs working in a general dental office reported pain more frequently in the shoulder region, and those working in a periodontal office reported forearm pain. Hand scaling caused neck pain among RDHs, and the use of ultrasonic scalers caused shoulder, upper back, or lower back pain for longer than two days.¹ RDHs who reported wearing loupes were less likely to report shoulder and wrist/hand pain, and less likely to have neck or upper back pain for more than two days.1

Dental hygiene students who do not exercise regularly have reported a higher incidence of low back pain, and working on a computer increases shoulder and upper back pain.⁴ Consequently, the daily lives of DHS have been affected by musculoskeletal pain, causing them to seek medical treatment.⁴ RDHs with pain were less likely to seek treatment if ergonomics were reinforced in the clinic during their dental hygiene education.³ In view of that, reinforcing ergonomics and incorporating the use of loupes and reinforced instrumentation into the dental hygiene curriculum may benefit the career longevity of RDHs.

Reinforced fulcrums for optimum scaling efficacy and injury prevention -- Dental hygiene instrumentation techniques have dramatically improved throughout the years to prevent MSD. New and innovative techniques using protective reinforced instrumentation techniques require scaling teeth with two hands instead of one to ensure optimum performance and to promote occupational health and career longevity. These techniques allow the nondominant hand to assist the dominant hand and instrument for more stability, lateral pressure, and precision.6

Using the index finger to press on the long terminal shank with the nondominant hand while using extraoral fulcrums helps the operator to adapt the instruments and attain more lateral pressure. As the dominant hand adapts and angulates the blade of an instrument to tooth surfaces, the nondominant hand provides additional pressure in the same direction to which the dominant hand's fingers are directing pressure. This helps operator protection during strenuous and extensive instrumentation processes by engaging the large muscle groups over the small muscle groups in the hand and wrist.

If a clinician experiences pain, the utilization of reinforced instrumentation techniques helps to decrease hand, wrist, and arm pain. The definition of "reinforce" is to strengthen with some added piece of support.⁷ The increase in strength while using reinforced fulcrums and rests occurs from the use of both hands. The thumbs are also beneficial to incorporate while using reinforced instrumentation. When the nondominant thumb bridges over to the dominant thumb of the working hand, both hands have the opportunity to work together as a unit. When both hands work in unison, the larger muscle groups of both arms can also work in unison.8

Intraoral and extraoral fulcrum techniques combined for stability and precision -- Intraoral fulcrum techniques are established by placing the pad of the fulcrum finger on a tooth surface adjacent or close to the tooth being instrumented. This technique has been the standard school of thought in the dental hygiene profession for many years. All dental hygiene schools introduce intraoral fulcrums before teaching extraoral fulcrums, which requires stabilization of the clinician's dominant hand against the patient's cheeks, jaws, and chin. Extraoral fulcrums require the front or back of the fingers to be used as hand rests to provide support, rather than the tips or pads of the fingers as with intraoral fulcrums. Using both intraoral and extraoral fulcrum hand rests simultaneously will increase stabilization of the hand and arm, as well as precision while scaling, versus using just one or the other.

Strategies for injury prevention to the hands and arms while scaling -- The following recommendations are worth considering to help prevent pain and injury to a clinician's hands and arms, and to enhance scaling efficacy with biomechanical and ergonomic principles:

Establish a modified pen grasp where the thumb and finger oppose one another and the instrument handle is visible between the fingers.
All fingers should work together as a unit while scaling.
Use large diameter handles and light instruments to reduce excessive pinch force.
Consider using 11.5 mm diameter silicone (LM-Dental) or resin handles in conjunction with power scaling for every patient appointment to prevent injury.
Always establish a neutral hand, wrist, and arm position while scaling.
Orient the instrument with the tooth surface to be instrumented, taking into consideration the angulation of all teeth.
Keep the instrument parallel to the long axis of the surface of the tooth. This will encourage a neutral hand, wrist, and arm posture.
Use intraoral and extraoral fulcrums to enhance a neutral position of the hand, wrist, and arm.
Avoid flexion and extension of the hand as much as possible while scaling.
Avoid sustained awkward wrist postures to prevent carpal tunnel syndrome.
Practice palm up fulcrums as often as possible, and avoid palm down fulcrums that increase strain on the hand and wrist.
Establish a "built-up" fulcrum, keeping fingers together as a unit while scaling.
Keep the ring finger straight, with the tip of the finger supporting the weight of the hand when using intraoral fulcrums.
Pivot on the fulcrum finger to support the hand as it turns to allow for hand repositioning.
Use advanced reinforced fulcrums using intraoral and extraoral rests to gain access to root surfaces and to prevent hand stress and strain.
Incorporate the nondominant hand by pressing on the instrument for more lateral pressure, power, and precision.
Implement thumb-to-thumb reinforcement for more stability and precision, and to engage the use of the larger muscle groups in both arms while scaling.
Consider bringing the elbow out and over the patient at times to keep wrist in alignment with the long axis of the forearm.
Keep the dominant hand neutral to prevent radial and ulnar deviation while scaling.
Use fulcrum pressure equal to the pressure of the instrument blade against the root surface being scaled.
Increase fulcrum pressure if slipping or lack of lateral pressure occurs.
Implement pull strokes instead of side-to-side rocking strokes in order to enhance instrument placement to the epithelial attachment and reduce repetitive motions.
Use sharp instruments to minimize lateral pressure and number of strokes.
Consider using XP sharpen-free technology instruments (American Eagle Instruments) to reduce lateral pressure while scaling.
Make every stroke count to reduce repetitive motion injuries.
Implement intermittent rests between strokes to prevent pain and injury.
Listen to your body and take mini-breaks to avoid prolonged, static postures.
Stretch hands, arms, and upper body routinely to prevent pain and injury.

Adverse effects of MSD and the use of complementary and alternative medicine (CAM)

MSD are frequently reported by practicing RDHs due to the physical demands placed on the body caused by poor ergonomics, repetitive motion, pinch force, and grasp.² RDHs who reported MSD reduced the number of hours they worked,3 took time off from work, called in sick,1,3 considered changing careers,1,3 and even left clinical practice.¹ CAM therapies including massage, herbal supplements, chiropractic care, yoga, and acupuncture are being used by RDHs to reduce musculoskeletal pain.³ RDHs are more likely to use a combination of CAM and conventional therapies to manage their MSD, although RDHs who use CAM therapies alone are less likely to temporarily quit work, experience improvement in musculoskeletal pain, and report higher career satisfaction.3

Using CAM therapies has increased job happiness and security and overall health and well-being, contributed to career longevity, and enabled RDHs to work the number of hours they prefer.³ RDHs with MSD feel that CAM therapies are acceptable methods of pain management that should be covered by medical insurance, and they would use CAM as an alternative method to conventional medicine.³ CAM therapies have a positive effect on RDHs' overall health and career satisfaction,3 and should be considered for use early on.

Yoga and pain reduction

Yoga is a CAM therapy that unites the body, mind, and spirit using breathing methods and a series of standing and seated postures. It is a mindful type of practice where individuals focus their breath and attention on proper alignment in order to gain the full benefits of each pose. There are many types of yoga styles, including but not limited to Hatha, Vinyasa, Kundalini, and Iyengar. Yoga targets a number of muscle groups, leading to improved posture and spinal alignment.⁹ Yoga has been shown to reduce pain,9,10,11,13 the need for medication,10 and to improve function9-13 among the general population. Pain reduction has been reported when individuals practiced yoga at least once a week for a minimum of 12 consecutive weeks.10-12 Yoga has also been shown to reduce stress and bring a sense of peace and well-being to the mind.⁹ Since yoga has been shown to reduce pain among the general population, serious consideration should be taken to incorporate yoga into the dental hygiene curriculum to prevent pain while in school and later in the career.

MSD have been reported among RDHs and DHS, causing a negative impact on their daily lives, and eventually leading to reduced work hours, calling in sick, or leaving the profession. Reinforced instrumentation techniques should be introduced during school and used throughout a dental hygiene career in order to reduce hand, wrist, and arm pain. Ultimately, ergonomics should be reinforced in the clinical setting, and CAM education, such as yoga, should be incorporated into the dental hygiene curriculum to prevent MSD from occurring. Incorporating change is not always easy for clinicians to accept or adapt to, although action must be taken in order to get a different result so as to increase career satisfaction and longevity of the dental hygiene profession.

Aubreé M. Chismark, RDH, MS, is an assistant professor in the dental hygiene department at West Coast University in Anaheim, Calif., and is a member of the CDHA Journal Advisory Board. She is registered yoga teacher with the Yoga Alliance (200- hours) and is currently working toward her 500-hour certification. Her research interests include ergonomics and the use of complementary and alternative medicine to reduce chronic musculoskeletal pain. She can be contacted at: achismark@westcoastuniversity.edu.

Diane Millar, RDH, MA, graduated from the West Los Angeles College dental hygiene program in 1981. Her career in dental hygiene has embraced working in private practice and teaching advanced instrumentation techniques at The University of Southern California, Cerritos College, and currently at West Coast University. She is a national speaker and is also the published author of "Reinforced Periodontal Instrumentation and Ergonomics for the Dental Care Provider." Diane is a CE Provider for the CA Dental Board and conducts seminars and hands-on workshops to help dental professionals learn how to practice more efficiently and ergonomically safe to ensure career longevity. She can be contacted at dMillar@westcoastuniversity.edu.

References

1. Hayes MJ, Taylor JA, Smith DR. Predictors of work-related musculoskeletal disorders among dental hygienists. Int J Dent Hygiene. 2012;10:265-269.
2. Dong H, Barr A, Loomer P, Rempel D. The effects of finger rest positions on hand and muscle load and pinch force in simulated dental hygiene work. J Dent Hyg [Internet]. 2005 [cited 2014 Feb 10]; 69(4): 453-460. Available fromhttp://www.adha.org. Registration required for access.
3. Chismark A, Asher G, Stein M, Tavoc T, Curran A. Use of complementary and alternative medicine for work-related pain correlates with career satisfaction among dental hygienists. J Dent Hyg [Internet]. 2011 [cited 2014 Feb 10]; 85(4):273-284. Available from http://www.adha.org. Registration required for access.
4. Hayes MJ, Smith DR, Cockrell D. Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students. Int J Dent Hygiene. 2009; 7:176-181.
5. Morse T, Bruneau H, Michalak-Turcotte C, et al. Musculoskeletal disorders of the neck and shoulder in dental hygienists and dental hygiene students. J Dent Hyg [Internet]. 2007 [cited 2014 Feb 10]; 81(1):e16. Available fromhttp://www.adha.org. Registration required for access.
6. Millar D. Reinforced periodontal instrumentation and ergonomics for the dental care provider. 1st ed. Baltimore, MD. Lippincott, Williams, & Wilkins. 2007. pp. 1-38.
7. Reinforce. Dictionary.com, Random House Publishing [Internet]. 2014 Jan [cited 2014 Jan 3]. Available from http://dictionaryreference.com/browse.Reinforce.
8. Millar D. Reinforced periodontal instrumentation and ergonomics: the best practice to ensure optimal performance and career longevity. Journal of the California Dental Hygienists' Association. 2009; 24(3):10-17.
9. Sarosky S, Stilp S, Akuthota V. Yoga and Pilates in the management of low back pain. Curr Rev Musculoskeletal Med [Internet]. 2007 [cited 2014 Feb 10]; 1:39-47. Available from http://link.springer.com/article/10.1007/s12178-007-9004-1/fulltext.html.
10. Saper RB, Boah AR, Keosaian J, et al. Comparing once- versus twice-weekly yoga classes for chronic low back pain in predominantly low income minorities: a randomized dosing trial. Evidence-Based Complementary and Alternative Medicine [Internet]. 2013 [cited 2014 Feb 10]. Available from www.hindawi.com/journals/ecam/2013/658030/.
11. Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Archives of Internal Medicine [Internet]. 2011 [cited 2014 Feb 10]. Available from: http://archinte.jamanetwork.com/article.aspx?articleid=1106098.
12. Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain. Ann Intern Med [Internet]. 2011 [cited 2014 Feb 10];155(9):569-578. Available from http://annals.org/issue.aspx?journalid=90&issueID=20366&direction=P.
13. Williams K, Abildso C, Steinberg L, et al. Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain. Spine. 2009; 34(19):2066-2076.
14. Payne L, Usatine R. Yoga Rx: a step-by-step program to promote health, wellness, and healings for common ailments. 1st ed. New York, NY. Broadway Books. 2002. pp.146-148.
15. Yoga Poses. Yoga Journal.com [Internet]. 2014 [cited 2014 Feb 19]. Available fromhttp://www.yogajournal.com/poses/finder/browse_index.

Homer Simpson and the Dental Hygienist

2014-05-04T15:02:00.000+02:00

Sorrisos das Celebridades - Antes e Depois

2014-05-02T22:56:00.000+02:00

1. Celine Dion.

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2. Zac Efron.

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3. LeAnn Rimes.

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4. Lindsay Lohan.

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5. Noel Gallagher.

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6. 50 Cent.

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7. Cher Lloyd.

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8. Nicolas Cage.

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9. Michael Douglas.

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10. Cheryl Cole.

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11. Tom Cruise.

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12. Niall Horan.

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13. Kate Beckinsale.

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14. Steve-O.

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15. Nicola Roberts.

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16. Melanie C.

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17. David Beckham.

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18. Victoria Beckham.

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19. David Bowie.

Diane Freed

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20. Hilary Duff.

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21. Keith Urban.

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22. Tulisa.

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23. Madonna.

Diane Freed

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24. Matthew Lewis.

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25. George Clooney.

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26. Gwen Stefani.

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27. Morgan Freeman.

Newsmakers

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28. Miley Cyrus.

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29. Louis Walsh.

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30. Katie Price.

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31. Nicole Kidman.

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32. Cristiano Ronaldo.

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33. And finally, Ronan Keating.

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George Washington’s Weakness: His Teeth by The New York Times

2014-04-30T17:51:00.000+02:00

George Washington’s Weakness: His Teeth

APRIL 28, 2014

George Washington's Mount Vernon

Michael Beschloss

@BeschlossDC

When George Washington opened his mouth 225 years ago this Wednesday at New York’s Federal Hall to take the oath as the first president of the United States, he wore awkward-fitting, painful, face-disfiguring dentures. For years, he had suffered from dental problems; that morning he had swollen, burning gums and only a single original tooth in his mouth. He wore this particular set of dentures during the last nine years of his life. They clacked and creaked open and shut on tight wire springs.

Folklore notwithstanding, Washington’s false teeth were not wooden. He obtained them instead from horses, donkeys, cows — and human beings. (According to his account books, in 1784, emulating some of his affluent friends, he bought nine teeth from unidentified “Negroes” — perhaps enslaved African-Americans at his beloved Mount Vernon; the price was 122 shillings.)

Washington strove, in life, to resemble a monument. This was important to his self-esteem and, he believed, to the dignity and credibility of his fledgling nation. To him, the dentures were a mortifying sign of weakness. (For years, Washington’s dentures were kept out of public view to avoid marring his image; they are now a popular attraction at Mount Vernon’s excellent museum.)

National Portrait Gallery

He once pleaded with his dentist, John Greenwood, by letter, to avoid any change to the denture “which will, in the least degree force the lips out more than now do, as it does this too much already.” Members of his cabinet sadly noted how rarely the tight-lipped president smiled or laughed. Others insisted that his embarrassment about his dentures, which sometimes caused him to hiss as he spoke, made him reclusive.

The French mathematician and philosopher Pascal once said that had Cleopatra’s nose been shorter, “the whole face of the world would have been changed.” Had Washington kept his original mouthful of gleaming white teeth, the commanding president might have been even more effective in using the force of his personality on Hamilton, Jefferson and the other combative Americans he dealt with in the 1790s. These dentures also underscore the axiom that anyone nostalgically longing to reside in some earlier century should ponder what daily human life was like before modern dentistry.