Wednesday, June 3, 2020

Welcome Back! We are open !

A quick update to all our valued patients.  We are back!  We are thrilled to be able to announce that we are back to work to take care of all of your dental needs.  Our college, the RCDSO, in coordination with the CDC have determined guidelines to allow us to return to dentistry while keeping you, our patients and staff, safe.
Some new things you may experience at the office at your next appointment.
1. Covid pre-screening and in office screening
2. In office temperature check
3. Please wear a mask to your appointment ( if you forget we will supply)
4. Multiple hand washing stations ( pls wash hands on entry and exit)
5. Peroxl pre-procedural rinse
6. Staff may have different types of personal protective equipment as mandated by the CDC and RCDSO.  (Face Sheilds, gowns etc)
7. Limited patients in waiting room.  You may be asked to wait in car or outside until you are alerted by front desk
8. Only patient in treatment room.  Parents will have to explain to their children that they have to be in treatment room on their own.
9. A little bit longer waiting time as we are observing proper wait times between cleaning rooms.
10. Less aerosol generating procedures early on in our return to practice.  Hygienist may be doing more hand scaling versus using a cavitron ( buzzy thing that sprays lots of water)
So a few changes as we ramp our practice back up to normal.  As usual, due to our rigorous disinfecting procedures we still believe our office will be one of the safest places you can visit during these interesting times.
Whether it is a cleaning, emergency, filling or any other dental procedure we are back and ready to see you.  We are thrilled to finally be able to take care of all you dental needs once again
Please Call our office at 613-728-0239 to book your appointment
Dr. Pettigrew and all staff

Thursday, April 23, 2020

Dental Emergencies During Covid-19

Just a note to all of our patients during this strange time we are currently find ourselves in.   First and foremost we at Dr. Jordan Pettigrew and Associates are all healthy and trying to keep busy while self isolating.  We hope all of you are as well.  We are working behind the scenes to hit the ground running once we are allowed to return to the practice of dentistry.  Our return date is fluid and we will update you as soon as we know a firm return date.  At this point it looks like June but that could change.  In the mean time we are available by phone to discuss any and all dental concerns you may have.  My person cell number is 613-852-5393.  I am available 24/7 for dental emergencies.  If you call the office phone number you can find the numbers for Dr. Kooner and Dr. Hakimi as well.  We also have the number for several emergency clinics we are working with for the most urgent dental emergencies.
Please refer to this post by the RCDSO (Royal College of Dental Surgeons of Ontario)

COVID-19 (Novel Coronavirus) - Patients

The College has recommended that all non-emergency dental services should be postponed to help prevent the spread of COVID-19.
If you think you have an emergency case, call your dentist. They will ask you for information about your situation and give you advice about next steps.  If you need to visit the office, they will let you know if they can help or will direct you to another dentist.

Do not go to a hospital emergency room for a dental problem at this time. 
If you don’t have a dentist, see our list of emergency clinics.

Where do I go if I am experiencing symptoms of COVID-19? 

Contact your doctor if you’re experiencing symptoms of the COVID-19 novel coronavirus.

Telehealth Ontario is also a key hub for advising the public on options for in-person assessment (if deemed necessary). The Telehealth number is 1-866-797-0000. Stay in self-isolation until you receive instructions otherwise from one of the above sources.
Click here for the Ministry self-assessment link.

Is it safe to visit my dentist? 

Infection prevention and control in dentistry is vital for safe patient care.
The College has developed a Standard on Infection Prevention and Control that is in effect.
If you have a dental emergency, your dentist will ask you questions over the telephone and determine if you need to be seen.
If you need to be seen in the office, there are strict Infection Prevention and Control Standards that they must comply with. 
Your dentist or oral health care worker should wear personal protective equipment such as gloves, protective eyewear, masks and protective clothing. Protective equipment should be used consistently during the treatment of patients.
Your dentist or oral health care worker should ensure that their hands are washed with plain or antimicrobial soap and running water or, if hands are NOT visibly soiled (i.e. in the majority of instances), the use of a 70-90% alcohol-based hand rub is the preferred method of hand hygiene.
All critical and semi-critical instruments used in dentistry, including handpieces, are available in heat-tolerant and/or single-use (disposable) forms. All heat-tolerant critical and semi-critical instruments must be heat-sterilized between uses. All single-use items must be disposed following use.

I don’t want to go to my dentist’s office. Can my dentist just prescribe medications for me over the phone?

If you have a dental emergency, your dentist should ask you questions over the telephone regarding your symptoms and their level of severity, your current medications, allergies, history of trauma, sleeplessness, etc.
With this information, the dentist will evaluate your emergency and determine if it is a true emergency. In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications.
Your dentist will then determine if over-the-counter medications (e.g. Advil, Tylenol) are recommended, if prescription medications are necessary, and/or if you need to be seen at the office.
If a prescription is indicated, your dentist can provide either a verbal or a faxed prescription to the pharmacy directly.
During this pandemic, dentists must continue to practice within the College's Guidelines with respect to writing prescriptions for narcotics and/or opioids
See guidance regarding the management of emergencies.

Will the College continue to recommend that dental offices treat emergencies only

Since our advice to dentists released March 15, the Government of Ontario has declared a State of Emergency. The government has also clarified that only “health care professionals providing emergency care including dentists” are considered to be in the category of ‘essential services’.
As a result, the College will not revisit its strong recommendation that all non-essential and elective dental services should be suspended until the State of Emergency has been lifted by the Government of Ontario.
As the situation continues to evolve very rapidly, visit the College’s website and follow us on Twitter on a regular basis for updates.

What is a patient dental emergency during the pandemic?

In dentistry, an emergency could include an injury to the mouth and face, severe infection (such as an abscess or swelling), bleeding that continues for a long time or pain which cannot be managed by over-the-counter medication like Advil or Tylenol.
Non-emergency dental procedures include but are not limited to:
  • initial or periodic oral examinations and recall visits, including routine dental radiographs
  • routine dental cleaning (scaling, polishing) and other preventive therapies such as fluoride applications
  • orthodontic procedures other than those to address acute issues (e.g., pain, infection, trauma, wire cutting into the gum/cheek)
  • removal of asymptomatic (non-pain/no swelling/no discomfort) teeth
  • restorative dentistry (e.g. dental fillings, including treatment non-painful carious lesions).
  • replacement of teeth with implants or bridges
  • aesthetic dental procedures such as teeth whitening, veneers.

Can dentists cement a permanent or temporary crown/bridge or deliver a denture to a patient?

The Acting Chief Medical Officer of Health has advised that all non-essential and elective services should be ceased or reduced to minimal levels, subject to allowable exceptions, until further notice. Allowable exceptions can be made for time sensitive circumstances to avert or avoid negative patient outcomes or to avert or avoid a situation that would have a direct impact on the safety of patients.
In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications.  Refer to the above questions and answer and our guidance on true emergencies.
If you believe you have a unique clinical situation and would like to discuss further, please reach out by email to the Practice Advisory Service to seek guidance.

I think I have an emergency dental situation. What do I do?

If you think you have an emergency case, call your dentist. They will ask you for information about your situation and give you advice about next steps.  If you need to visit the office, they will let you know if they can help or will direct you to another dentist.
If you don’t have a dentist, see our list of emergency clinics. This list has been organized alphabetically by city and the names of the office identify if it is a specialty office.   
Not all dentists have the safety equipment needed to guard against COVID-19. Dentists that are equipped to treat emergency cases are required to maintain all standards of infection, prevention and control set by the College and Public Health.
Do not go to a hospital emergency room for a dental problem at this time.

Many dentists apparently are not heeding the College’s recommendation and are continuing with non-emergency treatment in their office. What will the College do about this?  

The College sought legal advice and confirmed that we do not have the legal authority to close dental offices. Our approach and advice is similar to most health care regulators under Ontario’s Regulated Health Professions Act (RHPA), and by regulators in many other provinces; we are limited to “strongly recommending” that all dental offices close.
Ontario’s Chief Medical Officer of Health and Canadian health authorities have asked that dentists remain open to ONLY provide emergency services and ONLY when they have the PPE and facilities to do that safely.
Dentists are expected to consider the best interests of their patients and communities at all times. Ontario has declared a state of emergency, and the Canadian government is strongly urging all Canadians to practice social distancing.
We continue to raise these issues with the relevant authorities. In the meantime, be aware that if a clinic remains open other than for emergency care, Public Health could be notified to take strong action.

Where to find up-to-date information

Follow us on Twitter @rcdso_org for regular updates.

Finally, stay isolated and stay healthy and we will be on the other side of this shortly.


Dr. Jordan Pettigrew 

Wednesday, March 4, 2020

Feel a cold sore developing? Get in here quick! We'll zap it with our laser!

How Do Lasers Treat Cankers and Cold Sores?

Oh, the future of glorious. At one time the only remedy for cold sores and cankers were topical treatments and oral medications. Today, dentists make use of dental lasers to provide patients with pain relief and healing from cold sores and cankers.

Traditional Treatments

Traditional treatments for cold sores and cankers are limited to oral and topical medications. The downside to these creams and medications is that the healing process can take longer to start and you can never be sure if you’re going to have a reaction to new treatments.
Some treatments that contain steroids or vitamin therapy treatments can actually make the problem worse than it was before. For individuals who don’t want the pain of side effects, they might consider home remedies. Even though home remedies commonly create less side effects, they can also be less effective. There is another option.
Enter the healing power of lasers.
In the spirit of Star Trek, dentists have turned to lasers to make the world a better place. Dental lasers have been used since the 1990s, and they can be much more effective than any other cold sore or canker treatment.
When a patient visits their dentist for treatment, the laser used is completely painless. The only sensation felt during the procedure is a sensation of warmth where the laser is being applied. The laser works in two major ways:
  • The laser deadens the nerve cells around the area providing near-instant pain relief.
  • The laser promotes healing in biostimulation, meaning your body increases collagen formation.
While a medication can take weeks to have a full, healing effect, the healing process from lasers beings within a matter of days.

The Benefits

There are many reasons to opt for laser treatment rather than other traditional treatments:
  • The treatment is affordable and may even be covered by your insurance provider
  • Relief from pain is nearly instant when the laser is used
  • You’re sitting in the dentist char for just a few minutes while the procedure is being done
  • Cold sores can recur with less frequency and less intensity after treatment
  • You won’t feel a thing when the laser is being used
  • Individuals who get the treatment as soon as possible don’t develop a cold sore
Laser treatments, unlike traditional medications, can allow a person to move on with the more important things in their life.
The most important thing to remember is that time is of the essence!  The sooner we can zap that cold sore the better the result.  Remember some will have amazing results, some might take a few treatments to realize a dramatic result.  Repeated treatments can reduce symptoms, duration and recurrence rates.  The laser will work on canker sores too!

Monday, January 20, 2020

Do You Snore Or Have Sleep Apnea? We Have Solutions!

See the source imageThis is the D-SAD (Digital-Sleep Apnea Device).  It is the smallest device on the market to treat snoring and mild to moderate sleep apnea.  In severe cases of apnea it can help reduce the severity if a CPAP cannot be tolerated.  It has a 3 year warranty and  is wear resistant with patients with bruxism.  Snoring and apnea can have serious health consequences, not to mention being very annoying to our partners.  These appliances can help.  Please schedule an appointment today to discuss the fabrication of a D-SAD appliance to treat your snoring and mild to moderate apnea.

Saturday, January 4, 2020

Some points On Antibiotic Prophylaxis Prior to Dental Work

Antibiotic Prophylaxis Prior to Dental Procedures

Key Points

  • Compared with previous recommendations, there are currently relatively few patient subpopulations for whom antibiotic prophylaxis may be indicated prior to certain dental procedures.
  • In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”
  • According to the ADA Chairside Guide, for patients with a history of complications associated with their joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon; in cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and, when reasonable, write the prescription. 
  • For infective endocarditis prophylaxis, current guidelines support premedication for a relatively small subset of patients. This is based on a review of scientific evidence, which showed that the risk of adverse reactions to antibiotics generally outweigh the benefits of prophylaxis for many patients who would have been considered eligible for prophylaxis in previous versions of the guidelines. Concern about the development of drug-resistant bacteria also was a factor.
  • Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis (see “Patient Selection,” in the main text). For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.