Okay, so your kiddo just got their braces off! Jaw growth issues are easier to correct at an early age Children's braces treatment orthodontics. Hooray! All that hard work, all those rubber bands, finally paid off. Now you're probably thinking, "We're done, right? Perfect teeth forever!" Well, not quite. Teeth are like little adventurers, always wanting to wander back to where they started. That's where retainers and a solid routine come in.
Think of it this way: braces spent months, maybe even years, coaxing those teeth into their new, beautiful positions. The bone and gums around them are still adjusting. It's like moving a plant; you don't just plop it in the new pot and forget about it. You need to water it, give it sunlight, and make sure it settles in. A retainer is like the sunlight and water for your child's newly straightened teeth.
Without a retainer, those teeth will slowly, but surely, start to shift. We're talking about the potential for gaps to reappear, crowding to creep back in, and all that precious orthodontic work to be undone. And nobody wants to go through braces twice, right?
That's why establishing a routine is key. It's not just about having a retainer; it's about using it consistently and properly. Talk to your orthodontist about a wear schedule that works for your child. Usually, it starts with wearing it almost all the time and then gradually transitioning to nighttime wear.
Make it a habit. Maybe incorporate it into the bedtime routine, like brushing teeth, putting on pajamas, and then putting in the retainer. Get a fun retainer case and let your child decorate it. Make it their own. Remind them gently, but consistently. Positive reinforcement works wonders!
And don't forget about regular check-ups with the orthodontist. They can monitor the teeth, make sure the retainer fits properly, and address any potential issues before they become big problems.
Essentially, preventing tooth shifting is all about consistency and communication. A little bit of effort now will save a whole lot of trouble (and money!) down the road. So, let's get that retainer routine going and keep those smiles shining bright!
Okay, so you've finally got that perfect smile. Braces are off, aligners are done, and you're ready to flash those pearly whites at every opportunity. Great! But here's the thing: that's not the end of the story. Your teeth, being the fickle things they are, have a tendency to want to drift back to where they were before. That's where retainers come in. Think of them as your smile's security guards, working tirelessly to maintain that hard-earned alignment.
Retainers aren't just some optional extra; they're a crucial part of ensuring your orthodontic treatment was actually worth it. Without them, all that time, effort, and money you invested could slowly start to unravel. And nobody wants that!
There are a few different types of retainers you might encounter. The most common are removable retainers, like the clear plastic Essix retainers that fit snugly over your teeth, or Hawley retainers, which have a wire that goes across the front of your teeth and is held in place by acrylic. Then there are permanent, or bonded, retainers, which are thin wires glued to the back of your front teeth. Your orthodontist will recommend the best type for you based on your specific situation.
Now, let's talk wear schedule. This is super important. Initially, you'll probably be wearing your retainer almost full-time, maybe just taking it out to eat and brush your teeth. Your orthodontist will give you specific instructions on how long to wear it each day. Gradually, you'll transition to wearing it just at night. And even after years, many orthodontists recommend wearing a retainer a few nights a week indefinitely. Think of it like brushing your teeth – it's an ongoing commitment to maintaining good oral health, but in this case, it's about maintaining your alignment.
Establishing a retainer routine is key. Keep your retainer clean by brushing it gently with a soft toothbrush and mild soap. Store it safely in its case when you're not wearing it – trust me, dogs love to chew on them! And most importantly, follow your orthodontist's instructions. By making retainers a non-negotiable part of your oral hygiene routine, you're investing in the long-term health and beauty of your smile. And who wouldn't want that?
Okay, let's talk about keeping those pearly whites in line. We're talking about stopping your teeth from deciding to go on a little vacation after braces, or just generally keeping things where they should be. And honestly, the secret sauce isn't some crazy expensive treatment; it's all about those daily habits. I mean, think about it: you brush your teeth, right? You should be. But are you brushing effectively?
Daily oral hygiene is basically the foundation. It's the bedrock upon which all other efforts to stabilize your teeth are built. We're talking brushing at least twice a day – morning and before bed – with fluoride toothpaste. Don't just give them a quick once-over either. Two minutes, folks! Set a timer! Make sure you're getting all the surfaces, including the ones in the back that are easy to forget.
And floss! I know, I know, everyone hates flossing. But seriously, it's crucial. Brushing alone can't get between your teeth, and that's where all sorts of nasty stuff likes to hang out and cause problems. Floss once a day, making sure you gently scrape along the sides of each tooth. Think of it like giving your teeth a little hug.
Beyond brushing and flossing, consider adding a mouthwash with fluoride. It's like a final rinse that helps strengthen your enamel and further dislodge any lingering bacteria. It's a nice little boost to your efforts.
The thing is, consistent, thorough oral hygiene isn't just about preventing cavities or bad breath. It's about maintaining healthy gums and bone structure. Healthy gums and bone are what hold your teeth firmly in place. If you let plaque and tartar build up, you're setting yourself up for gum disease, which weakens the support structures of your teeth. And guess what happens then? Shifting!
So, bottom line: those daily habits, those seemingly small acts of brushing and flossing, are actually a really big deal. They're the daily defense against tooth shifting and a whole host of other dental problems. Make them a non-negotiable part of your routine, and your smile will thank you for it. Trust me.
Okay, so you're thinking about keeping your teeth straight after braces or just generally trying to avoid future shifting? Smart move. It's not just about the retainer, though that's definitely a big part of it. What you eat actually plays a role in how your teeth behave down the line. Think of it like this: your teeth are constantly being pushed and pulled, not just by your tongue, but by the foods you chew.
Really hard, crunchy stuff like ice or super tough jerky? Yeah, those can put a lot of stress on your teeth and potentially contribute to minor shifts over time. It's not like one carrot stick is going to undo years of orthodontic work, but consistently challenging your teeth with really resistant foods isn't ideal.
Then there's the sticky situation – literally. Taffy, gummy candies, even some dried fruits can latch onto your teeth and create a force that pulls on them for an extended period. Plus, they often contain a lot of sugar, which, well, we know isn't great for overall dental health.
Ultimately, it's about balance. Nobody's saying you can never enjoy a crunchy apple or a chewy caramel again. But being mindful of the potential impact of really hard, sticky, or excessively sugary foods on your teeth and choosing softer alternatives more often can definitely contribute to keeping your smile where it's supposed to be. Think about it as another piece of the puzzle in maintaining that beautifully aligned smile.
Okay, so your kiddo's got braces off! Hooray! But now comes the real test: keeping those pearly whites perfectly aligned with that retainer. Easy peasy? Not always. Getting kids to consistently wear their retainers is like herding cats sometimes, but it's totally doable with a little patience and the right approach. The key, like with most good habits, is establishing a rock-solid routine. Think of it like brushing their teeth – it's just gotta be part of the daily grind.
First, make it visual. A chart on the fridge tracking retainer wear can be surprisingly effective. Stickers, small rewards for consistency (movie night instead of a toy binge, maybe?), anything to make it fun and engaging. Don't make it a punishment if they forget, though. Just gently remind them and move on.
Timing is everything, too. We found that associating it with something they already do religiously helped a ton. For example, right after dinner, retainer goes in. Before they start their homework, retainer goes in. Find those natural anchors in their day.
And let's be honest, retainers can be gross if not cleaned regularly. Make cleaning part of the routine too. A quick rinse after taking it out and a more thorough clean with a denture cleaner a couple times a week keeps things fresh and less icky.
Finally, be their cheerleader! Acknowledge their efforts, celebrate the wins, and remind them why they're doing this in the first place – that beautiful, straight smile they worked so hard for! It's a team effort, and your encouragement makes all the difference. A little consistency now prevents a lot of orthodontist visits (and bills!) later.
Okay, so you've gone through the whole orthodontic journey. Braces off, retainer shimmering, a smile you're finally proud of. Awesome! But here's the thing nobody really shouts from the rooftops: your teeth are sneaky little devils. They have a memory, and sometimes, they try to creep back to where they were before all that hard work. That's where regular check-ups with your orthodontist come in – they're basically your secret weapon against the dreaded tooth shift.
Think of it like this: you wouldn't just learn to drive and then never take your car in for a service, right? You need to make sure everything's still aligned, that there aren't any little issues brewing under the hood. It's the same with your teeth. Your orthodontist isn't just there to admire your post-braces grin; they're there to monitor the stability of your bite, check the fit of your retainer, and catch any early signs of shifting before they become a real problem.
These check-ups aren't usually super frequent – maybe every six months or once a year, depending on your individual situation. But honestly, that little bit of time invested can save you a whole lot of hassle (and potentially more treatment) down the road. Plus, it's a chance to ask any questions you might have about your retainer or oral hygiene. So, treat those orthodontist appointments as a vital part of your long-term smile maintenance. It's a small price to pay for keeping that hard-earned, perfectly aligned smile sparkling for years to come.
Okay, so you're thinking about keeping your teeth where they belong, right? Smart move! Nobody wants that slow-motion orthodontic nightmare where your pearly whites start doing the tango. Let's talk about spotting the early warning signs of tooth shifting and why getting on it fast is your best bet, then we'll swing into how a solid routine can keep things shipshape.
Think of your teeth like little architectural marvels. They're designed to fit together just so. But life happens. Maybe you grind your teeth at night (a sneaky culprit!), maybe you've had a filling or extraction that's left a little gap, or maybe, just maybe, time is doing its thing. So, what do you look for?
First, pay attention to how your teeth feel. A slight tenderness when you chew, a nagging discomfort that wasn't there before, or even a weird pressure sensation can be an early clue. Run your tongue over your teeth regularly. Notice any new gaps, any teeth that feel like they're poking out a bit more than usual? Floss is your friend here too. Is it suddenly harder to floss between certain teeth, or are you finding food getting stuck in new places? These are all red flags.
And honestly, don't brush it off (pun intended!). If you notice anything that seems off, don't wait. Call your dentist. A small shift caught early is way easier to deal with than a major realignment project later on. Think of it like a tiny crack in your windshield – ignore it, and it'll spread.
Now, prevention is the name of the game. Establishing a solid routine is key. We're talking about the basics here: brushing twice a day, flossing daily, and keeping up with your regular dental checkups. Your dentist is your ally in this. They can spot subtle changes you might miss and offer personalized advice on how to keep your teeth happy and stable.
Beyond the basics, consider things like a night guard if you grind your teeth. It's a simple, relatively inexpensive solution that can save you a lot of grief (and expense) down the road. If you've had a tooth extraction, talk to your dentist about replacement options like implants or bridges to prevent surrounding teeth from shifting into the gap.
Basically, it's about being proactive and paying attention. Your teeth are an investment, and a little bit of effort now can keep them smiling pretty for years to come. Don't ignore the whispers – listen to what your mouth is trying to tell you!
A health professional, healthcare professional, or healthcare worker (sometimes abbreviated HCW)[1] is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician (such as family physician, internist, obstetrician, psychiatrist, radiologist, surgeon etc.), physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.
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The healthcare workforce comprises a wide variety of professions and occupations who provide some type of healthcare service, including such direct care practitioners as physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, dentists, pharmacists, speech-language pathologist, physical therapists, occupational therapists, physical and behavior therapists, as well as allied health professionals such as phlebotomists, medical laboratory scientists, dieticians, and social workers. They often work in hospitals, healthcare centers and other service delivery points, but also in academic training, research, and administration. Some provide care and treatment services for patients in private homes. Many countries have a large number of community health workers who work outside formal healthcare institutions. Managers of healthcare services, health information technicians, and other assistive personnel and support workers are also considered a vital part of health care teams.[2]
Healthcare practitioners are commonly grouped into health professions. Within each field of expertise, practitioners are often classified according to skill level and skill specialization. "Health professionals" are highly skilled workers, in professions that usually require extensive knowledge including university-level study leading to the award of a first degree or higher qualification.[3] This category includes physicians, physician assistants, registered nurses, veterinarians, veterinary technicians, veterinary assistants, dentists, midwives, radiographers, pharmacists, physiotherapists, optometrists, operating department practitioners and others. Allied health professionals, also referred to as "health associate professionals" in the International Standard Classification of Occupations, support implementation of health care, treatment and referral plans usually established by medical, nursing, respiratory care, and other health professionals, and usually require formal qualifications to practice their profession. In addition, unlicensed assistive personnel assist with providing health care services as permitted.[citation needed]
Another way to categorize healthcare practitioners is according to the sub-field in which they practice, such as mental health care, pregnancy and childbirth care, surgical care, rehabilitation care, or public health.[citation needed]
A mental health professional is a health worker who offers services to improve the mental health of individuals or treat mental illness. These include psychiatrists, psychiatry physician assistants, clinical, counseling, and school psychologists, occupational therapists, clinical social workers, psychiatric-mental health nurse practitioners, marriage and family therapists, mental health counselors, as well as other health professionals and allied health professions. These health care providers often deal with the same illnesses, disorders, conditions, and issues; however, their scope of practice often differs. The most significant difference across categories of mental health practitioners is education and training.[4] There are many damaging effects to the health care workers. Many have had diverse negative psychological symptoms ranging from emotional trauma to very severe anxiety. Health care workers have not been treated right and because of that their mental, physical, and emotional health has been affected by it. The SAGE author's said that there were 94% of nurses that had experienced at least one PTSD after the traumatic experience. Others have experienced nightmares, flashbacks, and short and long term emotional reactions.[5] The abuse is causing detrimental effects on these health care workers. Violence is causing health care workers to have a negative attitude toward work tasks and patients, and because of that they are "feeling pressured to accept the order, dispense a product, or administer a medication".[6] Sometimes it can range from verbal to sexual to physical harassment, whether the abuser is a patient, patient's families, physician, supervisors, or nurses.[citation needed]
A maternal and newborn health practitioner is a health care expert who deals with the care of women and their children before, during and after pregnancy and childbirth. Such health practitioners include obstetricians, physician assistants, midwives, obstetrical nurses and many others. One of the main differences between these professions is in the training and authority to provide surgical services and other life-saving interventions.[7] In some developing countries, traditional birth attendants, or traditional midwives, are the primary source of pregnancy and childbirth care for many women and families, although they are not certified or licensed. According to research, rates for unhappiness among obstetrician-gynecologists (Ob-Gyns) range somewhere between 40 and 75 percent.[8]
A geriatric care practitioner plans and coordinates the care of the elderly and/or disabled to promote their health, improve their quality of life, and maintain their independence for as long as possible.[9] They include geriatricians, occupational therapists, physician assistants, adult-gerontology nurse practitioners, clinical nurse specialists, geriatric clinical pharmacists, geriatric nurses, geriatric care managers, geriatric aides, nursing aides, caregivers and others who focus on the health and psychological care needs of older adults.[citation needed]
A surgical practitioner is a healthcare professional and expert who specializes in the planning and delivery of a patient's perioperative care, including during the anaesthetic, surgical and recovery stages. They may include general and specialist surgeons, physician assistants, assistant surgeons, surgical assistants, veterinary surgeons, veterinary technicians. anesthesiologists, anesthesiologist assistants, nurse anesthetists, surgical nurses, clinical officers, operating department practitioners, anaesthetic technicians, perioperative nurses, surgical technologists, and others.[citation needed]
A rehabilitation care practitioner is a health worker who provides care and treatment which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. These include physiatrists, physician assistants, rehabilitation nurses, clinical nurse specialists, nurse practitioners, physiotherapists, chiropractors, orthotists, prosthetists, occupational therapists, recreational therapists, audiologists, speech and language pathologists, respiratory therapists, rehabilitation counsellors, physical rehabilitation therapists, athletic trainers, physiotherapy technicians, orthotic technicians, prosthetic technicians, personal care assistants, and others.[10]
Optometry is a field traditionally associated with the correction of refractive errors using glasses or contact lenses, and treating eye diseases. Optometrists also provide general eye care, including screening exams for glaucoma and diabetic retinopathy and management of routine or eye conditions. Optometrists may also undergo further training in order to specialize in various fields, including glaucoma, medical retina, low vision, or paediatrics. In some countries, such as the United Kingdom, United States, and Canada, Optometrists may also undergo further training in order to be able to perform some surgical procedures.
Medical diagnosis providers are health workers responsible for the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. This usually involves a team of healthcare providers in various diagnostic units. These include radiographers, radiologists, Sonographers, medical laboratory scientists, pathologists, and related professionals.[citation needed]
A dental care practitioner is a health worker and expert who provides care and treatment to promote and restore oral health. These include dentists and dental surgeons, dental assistants, dental auxiliaries, dental hygienists, dental nurses, dental technicians, dental therapists or oral health therapists, and related professionals.
Care and treatment for the foot, ankle, and lower leg may be delivered by podiatrists, chiropodists, pedorthists, foot health practitioners, podiatric medical assistants, podiatric nurse and others.
A public health practitioner focuses on improving health among individuals, families and communities through the prevention and treatment of diseases and injuries, surveillance of cases, and promotion of healthy behaviors. This category includes community and preventive medicine specialists, physician assistants, public health nurses, pharmacist, clinical nurse specialists, dietitians, environmental health officers (public health inspectors), paramedics, epidemiologists, public health dentists, and others.[citation needed]
In many societies, practitioners of alternative medicine have contact with a significant number of people, either as integrated within or remaining outside the formal health care system. These include practitioners in acupuncture, Ayurveda, herbalism, homeopathy, naturopathy, Reiki, Shamballa Reiki energy healing Archived 2021-01-25 at the Wayback Machine, Siddha medicine, traditional Chinese medicine, traditional Korean medicine, Unani, and Yoga. In some countries such as Canada, chiropractors and osteopaths (not to be confused with doctors of osteopathic medicine in the United States) are considered alternative medicine practitioners.
The healthcare workforce faces unique health and safety challenges and is recognized by the National Institute for Occupational Safety and Health (NIOSH) as a priority industry sector in the National Occupational Research Agenda (NORA) to identify and provide intervention strategies regarding occupational health and safety issues.[11]
Exposure to respiratory infectious diseases like tuberculosis (caused by Mycobacterium tuberculosis) and influenza can be reduced with the use of respirators; this exposure is a significant occupational hazard for health care professionals.[12] Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, including scabies.[13] Health professionals are also at risk for contracting blood-borne diseases like hepatitis B, hepatitis C, and HIV/AIDS through needlestick injuries or contact with bodily fluids.[14][15] This risk can be mitigated with vaccination when there is a vaccine available, like with hepatitis B.[15] In epidemic situations, such as the 2014-2016 West African Ebola virus epidemic or the 2003 SARS outbreak, healthcare workers are at even greater risk, and were disproportionately affected in both the Ebola and SARS outbreaks.[16]
In general, appropriate personal protective equipment (PPE) is the first-line mode of protection for healthcare workers from infectious diseases. For it to be effective against highly contagious diseases, personal protective equipment must be watertight and prevent the skin and mucous membranes from contacting infectious material. Different levels of personal protective equipment created to unique standards are used in situations where the risk of infection is different. Practices such as triple gloving and multiple respirators do not provide a higher level of protection and present a burden to the worker, who is additionally at increased risk of exposure when removing the PPE. Compliance with appropriate personal protective equipment rules may be difficult in certain situations, such as tropical environments or low-resource settings. A 2020 Cochrane systematic review found low-quality evidence that using more breathable fabric in PPE, double gloving, and active training reduce the risk of contamination but that more randomized controlled trials are needed for how best to train healthcare workers in proper PPE use.[16]
Based on recommendations from The United States Center for Disease Control and Prevention (CDC) for TB screening and testing the following best practices should be followed when hiring and employing Health Care Personnel.[17]
When hiring Health Care Personnel, the applicant should complete the following:[18] a TB risk assessment,[19] a TB symptom evaluation for at least those listed on the Signs & Symptoms page,[20] a TB test in accordance with the guidelines for Testing for TB Infection,[21] and additional evaluation for TB disease as needed (e.g. chest x-ray for HCP with a positive TB test)[18] The CDC recommends either a blood test, also known as an interferon-gamma release assay (IGRA), or a skin test, also known as a Mantoux tuberculin skin test (TST).[21] A TB blood test for baseline testing does not require two-step testing. If the skin test method is used to test HCP upon hire, then two-step testing should be used. A one-step test is not recommended.[18]
The CDC has outlined further specifics on recommended testing for several scenarios.[22] In summary:
According to these recommended testing guidelines any two negative TST results within 12 months of each other constitute a two-step TST.
For annual screening, testing, and education, the only recurring requirement for all HCP is to receive TB education annually.[18] While the CDC offers education materials, there is not a well defined requirement as to what constitutes a satisfactory annual education. Annual TB testing is no longer recommended unless there is a known exposure or ongoing transmission at a healthcare facility. Should an HCP be considered at increased occupational risk for TB annual screening may be considered. For HCP with a documented history of a positive TB test result do not need to be re-tested but should instead complete a TB symptom evaluation. It is assumed that any HCP who has undergone a chest x-ray test has had a previous positive test result. When considering mental health you may see your doctor to be evaluated at your digression. It is recommended to see someone at least once a year in order to make sure that there has not been any sudden changes.[23]
Occupational stress and occupational burnout are highly prevalent among health professionals.[24] Some studies suggest that workplace stress is pervasive in the health care industry because of inadequate staffing levels, long work hours, exposure to infectious diseases and hazardous substances leading to illness or death, and in some countries threat of malpractice litigation. Other stressors include the emotional labor of caring for ill people and high patient loads. The consequences of this stress can include substance abuse, suicide, major depressive disorder, and anxiety, all of which occur at higher rates in health professionals than the general working population. Elevated levels of stress are also linked to high rates of burnout, absenteeism and diagnostic errors, and reduced rates of patient satisfaction.[25] In Canada, a national report (Canada's Health Care Providers) also indicated higher rates of absenteeism due to illness or disability among health care workers compared to the rest of the working population, although those working in health care reported similar levels of good health and fewer reports of being injured at work.[26]
There is some evidence that cognitive-behavioral therapy, relaxation training and therapy (including meditation and massage), and modifying schedules can reduce stress and burnout among multiple sectors of health care providers. Research is ongoing in this area, especially with regards to physicians, whose occupational stress and burnout is less researched compared to other health professions.[27]
Healthcare workers are at higher risk of on-the-job injury due to violence. Drunk, confused, and hostile patients and visitors are a continual threat to providers attempting to treat patients. Frequently, assault and violence in a healthcare setting goes unreported and is wrongly assumed to be part of the job.[28] Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault.[29] In the United States, healthcare workers experience 2⁄3 of nonfatal workplace violence incidents.[28] Psychiatric units represent the highest proportion of violent incidents, at 40%; they are followed by geriatric units (20%) and the emergency department (10%). Workplace violence can also cause psychological trauma.[29]
Health care professionals are also likely to experience sleep deprivation due to their jobs. Many health care professionals are on a shift work schedule, and therefore experience misalignment of their work schedule and their circadian rhythm. In 2007, 32% of healthcare workers were found to get fewer than 6 hours of sleep a night. Sleep deprivation also predisposes healthcare professionals to make mistakes that may potentially endanger a patient.[30]
Especially in times like the present (2020), the hazards of health professional stem into the mental health. Research from the last few months highlights that COVID-19 has contributed greatly to the degradation of mental health in healthcare providers. This includes, but is not limited to, anxiety, depression/burnout, and insomnia.[citation needed]
A study done by Di Mattei et al. (2020) revealed that 12.63% of COVID nurses and 16.28% of other COVID healthcare workers reported extremely severe anxiety symptoms at the peak of the pandemic.[31] In addition, another study was conducted on 1,448 full time employees in Japan. The participants were surveyed at baseline in March 2020 and then again in May 2020. The result of the study showed that psychological distress and anxiety had increased more among healthcare workers during the COVID-19 outbreak.[32]
Similarly, studies have also shown that following the pandemic, at least one in five healthcare professionals report symptoms of anxiety.[33] Specifically, the aspect of "anxiety was assessed in 12 studies, with a pooled prevalence of 23.2%" following COVID.[33] When considering all 1,448 participants that percentage makes up about 335 people.
Slips, trips, and falls are the second-most common cause of worker's compensation claims in the US and cause 21% of work absences due to injury. These injuries most commonly result in strains and sprains; women, those older than 45, and those who have been working less than a year in a healthcare setting are at the highest risk.[36]
An epidemiological study published in 2018 examined the hearing status of noise-exposed health care and social assistance (HSA) workers sector to estimate and compare the prevalence of hearing loss by subsector within the sector. Most of the HSA subsector prevalence estimates ranged from 14% to 18%, but the Medical and Diagnostic Laboratories subsector had 31% prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24% prevalence. The Child Day Care Services subsector also had a 52% higher risk than the reference industry.[37]
Exposure to hazardous drugs, including those for chemotherapy, is another potential occupational risk. These drugs can cause cancer and other health conditions.[38]
Female health care workers may face specific types of workplace-related health conditions and stress. According to the World Health Organization, women predominate in the formal health workforce in many countries and are prone to musculoskeletal injury (caused by physically demanding job tasks such as lifting and moving patients) and burnout. Female health workers are exposed to hazardous drugs and chemicals in the workplace which may cause adverse reproductive outcomes such as spontaneous abortion and congenital malformations. In some contexts, female health workers are also subject to gender-based violence from coworkers and patients.[39][40]
Many jurisdictions report shortfalls in the number of trained health human resources to meet population health needs and/or service delivery targets, especially in medically underserved areas. For example, in the United States, the 2010 federal budget invested $330 million to increase the number of physicians, physician assistants, nurse practitioners, nurses, and dentists practicing in areas of the country experiencing shortages of trained health professionals. The Budget expands loan repayment programs for physicians, nurses, and dentists who agree to practice in medically underserved areas. This funding will enhance the capacity of nursing schools to increase the number of nurses. It will also allow states to increase access to oral health care through dental workforce development grants. The Budget's new resources will sustain the expansion of the health care workforce funded in the Recovery Act.[41] There were 15.7 million health care professionals in the US as of 2011.[36]
In Canada, the 2011 federal budget announced a Canada Student Loan forgiveness program to encourage and support new family physicians, physician assistants, nurse practitioners and nurses to practice in underserved rural or remote communities of the country, including communities that provide health services to First Nations and Inuit populations.[42]
In Uganda, the Ministry of Health reports that as many as 50% of staffing positions for health workers in rural and underserved areas remain vacant. As of early 2011, the Ministry was conducting research and costing analyses to determine the most appropriate attraction and retention packages for medical officers, nursing officers, pharmacists, and laboratory technicians in the country's rural areas.[43]
At the international level, the World Health Organization estimates a shortage of almost 4.3 million doctors, midwives, nurses, and support workers worldwide to meet target coverage levels of essential primary health care interventions.[44] The shortage is reported most severe in 57 of the poorest countries, especially in sub-Saharan Africa.
Nurses are the most common type of medical field worker to face shortages around the world. There are numerous reasons that the nursing shortage occurs globally. Some include: inadequate pay, a large percentage of working nurses are over the age of 45 and are nearing retirement age, burnout, and lack of recognition.[45]
Incentive programs have been put in place to aid in the deficit of pharmacists and pharmacy students. The reason for the shortage of pharmacy students is unknown but one can infer that it is due to the level of difficulty in the program.[46]
Results of nursing staff shortages can cause unsafe staffing levels that lead to poor patient care. Five or more incidents that occur per day in a hospital setting as a result of nurses who do not receive adequate rest or meal breaks is a common issue.[47]
Practicing without a license that is valid and current is typically illegal. In most jurisdictions, the provision of health care services is regulated by the government. Individuals found to be providing medical, nursing or other professional services without the appropriate certification or license may face sanctions and criminal charges leading to a prison term. The number of professions subject to regulation, requisites for individuals to receive professional licensure, and nature of sanctions that can be imposed for failure to comply vary across jurisdictions.
In the United States, under Michigan state laws, an individual is guilty of a felony if identified as practicing in the health profession without a valid personal license or registration. Health professionals can also be imprisoned if found guilty of practicing beyond the limits allowed by their licenses and registration. The state laws define the scope of practice for medicine, nursing, and a number of allied health professions.[48][unreliable source?] In Florida, practicing medicine without the appropriate license is a crime classified as a third degree felony,[49] which may give imprisonment up to five years. Practicing a health care profession without a license which results in serious bodily injury classifies as a second degree felony,[49] providing up to 15 years' imprisonment.
In the United Kingdom, healthcare professionals are regulated by the state; the UK Health and Care Professions Council (HCPC) protects the 'title' of each profession it regulates. For example, it is illegal for someone to call himself an Occupational Therapist or Radiographer if they are not on the register held by the HCPC.
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In dentistry, crossbite is a form of malocclusion where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either closer to the cheek or to the tongue) than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral misalignment of the dental arches.[1][2]
An anterior crossbite can be referred as negative overjet, and is typical of class III skeletal relations (prognathism).
An anterior crossbite in a child with baby teeth or mixed dentition may happen due to either dental misalignment or skeletal misalignment. Dental causes may be due to displacement of one or two teeth, where skeletal causes involve either mandibular hyperplasia, maxillary hypoplasia or combination of both.
An anterior crossbite due to dental component involves displacement of either maxillary central or lateral incisors lingual to their original erupting positions. This may happen due to delayed eruption of the primary teeth leading to permanent teeth moving lingual to their primary predecessors. This will lead to anterior crossbite where upon biting, upper teeth are behind the lower front teeth and may involve few or all frontal incisors. In this type of crossbite, the maxillary and mandibular proportions are normal to each other and to the cranial base. Another reason that may lead to a dental crossbite is crowding in the maxillary arch. Permanent teeth will tend to erupt lingual to the primary teeth in presence of crowding. Side-effects caused by dental crossbite can be increased recession on the buccal of lower incisors and higher chance of inflammation in the same area. Another term for an anterior crossbite due to dental interferences is Pseudo Class III Crossbite or Malocclusion.
Single tooth crossbites can occur due to uneruption of a primary teeth in a timely manner which causes permanent tooth to erupt in a different eruption pattern which is lingual to the primary tooth.[3] Single tooth crossbites are often fixed by using a finger-spring based appliances.[4][5] This type of spring can be attached to a removable appliance which is used by patient every day to correct the tooth position.
An anterior crossbite due to skeletal reasons will involve a deficient maxilla and a more hyperplastic or overgrown mandible. People with this type of crossbite will have dental compensation which involves proclined maxillary incisors and retroclined mandibular incisors. A proper diagnosis can be made by having a person bite into their centric relation will show mandibular incisors ahead of the maxillary incisors, which will show the skeletal discrepancy between the two jaws.[6]
Bjork defined posterior crossbite as a malocclusion where the buccal cusps of canine, premolar and molar of upper teeth occlude lingually to the buccal cusps of canine, premolar and molar of lower teeth.[7] Posterior crossbite is often correlated to a narrow maxilla and upper dental arch. A posterior crossbite can be unilateral, bilateral, single-tooth or entire segment crossbite. Posterior crossbite has been reported to occur between 7–23% of the population.[8][9] The most common type of posterior crossbite to occur is the unilateral crossbite which occurs in 80% to 97% of the posterior crossbite cases.[10][3] Posterior crossbites also occur most commonly in primary and mixed dentition. This type of crossbite usually presents with a functional shift of the mandible towards the side of the crossbite. Posterior crossbite can occur due to either skeletal, dental or functional abnormalities. One of the common reasons for development of posterior crossbite is the size difference between maxilla and mandible, where maxilla is smaller than mandible.[11] Posterior crossbite can result due to
Unilateral crossbite involves one side of the arch. The most common cause of unilateral crossbite is a narrow maxillary dental arch. This can happen due to habits such as digit sucking, prolonged use of pacifier or upper airway obstruction. Due to the discrepancy between the maxillary and mandibular arch, neuromuscular guidance of the mandible causes mandible to shift towards the side of the crossbite.[14] This is also known as Functional mandibular shift. This shift can become structural if left untreated for a long time during growth, leading to skeletal asymmetries. Unilateral crossbites can present with following features in a child
A child with posterior crossbite should be treated immediately if the child shifts their mandible on closing, which is often seen in a unilateral crossbite as mentioned above. The best age to treat a child with crossbite is in their mixed dentition when their palatal sutures have not fused to each other. Palatal expansion allows more space in an arch to relieve crowding and correct posterior crossbite. The correction can include any type of palatal expanders that will expand the palate which resolves the narrow constriction of the maxilla.[9] There are several therapies that can be used to correct a posterior crossbite: braces, 'Z' spring or cantilever spring, quad helix, removable plates, clear aligner therapy, or a Delaire mask. The correct therapy should be decided by the orthodontist depending on the type and severity of the crossbite.
One of the keys in diagnosing the anterior crossbite due to skeletal vs dental causes is diagnosing a CR-CO shift in a patient. An adolescent presenting with anterior crossbite may be positioning their mandible forward into centric occlusion (CO) due to the dental interferences. Thus finding their occlusion in centric relation (CR) is key in diagnosis. For anterior crossbite, if their CO matches their CR then the patient truly has a skeletal component to their crossbite. If the CR shows a less severe class 3 malocclusion or teeth not in anterior crossbite, this may mean that their anterior crossbite results due to dental interferences.[17]
Goal to treat unilateral crossbites should definitely include removal of occlusal interferences and elimination of the functional shift. Treating posterior crossbites early may help prevent the occurrence of Temporomandibular joint pathology.[18]
Unilateral crossbites can also be diagnosed and treated properly by using a Deprogramming splint. This splint has flat occlusal surface which causes the muscles to deprogram themselves and establish new sensory engrams. When the splint is removed, a proper centric relation bite can be diagnosed from the bite.[19]
Literature states that very few crossbites tend to self-correct which often justify the treatment approach of correcting these bites as early as possible.[9] Only 0–9% of crossbites self-correct. Lindner et al. reported that 50% of crossbites were corrected in 76 four-year-old children.[20]
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