Masking Requirements for Pennsylvania Dental Offices: There remains some confusion as to whether patients should be wearing masks upon entrance, waiting in waiting rooms and other public areas of our dental office.
The ADA’s interpretation of the CDC’s new “COVID-19 Community Levels” guidance (Feb. 25, 2022), is that it may apply to public areas of a dental facility and that some patients would not have to wear masks should certain conditions be met.
Due to concerns about increased transmissibility of the SARS-CoV-2 Omicron variant, this guidance is being updated to enhance protection for healthcare personnel, patients, and visitors and to address concerns about potential impacts on the healthcare system given a surge in SARS-CoV-2 infections.
The Pennsylvania Dental Association in conjunction with the Department of Health as well as the CDC's most current recommendations for health care settings (Feb. 2, 2022) first and foremost recommends universal source control. That means well-fitting masks are recommended for everyone in a healthcare setting. This includes waiting rooms and other "public" areas.
Therefore, in order to enter our dental office, we are asking all of our patients to continue to wear their mask upon entering our facility until we get the official all clear from the American Dental Association as well as the Pennsylvania Dental Association.
Thank you in advance for your cooperation
Bronchitis vs. Pneumonia: How to Tell the Difference, According to Experts:
During the fall and winter months, your respiratory system is opened up to the risk of quite a few different illnesses: colds, the flu, and now, COVID-19. Bronchitis and pneumonia are two more illnesses that directly affect your airways—and though The American Lung Association (ALA) says bronchitis—specifically acute bronchitis—is the sudden development of inflammation in the bronchial tubes, or the lungs' major airways. "The infection gets beyond the confines of the bronchial tubes and actually gets into the substance of the lung," says William Schaffner, MD, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville. "Then it causes inflammation in the tissues of the lung."
Most cases of bronchitis are caused by viruses, often the same viruses that are responsible for common colds and the flu. "The same virus that causes the common cold settles lower down and causes bronchitis" in some people, Ephraim L. Tsalik, MD, PhD, associate professor of medicine in the division of infectious diseases at Duke Health in Durham, North Carolina, tells Health. But bronchitis is often not severe, is temporary, and usually doesn't cause any permanent lung damage.
they're different conditions, they can present similarly.
Pneumonia, on the other hand, is an infection in one or both of the lungs, affecting the air sacs of the lungs, causing them to fill up with fluid or pus. Bacteria is the most common cause of pneumonia and it can occur on its own, or it can be the result of a viral infection, like the cold or the flu.
Viruses, too, can cause pneumonia—like respiratory syncytial virus (RSV) or SARS-CoV-2 (the virus that causes COVID-19)—though those cases are often less severe.
Fungal infections can lead to pneumonia too, but commonly only occur in those with chronic health issues or weakened immune systems.
In any case, however, pneumonia can range from mild to severe, depending what caused the infection, and the infected person's age or overall health. How much of the lung or lungs is affected can also determine the severity of the disease: "The larger the proportion it affects, the more seriously ill you are going to become," Dr. Schaffner says.
What are the symptoms of bronchitis vs. pneumonia?
The most prominent Bronchitis Symptoms is a cough—often a cough that occurs in spells, says Dr. Schaffner. And during the first few days of bronchitis, symptoms often mimic the common cold.
Other symptoms include:
Runny, stuffy nose
Low-grade fever
Chest congestion
Wheezing or a whistling sound while breathing
A cough that may produce yellow or green mucus (sputum)
Feeling run-down or tired
The bronchitis infection itself usually lasts a week to 10 days, but don't be surprised if the cough outlasts it—even by several weeks.
Pneumonia symptoms can be similar to those of bronchitis, but there are some pretty major differences—namely the severity of symptoms. Those include:
Fever
Chills
Cough, usually with phlegm (a slimy substance from deep in your lungs)
Shortness of breath
Chest pain when you breathe or cough
Nausea and/or vomiting
Diarrhea
Those symptoms, however, can vary between populations. Young children, for example, may experience the gastrointestinal issues, while older adults may experience more milder versions of the respiratory symptoms.
Generally, pneumonia lasts longer than bronchitis—a few weeks to a few months and, unlike bronchitis, it can lead to more severe issues like bacteremia (when bacteria move to the bloodstream), lung abscesses, kidney failure, or respiratory failure.
How can you treat (and prevent) bronchitis and pneumonia?
Because bronchitis is almost always viral, antibiotic treatments aren't effective. You may be able to relieve some symptoms with over-the-counter mucus-loosening drugs or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. A humidifier in your room or a couple of teaspoons of honey in tea or warm water may soothe the coughing as well.
The best way to prevent bronchitis is to continue practicing healthy habits. That means avoiding lung irritants in work settings, and staying on the defense during winter months, like washing your hands regularly, avoiding sick people, and getting a flu shot every year.
Antibiotics, however, can help treat bacterial pneumonia, while some people with viral infections may benefit from antiviral medication. No matter the cause, rest and fluids can help you recover from pneumonia, but more serious cases may involve hospitalization.
Luckily, there is a vaccine for one type of bacterial pneumonia. The pneumococcal vaccine is recommended for children under the age of 2, adults 65 years or above, and people in between who have certain chronic medical conditions. "That's important for people with underlying illnesses of any kind," says Dr. Schaffner. "Even smokers are at increased risk of pneumonia."
But overall, if you have a really high fever, trouble breathing, or a cough that pulls up pus or blood, see your doctor no matter what you think the cause of your symptoms might be. Your doctor might order a chest X-ray to help determine whether you have bronchitis or pneumonia.
What Actually Causes Shingles—and How You Can Prevent It: Shingles is caused by a reactivation of the varicella zoster virus (which also causes chickenpox), is preventable, provided you're up to date on your vaccines.
While not everyone who has chickenpox as a kid will see it reappear as shingles as adults, one in three people will experience shingles over the course of a lifetime.
How do you know if have shingles? The symptoms begin as an itching, burning feeling that occurs either on the left or right side of your torso followed by a painful rash (which can sometimes be accompanied by a headache and a low fever). Then fluid-filled blisters appear, says Eric Grahling, MD, a pain management expert in Plainville, Connecticut.
These blisters appear on a path of the nerve that the virus is extending along. "However, most people don't know where the paths of various nerves are," says David Cutler, MD, a family medicine physician at Providence Saint John's Health Center in Santa Monica, California. "But if you've had sciatica or a pinched nerve in your neck going down your arm, those are the patterns shingles will take."
What worries health care providers is that occasionally shingles blisters will appear on your face or get into your eyes, which is much more dangerous and requires immediate treatment.
"The hallmark of shingles is that there is pain that precedes the rash," Dr. Cutler says. "This can be confusing for people who go to the doctor with pain and no rash. This can mean your shingles diagnosis will be missed."
If you do have a shingles outbreak, it's imperative to know that this is contagious. In fact, you can pass the virus to anyone who isn't immune to chickenpox if that person has direct contact with your shingles sores. Interestingly, if a person becomes infected, he or she will develop chickenpox, not shingles. A safe bet: Avoid anyone with a weakened immune system, pregnant women, and newborns until your shingles blisters scab over.
"While the exact cause of shingles is unknown, experts do know that the virus can remain inactive in nerve tissues near the spinal cord and brain for decades," Dr. Grahling says. "We believe that it may recur so many years later if a person has a lowered immunity due to infections that comes with age or has a weakened immune system due to medical treatments or a disease."
Why is the shingles vaccine is so important? Shingrix, was approved in 2017 by the FDA and is now the preferred choice. Shingrix is said to be over 90% effective, according to the CDC. Ideally, health care providers are hoping to prevent adults from ever getting shingles, and, ultimately, shingles-related complications such as vision loss, neurological problems, skin infections, and ongoing nerve pain, which can affect up to 20% of those who have experienced shingles.
"Thankfully, most shingles cases are highly treatable," says Dr. Grahling. "However, the dreaded consequence of shingles is the extreme pain known as postherpetic neuralgia (PHN), which can persist for months or even years."
Until next time, stay SAFE and Stay HEALTHY
James A. Vito, D.M.D.