skin, without compression or bagginess. Gloves
that are too tight lead to hand and thumb pain,
and gloves that are too loose interfere with
tactile sensitivity and precision gripping. Proper glove fit depends on the size and shape of
your palm, the length and diameter of your
fingers, and the flexibility of the glove fabric.
Another important consideration is thumb
positioning. Some ambidextrous gloves exert
excessive force on the thumb, which creates a
dangerous postural situation.
Nitrile and polychloroprene gloves are the
most popular today. Several brands of gloves have
been subjected to rigorous independent testing
to determine a minimal impact to hand muscles
while not interfering with performance, hand
posture, or gripping. Consider a brand that holds
an ergonomic certification. Just like women’s
clothing, sizing is not standardized. One company’s medium may not be the same fit as another company’s medium. Everything depends
on the size and shape of the hand formers used
in glove fabrication. Half sizes, are now available,
a breakthrough for those who have never found
the right size. It’s easy to order samples and
determine your perfect fit.
Finally, consider the fit and fabric of your clinical attire. Research has shown that tight clinical
jackets impinge on shoulder mechanics. If your
jacket is too tight or the fabric does not stretch
sufficiently, activities such as reaching for the
overhead light or attempting to retrieve an item
behind you can have a negative impact on the
musculoskeletal system. Tight-fitting pants can
also cause a person to lean further for ward when
sitting down or when seated. The pelvic angle
also increases with these two postures, which
creates additional musculoskeletal strain on the
lumbar spine and pelvis.
So, even if you don’t enjoy shopping, it’s important to pay attention to your body, and then
take the time to shop for the proper equipment
that will make your day in the operatory much
more productive and comfortable. RDH
continued from pg. 41
Raised temperatures lead to progressing
fermentation, thus compounding its
Toombak users are more susceptible to infec-
tions, inflammation of the oral tissues as well as
premalignant lesions (dysplasia, keratinization,
and hyperkeratosis). It is scientifically proven that
toombak lesions display increased dyskeratosis,
apoptosis is inhibited, and genetically the P53
tumour suppressor gene is downregulated.
Thus, the development of lesions are much
more likely to have an invasive nature with the
ability to metastasize.
According to Ahmed (2013), four types of
tobacco products are consumed. Loose leaf or
chewing tobacco, snuff, plug tobacco, and twist
or roll tobacco. Chewing tobacco and snuff
are reported to be the most widely used. The
most favored is toombak is placed in the cheek
or lower lip area.
It is also known in Sudan that toombak is
associated/implicated with cancers of the na-
sal cavity, esophagus, pancreas, kidney, and
urinary bladder cancers. However, the use of
the product is still widely continued, observ-
able in oral cancer rates overall in Sudan.
Its damage being seen in the United States
amongst Sudanese users of toombak.
Because of cultural norms in Sudan, women
do not admit to Toombak use; however, recent
studies suggest increasing numbers of female
We continue to see many individuals from
all corners of the world and increasing our own
knowledge in the possibilities and intricacies
of oral cancer assist us in our own repertoire
of possibilities. It may be wise to include ques-
tions of toombak use in dental practices for
As always, keep asking good questions and
always listen to your patients.
Author’s note: The author would like to
thank Dr. Amel Sami for her contribution to
this article. She is an oral medicine specialist
in Sudan. RDH
1. Ahmed HG. (2013). Etiology of Oral Cancer in the
Sudan. Journal of Oral & Maxillofacial Research, 4( 2),
2. Babiker TM, Osman KAA, Mohamed SA, Mohamed
MA, Almahdi HM. Oral cancer awareness among dental
patients in Omdurman, Sudan: a cross sectional study.
BMC Oral Health:2017: 17: 69.
BUT YOU DON’T LOOK SICK
continued from pg. 54
stimulates flow for two reasons—chewing and
the effect of xylitol on salivary glands. However,
some experience TMJ or muscle fatigue from
Allday spray is a supersaturated 44% xylitol
liquid formulated with a muco-adhesive complex.
The flavor is a very light mint, and the liquid is
more viscous than other mouth sprays, which
enhances the protection of soft tissues. Lubricity
Oral Spray also contains xylitol and uses
hyaluronan, a lubricating ingredient that has the
properly to retain a large amount of water and
reduce the co-efficient of friction in the oral cavity.
Several companies offer xylitol lozenges or
candies. Two unique products in this category
are Nuvora lozenges, which dissolve slowly and
have the added antimicrobial benefit of essential oils, and XyliMelts, 100% xylitol discs
with a vegetable adhesive backing. This allows
users to position the disc just above the maxillary molars opposite the parotid gland to facilitate salivary flow.
Another approach to alleviating the
devastating effects of oral dryness is prescription
powders mixed with water, which create a
supersaturated calcium phosphate oral rinse that
can be used two to 10 times a day. NeutraSal has
been available for several years and SalivaMAX is
the newest entry in this category. After regular
use for a few days, patients achieve oral comfort
since the electrolyte concentration of the rinse is
equal to that of human saliva.
Most of us have experienced dry eyes. The
speaker who addressed ocular issues at the
conference provided some very interesting
information. Those who develop the sicca
symptoms from Sjögren’s or other autoimmune
disorders are at increased risk for infection, an
abraded cornea, blurry vision, and eyelids that
get stuck closed during sleep due to the lack of
blinking. A patient’s dry eye syndrome can be a
combination of insufficient aqueous volume and
rapid tear evaporation.
On average, most people blink every seven
seconds, which is about 8,000 blinks per day. Not
surprisingly, many people now suffer from
computer vision syndrome, a condition that can
cause damage to the gland in the eyelids.
Blinking helps keep the eyes moist and healthy.
Those spending three to four hours a day
staring at a screen can have a blink rate
reduction of 50% to 60%.
Tears are Mother Nature’s first line of defense
against microbes, and adequate tear production
supports comfort. Since those with Sjögren’s have
a compromised quantity and quality of tear film,
it is estimated that the eyes can have up to six
waking hours where the surface of the eye is left
without adequate tear protection.
Conference attendees said repeatedly that
they did not want anyone to know they had