Lynnwood dentist says stress of COVID is grinding on patients, but routine care remains vital

Stress from the coronavirus pandemic has people gnashing their teeth and avoiding dental care.

LYNNWOOD, Wash. — The dentist’s office was a scary place for many people long before the coronavirus pandemic. For some, it’s even scarier now. 

People are avoiding dentists because they worry it isn’t safe — and that’s creating another set of health issues. 

The ongoing global pandemic is quite literally grinding people down to their breaking point.

“This patient said she started to notice herself clenching and grinding,” said Dr. Bradley Jonnes of Lynnwood’s Cedar View Dental, pointing to an X-ray. “She actually broke the tooth off at the gum line.”

Jonnes said, prior to the pandemic, he’d see a broken tooth every couple of weeks. Now he sees several a week.

“People come in and I ask them what changed, and they say, ‘Look at the world! It’s stress. I’m definitely clenching and grinding now.'”

Fear of contracting COVID-19 also has people putting off check-ups, turning small problems into big ones. Routine cavities can become root canals.

After dental offices across the country were completely shut down at the beginning of the pandemic, the American Dental Association changed its policy, designating check-ups as “essential” services.

When asked whether a check-up truly is “essential,” Jonnes responded, “That’s an interesting question. Sometimes we do a check-up and we find a lot more, so we can prevent a lot more. In some cases, it saves people time and money and pain and hassle by doing that check-up. We screen for oral cancer and other issues. We never know what we’re going to find until we get in there.”

Washington state is now allowing dentists to operate as they did prior to the pandemic with additional requirements, including screening of patients for symptoms and thorough cleaning of facilities.

Though not required, Jonnes uses a hand-held fogger to coat his office with a natural disinfectant every day.

He wears both an N95 and additional surgical mask during each procedure. A hospital grade air purification system filters the air in the office every 15 minutes.

“The good thing is, we now have a track record,” said Jonnes. “When we were first opening, we didn’t know how COVID and dentistry would be affected. Talking with my colleagues, the American Dental Association and the national association, we can see dental offices have been safe.”

The American Dental Association reports less than 1% of the nation’s 200,000 dentists have tested positive for coronavirus, compared to more than 200,000 health care workers who have been infected.

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Pediatric mental health screenings increasing, but need remains

The number of behavioral health screenings for children are increasing year-over-year, but experts said more can be done to catch mental health conditions early on, especially as they pose more of a risk to children during the COVID-19 pandemic.

According to data from the Connecticut Department of Social Services, behavioral health screenings billed to Medicaid for children aged four to 17 went up by 50,000 from 3,697 in 2013 to 53,756 in 2019. Similar screenings for children under the age of three went up from 27,992 to 73,262.

“I wish I could say it’s because of educating practices but the bottom line is those numbers are increasing as time goes on and more resources become available,” said Dr. David Krol, a pediatrician who is also vice president for health initiatives for the Child Health and Development Institute of Connecticut. “We’re seeing more pediatricians doing these screenings.”

Valerie Lepoutre, statewide peer recovery program manager for the National Alliance on Mental Illness’ Connecticut chapter, said screenings and loved ones keeping an eye out for mental illness in children is even more crucial as many experience new levels of stress given the COVID-19 pandemic.

“We’re constantly…saying to keep an eye out to how your child is responding and acting during this time and not dismiss it,” Lepoutre said. “We don’t know what the long-term effects will be and it could lead to other mental health challenges. Even if it goes away, it’s better to get help now.”

While behavioral health screenings and mental illness awareness are increasing, the American Academy of Pediatrics reported in a 2017 study that up to 20 percent of children experience a mental health disorder and many remain untreated. Lepoutre said that it can take up to a year for some mental illnesses to be diagnosed.

These delays are costly, not only in setting out a treatment plan, but for a patient’s physical health. Lepoutre said delays in diagnosis can lead to many patients not getting help for their mental illness until their 20s at which point many young adults are on their own insurance and may struggle with finding the time to navigate the behavioral health care system and to find a care team. Mental health can also take a toll on physical health, particularly if a child experiences trauma at a young age.

“This could cause other challenges for our generation ahead of us to see how are they physically handling the stress,” Lepoutre said. “Children are resilient but that post-traumatic growth is huge. We have to be mindful of negative consequences and effects this can have later in their lives.”

But there’s a number of ways experts are working to improve early detection. NAMI hosts educational programs, including one called “Ending the Silence” which is designed to teach teens the signs of mental illness.

Lepoutre said that many pediatricians only see patients once a year for wellness visits. This means it’s important to educate family, teachers and students of the signs of mental illness since they’re

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Wakefield Coronavirus Rate Rises, Risk Level Remains High

WAKEFIELD, MA — Wakefield is still considered a high-risk community for the coronavirus, according to weekly state data released Thursday. It was among 77 cities and towns across the Commonwealth labeled high risk, or “red,” up from 63 from last week.

Wakefield had 59 confirmed cases over the last two weeks, with an average daily rate of 15.6 cases per 100,000. That was a significant increase from 9 cases per 100,000 last week, when the town attributed a spike in cases to a cluster at one location.

State officials have said that high-risk communities, along with those considered high risk in the past two updates, cannot move on to the next phase of reopening. Towns were marked high risk, or “red,” if they reported more than eight confirmed COVID-19 cases per day per 100,000 residents over the past two weeks.

Statewide, the positive test rate rose to 1.4 percent, the highest level since mid-August and up from 0.8 percent in mid-September. In Wakefield, the positive rate rose to 3 percent from 1.57 percent last week.

Health officials say positive test results need to stay below 5 percent for two weeks or longer and, preferably, be closer to 2 percent, for states to safely ease restrictions.

The state reported 986 confirmed cases and 30 deaths associated with the virus Thursday. There have been 9,589 deaths and 143,927 confirmed cases statewide since the pandemic reached the Bay State in March.

In Wakefield, 434 people have tested positive for the virus during that time.

Statewide, there were 9 average daily cases per 100,000 residents, keeping the state above the high-risk threshold for the second week in a row.

View the state’s interactive COVID-19 map.

This article originally appeared on the Wakefield Patch

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Germany’s daily virus count remains near record

BERLIN — Germany’s disease control center says the number of new daily coronavirus cases remains near a record high, as the pandemic continues to spread.

The Robert Koch Institute said Friday that 11,242 new cases were reported over the last 24-hour period, just shy of the record 11,278 mark set the day before. The nationwide infection rate over the last seven days rose to 60.3 cases per 100,000 residents, up from 56.2 the day before.

Some hot spots, like the capital, are much higher than that, with Berlin reporting a rate of 110.6 cases per 100,000 residents, with the district of Neukoelln at more than double that with a rate of 236.7 per 100,000.


The Health Ministry, which said earlier this week that Health Minister Jens Spahn had tested positive for the coronavirus and was in quarantine at home exhibiting cold-like symptoms, said Friday his husband, Daniel Funke, had also tested positive.

It said Funke tested positive on Thursday morning and was symptom free, but had been in quarantine with Spahn since Wednesday afternoon.

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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— FDA approves first COVID-19 drug: antiviral remdesivir

— Europe faces more curfews, restrictions as virus cases swell

— UN chief says G-20 leaders must coordinate to fight COVID-19

— U.K. Treasury chief Rishi Sunak has announced increased help for bars, pubs and restaurants that have seen business collapse because of COVID-19 controls, saying that even businesses that remain open face profound economic uncertainty.

— France’s prime minister has announced a vast extension of the nightly curfew that is intended to curb the spiraling spread of the coronavirus.

— A scientist newly appointed as an advisor to the British government has expressed skepticism about focusing on the role of structural racism in the disproportionate effect that the coronavirus has on ethnic minority groups.

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Follow all of AP’s coronavirus pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

NEW DELHI — India has reported below 60,000 new coronavirus cases for a fifth day as the promise of a free COVID-19 vaccine turned into a key state election issue.

The Health Ministry says 54,366 new cases have taken the overall tally past 7.7 million on Friday. It also reported 690 deaths in the past 24 hours, raising total fatalities to 117,306.

India recorded a daily average of more than 61,000 cases last week. The ministry also said India’s active caseload was below 700,000.

A political row erupted after Prime Minister Narendra Modi’s Hindu nationalist party promised free vaccination to people in eastern Bihar state where voting is scheduled to begin next week. Bihar is India’s third largest state with a population of about 122 million people.

Finance Minister Nirmala Sitharaman, releasing the party’s election manifesto, said every Bihar resident will be given free vaccination when it becomes available. She said at least three vaccines have reached the last trial stage and are on the cusp of production.

The promise angered the Congress and

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Bad Bunny, Daddy Yankee top Billboard Latin Music Awards with 7 wins each: ‘Music remains medicine’

Bad Bunny energizes New York with surprise mobile concert

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Bad Bunny and Daddy Yankee each claimed seven wins Wednesday night at the pandemic-delayed Billboard Latin Music Awards. 

Bad Bunny won artist of the year, the night’s top honor, as well as top Latin album for “X 100PRE” and songwriter of the year. He did not attend the ceremony.

Daddy Yankee won six of his awards for his hit “Con Calma,” which featured the 1990s artist Snow. His honors included the hot Latin song aware, and song of the year honors for streaming and airplay and digital platforms.



Daddy Yankee wearing sunglasses posing for a photo: Bad Bunny, left, accepts the award for social artist of the year at the Billboard Latin Music Awards on April 25, 2019, in Las Vegas and Daddy Yankee accepts the award for favorite male artist at the Latin American Music Awards at the Dolby Theatre on Oct. 25, 2018, in Los Angeles. Bad Bunny and Daddy Yankee triumphed at the Billboard Latin Music Awards Wednesday, Oct. 21, 2020, claiming seven trophies apiece at the pandemic-delayed show.


© AP
Bad Bunny, left, accepts the award for social artist of the year at the Billboard Latin Music Awards on April 25, 2019, in Las Vegas and Daddy Yankee accepts the award for favorite male artist at the Latin American Music Awards at the Dolby Theatre on Oct. 25, 2018, in Los Angeles. Bad Bunny and Daddy Yankee triumphed at the Billboard Latin Music Awards Wednesday, Oct. 21, 2020, claiming seven trophies apiece at the pandemic-delayed show.

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The reggaeton star dedicated the first of his awards to those who had lost loved ones due to COVID-19, the disease caused by the coronavirus. “Music remains medicine,” he said.

Actress Gaby Espino hosted the ceremony, which aired live on Telemundo from the BB&T Center in Sunrise, Florida. The event had a red carpet, but no audience.

Mexican romance singer-songwriter Armando Manzanero received a Lifetime Achievement Award during the ceremony. Enrique Iglesias was honored as Billboard’s Top Latin Artist of All Time. 

Luis Fonsi and Daddy Yankee were also recognized for “Despacito,” which was named song of the decade.

The ceremony, rescheduled from April to October, took place in-person at the BB&T Center in Sunrise, Florida. It featured a limited audience, but had most of the trappings of a pre-pandemic awards show including a red carpet and live performances. 

Billboard and NBCUniversal, Telemundo’s parent company, said they put a number of safety measures in place to mitigate risk of performers and crew members contracting COVID-19.

Five stages were constructed: a central stage for Espino and four outlying stages for performers, which allowed sets to be sanitized between acts and helped facilitate social distancing. 

“It’s certainly unprecedented for us,” Jeff Mayzurk, Telemundo’s executive vice president of operations and technology, told USA TODAY. “It’s almost like producing four separate shows.”

Contributing: Gary Dinges and Hannah Yasharoff, USA TODAY; the Associated Press

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L.A. County to ease some coronavirus rules, though a wide reopening remains elusive

Although Los Angeles County remains rooted in the most restrictive tier of California’s coronavirus reopening road map, officials this week announced plans to relax some requirements on businesses to bring the county’s standards in line with wider state guidelines.



a group of people sitting on a bench: Adan Gutierrez, left, Ramon Ayala and Vicente Fernandez enjoy a beer outside Grand Central Market in Los Angeles on June 30. (Francine Orr / Los Angeles Times)


© (Francine Orr / Los Angeles Times)
Adan Gutierrez, left, Ramon Ayala and Vicente Fernandez enjoy a beer outside Grand Central Market in Los Angeles on June 30. (Francine Orr / Los Angeles Times)

The changes — expected this week — will allow family entertainment centers to open outdoors; eliminate a requirement that customers at wineries and breweries make reservations; and remove the food requirement for wineries.

“I hope this provides much-needed relief and respite for residents who are looking for some activities outside of their homes,” Kathryn Barger, chairwoman of the L.A. County Board of Supervisors, said during a briefing Wednesday.

“These updates will also bring more employees back to work,” she said — a pivotal development in a region where the unemployment rate has been estimated at 16%.

Barger also said county schools are in line to welcome back more students for in-person instruction.

According to the supervisor, schools have been allowed to bring up to 10% of students back on campus at a time if the students have special needs, such as those with disabilities or who are learning English.

“We will now increase to 25% capacity for high-needs students so more children and youth can have access to their teachers and the on-site support systems that are so critical for their growth and for their education,” Barger said.

It is unclear when that change will go into effect. But as L.A. County remains in Tier 1 of the state’s four-tier reopening plan — also called the purple tier, which indicates widespread risk of community coronavirus transmission — campuses cannot reopen for all students.

The county’s spot in the state’s most stringent tier also prevents wider economic reopenings. Under the purple category, many businesses and public facilities either cannot operate indoors or can do so only at a strictly limited capacity.

Counties land in the purple tier if they have more than seven new coronavirus cases per 100,000 people per day or a test positivity rate of more than 8%.

As of Wednesday, L.A. County’s case rate remained above the threshold required to move down into the red tier.

“I think many of us are discouraged that we haven’t yet reduced our case rate enough to move to Tier 2,” L.A. County Public Health Director Barbara Ferrer said Wednesday. “I do want to note that we do have the tools in hand to drive transmission rates down in our communities. Not only do we want to eventually progress into less restrictive tiers, but we want to be able to continue to keep businesses and institutions open.”

Ferrer announced 33 new COVID-19 deaths in the county, raising the total toll to 6,944, as well as 510 new cases for a total of 290,486.

But she cautioned that “some significant

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Stroke After TIA: Risk Remains High

The incidence of stroke following a transient ischemic attack (TIA) has decreased somewhat over the past 50 years but hardly at all during the past decade, a new meta-analysis shows.

“This systematic review and meta-analysis found that transient ischemic attack continues to be associated with a high risk of early stroke. However, the rate of post-TIA stroke might have decreased slightly during the past 2 decades,” the authors conclude.



Dr Ramin Zand

“In recent years, there has been a lot of advancement in the treatment of stroke but not so much improvement for TIA,” senior author Ramin Zand, MD, Geisinger Neuroscience Institute, Danville, Pennsylvania, told Medscape Medical News.

“Many strokes happen in the first few days after a TIA, so it is of utmost importance to evaluate these patients quickly and get preventative treatments on board as soon as possible. Unfortunately, this does not always happen,” he said.

“Speedy diagnosis and treatment of TIA is possibly even more important than for stroke, as no brain damage has yet occurred in TIA patients and we have the opportunity to stop such damage from occurring,” Zand added.

The meta-analysis of all published studies of TIA outcomes from 1971 to 2019 was published online in JAMA Neurology on October 12. A total of 68 studies involving 206,455 patients were included.

The rate of subsequent ischemic stroke after TIA over the whole time span was estimated to be 2.4% within 2 days, 3.8% within 7 days, 4.1% within 30 days, and 4.7% within 90 days.

The authors evaluated the population with respect to three periods ― before 1999 (group A), from 1999 to 2007 (group B), and after 2007 (group C). These periods were chosen on the basis of changes to the guidelines on TIA made in 1999 and two important publications on TIA in 2007.

Results showed that there was a significant reduction in stroke following TIA after the change in the guidelines in 1999.

For the 2 days after TIA, stroke rates fell from 3.4% in group A (before 1999) to 2.1% in groups B and C.

Similarly, stroke rates within 7 days of TIA went from 5.5% before 1999 to 3.2% during the period 1999–2007 and to 2.9% after 2007.

For the period within 30 days of a TIA, stroke rates dropped from 6.3% pre-1999 to 3.4% in 1999–2207 and 2.9% after 2007.

Within 90 days of TIA, stroke rates were 7.4% pre-1999 and 3.9% in both 1999–2007 and after 2007.

Zand explained that some changes were made to the guidelines regarding TIA treatment in 1999, and in 2007, a couple of landmark publications on risk for stroke following TIA appeared.

“We thought these may have had an effect on subsequent stroke rates by raising awareness,” he added.

“In 1999, after the guidelines changed, we did see a reduction in stroke after TIA,” he said.

They were hoping to see another reduction after the publication of the landmark studies, which confirmed the high risk for stroke after TIA and the

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‘Widespread growth’ of coronavirus epidemic as R rate remains as high as 1.5

A person wearing a protective mask walks past a covid warning sign as the spread of the coronavirus disease (COVID-19) continues, in Liverpool, Britain October 15, 2020. REUTERS/Phil Noble
Liverpool became the first city to be graded as Tier 3 – Very High – this week due to the rapid increase in coronavirus infections in the city (REUTERS/Phil Noble)

The reproduction rate of coronavirus in the UK is 1.3 to 1.5, meaning there is still “widespread growth” across the country.

Last week the figure was given as 1.2 to 1.5.

Experts on the government’s Scientific Advisory Group for Emergencies (SAGE) published the latest figures on Friday.

A statement from SAGE said: “It is SAGE’s expert view… that this week’s estimates are reliable, and that there is still widespread growth of the epidemic across the country.

“SAGE is confident that the transmission is not slowing. There is no clear evidence that the epidemic’s trajectory has changed in the past month. 

Rate of coronavirus infection in England as of 16 October (gov.uk)
Rate of coronavirus infection in England as of 16 October (gov.uk)

“While the R value remains above 1.0, infections will continue to grow at an exponential rate. This is currently the case for every region of England and all have positive growth rates, reflecting increases in the number of new infections across the country.”

Watch: Coronavirus: what is the R0 reproduction rate?

The growth rate is between +4% and +7% meaning the number of new infections is growing by 4% to 7% every day, a slight decrease from 4% to 9% last week.

The data comes after a new three-tier system was introduced in England to classify areas according to COVID-19 infection risk.

The Liverpool City region became the first to enter the ‘very high’ Tier 3 band on Wednesday, with local leaders in Manchester becoming embroiled in a bitter battle with government to resist the city and surrounding areas also being upgraded from Tier 2 to Tier 3.

In these areas the R rate has remained at a similar level to the previous week, but the figures for the south west of England are now the highest in the country, with an R rate of 1.3 to 1.6 and a growth rate of 6% to 10%.

Britain's Prime Minister Boris Johnson speaks during a virtual press conference inside 10 Downing Street in central London on October 12, 2020, after announcing a new COVID-19 alert system. - British Prime Minister Boris Johnson on Monday ordered pubs in Liverpool to shut as part of a new strategy to tackle a surge in coronavirus cases, as staff at three field hospitals across the country were told to prepare for a wave of admissions. The northwest English city is the first to be placed at "very high risk" under a new three-tiered system designed to bring order what has become a complex web of local restrictions. (Photo by TOBY MELVILLE / POOL / AFP) (Photo by TOBY MELVILLE/POOL/AFP via Getty Images)
Boris Johnson has insisted that local lockdowns can be effective and will help avoid a second nationwide lockdown (Toby Melville / Pool / AFP via Getty Images)

Boris Johnson has said his “whack-a-mole” strategy of localised lockdowns could help prevent another nationwide lockdown, but scientific advisors to the government have questioned whether the localised tier-system could have come too late.

Scientific advisor Graham Medley, from the London School of Hygiene and Tropical Medicine, said of the likelihood of success of local lockdown measures: “I really hope that they are [successful] but the general feeling is that they might not be, that we might have to have much more of an approach and that this three week delay between the impact of interventions and it affecting hospitalisations means we are already going to be close to where we were in April in two or three weeks time.”

Medley was speaking to BBC Radio 4’s Today programme ahead of an interview with Dominic

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