Posts for: May, 2014
When it comes to dental procedures, not everybody has the same comfort level; what’s easily tolerated by some can be a major source of anxiety and stress for others. In fact, by some estimates perhaps 10 to 15 percent of Americans avoid visiting the dentist entirely because of the fear factor — and this applies to kids as well as adults. So what should you do if your child needs dental work but is seriously scared of the chair? Here are the top five reasons for considering conscious sedation to relieve your child's dental anxiety.
- It allows dentists to treat children and teens who would otherwise be too fearful to come in. This can be especially useful when invasive treatments like root canals or extractions are needed. When problems are treated at an early stage, it’s often possible to prevent more extensive work from being required later; this can reduce the overall cost of treatment — and also help to preserve the natural teeth!
- Dentists who use pediatric conscious sedation are specially qualified to do so. Advanced training and continuing education are part of the qualification process. In addition, emergency life support equipment is kept on hand, and practitioners are familiar with its use.
- The medications used are safe and effective. New, fast-acting drugs get the job done and then leave the body quickly. They are commonly administered by mouth (orally), so there is no need to fear the needle. While any type of sedation comes with a slight risk, minimal conscious sedation is a lower-risk alternative to deeper levels of sedation, or general anesthesia.
- A designated staff member monitors your child at all times. Vital signs such as heart rate, blood oxygen level, respiration rate, blood pressure and temperature are constantly under observation. This helps ensure that the level of sedation remains effective, yet safe.
- It can form a foundation for stress-free dental treatment in the years to come. No one wants to put their child through a terrifying experience — especially when the fearful memories could prevent them from getting necessary treatment in the future. With conscious sedation, that’s not an issue. In fact, with many of the medications currently in use, your child may not even remember the procedure when it’s over.
Dental anxiety can be a serious problem — but it’s good to know there are ways to control it. If you would like more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”
Tooth wear, especially on biting surfaces, is a normal part of aging — we all lose some of our tooth enamel as we grow older. Even primary (“baby”) teeth may show some wear before they’re lost. But there’s also excessive, premature tooth wear caused by disease or abnormal biting habits. This type of wear is cause for concern and action before it leads to tooth loss.
Normal tooth wear occurs because of what teeth naturally do — bite and chew. When teeth come together as we eat they generate a modest amount of force: between 13 and 23 pounds. Our teeth also make brief contacts hundreds to thousands times a day. Again, this produces force, though not to the extent we see with biting and chewing: somewhere between 0.75 and 7.5 pounds. These glancing contacts are actually good for dental health because they provide needed stimulation to the teeth and jaws that help the body maintain healthy bone and tooth attachments.
But parafunctional (outside the normal function) habits like teeth grinding or foreign object chewing can greatly increase the generated force, up to 230 pounds. These may result in noticeable symptoms like fractures or loose teeth, but not always — the damage may not be noticeable until much later in the form of excessive tooth wear.
These parafunctional habits aren’t the only cause for excessive tooth wear; tooth decay can weaken the tooth structure, making it more susceptible to wear. And, some restorative materials used for fillings may also affect the rate of wear.
Because excessive tooth wear may or may not present with immediate symptoms, it’s important to maintain regular dental checkups to monitor the condition of your teeth. Our training and experience helps us identify signs of excessive tooth wear and, depending on the extent of damage, work with you on a treatment plan. You should also keep us informed about oral habits, especially teeth grinding, thumb sucking or foreign object chewing (toys, nails, pencils, etc.).
Your teeth will wear as you grow older. By keeping a close eye on your teeth, we’ll help you keep that wear at a normal rate.
If you would like more information on preventing excessive tooth wear, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Children Grind Their Teeth.”
Q: Why should I consider cosmetic gum surgery to improve my smile?
A: If you’re looking to enhance the natural beauty of your smile, you may have heard about various cosmetic procedures that can improve the appearance of your teeth. But don’t forget about the other, equally important element of a bright, appealing smile: the healthy-looking and well-proportioned gums that surround and support those pearly whites. Many times, cosmetic flaws are caused by gum tissue that’s covering too much or too little of the tooth’s surface; in other situations, the gum line is uneven, and covers some teeth more than others. Cosmetic gum surgery can successfully remedy these imperfections.
Q: How exactly does cosmetic gum surgery resolve smile defects?
A: There are several minor surgical procedures that may be recommended, depending on what’s best for your individual situation. For example, some people have a “gummy smile,” where teeth seem excessively “short” because they’re covered with too much gum tissue. In this case, a “crown lengthening” procedure can be performed, where gum tissue (and perhaps a small amount of bone tissue) is removed; this makes the teeth appear in better proportion to the smile. In the opposite case — where the teeth appear too “long” due to receding (shrinking) gums, tissue can be grafted (added on) to the gums. Gum recontouring procedures are used to re-shape the gum line for a more even, pleasing effect.
Q: Are there non-cosmetic reasons for having gum surgery?
A: Yes. A tooth with too much of its root area exposed is often more prone to decay, and may become extremely sensitive to hot or cold. Covering an exposed root with gum tissue is just one non-cosmetic reason why gum surgery may be necessary.
Q: What’s involved in gum surgery — do I have to go to the hospital?
A: Cosmetic gum surgery is normally performed in the dental office, and usually involves only a local anesthetic. However, if you need a deeper level of relaxation, other forms of sedation may be available. In some cases, lasers can be used instead of conventional surgical tools to remove excess gum tissue. If you need a tissue graft, the grafting material can be taken from your own mouth, or may come from donor tissue that is processed to ensure your safety. Gum surgery is minimally invasive, and most people experience only minor discomfort.
If you’d like to know whether cosmetic gum surgery could help you get the smile you’ve always wanted, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Gummy Smiles” and “Periodontal Plastic Surgery.”
One’s a singer who made her name playing New York clubs in the 1980’s before catapulting to international pop stardom; the other’s an actress from New Zealand who, in 1994, at the age of 11, became the second-youngest person ever to win an Academy Award. Both remain at the top of the A-list today. What other feature do Madonna and Anna Paquin have in common?
You guessed it — it’s their teeth. Both have a small but noticeable gap between their two front teeth, known as a diastema. This condition is relatively common, and it’s normally easy to treat — if that’s something you’d like to do. But wait a moment… In certain African countries, this kind of smile is considered a sign of fertility; in France, they call it “dents du bonheur” (lucky teeth); some other cultures consider the gap a predictor of future wealth. So if you’ve already made this look work for you, there’s no need to change it — even if you might need other cosmetic dental work.
The “perfectly imperfect” smile has become an increasingly popular option for people having veneers, cosmetic bonding, or even dental implants. Some trend-watchers have even noted a pushback against the ideal of a completely even, flawless, Hollywood-white smile. Does that create a problem at the dentist’s office?
Absolutely not! We call the process of figuring out how your teeth should look “smile design” — and it’s as much an art as a science. When we’re just beginning to design your smile, we look at a number of features — including the size, shape, color and alignment of your teeth, the position of your lips, the amount of gums exposed, and the relationship between your smile and your other facial features. We’re also listening carefully to you: what you like and don’t like about your smile, how you think it could be improved… and what should stay just the way it is.
Of course, before doing any cosmetic work, we will always perform a complete dental exam to detect any underlying condition and determine what treatments are best. Then, we will work with you to help you get the smile you’ve always wanted. Not sure exactly how it will look when it’s all done? Ask us for a preview — from computer-generated pictures to actual 3-D models, we can show you how your new smile will enhance your appearance.
So if your smile needs a little help to look its best — but you still want it to be uniquely yours — maybe now is the time to come in and see us. If you would like more information on smile design, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “The Impact of a Smile Makeover” and “Beautiful Smiles by Design.”
Are tooth-colored fillings safer than silver fillings?
No. Both are considered safe based on the most reliable and up-to-date scientific evidence. Still, tooth-colored fillings do have some definite advantages. Not only do they blend in with your smile far better than “silver” (dental amalgam) fillings, but they often require less removal of healthy tooth structure. That’s because in order to fill a tooth with amalgam, it is necessary to create indentations in the tooth called “undercuts” to hold the amalgam in; this requires the removal of some healthy tooth material. With a tooth-colored filling, we need only remove the decayed part of the tooth to place the filling.
Are there any disadvantages?
Yes, tooth-colored fillings don’t always wear as well as metal fillings — particularly on back molars where they are subjected to the most stress from chewing. They are also more expensive and less likely to be fully reimbursed under dental insurance plans.
Are there different types of tooth-colored fillings?
Yes, three different choices of tooth-colored fillings are available:
- Composite — This mixture of plastic and glass is the most common type of tooth-colored filling. Newer materials can hold up almost as long as amalgam fillings and look very natural, though they can stain over time just as natural teeth do.
- Porcelain — High-tech dental ceramics are considered the most aesthetic choice of filling material. They don’t stain as composites can, but their relatively high glass content can make them more brittle and prone to breakage. They may be more expensive than composites.
- Glass Ionomer — Made of acrylic and glass powders, these inexpensive, translucent fillings blend in acceptably well with natural teeth and have the advantage of releasing small amounts of fluoride to help prevent decay. However, they generally don’t last as long as other restorative materials.
We would be happy to offer guidance on which choice would be best in your own unique situation.
If you have any questions about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”