Posts for category: Dental Procedures
Eliminating pain and discomfort is one of our major objectives during dental treatment. To that end, our profession has developed a number of anesthetic drugs and deliveries that ensures your experience in the dentist’s chair is as pain-free as possible.
But there’s another experience many people have with dental care that’s different from physical discomfort — emotional anxiety. These negative emotions can range from nervousness about a procedure to extreme fear. Very often the patient has no control over these emotions — they’ve become imbedded from earlier experiences or the influence of others.
Although each can influence and heighten the other, anxiety and physical discomfort are different and require a different approach. Physical pain and sensation is eliminated through anesthesia, either locally through topical application or injection or generally through intravenous medication that renders a person unconscious. Anxiety, on the other hand, requires first building a trustful relationship with an understanding dentist. But it may also call for certain drugs that sedate — promote a feeling of relaxation — rather than numb sensation.
We’ve incorporated a number of sedative medications in dentistry like Valium or Ativan that work well to reduce anxiety before and during treatment. Many are taken orally, usually just before scheduled treatment, and they dissipate from the system quickly afterward. Some medications also have “amnesic” qualities, meaning you won’t remember anything or little at all about the treatment period. This can be helpful in amassing positive treatment experiences that may diminish negative feelings you’ve developed about dental treatment.
It’s important, though, to find the right types of medication that work well for you. For that reason we’ll take a thorough medical history, including prescription or over-the-counter medications and supplements you’re taking and any medical conditions you may have. It’s also important to discuss your diet (certain foods can inhibit the action of some sedatives) as well as if you use tobacco or regularly drink alcoholic beverages.
Taken properly, oral sedation can effectively reduce your anxiety during treatment. As a result, it will be much easier and pleasant for you to receive the care you need for a healthy mouth.
If you would like more information on reducing anxiety during dental treatment, 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 “Oral Sedation Dentistry.”
Are you interested in dental implants but a little hesitant about the surgery? Don’t be—this procedure to imbed an implant’s titanium post in the jawbone is relatively minor with little to no discomfort for most patients.
Some time before, however, we’ll need to pre-plan the surgery to pinpoint the best location for the implant, critical to achieving a solid hold and a life-like appearance. During these first visits we often create a surgical guide, a device inserted in the mouth during surgery that identifies the exact location for the hole (or channel) in the bone we’ll drill to insert the implant.
On surgery day, we’ll prepare you for a pain-free and relaxing experience. If you’re normally anxious about dental work, we may prescribe a sedative for you to take ahead of time. As we begin we’ll thoroughly numb the area with local anesthesia to ensure you won’t feel any pain.
The surgery begins with an incision through the gum tissue to access the underlying bone. Once it’s exposed, we’ll insert the surgical guide and begin a drilling sequence to gradually increase the size of the channel. This takes time because we want to avoid damaging the bone from overheating caused by friction.
Once we’ve created a channel that matches precisely the implant’s size and shape, we’ll remove the implant from its sterile packaging and immediately fit and secure it in the channel. We’ll then take x-rays to ensure it’s in the best position possible.
Satisfied we’ve properly situated and secured the implant, we’ll suture the gum tissue back in place to protect the implant with or without attaching a healing abutment to it as it fully integrates with the jawbone over the next few months (after which you’ll come back to receive your permanent crown). After a short recovery, you’ll return to full activity. Most patients only experience mild to moderate discomfort usually manageable with over-the-counter pain medication like aspirin or ibuprofen.
While implantation is a long process, you’ll be obtaining what’s considered by most dentists and their patients as the most durable and life-like tooth replacement available. Your new attractive smile will be well worth it.
If you would like more information on dental implants, 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 “Dental Implant Surgery: What to Expect Before, During and After.”
Imagine not having your upper teeth for talking and eating, not to mention your appearance, and you’ll have some idea of what Beauty the bald eagle experienced after losing the top of her beak to a hunter’s bullet in northern Idaho. She couldn’t groom or feed herself and could barely drink water, relying instead on the conservation group that had taken her under their wing for assistance. But the magnificent raptor was eventually made whole and able once again to eat, drink and preen unaided. It took a visionary mechanical engineer and a very skillful dentist who designed and attached the first-of-its-kind bald eagle “dental” prosthetic — dubbed the “bionic beak.”
Prosthetic Teeth for Humans
Fortunately, the field of human prosthetic dentistry (or prosthodontics) is much more advanced than it is for our avian friends. We have several options for replacing missing teeth (as well as parts of missing teeth) that restore aesthetic appearance and functionality while potentially preventing other problems such as the drifting out of alignment or loss of remaining teeth.
Bridges. As the name suggests, these custom-made devices span the area that is missing a tooth/teeth. Fixed (not removable) bridges are made up of an artificial tooth/teeth fused between two crowns that fit over your existing teeth or dental implants (see below) on either side of the gap. There are removable bridges, but they are considered temporary fixes.
Dentures. These are custom-made removable replacements for missing teeth. Partial dentures offer a removable alternative to fixed bridges and are used when some teeth are missing in an upper or lower arch (jaw). Full dentures are used when all teeth are missing in an arch. Replacement teeth are embedded in an acrylic base that fits over your gums and mimics their color.
Dental Implants. These are the closest thing to having your own tooth/teeth back. An implant is a small titanium post that is placed in the jawbone beneath the gum to serve the same purpose as a tooth root. Once the bone joins to the implant (a process called osseo-integration), a lifelike crown is attached to it.
We would be glad to discuss which option would be right for you.
If you have questions about tooth replacement, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Dental Implant Surgery,” and “Crowns & Bridgework.” Beauty the eagle’s story of rehabilitation can be found here: //blog.theanimalrescuesite.com.
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.
Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.
The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.
Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.
It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.
In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.
If you would like more information on tooth restorations for teenagers, 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 “Teenagers & Dental Implants.”