Dental visit anxiety is a serious problem: Half of all Americans admit to some level of dental fear, while 15% avoid dental care altogether due to acute anxiety. The harm this can cause to dental health is incalculable.
But dentists have a number of sedation techniques that can relax anxious patients and allow them to receive the care they need. Although often used together, sedation is slightly different from anesthesia, which aims to deaden pain sensation. The aim of sedation is to calm the emotions and state of mind.
Sedation isn't a new approach: Physicians have used substances like root herbs or alcohol to relieve anxiety since ancient times. Modern dentistry also has a long history with sedation, dating from the early 1800s with the first use of nitrous oxide gas.
Modern dental sedation has expanded into an array of drugs and techniques to match varying levels of anxiety intensity. At the milder end of the scale are oral sedatives, taken an hour or so before a dental appointment to produce a calmer state. This may be enough for some patients, or it can be used in conjunction with nitrous oxide.
For those with more intense anxiety, dentists can turn to intravenous (IV) sedation. In this case, the sedative is delivered directly into the bloodstream through a small needle or catheter inserted in a vein. This causes a quicker and deeper reaction than oral sedatives.
Although similar to general anesthesia, IV sedation does differ in significant ways. Rather than unconsciousness, IV sedation places a patient in a “semi-awake” state that may still allow them respond to verbal commands. And although the patient's vital signs (heart rate, breathing, blood pressure, etc.) must be monitored, the patient doesn't need breathing assistance as with anesthesia.
There's one other benefit: The drugs used often have an amnesic effect, meaning the patient won't remember the treatment experience after recovery. This can be helpful in creating more pleasant memories of their dental experience, which could have its own sedative effect in the future.
Whether oral, gas or IV, sedatives are a safe and effective way to calm dental fears during treatment. That could help someone with anxiety maintain their oral health.
If you would like more information on reducing dental anxiety, 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 “IV Sedation in Dentistry.”
White, translucent teeth are the hallmark of a beautiful smile. But with age or the foods we eat our teeth’s natural brightness can dim to a dingy yellow.
If this is your case, you may be able to benefit from teeth whitening techniques that brighten up your less than “pearly whites.” A teeth whitening treatment from time to time could put the dazzle back in both your smile and your self-confidence.
Here, then, are 3 reasons for considering tooth whitening to improve your smile.
You might be able to do it yourself. There are a number of home whitening options (including whitening strips) that are safe and effective to use at home. But there are a couple caveats: because your dentist can use stronger bleaching solutions they may be able to perform the procedure in less time and with longer lasting results than a home kit. Also, some forms of staining originate inside a tooth—a home kit won’t help with that kind of discoloration.
It’s safe and relatively inexpensive. Home bleaching solutions aren’t strong enough to be harmful (unless you disregard the product directions) and are usually not very costly. Your dentist uses stronger solutions but with the training and curing equipment to minimize any risk to your teeth. And compared to other cosmetic treatments, dental office teeth whitening is still a relatively inexpensive option.
Dental office whitening can be more comprehensive and precise. Another reason to opt for your dentist to whiten your teeth is the wide range of discoloration they can alleviate. They have clinical techniques for alleviating internal tooth staining, and could even combine these with treatments for external staining. Your dentist can also help you achieve the exact degree of whiteness you desire—from a more subtle, natural shade to “Hollywood Bright.”
Whitening isn’t permanent—but with a thorough application and avoiding foods and habits that contribute to staining, professional whitening effects can last up to two years. If you’re interested, see your dentist for a full dental examination for any issues that might interfere with the whitening process. From there, you’re not far from a brighter and more attractive smile.
If you would like more information on teeth whitening and other dental cosmetic enhancements, 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 “Teeth Whitening: Brighter, Lighter, Whiter….”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.
Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.
Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.
People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.
Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:
- brushing the surgical area (if advised by your surgeon);
- rinsing too aggressively;
- drinking through a straw or consuming hot liquid;
If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.
While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.
If you would like more information on oral surgery, 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 “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”
As a saying, “Necessity is the mother of invention” is no more appropriate than when you have something caught between your teeth. And humans, as inventive and creative as we are, have used a weird assortment of items—usually within arms' reach—to dislodge a pesky bit of food.
According to a recent survey, more than three-fourths of Americans admit to using a number of “tools” to clean between teeth including twigs, nails (the finger and toe variety), business cards or (shudder!) screwdrivers. And it's one thing to do this alone, but among dinner companions and other folk it's a definite faux pas.
Usually, it's smarter and more economical if you can use a particular tool for many different applications. But when it comes to your teeth, you should definitely go with a “unitasker” designed specifically for the job: dental floss. It's not only the safest item you can use to clean your teeth, it's specifically designed for that purpose, especially to remove disease-causing plaque from between teeth.
Of course, the reason many of us use alternate items for cleaning between teeth is that they're the closest ones at hand. You can remedy this by keeping a small spool (or a short length) of dental floss or floss picks handy for those moments you encounter a wedged piece of food. In a pinch, you can use a rounded toothpick (better for your gums than the flat variety).
At home if you find flossing difficult, consider using a water flosser. This handheld device emits a pulsating stream of pressurized water that loosens and flushes away plaque and bits of food remnant. It's ideal for people who have a hard time maneuvering floss or who wear braces, which can block regular floss thread from accessing between teeth as fully as possible.
In any case, use the other “tools” at hand for whatever they're intended. When it comes to what's best for your teeth, use floss to keep the in-between clear and clean.
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