Posts for: September, 2018
Controlling discomfort during dental work is one of our top priorities. Advances in anesthesia over the last century have made that objective easier to attain, especially for routine procedures.
The term anesthesia means “without feeling or pain.” It refers to the use of substances to prevent a patient’s nervous system from sensing pain. There are two basic types: general, through intravenous injection (IV) or gas inhalation that places a patient in an unconscious state; and local, which only affects the part of the body involved in the procedure while the patient remains conscious.
The latter type has become very important in dentistry, especially for mild to moderate procedures. Because teeth and gum tissues are rich in nerves, patients can have a heightened level of sensitivity that can increase anxiety and discomfort during dental work. Local anesthesia reduces that discomfort and relaxes both patient and dental provider.
We typically administer local anesthesia in two ways: by applying the anesthetic to the outside tissue surface (with a cotton swab, patch or spray) or by injection. The first type, topical anesthesia, is most often used to eliminate the pricking discomfort of the needle used to inject the main anesthetic. Using both applications eliminates any painful sensation at all — the only thing you might feel is a slight pressure during the procedure.
As mentioned before, local anesthesia benefits us as well as you. Knowing you’re at ease and comfortable allows us to better focus on the procedure — we’re not rushed to finish to spare you further discomfort. A relaxed, unhurried atmosphere is essential to a successful outcome for any dental procedure.
We’ve also found solutions for another issue with local anesthesia that concerns patients: the length of time the numbing effect lingers after a procedure. In response, the dental profession has developed different types of anesthesia that reduce this after effect considerably. We’re also more selective about what procedures actually require anesthesia — some, like routine teeth cleaning or work on the outer enamel (which doesn’t contain nerves), can usually be performed without it.
All in all, local anesthesia reduces your level of discomfort and increases our ability to be thorough in performing your dental work. You’ll not only find the experience more pleasant, but it will also enhance the quality of your care.
If you would like more information on alleviating pain and discomfort during dental work, 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 “Local Anesthesia for Pain-Free Dentistry.”
Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.
If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.
The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.
But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.
But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.
If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.
Like other living tissue, your teeth can feel. Dentin, the layer below the enamel, houses fluid-filled conduits that transmit temperature or pressure sensations to a nerve network within the tooth’s inner pulp. It’s so effective that incoming sensations must be buffered — “toned down”— to avoid a painful overload of the nerves. The enamel above the gum line and a bone-like substance called cementum below help do this.
Unfortunately, if teeth lose this protection they can become hypersensitive. This can cause a flash of sharp pain while eating or drinking something cold or hot or just biting down.
There are a number of causes for tooth sensitivity, any of which can influence how we treat it. While you’ll need a dental exam to know for sure, your hypersensitivity will more than likely stem from one of these 3 problems.
Periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of bacteria and food particles that accumulates on the teeth due to poor oral hygiene. The inflamed gum tissues weaken and detach from the teeth, causing them to shrink back or recede. This leaves the cementum unprotected, which easily erodes and exposes the dentin to acid and bacteria — and hypersensitivity. Clinically removing the plaque helps the affected gums heal. In extreme cases, the gums may need surgical grafting to regenerate.
Overaggressive brushing. While a lack of oral hygiene can contribute to gum recession, ironically too much hygiene — brushing too hard for too long — can damage your gums and cause them to recede. Brushing really doesn’t require a lot of elbow grease — a gentle scrubbing motion over all tooth surfaces is sufficient to remove plaque. Fine-tuning your brushing will help your gums to recover and heal.
Mouth acid. Although quite strong, enamel has one formidable enemy: acid, which can erode enamel and expose the dentin. Over-indulgence in acidic foods and beverages can make your mouth more acidic; more likely, though, bacterial plaque will again be the culprit, because bacteria excrete an acidic waste product. You can reduce mouth acid with daily brushing and flossing and consuming less acidic foods and beverages.
If you’re experiencing any kind of tooth pain, see us for an examination. We’ll determine the cause and initiate the appropriate treatment to regain your oral health.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”
All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
When things get unpleasant in your mouth, it’s most often related to some underlying cause. In fact, the discomfort you’re feeling is often a call to action to have it checked and treated.
The American Dental Association recently surveyed approximately 15,000 U.S. adults about their oral problems. If you have any of the top 3 problems found in this survey, it could be a “warning bell” sounding in your mouth right now.
Here, then, are the top 3 dental problems in America, what they mean and what you should do about them.
#3: Tooth Pain. About a third of respondents (more among those younger or from lower-income households) indicated pain as a problem. As a warning sign of something wrong, tooth pain could be telling you that you have a decayed tooth, a gum abscess or something similar. The best thing to do is get a checkup as soon as possible. It’s unlikely that whatever is causing the pain will go away on its own and procrastination could make ultimate treatment more complex and difficult.
#2: Difficulty Biting. A slightly higher number of people named difficulty chewing and biting as their main oral problem. As with tooth pain, chewing difficulty causes could be many: cracked, loose or decayed teeth, ill-fitted dentures, or a jaw joint disorder (TMD). Again, if it hurts to chew or bite, see a dentist. Besides the underlying problem, chewing difficulties could also affect the quality of your nutrition.
#1: Dry Mouth. Chronic dry mouth garnered the highest response in the survey, especially among older adults. This is more serious than the occasional “cotton mouth” feeling we all experience—with chronic dry mouth the salivary glands aren’t producing enough saliva to neutralize mouth acid or fight disease, thus increasing your risk for tooth decay or periodontal (gum) disease. It’s most likely caused by medications or systemic conditions, so talk with your dentist or physician about boosting saliva flow.