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.”
In February, the American Dental Association sponsors Children’s Dental Health Month to raise awareness about the importance of good oral health for kids of all ages. It’s a great time to focus on concerns unique to children—teething, for example. This stage of development can be stressful for children and parents alike. Just ask tennis legend (and new mom) Serena Williams. When her baby daughter recently began teething, the Olympic gold medalist and multi-Grand-Slam champion asked her instagram followers for help:
“Teething… is so hard. Poor Alexis Olympia has been so uncomfortable. She cried so much… I almost need my mom to come and hold me to sleep cause I’m so stressed. Help? Anyone?”
We certainly sympathize with Serena’s plight. The process of teething—where a child’s primary teeth start to emerge (erupt) from below the gum line—can make both baby and parents irritable in the daytime and sleepless at night. While a few infants are born with tiny teeth already showing, most kids’ teeth begin emerging at age 4-7 months.
Teething is an important milestone in baby’s growth…but it’s one that’s not always cause for celebration. It can lead to pain, drooling, gnawing, and biting; ear rubbing and gum swelling; decreased appetite and disrupted sleeping patterns. And did we mention that irritability and stress are common as well? But if you notice fever, diarrhea, or widespread rash, it may be wise to consult your dentist or pediatrician.
What can you do to ease the discomfort of teething? The American Dental Association (ADA) has a few recommendations: Try soothing the gums by rubbing them gently with a clean finger or a cool, moist towel or washcloth; or let your baby chew on a cold (but not frozen) teething ring or pacifier.
If your pediatrician recommends it, over-the-counter medications like acetaminophen or ibuprofen can be used for persistent teething pain—but make sure to use the correct dosage and wait the proper amount of time between doses.
There are also a few things you should NEVER do. Don’t give alcohol to a baby in any form, and don’t rub any medications on baby’s gums. Don’t give a baby anything to chew on that’s unsafe (bones, breakable items, etc). And don’t use teething gels containing benzociane, lidocaine or certain homeopathic ingredients: According to a recent FDA warning, they may pose a danger to infants, including risks of rare but serious medical conditions. Feel free to check with us if you are not sure whether a particular remedy is safe for your baby.
There’s no doubt that teething can be stressful. But it’s a sign of normal development—and in time it will pass…like babyhood itself. If you’re concerned about your child’s teething or would like more information, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Teething Troubles.”
Tooth enamel erosion is a serious issue for many children that can result in permanent impairment of oral health. The problem isn’t just bacterial acid that causes tooth decay — it’s also the high acid content of sodas, energy and sports drinks widely popular among children and teenagers today.
Enamel is made of the strongest substance in the human body, which enables it to shield the inner layers of the teeth from disease and other environmental factors. Its chief nemesis, though, is acid: when enamel interacts with high concentrations of acid for a prolonged time, its mineral content will begin to soften and dissolve, a process known as de-mineralization. Saliva is the enamel’s main protection against acid with the ability to neutralize (or buffer) acid and restore some of the enamel’s mineral content, usually within thirty minutes to an hour after we eat.
The high acid content of many popular beverages, however, can overwhelm saliva’s buffering ability, especially if a person is sipping for an extended time on an acidic drink. This kind of exposure is different from acid produced by bacteria that causes tooth decay: bacterial acid tends to concentrate in specific areas of the teeth, while the constant wash from acidic beverages will have a more generalized eroding effect on teeth.
This level of enamel loss is irreversible, which can leave a tooth in peril of decay and ultimate loss — and increase long-term dental care and costs. The best strategy is to have your child stop or significantly curtail drinking highly acidic beverages. Rather than drink sports beverages for hydration, substitute water, nature’s hydrator. Milk can also be a viable beverage substitute.
If you do allow some acidic beverages, try to limit them to mealtimes and discourage extended sipping. Look for drinks with added calcium as this can reduce the beverage’s erosive potential. The goal is to reduce the amount and duration beverage acid is in contact with tooth enamel.
Making these changes will help greatly to protect your child’s tooth enamel, and give saliva a chance to do its job protecting it. Your efforts will also increase your child’s chances of better dental health in the future.
If you would like more information on dental erosion, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Erosion.”
While you do all you can to provide your child healthy meals and snacks at home, they still face tempting choices for unhealthy fare when they’re away. Unfortunately, their school campus could be one of those places with food choices that raise their risk for dental disease.
Thankfully, that situation is beginning to change. The U.S. Department of Agriculture (USDA) issued regulations a few years ago tightening minimum health standards for snacks available on school grounds. Called the Smart Snacks in Schools initiative, it promotes whole grains, fruits, vegetables and low-fat dairy products, while discouraging snacks with empty calories, fat, sugar and excessive salt. This is good news in particular for preventing tooth decay in children and teenagers.
Unfortunately, the initiative may not go far enough. There are a few “loopholes”: it allows for chocolate milk with added sugar as long as it’s fat-free; high schools can also sell beverages like sports and energy drinks, which are low in sugar but high in enamel-harming acid. So, although the general nutrition of snacks in schools may be improving, you should still remain alert to poor choices that may fall through the cracks.
For one thing, you can advocate for better nutrition policies in your child’s school. The USDA initiative is a minimum standard — schools can exceed them and eliminate borderline snacks allowed under the federal regulations.
You can also provide your child snack alternatives to the school vending machine. A little creativity and fun can go a long way: a dash of cinnamon or parmesan cheese on popcorn instead of butter; finger sandwiches made of real cheese on whole-grain bread (with some whimsical shaping with a cookie-cutter); or bite-sized fruits and vegetables like grapes, baby carrots or nuts. The more healthy (and enjoyable) snacks you can send with them, the less chance they’ll turn to a less nutritious choice in the vending machine.
A healthier approach to snacking depends on setting good examples, providing ample selections and accentuating the positive about healthy foods. Choosing nutritious foods, at home and away, is a key building block for healthy teeth and gums.
If you would like more information on nutrition and dental health, 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 “Snacking at School.”
There are a lot of ways to improve the appearance of your teeth. Some methods can be quite involved like crowns or bridgework, which require extensive alteration of teeth to accommodate them.
Other methods, though, can achieve stunning results with less tooth reduction or alteration to your teeth. Porcelain veneers are one such alternative that literally puts a new face on your teeth. A dental veneer is a thin layer of restorative material (usually porcelain) that is bonded to the outside of a tooth to cover blemishes. They’re an excellent choice for dealing with otherwise healthy teeth with mild to moderate chipping, wearing, staining or slight misalignment.
Veneers can be fashioned to match the shape and texture of the prepared tooth, as well as coloring that blends with neighboring teeth. They’re created by skilled dental lab technicians who use porcelain powder mixed with water to create layers of pliable porcelain laminated together to achieve the appropriate thickness and shape. The veneer is then oven-fired to produce a strong, durable product.
Their use in various dental situations does require some tooth preparation, though normally not as much as other restorative measures — usually no more than 0.5 mm of surface enamel. Removing this small amount will ensure the veneer doesn’t look too thick and bulky once bonded to the tooth.
There are some situations, though, where veneers aren’t the best choice: because they’re mainly a cosmetic solution, they can’t remedy problems like poor tooth position and bite or large discrepancies in root position. And teeth that are heavily decayed may require more extensive dental work to repair and preserve them.
In the right situation, though, veneers can make a huge difference to your smile and last for years, as long as you practice effective oral hygiene and don’t subject them to abnormal biting force (no cracking hard shell nuts with them — they can shatter). In skilled hands, veneers can transform your teeth from embarrassing to dazzling.
If you would like more information on porcelain veneers, 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 “Smile Design Enhanced with Porcelain Veneers.”
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