We always look forward to seeing our patients, but not all of you look forward to seeing us! If you’re one of them, don’t worry — we don’t take it personally. Dental anxiety prevents many people from seeking the care they require to restore or maintain a healthy smile.
But if dental problems are allowed to progress, they can affect not only the beauty of your smile and health of your mouth, but your overall wellness, too. Infection can travel from the mouth to other areas of the body, and dental disease exacerbates chronic health conditions like heart disease or diabetes.
Fear should never be an obstacle (in the immortal words of President Franklin Roosevelt, “…the only thing we have to fear is fear itself…”). And fortunately there are some safe options for those of us who can’t get past our anxiety when it comes to dental care:
Oral Sedation. A sedative medication can be prescribed that you take by mouth approximately an hour before your dental visit to minimize anxiety and promote relaxation.
Intravenous (IV; “intra” – inside, “venous” – vein) Sedation. If oral sedation isn’t entirely effective in facilitating treatment, then a medication combining a sedative for relaxation and a pain-blocking anesthetic can be delivered through or small needle or catheter that is gently inserted into a vein. This is referred to as “conscious sedation” because you are in a semi-awake state during which you are able to respond to verbal direction. It takes effect quickly, and you can come out of it quickly. However, you may not remember much about your procedure. It is very different from general anesthesia during which you are completely unconscious.
Dentists who offer IV sedation receive extensive training after which we must pass an exam and apply for a special permit that we maintain through continuing education. We carefully screen patients for eligibility and monitor you throughout so you can rest easy before, during, and after your procedure.
If you would like more information about sedation in dental care, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “Oral Sedation Dentistry.”
According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.
At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.
And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.
As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.
Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.
Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.
Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.
If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”
Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.
The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.
Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.
Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.
All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.
Search online for “right tool for the job” and you'll get over a billion results related to everything from baking cakes to repairing cars. It's also just as applicable to oral hygiene.
One of those “right” tools is the humble toothbrush. Most of us use the manual variety whose basic components—a long narrow handle and a bristled head—haven't changed much in a couple of centuries. That hasn't stopped competing manufacturers, however, from striving to produce the latest and greatest toothbrush. It's a wonderful testament to the free market, but it might leave you dizzy with indecision about which product is right for you.
You can avoid this paralysis if you remember why you're using a toothbrush in the first place—to remove the daily buildup of dental plaque, a thin bacterial film that causes tooth decay and gum disease. With that in mind, here are the top things to consider when picking out your next toothbrush.
Bristle texture. Although you might think a stiff-bristled brush would be better at removing plaque, most dental professionals recommend soft bristles. Stiffer bristles can damage your gums and lead to recession; on the other hand, coupled with the mild abrasives and detergents in toothpaste, soft bristled-brushes are just as effective in removing plaque.
Comfortable size and shape. Toothbrushes come in various lengths and handle widths, so choose one that's comfortable in your hand. If you have issues with manual dexterity, consider one with a wider and thicker handle that's easier to hold. You'll be acquainted for at least six months (that's how often you should change out your current brush for a new one), so get a toothbrush that feels right to you.
The ADA Seal of Acceptance. Like toothpaste, the American Dental Association also tests toothbrushes. Those that meet the ADA's high dental product standards can include the ADA Seal of Acceptance on their packaging. When you see it, it's a good indication that particular toothbrush will perform well. You can also get advice from your dentist or hygienist on what type of brush you should use.
Every time you brush, you're potentially improving your dental health and avoiding disease. Make sure it counts with a toothbrush that's right for you.
If you would like more information on toothbrushes, 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 “Sizing Up Toothbrushes.”
It's normal for people to breathe through their nose. And for good reason: Nasal breathing filters contaminants, warms and humidifies incoming air, and helps generate beneficial nitric oxide. Chronic mouth breathing, on the other hand, can trigger a number of harmful effects, especially for the teeth and gums.
Because our survival depends on continuous respiration, our bodies automatically seek out the air flow path of least resistance, normally through the nose. But if our nasal passages become obstructed, as with enlarged adenoids or sinus congestion, we may involuntarily breathe through the mouth.
This can lead to oral problems like chronic dry mouth, which not only creates an unpleasant mouth feel, it also produces the ideal environment for dental disease. And, it could cause an even more serious problem for children during jaw and teeth development.
This is because the tongue rests along the roof of the mouth (palate) while breathing through the nose. In this position, the tongue serves as a mold for the upper jaw and teeth while they're growing during childhood. During mouth breathing, however, the tongue moves away from the palate, depriving the jaw and teeth of this molding effect, and possibly resulting in a poor bite.
You can prevent these and other oral problems by seeing a healthcare professional as soon as you notice your child regularly breathing through their mouth. The best professional for this is an ENT, a medical specialist for conditions involving the ears, nose and throat. ENTs provide treatment for diagnosed obstructions involving the tonsils, adenoids and sinuses.
Even so, persistent mouth breathing may already have affected your child's bite. It may be prudent, then, to also have their bite evaluated by an orthodontist. There are interventional measures that can help get jaw development back on track and minimize future orthodontic treatment.
Finally, a child who has undergone treatment to remove nasal breathing obstructions usually reverts to nasal breathing automatically. But sometimes not: To “relearn” normal breathing, a child may need to undergo orofacial myofunctional therapy (OMT) with a certified therapist to retrain their facial muscles and tendons to breathe through the nose.
Your child's tendency to mouth breathing may not seem like a major problem. But prompt attention and treatment could prevent it from interrupting their dental development.
If you would like more information on correcting mouth breathing, 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 “The Trouble With Mouth Breathing.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.