Posts for: April, 2014
In dentistry (as well as other branches of medicine) pediatric conscious sedation is becoming more widespread than ever — but some people aren’t yet familiar with this beneficial therapy. Conscious sedation can remove anxiety and produce a feeling of calm and relaxation during dental treatment; however, unlike general anesthesia, it doesn’t cause the loss of consciousness. That means patients can still breathe normally and can respond to certain stimuli, while feelings of pain and anxiety are blocked.
Conscious sedation is often employed for invasive procedures such as tooth extractions or root canals — which cause some people a great deal of apprehension, no matter what their age. It can be especially useful for children, however, who may have a more limited ability to understand (and cooperate with) their dental treatment. Because the medications are commonly administered orally (by mouth), there’s no needle to provoke fear. And when it’s over, there is usually little or no memory of the procedure that was done.
Pediatric conscious sedation is typically administered in an office setting by a dentist with special qualifications. The American Dental Association, the American Academy of Pediatric Dentistry, and the American Academy of Pediatrics have jointly established criteria for its use. Specialized training and continuing education are part of the qualification process; additionally, the dental office must be equipped with advanced life-support equipment and trained staff, who can help in the unlikely case of an emergency.
While your child is receiving conscious sedation, he or she will be monitored by a designated staff member who keeps a close watch on vital signs like blood pressure, oxygen levels, pulse rate and respiration. This helps to ensure that the level of sedation remains safe, yet effective. When the procedure is over, the medications wear off quickly; however, children will certainly need a ride home, and shouldn’t return to school until the next day.
As new medications are developed, more dentists receive special training, and the cost of associated equipment becomes more reasonable, the practice of pediatric conscious sedation is becoming more widespread. For many kids, it could mean the difference between having fearful childhood memories of the dental office that linger on through life — and remembering almost nothing at all.
If your child has dental anxiety or requires invasive procedures, pediatric conscious sedation may be a good option for you to consider. For more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”
If your gums appear reddish, puffy and bleed easily — especially at the margins where they meet your teeth — instead of their normal pink, you have gingivitis (“gingiva” – gums; “itis” – inflammation). Gingivitis is one of the first signs of periodontal disease (“peri” – around; “odont” – tooth) that affects the tissues that attach to the teeth, the gums, periodontal ligament and bone. Other common symptoms of periodontal disease include bad breath and taste.
If periodontal (gum) disease is allowed to progress, one possible consequence is gum recession exposing the root surfaces of the teeth. This can cause sensitivity to temperature and touch. Another sign is that the gum tissues may start to separate from your teeth, causing pocket formation; this is detectable by your dentist or hygienist. As pocket formation progresses the bone supporting the teeth is destroyed leading to loose teeth and/or gum abscesses. Unchecked or untreated it leads to tooth loss.
Inflammation, a primary response to infection is actually your immune (resistance) system's way of mounting a defense against dental plaque, the film of bacteria that concentrates between your teeth and gums every day. If the bacteria are not removed, the inflammation and infection become chronic, which literally means, “frustrated healing.” Smoking is a risk factor for periodontal disease. Smokers collect plaque more quickly and have drier mouths, therefore, cutting down or quitting smoking can reduce the severity of gum disease. Stress has also been shown to affect the immune (resistance) system, so stress reduction practices can help here as well as in other parts of your life. Gum disease can also affect your general health especially if you have diabetes, cardiovascular or other systemic (general) diseases of an inflammatory nature.
Periodontal disease is easily preventable. The best way to stop the process is to remove each day's buildup of plaque by properly brushing and flossing your teeth. Effective daily dental hygiene has been demonstrated to be effective in stopping gingivitis. It sounds simple, but although most people think they're doing a good job, they may not be. Effective brushing and flossing requires demonstration and training. Come and see us for an evaluation of how well you're doing. Regular checkups and cleanings with our office are necessary to help prevent gingivitis and periodontal disease. In addition if you already have periodontal disease you may need a deep cleaning known as root planing or debridement to remove deposits of calcified plaque called calculus or tartar, along with bacterial toxins that have become ingrained into the root surfaces of your teeth.
Gum disease is often known as a silent disease because it doesn't hurt, so see our office for a periodontal exam today.
Contact us today to schedule an appointment or to discuss your questions about gingivitis and periodontal disease. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”
Perhaps you’ve been told that you need to have root canal treatment in order to save one or more of your teeth. By now, you know that the procedure itself is essentially pain-free, and that it has an excellent chance of success. But you may be wondering — just how long can you expect that “saved” tooth to last?
The short answer is: decades… or even a lifetime. But in just the same way that no two fingerprints are exactly identical, neither are any two teeth with root canals. There are some factors that could result in one tooth having a greater longevity after root canal treatment (RCT) than another — but before we go into them, let’s look at what RCT actually involves.
When infection and inflammation is allowed to get a foothold deep inside a tooth — usually due to uncontrolled decay or trauma — the nerves, blood vessels and connective tissue that make up the tooth’s pulp begin to die. If left untreated, the infection can spread out of the tooth and into the bone of the jaw. This may lead to further problems, including the development of a painful abscess, and eventual loss of the tooth.
Root canal treatment involves gaining access to the infected pulp tissue through a tiny hole made in the tooth, and then removing it. Next, the space inside the tooth is disinfected and filled with sterile material, and the access hole is closed. Afterward, a crown or “cap” is often needed to protect the tooth and restore it to full function in the mouth.
One factor that can influence how long a treated tooth will last is how soon the tooth is restored following the root canal procedure: The sooner it receives a permanent filling or crown, the longer it is likely to last. Another factor is whether or not the underlying infection has spread into the bone of the jaw: A tooth that has received RCT promptly, before the infection has had a chance to spread, is likely to have greater longevity.
Some of the other factors that may influence the longevity of a tooth after RTC are: the location of the tooth (front teeth are easier to treat and receive less biting force than back teeth); the age of the individual (teeth become more brittle over time); and what other work needs to be done on the tooth (such as the placement of posts, which may in time weaken the tooth’s structure.) In general, however, there’s no dispute that a tooth which has received a quality root canal treatment should last for many years to come — if not an entire lifetime. And to many people, there’s simply no substitute for having your own natural teeth.
If you would like more information about root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will It Last?”
Refined table sugar (sucrose) has been in the health spotlight for some time now. While its effects on nutrition and general health are just now gaining attention, its effect on dental health, particularly as a food source for bacteria that cause tooth decay, has been known for decades.
In recent years, though, a different kind of natural sugar known as xylitol has come into popularity. Mutans Streptococci, the main bacteria responsible for tooth decay, is unable to break down and consume this alcohol-based sugar as it can with sucrose. What’s more, there’s evidence that xylitol can actually “starve” the offending bacteria and reduce its levels in the mouth. Xylitol also helps to reduce the level of acid in saliva and supports this vital fluid in its role of balancing the mouth’s pH level. By helping maintain a more pH neutral environment, xylitol can help prevent decay from even starting and promote the production of bacteria that doesn’t produce acid.
One of the most prevalent ways to include xylitol in your diet is through chewing gum. Researchers have found xylitol chewing gum can significantly reduce the risk of tooth decay, especially by inhibiting the decay process. Its reaction with saliva also contributes to the process of hardening the mineral content of enamel, a further inhibition to tooth decay.
Depending on your risk factors for dental disease, we might direct you to chew two pieces of xylitol gum for five minutes after meals and snacks, up to four times a day. Our target dose is about one to two teaspoons spread out during the day. If chewing gum is problematic or undesirable, it’s also possible to receive the recommended dosage of xylitol through hard candy, mints and oral products like toothpaste, mouthwash or sprays that contain the sugar.
Depending on your risk factors, a daily dosage of xylitol in chewing gum and other products can change the environment in your mouth for the better. A few minutes of gum chewing after meals and snacks might provide you the winning edge in the battle against tooth decay.
If you would like more information on the benefits and uses of xylitol, 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 “Xylitol in Chewing Gum.”
When most people think of orthodontic treatment, they may think of braces worn during the teenage years. But there are some types of malocclusions (bad bites) that may benefit from intervention much earlier than adolescence. A cross-bite is one example.
A cross-bite occurs when the front teeth of the lower arch bite in front of the upper teeth rather than behind them. The condition can have an adverse effect on any of the six front teeth of either arch. This type of malocclusion can develop quite early in childhood.
Orthodontists have developed a two-phase treatment for a cross-bite, with the possibility that the first phase may be all that’s needed. If your child has a cross-bite, your orthodontist may first recommend he or she wear a specially-designed retainer for a few months. The retainer could stop and correct an existing problem before it becomes worse, or it could prevent a deeper problem from developing in the first place. The retainer could also help guide jawbone development during these formative years, even as early as age 7, for children at risk.
Even if this first phase doesn’t fully correct the cross-bite and the second phase (most likely braces or a similar orthodontic device) becomes necessary, it could still help to make the second phase easier and less costly. On the other hand, if orthodontic treatment is postponed until adolescence when the mouth structures are more fully formed it may become quite difficult or even impossible to correct the problems that have developed.
As a result, early intervention for this or similar orthodontic conditions is the most efficient strategy, even when later treatment is necessary. As part of your child’s regular dental care (which should begin ideally around their first birthday), we can advise you on any need for an orthodontic evaluation based on our observations. An orthodontist can then best advise whether waiting until later for treatment is best, or whether intervention now could lessen problems later.
If you would like more information on preventative orthodontics, 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 “Preventative & Cost Saving Orthodontics.”