Posts for: June, 2016
Making sure children are comfortable when visiting the dentist is an essential part of creating a lifetime habit of dental care. We recommend children start dental visits around their first birthday.
But for some children this may not be enough — despite parents’ and dentists’ best efforts they may still develop an inordinate fear of dental visits and even routine procedures. This kind of anxiety could inhibit them now and later in life from receiving needed dental care.
To relieve this anxiety, dentists have developed sedation therapy for children. Not to be confused with anesthesia, which numbs pain, sedation uses drugs to place a patient in a relaxed state. Depending on the drugs and dosage used, we’re able to achieve anywhere from a light state of relaxation to a deep suppression of consciousness. The approach is similar to one used with adults, although drug dosages and applications will differ with children.
Â If we’re planning to use sedation with your child we recommend you feed them a low-fat dinner the night before and then refrain from any other foods or liquids until after treatment the next day.Â Just before the procedure (and after we’ve evaluated them physically to be sure they’re healthy enough for the sedation medication), we’ll administer the sedative, usually Midazolam and Hydroxyzine. Taken by mouth in a syrup form, this places them in a mildly relaxed state.
During the procedure a designated staff member will continually monitor their pulse, breathing, blood pressure and other vital signs. We may also take other protective measures like special chair positioning or immobilization to keep movement to a minimum.
After the procedure, your child will remain in the office until their vital signs return to pre-sedation levels. Once at home, you should keep an eye on them for the rest of the day. They should not return to school or regular activities until the next day.
As sedation medication and techniques continue to advance, they’re becoming a routine part of dental care. If your child experiences anxiety, this can help make dental visits more pleasant and more likely to become part of their life from now on.
If you would like more information on taking the anxiety out of children’s dental care, 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 “Sedation Dentistry for Kids.”
Your regular dental checkups should periodically include an important screening for oral cancer, especially as you grow older. Although oral cancers make up less than 3% of all other types, they’re among the most deadly with a 58% survival rate after five years.
Besides hereditary factors, oral cancer is strongly linked to tobacco use, alcohol abuse or diets low in fresh fruits and vegetables. It’s also a greater concern as we age: 90% of new cases of oral cancer occur in people over the age of 40, heightening the need for regular screenings. These screenings become all the more important because many early sores or lesions can mimic other conditions like canker sores — without early detection, the disease could already be in advanced stages when it’s diagnosed.
An oral screening for cancer involves both sight and touch. We’ll first look for any suspicious lesions and red or white patches in the soft tissues of the face, neck, lips and mouth. We’ll then feel for any abnormal lumps on the mouth floor, the sides of the neck and in gland locations. We’ll also examine all sides of the tongue including underneath, as well as the tissues lining the back of your throat.
If we notice anything that’s concerning we may then perform a biopsy by removing a small bit of the suspicious tissue and have it examined microscopically for the presence of cancer cells. We may also remove any lesions deemed pre-cancerous as an added precaution against possible cancer development.
The American Cancer Society recommends an oral cancer screening annually for people forty years or older and every three years for people between the ages of 20 and 39. Even better, we recommend all adults undergo a screening every year. This, along with ending tobacco use and other lifestyle and dietary changes, will greatly improve your chances of remaining free of oral cancer.
If you would like more information on detecting and treating oral cancer, 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 Cancer.”
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.
The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.
Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.
The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.
If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.
If you would like more information on cracked mouth corners, 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 “Cracked Corners of the Mouth.”
Have you started orthodontic treatment recently? Are you having a little trouble getting used to your braces? If so, you are not alone: Everybody goes through an adjustment period during which they momentarily wonder if they’ll really ever get used to this. Don’t worry — you will! And we’ve never heard anyone say, on the day their braces come off and their new smile is revealed, that they aren’t glad they went the distance. Just ask Houston Rockets all-star center Dwight Howard, who discussed his own orthodontic treatment in a recent interview.
“I’m sure I was no different than anyone else who has ever had braces,” he told Mediaplanet. “At first I hated them so much… That changed once I got used to them and I actually grew to love them.” What’s Howard’s advice? “Do exactly what your orthodontist says and know that the outcome is well worth it in the end.” We couldn’t agree more! Here are some tips for wearing braces comfortably:
- Hard & Chewy Foods: If you love fresh fruits and vegetables, that’s great; there’s no reason to give them up, just the really hard ones. You don’t want to bite into an apple or carrot or any other hard foods like bagels and pizza that have any “size” to them. Small pieces may be ok as long as they can’t bend your wires. Chewy, sticky candy should really be avoided completely. Same with soda, sports drinks and so-called energy drinks because they contain acids that promote tooth decay and can cause a lot of damage around the braces.
- Effective Oral Hygiene: Keeping your teeth clean is more important than ever, but also more challenging than ever. It’s easy for food to get stuck under wires and around brackets, but failing to remove it can cause tooth decay, gum irritation and soreness. Therefore, the cleaner your teeth and your braces are, the healthier you will be. Use interdental cleaning brushes and/or a floss-threader to get behind your wires. A mouthrinse can also help strengthen teeth and keep bacteria in check. If you have any questions about how to clean between your teeth, please ask for a demonstration at your next visit.
- Pain Relief: Some soreness at the beginning of orthodontic treatment is normal. To relieve it, you can use an over-the-counter pain reliever and/or a warm washcloth or heating pad placed on the outside of the jaw. If brackets or wires are rubbing against the inside of your cheeks or lips, try applying wax to these areas of your braces. If this does not offer enough relief, we may be able to trim the end of a poking wire. Call us if you need help with this.
Our goal is to make your orthodontic treatment as comfortable as possible on the way to achieving your all-star smile. If you have questions about adjusting to braces, contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”