Posts for: August, 2012
No one wants to experience pain when they go to the dentist. However, are you aware that anesthesia is beneficial to both you and your dental professionals? It enables us to concentrate on doing our best work with the assurance that you are perfectly comfortable. In fact, local anesthesia has literally revolutionized pain control; it is one of the most effective tools in dentistry and medicine.
But before we continue, let's cover a few of the basics. “Anesthesia” (“ana” – without; “esthesia” – sensation) literally means without feeling or pain. “Local” refers to the site at which the anesthesia is used, in other words, where the action (and pain relief) is needed. Local anesthetics come in two varieties: topical and injectable.
We use topical anesthetics to numb just the top surface of the gums or oral lining surfaces of the mouth to provide surface comfort during procedures such as a superficial teeth cleaning. We apply them in a variety of ways: with a Q-tip, cotton swab, adhesive patch or a spray. Most importantly, we use them before administering injections (shots) so you don't feel a thing.
Injectables deliver medication though a needle that will briefly block the sensation of pain from the teeth, gums and bone. They accomplish this by temporarily blocking the conduction of electrical impulses along the nerves that supply the gums and teeth with feeling so that you can be treated comfortably. They are especially important for treatments such as filling a deep cavity, tooth cleaning or extraction, or for gum surgery.
So which anesthesia is right for you?
Depending on the type of treatment or procedure we are performing, we will select the most suitable anesthetic. However, if you normally feel anxious about your dental visits, please let us know this in advance when scheduling your appointment. Having this knowledge in advance, we can ensure that your experience is free of both anxiety and pain — a result that will make both of us happy!
To learn more about this topic, continue reading the Dear Doctor magazine article “Local Anesthesia For Pain-Free Dentistry.” Or you can contact us today to schedule an appointment to discuss your questions.
It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.
What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).
The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.
What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.
What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.
Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.
How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.
FAQs About This New and Miraculous Procedure
How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.
What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.
Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.
Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.
Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.
If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.
How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.
How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.
How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.
How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.
What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.
Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.
If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”
Whether you have worn dentures for years or they are new to you, knowing the proper way to care for them is critical. This is why we have put together this fun and insightful test so that you can see just how much you know.
After reading each of the following statements below, determine whether you think the statement is true or false. See below for the answers.
- Boiling your dentures at least once a week is an excellent way to sterilize them.
- With a proper fit, it is perfectly acceptable to wear your dentures continuously (24 hours per day).
- The bacterial biofilm that accumulates under a denture causes inflammation referred to as denture stomatitis.
- You should store your dentures immersed in water after cleaning or when not in your mouth.
- Once you have dentures (and no longer have any teeth), you really only need to schedule a dental appointment if you have a problem with your dentures or damage them.
- To best clean a denture, you should use a slightly abrasive cleanser and a firm toothbrush.
- The pressure from wearing dentures causes jawbone loss over time.
- The optimal method for cleansing your gums is to take a moistened washcloth and gently massage your gums two times each day.
- If you are careful, you can use denture cleaners while your false teeth are in your mouth.
- You should never use sodium hypochlorite bleach to clean your dentures.
1. False. You should never boil dentures. 2. False. You should not wear your dentures 24/7. 3. True. 4. True, as this prevents your dentures from warping. 5. False. Even though you may not have teeth, you need to visit our office at least once a year for a thorough examination and to ensure your dentures are fitting and functioning properly. 6. False. You should never use a firm toothbrush OR any type of abrasive cleanser to clean your dentures. 7. True. This is unfortunate, but a fact nonetheless. 8. True. 9. False, you should only use a denture cleanser outside of the mouth. 10. False. Sodium hypochlorite bleach is an excellent cleanser; however, you should never soak your dentures in this solution for periods that exceed 10 minutes.
When you have your teeth bleached in a dental office, the results almost seem like magic. Let's push aside the magician's cape and see what is really happening in professionally-applied, in-office tooth whitening.
How do teeth become discolored?
A tooth's enamel covering is mostly composed of mineral crystals. At a microscopic level, you can see a framework or matrix of organic (living) matter interspersed between the crystals of enamel creating a very irregular surface capable of retaining stains. Chromagenic (color generating) organic compounds can become part of this organic matrix resulting in tooth staining. They can be bleached without affecting the mineral structure of the tooth's enamel.
As people get older and their teeth wear, the enamel loses its youthful translucency and the underlying layer, called dentin, thickens and becomes more yellow. Such changes to the actual tooth structure are called intrinsic staining. Other causes of intrinsic discoloration are exposure to high levels of fluoride or tetracycline antibiotic administration during childhood, tooth decay, or root canal problems, among others. Discoloration can also be caused by external staining from certain foods, drinks, or tobacco products. Such surface stains are called extrinsic staining.
Behind the Magic
Materials used for tooth bleaching are hydrogen peroxide and carbamide peroxide. Peroxides are commonly used as bleach, and you may have seen them used as hair bleaches, for example. Hydrogen peroxide is a strong oxidizing agent that attacks the organic molecules responsible for tooth discoloration, bleaching them until they lose their color. Carbamide peroxide also contains urea, which is a compound that permits the peroxide to remain in contact with the teeth for longer amounts of time without harming them.
Often called power bleaching, the in-office technique uses a high concentration of peroxide solution (35-45% hydrogen peroxide), placed directly on the teeth in the form of a gel. A heat or light source may enhance the peroxide release. The gel is applied with trays custom fitted to your mouth, and specific barriers are applied to protect sensitive gum tissue from the solution. Results show teeth becoming up to ten shades lighter in about an hour.
In-office bleaching under the supervision of my staff and me is recommended if you have severely stained teeth, and particularly if you are about to have veneers or crowns made. It's a way to rediscover the pearly translucency of your youthful smile.