Posts for: May, 2015
Although we’ve made great strides over the last century making dental visits more pleasant and comfortable, many people still feel a little apprehension about them at one time or another. For a few, though, this apprehension escalates into high anxiety — so high they may even avoid important dental treatment altogether.
If you have a significant phobia regarding dental visits and treatment, here are some things you can do to reduce your anxiety and feel more comfortable when you undergo treatment.
Let us know about your feelings of anxiety. We’re conditioned by society to regard such fears as irrational or “silly,” and so we tend to hide our negative emotions. Dentists, however, have been trained to work with fearful patients to reduce their anxiety levels. Being honest with us about your fears and nervousness is the first step to developing an anxiety-reducing strategy that will make your visits more pleasant.
Counteract bad experiences with good. For most people the fear they have during dental visits stems from earlier unpleasant experiences at the dentist. The fear can be so ingrained that simply trying to convince yourself or to be told “there’s nothing to be afraid of” will have little to no effect. Instead, build a memory collection of positive and pleasant dental visit experiences that serve to counteract the unpleasant. To do this we might first get you acclimated to routine visits and then gradually transition to more invasive procedures. This may increase the normal time for dental treatment, but the reduction in anxiety is worth the extra time.
Consider sedation therapy. In addition to modifying your experiences, you may also benefit from sedation medications that reduce anxiety, especially in the early stages of treatment. Depending on your medical history and current status, we can prescribe a sedative for you to take an hour or so before your appointment to help you relax. We can also increase the level of anesthesia (from local to intravenous or gas anesthesia, for example) if your anxiety is especially acute.
Taking proactive steps to minimize dental visit anxiety will increase the probability that you’ll obtain needed dental care. Your teeth and gums will be healthier for it.
If you would like more information on coping with dental visit anxiety, 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 “Overcoming Dental Fear & Anxiety.”
Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.
In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.
This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.
For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.
Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.
If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”
Installing dental implants involves more than the mechanics of placing them into the jawbone. Ultimate success — a natural and beautiful smile — requires painstaking attention to detail and artistry.
Here are a few of the factors we must consider to achieve a smile with dental implants you’ll be proud to display.
The amount of available bone. For the permanent crown to appear natural, it’s crucial to position the implant precisely. To achieve this precision requires an adequate amount of bone to be present. Unfortunately, bone loss is quite common after tooth loss; to minimize this we place bone grafts in the empty socket if at all possible after extraction to encourage bone growth. It’s also possible in some cases to perform bone grafting surgery before implants to build up bone volume.
Your genetic gum tissue type. There are basically two types of gum tissue people are born with: thin or thick. Thin tissues are more subject to wear, difficult to work with during surgery and can make it difficult to hide the metal components of an implant. Thicker tissues are easier to work with, but can have a tendency to overgrow.
Achieving a natural “emergence profile.” To look natural, the implant crown must appear to seamlessly emerge from the surrounding gum tissue. To achieve this, we must carefully plan and place the implant in the precise location in the bone, taking into account the implant shape and how far it should be placed within the bone to match the position and height of adjacent teeth and gum tissues.
Blending color shades with adjacent natural teeth. When it comes to color, everyone has subtle differences in tooth shades and hues. In fact, there are slight color variations within individual teeth, from the root to the tip of the crown. To make sure the implant blends in with adjacent teeth, it’s important to match the color incorporated into the porcelain crown with the natural crowns beside them.
These and other factors require both technical expertise and a sense of artistry. Carefully considering all of them will help ensure your dental implants result in the smile you want.
If you would like more information on smile transformations with dental implants, 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 “Matching Teeth & Implants.”
When decay spreads to the tooth’s inner pulp, a root canal treatment may be necessary to save it. It’s a common procedure: after removing all tissue from the pulp, the pulp chamber and root canals are filled with a special filling. The tooth is then sealed and a crown installed to protect the tooth from re-infection and/or fracture, possibly extending the tooth’s life for many years.
Sometimes, however, the tooth doesn’t respond and heal as expected: the number, size and shape of the patient’s root canals may have complicated the procedure; there may have been a delay before installing the final crown or restoration or the restoration didn’t seal the tooth as it should have, both occurrences giving rise to re-infection. It’s also possible for a second, separate occurrence of decay or injury to the tooth or crown to undo the effects of successful treatment.
It may be necessary in these cases to conduct a second root canal treatment, one that may be more complicated or challenging than the first one. For one thing, if the tooth has been covered by a crown or other restorative materials, these will most likely need to be removed beforehand. In cases where the root canal network and anatomy are challenging, it may require the expertise of an endodontist, a dental specialist in root canal treatments. Using advanced techniques with microscopic equipment, an endodontist can locate and fill unusually narrow or blocked root canals.
Because of these and other possible complications, a root canal retreatment may be more costly than a first-time procedure. Additionally, if you have dental insurance, your particular benefit package may or may not cover the full cost or impose limitations on repeated procedures within a certain length of time. The alternative to retreatment, though, is the removal of the tooth and replacement with a dental implant, bridge or partial denture with their own set of costs and considerations.
The complications and costs of a repeated procedure, though, may be well worth it, if it results in a longer life for the tooth. Preserving your natural tooth is in most cases the most desired outcome for maintaining a healthy mouth.
If you would like more information on root canal treatments, 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 “Root Canal Treatment.”