Posts for: September, 2014
We're always tickled to see dentists represented in popular culture, especially when portrayed by an actor as handsome as John Stamos. On the hit television show Glee, Stamos played a dentist who made sure the glee club members cleaned up their act when it came to oral hygiene — though perhaps he used a bit too much anesthesia to achieve this admirable goal. While under his care — and lots of sedation — several Glee characters had music-infused hallucinations in which they danced and sang with pop star Britney Spears.
Far-fetched? No doubt. Still, it's worth mentioning that sedation has its place in dentistry. In fact, if you are someone who tends to get anxious or even fearful about dental treatment, you should know that sedation can help you relax both mind and body so you can feel peaceful rather than anxious in the dentist's chair. And that's the whole point: Fear of pain should not stand in the way of your getting the care that will keep you healthy and allow you to keep your teeth for as long as possible.
You may not know this, but when you are afraid, your threshold for pain is actually lower. You become hypersensitive to every sensation and sound, and you tense your muscles. Fear and anxiety trigger the release of certain chemicals that put you in “fight or flight” mode. In this heightened state of alert you experience more pain during and even after treatment.
The good news is that this response can virtually be eliminated with various oral sedatives and/or with nitrous oxide, which is inhaled. Both treatments will allow you to let your guard down and relax. Your apprehension and hypersensitivity to pain will disappear, even though you are still conscious. And when you are relaxed, we are better able to focus on the task at hand, knowing that you are comfortable.
The sedatives used in dentistry have been subjected to rigorous testing and have a strong safety record backed by decades of use. Several even have “amnesic” properties, meaning that you will remember little to nothing of your treatment — unless, of course, you end up singing and dancing with Britney Spears!
If you would like more information about sedation in dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Oral Sedation Dentistry.” Dear Doctor also has more on “Overcoming Dental Fear & Anxiety.”
A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.
Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.
Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.
Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.
In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.
If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.
If you would like more information on loose teeth, 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 “Loose Teeth.”