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Posts for: May, 2020

SedationTherapyCanHelpAnxiousPatientsGettheDentalCareTheyNeed

Dental visit anxiety is a serious problem: Half of all Americans admit to some level of dental fear, while 15% avoid dental care altogether due to acute anxiety. The harm this can cause to dental health is incalculable.

But dentists have a number of sedation techniques that can relax anxious patients and allow them to receive the care they need. Although often used together, sedation is slightly different from anesthesia, which aims to deaden pain sensation. The aim of sedation is to calm the emotions and state of mind.

Sedation isn't a new approach: Physicians have used substances like root herbs or alcohol to relieve anxiety since ancient times. Modern dentistry also has a long history with sedation, dating from the early 1800s with the first use of nitrous oxide gas.

Modern dental sedation has expanded into an array of drugs and techniques to match varying levels of anxiety intensity. At the milder end of the scale are oral sedatives, taken an hour or so before a dental appointment to produce a calmer state. This may be enough for some patients, or it can be used in conjunction with nitrous oxide.

For those with more intense anxiety, dentists can turn to intravenous (IV) sedation. In this case, the sedative is delivered directly into the bloodstream through a small needle or catheter inserted in a vein. This causes a quicker and deeper reaction than oral sedatives.

Although similar to general anesthesia, IV sedation does differ in significant ways. Rather than unconsciousness, IV sedation places a patient in a “semi-awake” state that may still allow them respond to verbal commands. And although the patient's vital signs (heart rate, breathing, blood pressure, etc.) must be monitored, the patient doesn't need breathing assistance as with anesthesia.

There's one other benefit: The drugs used often have an amnesic effect, meaning the patient won't remember the treatment experience after recovery. This can be helpful in creating more pleasant memories of their dental experience, which could have its own sedative effect in the future.

Whether oral, gas or IV, sedatives are a safe and effective way to calm dental fears during treatment. That could help someone with anxiety maintain their oral health.

If you would like more information on reducing dental 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 “IV Sedation in Dentistry.”


4ThingsYouShouldDo-orNotDo-toMaintainYourOralAppliance

Millions of people wear some form of removable oral appliance. The range is pretty extensive, from orthodontic clear aligners and retainers to full or partial dentures. But while they may vary in purpose, they all require the same thing: regular cleaning and maintenance.

And there's a right way to care for them, and a wrong way. The right way ensures you'll get the most out of your appliance—the wrong way might drastically curtail their longevity. Here, then, are 4 things you should and shouldn't do to keep your appliance in tip top condition.

Clean it properly. Only use cleaning agents appropriate for an oral appliance's materials. That means avoiding the use of toothpaste—the abrasives in it won't harm tooth enamel, but they can scratch some appliance materials. Instead, use dish detergent, hand soap or a recommended cleaner with a little warm water. Also, use a different brush than your regular toothbrush.

Avoid hot water and bleach. Hot or boiling water and bleach kill bacteria, but they will also damage your appliance. Hot water can warp an appliance's soft plastic and alter its fit. Bleach can blanch plastic meant to mimic gum tissue, making them less attractive; even worse, it can break down appliance materials and make them less durable.

Protect your appliance. When you take out your appliance, be sure to store it high out of reach of curious pets or young children. And while cleaning dentures in particular, place a small towel in the sink—if they slip accidentally from your hand, there's less chance of damage if they fall on a soft towel rather than a hard sink basin.

Don't wear dentures 24/7. Dentures can accumulate bacterial plaque just like your teeth. This can increase your risk of an oral infection, as well as create unpleasant mouth odors. To minimize this, take your dentures out at night while you sleep. And be sure you're cleaning them daily by hand, soaking them in an appropriate solution or with an ultrasonic cleaner.

Your oral appliance helps keep your dental health and function going. Help your appliance continue to do that for the long haul by taking proper care of it.

If you would like more information on how best to maintain your oral appliance, 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 “10 Tips for Cleaning Your Oral Appliance.”


By Greenbelt Smiles
May 02, 2020
Category: Oral Health
Tags: gummy smile  
WhyIsYourSmileGummyHereAre4Possibilities

What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.

But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”

There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.

Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.

Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.

Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.

Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.

As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.

If you would like more information on correcting gummy smiles, 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 “Gummy Smiles.”