Posts for: August, 2014
The next time you’re visiting Boston, why not make time for a stroll in the city’s renowned public garden? It’s got a little something for everyone: acres of greenhouses and formal plantings, a picturesque pond where you can go for a paddle in swan-shaped boats, and the first (and perhaps the only) statue dedicated to an anesthetic gas.
Yes, the Ether Monument (also called “The Good Samaritan”) is a vaguely Moorish-looking sculpture that commemorates the first use of anesthetic in a medical procedure. This ground-breaking event took place at nearby Massachusetts General Hospital in 1846. But if it seems that perhaps the park designers were feeling a bit light-headed when they commissioned this statue* then just think of what it would have been like to have a tooth drilled without it!
Today, of course, ether is no longer used for anesthesia; that’s because medical science has developed far better ways to make sure you don’t feel pain when you’re having a procedure. However, we do still use a gas for people who need a little more help relaxing during dental treatment. It’s called nitrous oxide, but sometimes goes by the nickname “laughing gas.”
This sweet-smelling gas, mixed with oxygen, is often administered in a process called inhalation conscious sedation. It doesn’t put you to sleep — you can still follow directions and respond to verbal cues — but it makes you very comfortable, and may even induce a slightly euphoric feeling, which wears off quickly when the gas is stopped. That’s what makes it ideal for some dental procedures: It’s quite effective for people who might otherwise have a great deal of dental anxiety, yet it’s quick, easy and safe to administer — and you can usually drive yourself home afterward.
Sometimes, however, you may need even more relaxation — for example, if you’re having multiple wisdom teeth extracted. In this case, it may be best to use intravenous (IV) conscious sedation. Here, the precise amount of medication you need is delivered directly into your bloodstream via a tiny needle. As with nitrous oxide, you’ll remain conscious the whole time, but you won’t feel any pain — and afterward, you probably won’t remember a thing.
Sedation dentistry has come a long way since the days of ether… but making sure you don’t feel pain or anxiety remains a critical part of what we do. Before a procedure, we’ll talk to you about what type of anesthesia is best — and if you have any questions or concerns, we’ll work with you to make sure you have the best experience possible. If you would like more information about sedation dentistry or relieving dental anxiety, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Sedation Dentistry” and “Sedation Dentistry For Kids.”
A crown is an effective way to save a tooth and restore its form and function. These life-like “caps” that fit over and are permanently attached to teeth have been used for decades with good results.
For this type of restoration to be effective, though, there must be enough of the natural tooth remaining above the gum line for the crown to “grab on to.” This poses a problem if the tooth has broken or decayed too close to the gum tissue.
Fortunately, there is a way to expose more of the remaining tooth for applying a crown. Known as crown lengthening, this surgical procedure is also used for “gummy” smiles, where normal tooth length is obscured by excess gum tissue that makes the teeth appear shorter.
We begin the procedure by first numbing the tooth and gum area with a local anesthetic. We then make tiny incisions inside the gum line on both the tongue and cheek side of the tooth to create a small flap. With this area below the gum line now open to view, we then determine whether we need to remove excess gum tissue or a small amount of bone around the tooth to expose more of the tooth itself. We then position the opened gum tissue against the bone and tooth at the appropriate height to create an aesthetic result.
You shouldn’t experience any discomfort during the procedure, which usually takes about sixty minutes for a single tooth area (which needs to involve at least three teeth for proper blending of the tissues). The pressures and vibrations from equipment, as well as any post-procedure discomfort, are similar to what you would encounter with a tooth filling. After the gum tissue has healed (about six to eight weeks), we are then able to fit and attach a crown onto the extended area.
Crown lengthening a small area may result in an uneven appearance if you’re dealing within the aesthetic zone. One option in this case is to consider undergoing orthodontic treatment first to correct the potential discrepancy that may result from surgery. After orthodontics, we can perform crown lengthening on just the affected tooth and still achieve an even smile.
Crown lengthening is just one of many tools we have to achieve tooth restorations for difficult situations. Using this technique, we can increase your chances of achieving both renewed tooth function and a more beautiful smile.
If you would like more information on crown lengthening, 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 “Saving Broken Teeth.”
When it comes to our overall health, many of us think we’re pretty well-informed. But a recent survey quiz given by the American Dental Association (ADA) revealed something surprising: When it comes to dental health, most people could use plenty of “brushing up.” In fact, the average score on the true/false test was a barely passing D! Among the questions most people answered incorrectly were:
- How often should you brush your teeth? (91 percent got it wrong)
- At what age should you take your child to the dentist for the first time? (75 percent wrong)
- How often should you replace your toothbrush? (65 percent wrong)
- Can cavity-causing germs be passed from person to person? (59 percent wrong), and
- Does sugar cause cavities?
We’ll come back to the last question in a moment — but first, let’s recap some basic dental health information.
While you might think it’s best to brush after every meal, the ADA recommends brushing just twice a day. That’s because excessive brushing can erode tooth enamel (especially if it has already been softened by acidic food or drinks), and can also expose and irritate the root of the tooth. But when you do brush, you should keep at it for at least two minutes each time!
Bring your child in to the dental office within six months after the first tooth appears — but no later than his or her first birthday! The age-one dental visit starts your child off right with proper preventive care and screenings, and sets the stage for a lifetime of good oral health.
Most people think it’s OK to change your toothbrush twice a year — but the ADA recommends that you get a new one every three months; that’s because stiff, frayed bristles just don’t clean your teeth and gums as well as they should. Likewise, most people don’t realize that the bacteria that cause cavities can be passed from one person’s mouth to another — by putting a child’s pacifier in your mouth or sharing a toothbrush, for example.
And speaking of cavities: Technically, they aren’t caused by sugar, as 81 percent of people thought. Tooth decay occurs when certain types of oral bacteria release an acidic byproduct that attacks the tooth enamel and creates small holes (cavities). This occurs after the bacteria have metabolized sugar in your diet. So while sugar doesn’t directly cause cavities, it does lead to tooth decay by feeding harmful bacteria. How about partial credit for that one?
If you have additional questions about your dental health, please call our office to schedule a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Baseball legend Babe Ruth, President Ulysses S. Grant and George Harrison of the Beatles — these three notable people from different backgrounds and historical eras have a sad commonality — they all died from oral cancer. They are a reminder that regardless of one’s wealth or fame, no one is immune from oral cancer and its deadly effects.
Like other cancers, oral cancer is characterized by abnormal cell growth capable of spreading into nearby tissue or other parts of the body. Although oral cancer accounts for less than 3% of all occurring cancers, it’s among the most deadly: only 58% of oral cancer patients survive five years after treatment. This is mostly due to the difficulty of detecting oral cancer in its early stages; in fact, 30% of oral cancers have already spread (metastasized) when they’re finally diagnosed.
Early detection through careful monitoring is the best strategy for defeating oral cancer. If you have a predisposing factor like a family history of oral cancer, then regular screenings during dental checkups are a must. During an exam we may be able to detect abnormalities (like unusual white spots on the gums or jaws) that may signal a cancer in a pre-cancerous or early stage. You also should be on the lookout for a persistent sore throat or hoarseness, lingering mouth pain, a painless lump in the mouth or on the neck, or ear pain on only one side.
There are also conditions or behaviors that may increase your risk for oral cancer, like using tobacco (both smoke and smokeless) or consuming alcohol. If you use tobacco you should consider quitting it altogether; you should consider cutting back on alcohol consumption if you’re a moderate to heavy drinker. You should also avoid sexual behaviors that increase your chances of viral infection — research has found a link between oral cancer and the viral infection caused by the sexually-transmitted human papilloma virus (HPV 16).
Improving your nutrition can also reduce your cancer risk. A diet rich in fresh fruits and vegetables supplies the body with cancer-fighting nutrients, including antioxidants that protect cells from damage caused by carcinogens. Studies have shown this kind of diet consistently lowers the risk of oral and throat cancer, as well as cancers of the esophagus, breast, prostate, lung and colon.
If you would like more information on 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.”
Not long ago, a certain Royal Baby made his first major public appearance. At a “crawl-about” in New Zealand, young Prince George (the 8-month-old son of Prince William and Kate Middleton) was formally introduced to the world, along with a group of adorable tots and their proud parents. The press was quick to note not only the future King of England’s cute expressions and his determined crawling — but also the appearance of his first two tiny bottom teeth.
Congratulations, William and Kate — and now, it’s time to think about the taking care of those royal baby teeth. In fact, before you know it, it will be time for the age one dental visit. Why is this so important? Essentially, because proper dental care in the early years helps to establish routines that will lead to a lifetime of good oral health.
It’s a misconception to think that baby teeth aren’t important because they will be shed after a few years. In fact, not only do they have a vital function in a child’s ability to eat and speak properly — they also serve as guides for the proper development of the permanent teeth that will follow. So caring for a tot’s primary teeth is just as important as it is for grown-up teeth.
What’s the best way to do that? To prevent tooth decay, clean an infant’s gums after each feeding with a soft cloth moistened with water — and don’t let your baby go to sleep with a bottle in his or her mouth! When teeth appear, gently brush them with a soft-bristled toothbrush and a tiny dab of toothpaste. At around age two, your child can begin to learn how to brush — with your careful supervision and follow-up, of course.
Avoiding sugary and acidic drinks (including some fruit juices) is another excellent way to keep those tiny teeth healthy! If you do allow any sugar, limit it to mealtimes; this gives the saliva plenty of time to do its work of neutralizing the sugar and acid that can cause tooth decay.
And don’t forget the first visit to the dentist, which should take place by age one! Even at that early age, we’ll make sure your child (and you) feel comfortable in the dental office, and help you get started with the best oral hygiene practices. We will also check for signs of cavities, watch for developmental milestones, and screen for potential future problems.
If you have questions about caring for your young child’s teeth, please contact us or schedule an appointment. For more information, see the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “Age One Dental Visit.”