SEDATION DENTISTRY for DENTAL ANXIETY
Dental sedation is a technique that can be used when a patient suffers from dental anxiety or dental phobia. We are happy to offer a number of solutions for our patients to make their dental visit as comfortable as possible. Sedation dentistry techniques enable patients - who might otherwise avoid the dentist - to receive dental treatment necessary for a healthy smile.
Depending on the extent of the anxiety or phobia, varying degrees of dental sedation can be utilized as described below.
Nitrous Oxide Sedation
Nitrous Oxide sedation, also known as “laughing gas” is commonly used to make treatment more comfortable. This sedation is inhaled through a mask that allows you to breathe in the medication and induces a state of relaxation. Local anesthetic will be administered in conjunction with nitrous oxide to eliminate pain.
This medication can be given to a patient the night before a dentistry procedure or 30 minutes to an hour prior to the dental appointment, depending on the severity of the anxiety. Oral sedatives do not provide pain relief, so an injection of local anesthetic will also be administered.
Intravenous (IV) Sedation
IV Sedation provides relaxation medication through a small needle inserted in your hand or arm. Like oral sedatives, IV sedation does not provide pain relief, so a local anesthetic will also be administered. Intravenous sedation allows patients to still be awake but in an extreme state of relaxation, feeling little or no pain.
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A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason. A dental implant is a metal post that a periodontist or oral surgeon surgically positions into the jaw. Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post. While implants are typically more expensive than other methods of tooth replacement, they provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They are also a more favorable approach than bridgework since they do not depending on neighboring teeth for support.
To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants.
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TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.
Problems in this area can cause:
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.
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WISDOM TOOTH EXTRACTIONS
Wisdom teeth are the last molars, or “third molars” that develop on each side of the jaws. Wisdom teeth usually emerge in the back of the mouth between the ages of 16-20.
Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may grow sideways, emerge only part way through the gum or remain trapped beneath the gum and bone.
A wisdom tooth extraction is a relatively routine procedure. The dentist will numb the area in your mouth with a local anesthesia or use IV sedation so you are asleep during the procedure.
After the tooth (or teeth) is removed, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur. Some pain and swelling may occur but it will normally go away after a few days; however, you should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.
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Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there still sometimes necessary occasions when a tooth may need to be extracted. A tooth may need to be extracted if the following occurs:
- Severe decay
- Advanced periodontal disease
- Infection or abscess
- Orthodontic correction
- Malpositioned teeth
- Fractured teeth or roots
- Impacted teeth
After careful examination and treatment, the dentist may advise to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to a specialist called an oral surgeon.
For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches.
It is critical to keep the extraction area clean to prevent infection. We will provide you with dry, sterile gauze to bite down on for 30-45 minutes to limit bleeding while clotting takes place. For the next 24 hours, you shouldn't smoke, rinse your mouth vigorously, or brush teeth directly next to the extraction site.
A certain amount of pain and discomfort is to be expected following an extraction, which can be minimized with a pain killer and ice packs applied to the face for 15 minutes at a time. After a routine extraction, discomfort should lessen within three days to two weeks. If you have prolonged or severe pain, swelling, bleeding or fever, call our office immediately.
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NON-SURGICAL GUM TREATMENT
The gums, ligaments, and bone around the teeth form the foundation for ones teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. Any of these may be a sign of problem. With proper gum treatments, however, it may be possible to return gum tissue to a healthy state. If you're having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents. If the gum disease gets too severe it may need to be treated through surgery or extraction. This is why it is important to have it treated at the first sign of a problem.
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ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.
A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.
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NIGHTGUARDS AND ATHLETIC BITEGUARDS
Custom designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth. Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may get hit. In addition, these guards protect the soft tissues of your tongue, lips and cheek lining. Nightguards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.
If you have decided a guard is right for you, the dentist will take an impression of your teeth which will then be sent to a lab to make a custom fit guard for you. In most cases you can choose from a variety of colors and styles for your guard. On average, guards last between 3 and 10 years.
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