By Edward Joseph, D.D.S.
February 15, 2022
Category: Oral Health
Tags: medicine  
NSAIDs-SafeandEffectiveDrugsThatManagePost-DentalWorkDiscomfort

There's a good chance you have an over-the-counter pain reliever in your medicine cabinet right now. They're handy for safely and effectively coping with mild to moderate pain, swelling or fever. They could also prove an invaluable resource after your upcoming dental work—your dentist may recommend one of these common drugs to help you manage your recovery period.

These particular drugs are non-steroidal anti-inflammatory drugs or NSAIDs. The most common sold under various brand names are aspirin, ibuprofen and naproxen. Unlike narcotics (opioids), which depress the central nervous system to control pain, NSAIDs block substances in the body called prostaglandins, which are released when tissues become inflamed or damaged. This in turn reduces pain, swelling or fever.

There's another significant difference between NSAIDs and narcotics—NSAIDs aren't addictive like opioids. Because they're also milder, NSAIDs don't require a prescription except for stronger formulations. With the trend to limit the use of narcotics in both dentistry and medicine, dentists are turning to NSAIDs as their primary means for managing dental pain.

There are, of course, some situations where narcotics are the preferred course. But dentists are finding NSAIDs are just as effective for managing discomfort following most dental procedures. They've also found that combined doses of ibuprofen and acetaminophen greatly amplifies the pain relieving effect.

Although NSAIDs are much safer than narcotics, they do have potential side effects. For one, they can reduce the blood's ability to coagulate, especially when taken consistently over several weeks. This could make it difficult to stop bleeding due to injury or illness.

NSAIDs can also irritate the stomach lining in some people over an extended period of use, leading to ulcers and other digestive issues. Prolonged use has also been linked to major problems like kidney damage, miscarriage or heart attacks.

But NSAIDs are still a safe alternative to narcotics: Their side effect risks are quite low when taken in proper dosages—between 400 and 600 mg for adults—within a limited amount of time like a few days. Their temporary use can help you cope with discomfort after a dental procedure and get you well on the road to full healing.

If you would like more information on managing discomfort after dental work, 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 “Treating Pain With Ibuprofen.”

By Edward Joseph, D.D.S.
February 10, 2022
Category: Dental Procedures
Tags: veneers  
4SmileAppearanceProblemsThatDentalVeneersCouldSolve

It doesn't take much—some staining, a chipped tooth or a slight gap—for you to lose confidence in your smile. But you may be able to regain your smile confidence with porcelain veneers.

A veneer is a thin, tooth-colored shell of dental porcelain that we bond to the face of a tooth. As the name implies, a veneer covers mild to moderate imperfections in such a life-like fashion that it's difficult to tell a veneered tooth from a natural one.

Although veneers can't correct every dental appearance problem, they do have a wide range. Here are 4 situations where veneers could be a great choice for improving your smile.

Discoloration. People often turn to teeth whitening to help brighten dull or dingy teeth. But this technique may not work as well with heavy staining, or not at all if the discoloration originates from inside of a tooth. Veneers offer a permanent solution for heavily stained or discolored teeth.

Shaping and size. Teeth look best when they're in proper proportion to other oral or facial features. But congenitally small or odd-shaped teeth, as well as inordinate tooth wearing, could cause your smile to look out of place. Veneers can improve the appearance of small or worn teeth and restore proper balance to your smile.

Dental defects. Teeth with chips, craze lines (vertical cracks) or other dental flaws can distract from your smile. As with discoloration, veneers can mask mild to moderate dental flaws and restore teeth to their beautiful perfection.

Misalignments. We often correct bite misalignments that affect appearance with braces or clear aligners. But if it's a mild orthodontic problem like a slight tooth gap between the front teeth or a slight rotation, it's often possible to cover the misalignment with the help of dental veneers.

So, could veneers make a difference in your smile? There's only one way to find out—see your dentist for a complete dental assessment. Depending on the nature of the problems disrupting your appearance, veneers could be a great way to transform your smile.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”

By Edward Joseph, D.D.S.
February 05, 2022
Category: Dental Procedures
RemovingTeethCouldAidOrthodonticTreatment

There's usually more to straightening a smile than simply applying braces. That's why an orthodontist takes the time first to learn all they can about a patient's bite and, depending on what they find, take other actions before treating with braces or clear aligners. One such action might be removing one or more teeth.

That might at first seem out of place with our intended goal of straightening teeth. But there are situations where subtracting teeth can benefit bite correction. Here are a few scenarios where a dental extraction might be necessary before orthodontics.

Crowding. When a jaw is failing to grow to a normal width, teeth erupting later may not have sufficient room and thus come in misaligned. It's possible to help widen the jaw during early growth development through a device called a palatal expander, but it's best attempted before puberty. Later, it may be easier to open up more room for tooth movement on a crowded jaw by removing select teeth.

Impacted teeth. Impaction occurs when a tooth doesn't properly erupt and remains totally or partially submerged below the gum line. Although in some situations we may be able to coax an impacted tooth down onto the jaw, it may be easier to extract it, along with the matching tooth on the other side of the jaw for balance. We can then move the teeth or use other restorations to close the gap.

Jaw abnormalities.  A bite problem may in reality be a jaw problem: For example, a lower jaw set too far back may not be aligning properly with the upper jaw causing the bite to skew. Jaw surgery could correct this alignment, but those procedures can be highly invasive. An alternative is to remove a couple of select upper teeth, then use braces to move the remaining teeth back. This can result in a less noticeable overbite.

Orthodontics not only enhances your appearance, it can also a improve your oral health. Extracting one or more teeth may be a necessary prerequisite to straightening your smile.

If you would like more information about straightening a smile, 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 “Removing Teeth for Orthodontic Treatment.”

By Edward Joseph, D.D.S.
January 31, 2022
Category: Oral Health
AMinorProcedureCouldHelpanInfantWithThisNursingProblem

Newborns come into the world eager and ready to partake of their mother's milk. But an anatomical quirk with some infants could make breastfeeding more difficult for them.

The structure in question is a frenum, a tiny band of tissue connecting softer parts of the mouth with firmer parts, like the upper lip to the gums, and the tongue to the floor of the mouth. If they're abnormally short, thick or tight, however, the baby might find it difficult to obtain a good seal around the mother's nipple.

Without that seal, the baby has a difficult time drawing milk out of the breast and as a result, they may attempt to compensate by chewing on the nipple. The sad outcome is often continuing hunger and frustration for the baby, and pain for the mother.

To alleviate this problem, a physician can clip the frenum to loosen it. Known as a frenotomy, (or a frenectomy or frenuplasty, depending on the exact actions taken), it's a minor procedure a doctor can perform in their office.

It begins with the doctor deadening the area with a numbing gel or injected anesthesia. After a few minutes to allow the anesthesia to take effect, they clip the frenum with surgical scissors or with a laser (there's usually little to no bleeding with the latter).

Once the frenum has been clipped, the baby should be able to nurse right away. However, they may have a learning curve to using the now freed-up parts of their mouth to obtain a solid seal while nursing.

Abnormal frenums that interfere with nursing are usually treated as soon as possible. But even if it isn't impeding breastfeeding, an abnormal frenum could eventually interfere with other functions like speech development, or it could foster the development of a gap between the front teeth. It may be necessary, then, to revisit the frenum at an older age and treat it at that time.

Although technically a surgical procedure, frenotomies are minor and safe to perform on newborns. Their outcome, though, can be transformative, allowing a newborn to gain the full nourishment and emotional bonding they need while breastfeeding.

If you would like more information on tongue or lip ties, 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 “Tongue Ties, Lip Ties and Breastfeeding.”

SealantsCanPreventChildhoodCavitiesNowandaBiteProblemLater

Even with dedicated daily home care and regular dental cleanings, some children still have problems with cavities. And, that could morph into an even more serious problem in the future: Primary teeth lost prematurely to the disease could cause incoming permanent teeth to erupt out of position and form a poor bite.

To avoid this, parents often need a little extra help protecting their children's teeth from cavities. One way is with a dental sealant applied to larger teeth by their dentist.

A dental sealant is a protective coating of plastic or glass-like material that partially fills in the pits and crevices of the biting surfaces of larger teeth like molars. Even with diligent brushing it can be difficult to clean these surfaces of plaque, thus allowing bacteria to hide out in deep crevices. By "smoothing" out these areas with a sealant, they're easier to rid the teeth of decay-causing plaque.

Your child can undergo a quick and painless sealant application during a routine visit. After applying the liquid form of the sealant to the teeth with a brush, the dentist uses a curing light to harden the coating into a durable defense against decay.

Dentists have been applying sealants for several years now, which begs the question—do they work? At least two major studies say yes.

These independent studies both surveyed thousands of pediatric patients over several years. And, they both concluded that children with sealants experienced significantly fewer cavities than those without sealants. Furthermore, the protection appeared to last at least four years after the application.

A sealant application does involve a modest cost per tooth. But compared to what you'll spend to treat cavities, or even expensive orthodontic treatment later, sealants are well worth the cost.

If your child continues to develop cavities regardless of home and dental care, then talk with your dentist about sealants and other ways to minimize cavities. Taking these extra steps could help prevent a problem now, and a bigger problem in the future.

If you would like more information on dental care for children, 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 “Sealants for Children.”





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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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