Posts for: April, 2013

FAQsAboutCalmingYourFearsWithOralSedationDentistry

What is oral sedation dentistry? If you become frightened and anxious when facing a dental appointment or procedure, sedatives (also called “anxiolytics” meaning they dissolve anxiety), can completely transform the experience. Oral sedatives (taken by mouth) allow you to relax your mind and body so that you feel comfortable while in the dental chair.

How does anxiety affect my pain response? When you are afraid, your pain threshold is reduced. You experience a rush of adrenalin and you tense your muscles. As a result you end up in a state of heightened sensitivity. With sedation this sensitivity to pain vanishes along with your fear and anxiety.

What are some of the oral sedatives that my dentist may use? Most of the medications used in oral sedation dentistry belong to a class of medications called benzodiazepines, tried and tested over decades to be safe and effective. They are used in the treatment of anxiety, insomnia, and agitation. They include Valium®, Halcion®, Ativan®, and Versed®.

I'd just like to forget the experience after it is over. Can oral sedation help? Some of the medications prescribed as oral sedatives have amnesic properties (“a” – without; “mnesia” – memory). This means you will have little memory of the time in the dental chair when your procedure is finished.

What does my dentist need to know in order to prescribe the right oral sedation? We need a thorough medical and dental history, including all medical conditions you may have, and all medications you are taking — both prescription and over-the-counter (including allergies, alternative medications and even herbal supplements). We will also ask you whether you eat certain foods that could interfere with a sedative's effects.

How are the oral sedatives administered? Oral medications are either placed under the tongue (sub-lingual), and allowed to dissolve and then swallowed, or they may be swallowed whole. They are safe, effective, and fast acting. After the sedation takes effect, it will be easier to experience injections of local anesthesia if needed to numb your gums for the dental procedure.

What do I need to do before and after my appointment? Follow all directions we give you about restricting food and drink before your appointment. Until the medication wears off you may not be able to drive, operate heavy machinery or work so be sure to make arrangements to take time off and to have someone drive you to and from the appointment.

Contact us today to schedule an appointment to talk about any fears you may have about dental treatments. Using oral sedation, we can make sure that you have a relaxing experience. Oral sedation allows you to relax both your mind and body, and focus on feeling peaceful rather than anxious. You can learn more about oral sedation dentistry in the Dear Doctor magazine article “Oral Sedation Dentistry.”


By Edward Joseph, D.D.S.
April 20, 2013
Category: Oral Health
TreatingChippedTeethACommonSportsInjuryAmongKids

One went over the handlebars of his mountain bike. Another got an elbow going for a lay-up. For a third, it was that tricky maneuver on her new snowboard...

These are just a few of the ways that kids' teeth can be injured. (No doubt, parents can think of plenty more.) The good news is that modern dentistry offers more options than ever for treating the injury and restoring the appearance and function of the teeth.

Teeth that are fractured or dislodged are a serious condition that requires immediate, comprehensive treatment. The majority of dental injuries, however, are less severe: most often, they involve chipped teeth. If chips occur in the upper front teeth — as some 80% of dental injuries do — even small flaws can have a big affect on the appearance. And, especially in the teenage years, appearance can mean everything.

In many cases, small chips in the teeth can be repaired effectively using a procedure called “bonding.” In this treatment, we use a tooth-colored material made by mixing a plastic matrix and a glass-like filler, which provides adequate strength and aesthetic qualities similar to the natural teeth. In fact, this composite material can be matched to an individual's tooth color so accurately that it's hard to notice any difference.

Composite resins can be successfully bonded to most healthy teeth — and they offer some advantages over other restoration methods, particularly for children and teenagers. The bonding procedure avoids making tiny “undercuts” in the natural substance of the tooth, while metal fillings need to “lock in” to the tooth's structure. This means that bondings generally require less tooth preparation, which usually makes bonding a quick and relatively easy method of restoration.

It's true that, over time, some bonded restorations may not stand up to the tremendous biting forces of the jaw as well as porcelain restorations — but in young people whose permanent teeth have large pulp (nerve) chambers, the removal of too much tooth structure could compromise the long-term health of the tooth. Later on, we can look at performing a different type of restoration.

If you have questions about cosmetic bonding or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “An Introduction to Sports Injuries & Dentistry.”


By Edward Joseph, D.D.S.
April 12, 2013
Category: Oral Health
Tags: tooth decay   dry mouth  
DryMouth-CausesRisksandCures

A consistently dry mouth is not only uncomfortable and unpleasant but also probably more serious than you think. Dry mouth, medically known as xerostomia (“xero” – dry; “stomia” – mouth) affects millions of people, but few understand why it happens or why it is important.

What Causes Dry Mouth?

It is normal to awaken with a dry mouth because saliva flow decreases at night. But if your mouth is persistently dry throughout the day, it may be a result of habits such as smoking, alcohol or too much coffee drinking or even dehydration. It is also a common side effect of some medications. Xerostomia is not a disease in itself, but it could be a symptom of salivary gland or other systemic (general body) disease.

Why is Saliva Important?

A persistently dry mouth can be a problem. Not only does it feel unpleasant and lead to bad breath, it can also significantly increase your risk for tooth decay. Saliva lubricates your mouth for chewing, eating, digestion and even speaking. Saliva also has important antibacterial activities. Most importantly normal healthy salivary flow neutralizes and buffers acids in the mouth to protect the teeth from the acids produced by bacteria on the teeth that cause decay, and by acids in sodas, sports drinks and juices that can erode tooth enamel.

Not only does saliva neutralize acids but with its high mineral content it can actually reverse de-mineralization — the process by which acids attack enamel and remove calcium from the enamel surface. Healthy saliva actually re-mineralizes the outer layers of tooth enamel, but the process can take 30-60 minutes. That's why it's important not to snack on sugars or drink sodas between meals — one an hour and your mouth is acidic all the time.

Individuals without enough saliva are especially at risk for root decay and fungal infections, and they are also more likely to lose tooth substance through abrasion and erosion.

What Can We Do for a Dry Mouth?

If your mouth is usually dry, make an appointment with us to assess the causes of the problem. However it may be more serious with medical implications. The solution may be as simple as drinking more water and using good daily oral hygiene, or it may necessitate prescription medication to promote more saliva flow.

Contact us today to schedule an appointment to discuss your dry mouth and what we can do to help. For more information read the article in Dear Doctor magazine “Tooth Decay – How To Assess Your Risk.”


By Edward Joseph, D.D.S.
April 05, 2013
Category: Oral Health
HowtoHelpYourselfAvoidStainedTeeth

There are many ways to brighten and whiten teeth if they become dull and stained; but if you know the causes of staining on teeth, you may be able to avoid it in the first place. Here are some of the main causes of stained teeth. We hope this will help keep your smile stain-free.

Extrinsic Staining

  1. What we call extrinsic staining occurs when stain-producing substances collect on the enamel surface of your teeth. To stop or slow this process, cut down on consumption of coffee, red wine, and tea, which contains high tannin contents.
  2. Cut down on smoking. Tobacco can stain teeth, so it's best to stop the use of tobacco in any form.
  3. Some mouthwashes and toothpastes contain substances that can cause tooth staining. Mouthwashes containing chlorhexidine, a prescription antibacterial mouthrinse, or those containing cetylpyridium chloride, can cause dental staining after long-term use. Some toothpastes contain stannous fluoride, which can also induce brown discoloration.
  4. Dry mouth, a common problem, may contribute to extrinsic discoloration. This problem is sometimes a side effect of medications you are taking and drinking more water can often alleviate it. If drugs are the cause of mouth dryness, a consultation with your physician should be considered.
  5. Bacterial buildup by chromogenic (color or stain producing) bacteria in your mouth can cause staining. Hundreds of bacteria normally live in your mouth, and it is important to keep good regular dental hygiene habits to prevent bacteria from accumulating on your teeth and gums.

Intrinsic Staining

  1. Stains that are caused by various organic compounds that build up within the mineral matrix of your tooth's enamel are called intrinsic stains. They may be caused by tooth decay within the tooth or between the tooth and dental filling materials. Tooth decay is brown, it not only discolors teeth, but it also destroys tooth structure.
  2. Use of some medications, such as tetracycline antibiotics, can cause intrinsic staining.

Make an appointment for an examination and assessment of your teeth, so that we can determine why they are developing stains. Once we know the cause, we can draw up a plan for whitening and brightening your teeth.

Contact us today to schedule an appointment to discuss your questions about tooth staining and its treatments. You can also learn more by reading the Dear Doctor magazine article “Tooth Staining.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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