Posts for category: Dental Procedures
There's no doubt treating dental problems can improve your health. But because the mouth is among the most sensitive areas of the body, many dental procedures can be potentially uncomfortable after treatment.
We rely on pain medication to alleviate any dental work discomfort, especially during recuperation. Our arsenal of pain-relieving drugs includes strong opioid narcotics like morphine or oxycodone which have effectively relieved dental pain for decades. But although they work wonders, they're also highly addictive.
We've all been confronted in the last few years with startling headlines about the opioid addiction epidemic sweeping across the country. Annual deaths resulting from opioid addiction number in the tens of thousands, ahead of motor vehicle accident fatalities. Although illegal drugs like heroin account for some, the source for most addiction cases—an estimated 2 million in 2015 alone—is opioid prescriptions.
Dentists and other healthcare providers are seeking ways to address this problem. One way is to re-examine the use of opioids for pain management and to find alternative means that might reduce the number of narcotic prescriptions.
This has led to new approaches in dentistry regarding pain relief. In a trend that's been underway for several years, we've found managing post-discomfort for many procedures can be done effectively with non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen or ibuprofen. They don't share the addictive quality of narcotics and are regarded as safer when taken as directed.
There's also been a recent modification with using NSAIDs. Dentists have found that alternating the use of ibuprofen and acetaminophen often amplifies the pain relief found using only one at a time. By doing so, we may further reduce the need for narcotics for more procedures.
The trend now in dentistry is to look first to NSAIDs to manage pain and discomfort after dental work. Narcotics may still be used, but only in a secondary role when absolutely needed. With less narcotic prescriptions thanks to these new pain management protocols, we can reduce the risk of a dangerous addiction.
Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.
Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:
Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.
Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.
Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.
Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.
Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.
After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.
For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”
There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.
But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.
But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.
After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.
As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.
This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.
If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”
A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.
But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.
Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.
Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.
Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.
The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.
There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.
As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.
Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.
There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.
Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.
If you would like more information on surgical procedures for gum disease, 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 “Periodontal Surgery: Where Art Meets Science.”