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My Blog
Posts for category: Oral Health
Like other healthcare providers, dentists have relied for decades on the strong pain relief of opioid (narcotic) drugs for patients after dental work. As late as 2012, doctors and dentists wrote over 250 million prescriptions for these drugs. Since then, though, those numbers have shrunk drastically.
That’s because while effective, drugs like morphine, oxycodone or fentanyl are highly addictive. While those trapped in a narcotic addiction can obtain drugs like heroine illicitly, a high number come from prescriptions that have been issued too liberally. This and other factors have helped contribute to a nationwide epidemic of opioid addiction involving an estimated 2 million Americans and thousands of deaths each year.
Because three-quarters of opioid abusers began their addiction with prescription pain medication, there’s been a great deal of re-thinking about how we manage post-procedural pain, especially in dentistry. As a result, we’re seeing a shift to a different strategy: using a combination of non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen and acetaminophen, instead of a prescribed narcotic.
These over-the-counter drugs are safer and less costly; more importantly, though, they don’t have the high addictive quality of an opioid drug. A 2013 study published in the Journal of the American Dental Association (JADA) showed that when two NSAIDs were used together, the pain relief was greater than either drug used individually, and better than some opioid medications.
That’s not to say dentists no longer prescribe opioids for pain management following dental work. But the growing consensus among dental providers is to rely on the double NSAID approach as their first-line therapy. If a patient has other medical conditions or the NSAIDs prove ineffective, then the dentist can prescribe an opioid instead.
There’s often hesitancy among dental patients on going this new route rather than the tried and true opioid prescription. That’s why it’s important to discuss the matter with your dentist before any procedure to see which way is best for you. Just like you, your dentist wants your treatment experience to be as pain-free as possible, in the safest manner possible.
If you would like more information on how dentists are safely managing pain in dental care, please contact us or schedule an appointment for a consultation.
Losing teeth will certainly disrupt your otherwise beautiful smile. It could also potentially affect your food choices and whether or not you receive proper nutrition.
But something else just as consequential could be happening beneath the surface of your gums—you could be losing bone. Significant bone loss in the jaw could adversely affect remaining teeth and facial structure, as well as limit your future restoration choices.
To understand why this occurs we must first consider what bone is: living, cellular tissue. Like the body's other cells, bone has a life cycle: cells form, live and eventually dissolve (or resorb), and are then replaced by new cells. Stimulation from forces generated during chewing traveling up through the tooth roots to the jawbone keep this cycle going at a healthy pace.
But when a tooth is missing, so is this stimulation. This could slow the replacement rate and cause bone volume to gradually decrease. The jawbone width could decrease by as much as 25% the first year alone and several millimeters in height after just a few years.
Although dentures (a popular and affordable choice) can restore lost function and appearance, they can't duplicate this needed stimulation. They even accelerate bone loss by irritating and creating compressive forces on the bony ridges and the gums they rest upon.
One restoration, however, can actually help stop bone loss and may even reverse it: dental implants. This happens because an implant's metal titanium post imbedded in the jawbone attracts bone cells to grow and adhere to its surface. This could actually increase bone density at the site.
To gain this advantage, it's best to obtain implants as soon as possible after tooth loss. If you allow bone loss to occur by waiting too long, there may not be enough to properly support an implant. Even then it might be possible to build up the diminished bone through grafting. But if that's not possible, we'll have to consider a different restoration.
To determine the condition of your bone after losing teeth, visit us for a complete examination. Afterward, we'll be able to discuss with you the best way to address both your overall dental health and your smile.
If you would like more information on treating missing teeth, 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 “The Hidden Consequences of Losing Teeth.”
It’s been a long road with your braces, but now they’re finally off. Hopefully the first glimpse of your new smile more than made up for the time and effort they required.
But while braces removal is a big milestone, it’s not the end of your treatment—not, that is, if you want to keep that new smile! You’ll now need to wear an appliance called a retainer for a few years or, in some cases, from now on.
Orthodontic retainers are a must after braces for the same reason braces work in the first place—your teeth can move. While the teeth attach to the jawbone via the roots, they’re firmly held in place by an elastic gum tissue network called the periodontal ligament. This tough but elastic tissue lies between the teeth and gums and attaches securely to both with tiny fibers.
While the ligament provides stability, it’s also dynamic—constantly remodeling to allow the teeth to move in response to biting pressure and other mouth factors. Orthodontists use this mechanism when moving teeth to better positions. The braces apply pressure on the teeth in the desired direction and the periodontal ligament responds as the teeth move.
Afterward, however, the ligament can still retain a kind of “muscle memory” for a time of the teeth’s old positions. Free of the pressure once supplied by the braces the teeth have a tendency, especially early on, to “rebound” to where they were.
A retainer helps prevent this by exerting just enough pressure to “retain” the teeth in their new positions. In the beginning this may require wearing the appliance around the clock, but you may be able later to reduce wear time to just a few hours a day. Rebounding is unpredictable, so you should continue to follow your orthodontist’s recommendations on retainer wear.
Wearing a retainer may seem like a drag, but it’s absolutely essential. Being diligent about it will help ensure that the beautiful smile you and your orthodontist worked so hard to obtain stays with you for years to come.
If you would like more information on getting a new smile through orthodontics, 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 “The Importance of Orthodontic Retainers.”
Your baby will grow into an adult so rapidly it will seem like they're changing right before your eyes. And some of the biggest changes will happen with their teeth, gums and jaw structure.
Unfortunately, disease or a traumatic accident could short-circuit this natural process and potentially create future dental problems. Here are 4 things you should be doing now to protect your baby's long-term dental health.
Start oral hygiene now. Even if your baby has no visible teeth, there may still be something else in their mouth—bacteria, which could trigger future tooth decay. To reduce bacteria clean their gums with a clean, wet cloth after each feeding. When teeth begin to appear switch to brushing with just a smear of toothpaste on the brush to minimize what they swallow.
Make your baby's first dental appointment. Beginning dental visits around your baby's first birthday will not only give us a head start on preventing or treating tooth decay, but could also give us a better chance of detecting other developing issues like a poor bite (malocclusion). Early dental visits also help get your child used to them as routine and increase the likelihood they'll continue the habit as adults.
Watch their sugar. Bacteria love sugar. So much so, they'll multiply—and more bacteria mean an increase in one of their by-products, mouth acid. Increased mouth acid can erode tooth enamel and open the way for decay. So, limit sugary snacks to only meal time and don't give them sugary drinks (including juices, breast milk or formula) in a bottle immediately before or while they sleep.
Childproof your home. A number of studies have shown that half of all accidents to teeth in children younger than 7 happen from falling on home furniture. So, take precautions by covering sharp edges or hard surfaces on chairs, tables or sofas, or situate your child's play areas away from furniture. And when they get older and wish to participate in sports activities purchase a custom mouthguard to protect their teeth from hard knocks—an investment well worth the cost.
If you would like more information on dental care for your child, 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 “Top 10 Oral Health Tips for Children.”
Your sweet, happy baby has suddenly become a gnawing, drooling bundle of irritation. Don't worry, though, no one has switched babies on you. Your child is teething.
For most children, their first teeth begin breaking through the gums around six to nine months. Usually by age three all twenty primary (“baby”) teeth have erupted. While the duration and intensity of teething differs among children, there are some common symptoms to expect.
Top of the list, of course, is irritability from pain, discomfort and disrupted sleep. You'll also notice increased gnawing, ear rubbing, decreased appetite, gum swelling or facial rash brought on by increased saliva (drooling). Teething symptoms seem to increase about four days before a tooth begins to break through the gums and taper off about three days after.
You may occasionally see bluish swellings along the gums known as eruption cysts. These typically aren't cause for concern: Â the cyst usually “pops” and disappears as the tooth breaks through it. On the other hand, diarrhea, body rashes or fever are causes for concern — if these occur you should call us or your pediatrician for an examination.
While teething must run its course, there are some things you can do to minimize your child's discomfort:
Provide them a clean, soft teething ring or pacifier to gnaw or chew — a wet washcloth (or a cold treat for older children) may also work. Chill it first to provide a pain-reducing effect, but don't freeze it — that could burn the gums.
Use a clean finger to massage swollen gums — gently rubbing the gums helps counteract the pressure caused by an erupting tooth.
Alleviate persistent pain with medication — With your doctor's recommendation, you can give them a child's dosage of acetaminophen or ibuprofen (not aspirin), to take the edge off teething pain.
There are also things you should not do, like applying rubbing alcohol to the gums or using products with Benzocaine®, a numbing agent, with children younger than two years of age. Be sure you consult us or a physician before administering any drugs.
While it isn't pleasant at the time, teething is part of your child's dental development. With your help, you can ease their discomfort for the relatively short time it lasts.
If you would like more information on relieving discomfort during teething, 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 “Teething Troubles.”