• What is endodontic treatment? 
• Who performs endodontic treatment? 
• How will my injury be treated? 
• Do traumatic dental injuries differ in children? 
• Will the tooth need any special care or additional treatment?

What is endodontic treatment?

“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment (involves) the inside of the tooth.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

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Who performs endodontic treatment?

All dentists, including your general dentist, received training in endodontic treatment in dental school. General dentists can perform endodontic procedures along with other dental procedures, but often they refer patients needing endodontic treatment to endodontists.

Endodontists are dentists with special training in endodontic procedures. They provide only endodontic services in their practices because they are specialists. To become specialists, they complete dental school and an additional two or more years of advanced training in endodontics. They perform routine as well as difficult and very complex endodontic procedures, including endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

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How will my injury be treated?

Chipped teeth account for the majority of all dental injuries. Dislodged or knocked-out teeth are examples of less frequent, but more severe injuries. Treatment depends on the type, location and severity of each injury. Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.

Chipped or Fractured Teeth
Most chipped or fractured tooth crowns can be repaired either by reattaching the broken piece or by placing a tooth-colored filling. If a significant portion of the tooth crown is broken off, an artificial crown or “cap” may be needed to restore the tooth.

If the pulp is exposed or damaged after a crown fracture, root canal treatment may be needed. These injuries require special attention. If breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office. Never use topical oral pain medications (such as Anbesol^®) or ointments, or place aspirin on the affected areas to eliminate pain symptoms.

Injuries in the back teeth often include fractured cusps, cracked teeth and the more serious split tooth. If cracks extend into the root, root canal treatment and a full coverage crown may be needed to restore function to the tooth. Split teeth may require extraction.

Dislodged (Luxated) Teeth

During an injury, a tooth may be pushed sideways, out of or into its socket. Your endodontist or general dentist will reposition and stabilize your tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started a few days following the injury. Medication such as calcium hydroxide may be put inside the tooth as part of the root canal treatment. A permanent root canal filling will be placed at a later date.

Children between seven and 12 years old may not need root canal treatment since their teeth are still developing. For those patients, an endodontist or dentist will monitor the healing carefully and intervene immediately if any unfavorable changes appear. Therefore, multiple follow-up appointments are likely to be needed. New research indicates that stem cells present in the pulps of young people can be stimulated to complete root growth and heal the pulp following injuries or infection.

Knocked-Out (Avulsed) Teeth

If a tooth is completely knocked out of your mouth, time is of the essence. The tooth should be handled very gently, avoiding touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If possible, the tooth should be placed back into its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it. Call a dentist immediately!

If you cannot put the tooth back in its socket, it needs to be kept moist in special solutions that are available at many local drugstores (such as Save-A-Tooth). If those solutions are unavailable, you should put the tooth in milk. Doing this will keep the root cells in your tooth moist and alive for a few hours. Another option is to simply put the tooth in your mouth between your gum and cheek. Do not place the tooth in regular tap water because the root surface cells do not tolerate it.

Once the tooth has been put back in its socket, your dentist will evaluate it and will check for any other dental and facial injuries. If the tooth has not been placed back into its socket, your dentist will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks. Depending on the stage of root development, your dentist or endodontist may start root canal treatment a week or two later. A medication may be placed inside the tooth followed by a permanent root canal filling at a later date.

The length of time the tooth was out of the mouth and the way the tooth was stored before reaching the dentist influence the chances of saving the tooth. Again, immediate treatment is essential. Taking all these factors into account, your dentist or endodontist may discuss other treatment options with you.

Root Fractures

A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of the tooth. If the fracture is close to the root tip, the chances for success are much better. However, the closer the fracture is to the gum line, the poorer the long-term success rate. Sometimes, stabilization with a splint is required for a period of time.

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Do traumatic dental injuries differ in children?

Chipped primary (or “baby”) teeth can be esthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a knocked-out primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.

Children’s permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your dentist or endodontist to stimulate continued root growth.

Endodontists have the knowledge and skill to treat incompletely formed roots in children so that, in some instances, the roots can continue to develop. Endodontists will do all that is possible to save the natural tooth. These specialists are the logical source of information and expertise for children who are victims of dental trauma.

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Will the tooth need any special care or additional treatment?

The nature of the injury, the length of time from injury to treatment, how your tooth was cared for after the injury and your body’s response all affect the long-term health of the tooth. Timely treatment is particularly important with dislodged or knocked-out teeth in order to prevent root resorption.

Resorption occurs when your body, through its own defense mechanisms, begins to reject your own tooth in response to the traumatic injury. Following the injury, you should return to your dentist or endodontist to have the tooth examined and/or treated at regular intervals for up to five years to ensure that root resorption is not occurring and that surrounding tissues continue to heal. It has to be noted that some types of resorption are untreatable.

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San Francisco Dentist   415-931-7751

Trauma to the face or teeth can be caused by auto accidents, falls, and injury from sports such as football, hockey, soccer, volleyball, basketball, and baseball, etc. Patients suffering significant head, neck, or facial trauma should be evaluated and treated in hospital emergency rooms. Such trauma may involve bleeding from the nose or ears, concussion, dizziness, lapse of memory, disorientation, severe headache and earache, or breaking (fracture) of the skull and/or jaws. Most hospitals have on their staff oral surgeons who can treat fractures of the upper or lower jaw and perform emergency tooth removal (dental extractions) and reconstruction of the dental arches.

Wear and tear due to cavities and chewing hard objects, such as pencils, ice cubes, nuts, and hard candies, can also lead to tooth fractures. Dental injury without associated head and neck trauma can be evaluated and treated in a dental office. Such dental injuries include broken (fractured) teeth, teeth totally knocked out of the mouth, or teeth displaced by unexpected external forces. These dental accidents may be associated with swelling of the gum and oral tissue. Cold packs or ice cubes placed either inside the mouth directly above the injured tooth, or outside on the cheeks or lips, can reduce pain and swelling before the patient reaches the dentist.

What is a tooth fracture?

Tooth fractures can range from minor (involving chipping of the outer tooth layers called enamel and dentin) to severe (involving vertical, diagonal, or horizontal fractures of the root). Enamel and dentin are the two outer protective layers of the tooth. The enamel is the outermost white hard surface. The dentin is a yellow layer lying just beneath the enamel. Enamel and dentin both serve to protect the inner living tooth tissue called the pulp. The visible one-third of the tooth is called the crown, while the remaining two-thirds of the tooth buried in the bone is called the root. Dental X-rays are necessary in most instances to diagnose, locate, and measure the extent of tooth fracture.

A serious fracture is one that exposes both the dentin and the pulp tissue and should be treated promptly. The tooth may be displaced and loose, and the gums may bleed. To prevent the loose tooth from falling out completely, the dentist can splint the loose tooth by bonding it to the adjacent teeth to help stabilize it while the underlying bone and gums heal. Because of the high risk of pulp death, a root canal procedure may need to be performed during the first visit. Alternatively, the dentist may elect to only apply a sedative dressing on the splinted tooth to help calm the tooth pain. The tooth will then be reevaluated in two to four weeks for root canal procedure followed by a dental filling or crown. The splint is also removed at that time.

The most serious injuries involve vertical, diagonal, or horizontal fractures of the tooth roots. In most instances, fracture of the tooth root leaves the injured tooth very loose, thus necessitating tooth extraction. The extracted tooth is replaced with a removable plate containing a false tooth. Teeth with horizontal fractures near the tip of the root may not need extraction. However, root canal treatment for the injured tooth may be required in the future if symptoms of pulp death and tooth infection appear. Therefore, periodic X-rays of the fractured tooth are performed.

What about a chipped tooth?

A minor tooth fracture involves chipping of the enamel only. The tooth is not displaced, and there is no bleeding from the gums. The only symptom of such minor chipping may be sharp or rough tooth edges irritating the cheek and tongue. The injured tooth itself may not even be painful or sensitive to food or temperature. The risk of pulp injury is small, and treatment is not urgent. A small amount of orthodontic wax or sugarless gum can be placed over the rough edge until the dentist can be reached. Definitive treatment usually involves placing a dental filling, a porcelain or gold crown, or a “cap” to protect the pulp of the tooth and to restore normal tooth contour.

A deeper fracture can involve both the enamel and the dentin of a tooth. The tooth is still not displaced and the gums are not bleeding. These deeper fractures may be sensitive to cold temperature or food. Prolonged exposure of dentin to oral bacteria can cause the death of the inner pulp tissue. Death of pulp tissue can lead to serious tooth infection and abscess. Therefore, fractures involving the dentin should be treated promptly (within days of the injury). Treatment involves placing a sedative dressing over the exposed dentin, followed by a dental filling, a porcelain or gold crown, or a “cap” to protect the pulp of the tooth. A follow up X-ray in three to six months may be needed to be sure that the pulp has not died.

If the fracture has already significantly injured the pulp, then treatment involves either extracting the dying tooth or performing a root canal procedure to prevent serious tooth infection. The root canal procedure is done to save the dying tooth from infection and extraction. This procedure involves removing all the dying pulp tissue and replacing it with an inert material in order to keep infection out.

What if I get my teeth knocked out?

The upper front permanent teeth are the most common teeth to be completely knocked out. Knocked out baby or primary teeth are usually not reimplanted in the mouth, since they will be naturally replaced by permanent teeth later. However, knocked out permanent teeth should be retrieved, kept moist, and placed back into their sockets (reimplanted) as soon as possible. The most important variable affecting the success of reimplantation is the amount oftime that the tooth is out of its socket. Teeth reimplanted within one hour of the accident frequently reattach to their teeth sockets.

The knocked out tooth is rinsed in clean water or milk and placed back (reimplanted) into the socket from which it came. This can be done by the patient or parent and then checked by the dentist. Care should be taken to handle the tooth only by its crown and not by its root. If the parent or patient is unsure about reimplanting the tooth, then the tooth should be stored in milk (if available) or in water and brought to the dentist as soon as possible. Alternatively, in older children and adults who are calm, the tooth may be held within the cheeks inside of the mouth while traveling to the dental office.

After reimplanting the tooth into its original socket, the dentist can then splint this tooth to adjacent teeth for two to eight weeks. Splinting helps to stabilize it while the bone around it heals. During the splinting period, the patient eats soft foods, avoids biting on the splinted teeth, and brushes all the other teeth diligently to keep the mouth as clean as possible.

In adults, the reimplanted tooth should have a root canal procedure within seven to 10 days. On the other hand, reimplanted permanent teeth in children (where the tooth root has not yet completely formed) may not need a root canal procedure. These teeth are observed for at least five years for symptoms of dying pulp, such as pain, discoloration, gum abscesses, or abscesses seen on an X-ray.

In most patients who have had tooth reimplantation, over-the-countermedications like acetaminophen (Tylenol) or ibuprofen (Advil) are sufficient for pain relief. Chlorhexidine (Peridex) mouth rinse may be prescribed to prevent and control gum inflammation (gingivitis), since the splinted teeth cannot be brushed normally and the splint usually collects extra dental plaque and food debris. Oral antibiotics and tetanus toxoid injections are considered for patients with accompanying significant soft tissue cuts (lacerations).

What is a displaced tooth?

Instead of being completely knocked out of the mouth, a tooth can be displaced. A displaced tooth may be pulled out and appear elongated, or be pushed in and appear shorter. A displaced tooth can also be pushed forward, backward, sideways, or rotated. While not an emergency, the sooner the dentist can splint or realign the tooth with orthodontic brackets and wires, the easier it can be brought back into proper alignment. Trauma significant enough to cause tooth displacement can also lead to pulp injury. Therefore, a displaced tooth should be evaluated periodically for several months to determine if a root canal procedure or tooth extraction is needed.

Prevention of dental injuries involves aligning protruding front teeth by dental braces and using face masks and mouthguards while participating in sports. Mouthguards have been shown to reduce trauma not only to teeth, gums, and the surrounding jaw bone but also to reduce injury to the temporomandibular joints (TMJ) and to reduce the intensity and number of head concussions. Mouthguards also reduce pressure and bone deformation of the skull when a force is directed to the chin.

Before the mandatory use of face masks and mouthguards for high school and college football players in l963, 50% of all football injuries involved the face and the mouth. Since the mandatory use of these protective devices, dental injuries in football players have almost been eliminated. It is now recommended that mouthguards be worn, not only for organized football, but also for unorganized football, baseball, basketball, racquetball, soccer, ice, field, and street hockey, wrestling, boxing, martial arts, volleyball, rollerblading, skating, skateboarding, and bicycling.

Mouthguards can be purchased in pharmacies and sports supply stores and molded at home. They can also be custom made by the dentist. Store-bought mouthguards are less expensive than custom-made ones. However, the store-bought ones may not fit the athlete’s mouth, may become loose, may be uncomfortably bulky, and may interfere with speech or breathing. The ideal mouthguards are custom made by a dentist. An impression is made of the athlete’s upper dental arch to make a mold of his/her teeth and gums. A custom mouthguard made of a vinyl acetate ethylene copolymer (a special plastic) is then fabricated from this mold in the dental office or by a dental laboratory. A well-fitting custom mouthguard is comfortable and will not interfere with breathing and speech.

• A minor broken tooth (fracture) involves chipping of the enamel only.
• A deeper fracture can involve both the enamel and the dentin of a tooth.
• Death of pulp tissue can lead to serious tooth infection and abscess.
• A serious fracture that exposes both the dentin and the pulp tissue should be treated promptly.
• The most important variable affecting the success of reimplantation of a tooth that is knocked out is the amount of time that the tooth is out of its socket.
• Care should be taken to handle the knocked-out tooth only by its crown and not by its root.
• Prevention of dental injuries involves aligning protruding front teeth by dental braces and using face masks and mouthguards while participating in sports.

REFERENCE:

Source : Medicine Net

Snoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. For example, when we speak, our vocal cords vibrate to form our voice. When our stomach growls (borborygmus), our stomach and intestines vibrate as air and food move through them.

While we are asleep, turbulent airflow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Essentially, snoring is a sound resulting from turbulent airflow that causes tissues to vibrate during sleep.

Any person can snore. Studies estimate that 45% of men and 30% of women snore on a regular basis. Frequently, people who do not regularly snore will report snoring after a viral illness, after drinking alcohol, or when taking some medications.

People who snore can have any body type. We frequently think of a large man with a thick neck as a snorer. However, a thin woman with a small neck can snore just as loudly. In general, as people get older and as they gain weight, snoring will worsen.

While we are breathing, air flows in and out in a steady stream from our nose or mouth to our lungs. There are relatively few sounds when we are sitting and breathing quietly. When we exercise, the air moves more quickly and produces some sounds as we breathe. This happens because air is moving in and out of the nose and mouth more quickly and this results in more turbulence to the airflow and some vibration of the tissues in the nose and mouth.

When we are asleep, the area at the back of the throat sometimes narrows. The same amount of air passing through this smaller opening can cause the tissues surrounding the opening to vibrate, which in turn can cause the sounds of snoring. Different people who snore have different reasons for the narrowing. The narrowing can be in the nose, mouth, or throat.

The function of the nose in normal breathing

For breathing at rest, it is ideal to breathe through the nose. The nose acts as a humidifier, heater, and filter for the incoming air. When we breathe through our mouth, these modifications to the air entering our lungs occur to a lesser extent. Our lungs are still able to use the colder, drier, dirtier air; but you may have noticed that breathing really cold, dry, or dirty air can be uncomfortable. Therefore, our bodies naturally want to breathe through the nose if possible.

The nose is made up of two parallel passages, one on each side, called the nasal cavity. They are separated by a thin wall in the middle (the septum), which is a relatively flat wall of cartilage, bone, and lining tissue (called the nasal mucosa). On the lateral side (the wall of the nose closer to the cheeks) of each passage, there are three nasal turbinates, which are long, cylindrical-shaped structures that lie roughly parallel to the floor of the nose. The turbinates contain many small blood vessels that function to regulate airflow. If the blood vessels in the turbinates increase in size, the turbinate as a whole swells, and the flow of air decreases. If the vessels narrow, the turbinates become smaller and airflow increases.

Everyone has a natural nasal cycle that generally will shift the side that is doing most of the breathing about every eight hours. For example, if the right nasal turbinates are swollen, most of the air enters the left nasal passage. After about eight hours, the right nasal turbinates will become smaller, and the left nasal turbinates will swell, shifting the majority of breathing to the right nasal passage. You may notice this cycle when you have a cold or if you have a chronically (long standing) stuffy nose. The turbinates may also swell from allergic reactions or external stimuli, such as cold air or dirt.

Mouth breathing and snoring

As discussed above, we naturally want to breathe through our noses. Some people cannot breathe through their noses because of obstruction of the nasal passages. This can be caused by a deviation of the nasal septum, allergies, sinus infections, swelling of the turbinates, or large adenoids (tonsils in the back of the throat).

In adults, the most common causes of nasal obstruction are septal deviations from a broken nose or tissue swelling from allergies.

In children, enlarged adenoids (tonsils in the back of the throat) are often the cause of the obstruction.

People with nasal airway obstruction who must breathe through their mouths are therefore sometimes called “mouth breathers.” Many mouth breathers snore, because the flow of air through the mouth causes greater vibration of tissues.

The soft palate and snoring

The soft palate is a muscular extension of the bony roof of the mouth (hard palate). It separates the back of the mouth (oropharynx) from the nasal passages (nasopharynx). It is shaped like a sheet attached at three sides and hanging freely in the back of the mouth.

The soft palate is important when breathing and swallowing.

• During nasal breathing, the palate moves forward and “opens” the nasal airway for air to pass into the lungs.
• During swallowing, the palate moves backward and “closes” the nasal passages, thereby directing the food and liquid down the esophagus instead of into the back of the nose.

The uvula is the small extension at the back of the soft the palate. It assists with the function of the soft palate and also is used in some languages (Hebrew and Farsi) to produce the guttural fricative sounds (like in the Hebrew word “L’chaim”). English words do not use the guttural fricative sounds.

The palate and attached uvula often are the structures that vibrate during snoring and surgical treatments for snoring may alter these structures and prevent guttural fricative sounds. Therefore, if you speak a language that uses guttural fricative sounds, a surgical treatment for snoring may not be recommended or appropriate for you.

Narrowed airways and snoring

The tonsils are designed to detect and fight infections. They are located at the back of the mouth on each side of the throat (oropharynx). They are also called the palatine tonsils. Like other infection-fighting tissue, the tonsils swell while they are fighting bacteria and viruses. Often, the tonsils do not return to their normal size after the infection is gone. They can remain enlarged (hypertrophied) and can narrow the airway vibrate, and cause snoring.

The soft palate, as described above, is the flap of tissue that hangs down in the back of the mouth. If it is too long or floppy, it can vibrate and cause snoring.

The uvula is suspended from the center and back of the soft palate. An abnormally long or thick uvula also can contribute to snoring.

The base of the tongue is the part of the tongue that is the farthest back in the mouth. The tongue is a large muscle that is important for directing food while chewing and swallowing. It also is important for shaping words while we are speaking. It is attached to the inner part of the jaw bone (mandible) in the front and to the hyoid bone underneath.

The tongue must be free to move in all directions to function properly. Therefore, it is not attached very tightly at the tip or top of the tongue. If the back of the tongue is large or if the tongue is able to slip backwards, it can narrow the space through which air flows in the pharynx, which can lead to vibrations and snoring.

Stage of sleep and snoring

Sleep consists of several stages, but in general they can be divided intoREM (rapid eye movement) and non-REM stages. Snoring can occur during all or only some stages of sleep. Snoring is most common in REM sleep, because of the loss of muscle tone characteristic of this stage of sleep.

During REM sleep, the brain sends the signal to all the muscles of the body (except the breathing muscles) to relax. Unfortunately, the tongue, palate, and throat can collapse when they relax. This can cause the airway to narrow and worsen snoring.

Sleeping position and snoring

When we are asleep, we are usually (though not always) lying down. Gravity acts to pull on all the tissues of the body, but the tissues of the pharynx are relatively soft and floppy. Therefore, when we lie on our backs, gravity pulls the palate, tonsils, and tongue backwards. This often narrows the airway enough to cause turbulence in airflow, tissue vibration, and snoring. Frequently, if the snorer is gently reminded (for example, with a gentle thrust of the elbow to the ribs or a tickle) to roll onto his or her side, the tissues are no longer pulled backwards and the snoring lessens.

Contact Dr Ali to take care of your snoring Problem

Call SAN FRANCISCO DENTIST (415) -391-7751

In a previous introductory article on dental caries (tooth decay), we discussed both the causes of the disease process along with new strategies to promote health (“Tooth Decay — The World’s Oldest & Most Widespread Disease,”). Now we’ll discuss Caries Management By Risk Assessment (CAMBRA) — the latest way to minimize risk and prevent decay.

Modern dentistry is moving towards an approach to tooth decay management that is evidence-based — meaning it is based on years of systematic, accumulated, and valid scientific research. In other words, using current science, your dental treatment is tailored to your actual risk rather than a “one size fits all” approach. The previous method of “drilling and filling” to treat decay does not change the conditions that lead to the disease in the first place, so that the risk for further infection still remains. What follows below are facts you should know to change the conditions that lead to decay!

A New Look At Dental Decay — A Dynamic Infectious Disease Process

To help you understand, think of the mouth as an ecosystem, where living organisms continually interact with every other element within their environment. The teeth are composed of an outer covering of enamel, a highly mineralized and crystalline structure composed mainly of calcium and phosphate. The teeth are bathed in a remarkable fluid — saliva. While it has many functions, one of the most important is its role in maintaining a neutral pH environment or balance between the acids and bases found in your mouth.

Acidity is measured scientifically by the pH scale, which ranges from 1 – 14. A pH value of 1 is extremely acidic while a pH value of 14 is extremely basic. The pH of the mouth is generally 7 – neutral.

The oral environment is loaded with bacteria with some of them having the potential to cause decay. Specific acidogenic (acid producing) bacteria attach themselves to dental plaque, the whitish sticky biofilm that collects and forms on the teeth. When you eat sugars or carbohydrates, these acidogenic bacteria break down the sugars and produce acid as a by-product, which in turn drops the salivary pH. At about pH 5.5, the minerals just below the enamel surfaces of the teeth begin to dissolve in a process known as de-mineralization. During this process, more calcium and phosphate leave the surface of the teeth than enter it — the first step in the decay process leading toward cavity formation. And because a tooth’s roots are made of dentin, which is softer than enamel, they are more susceptible to decay. For example, the roots of an exposed tooth will de-mineralize quickly and easily with even weak acids at pH 6.0 – 6.7, which is much closer to neutral.…. Read more – Read Full Article in our library…

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Are you someone who is anxious or fearful about dental treatment and even worries about it all the time? In Part One of this series, Comfortable Dentistry in the 21st Century “Overcoming Fear and Anxiety” we discussed how you can learn to overcome and cope with these negative emotions and become comfortable with modern dentistry so that you really do have the opportunity to have a “Lifetime of Dental Health.”

While it might take some faith in the beginning to realize that this is possible, Dear Doctormagazine describes exactly how to develop a relationship with the right dentist promoting:

• Open discussion of your fears and experiences in a calm and safe environment;
• The listening relationship that you need to feel safe and in which you have the time you need to go at your own pace;
• Ultimately allowing you to develop the sense of control you need to reduce automatic anxiety responses.

Part Two bridges the gap to the next step in making your dental visits even more comfortable with the help of oral sedation or anti-anxiety medication. These oral sedatives or “anxiolytics” (dissolve anxiety) are administered by mouth (orally) to help transition you from anxiety to comfortable dental procedures.

Anxiety Just Melts Away

When you are afraid, your threshold for pain is much lower, you become hypersensitive to every sensation, prick, and noise. Fear and anxiety trigger the release of certain chemicals like adrenalin which put your “fight or flight” instincts on high alert. You anticipate that something is going to hurt and so you tense your muscles, even if it is subconsciously. In this heightened state of anxiety you experience more pain during and even after treatment. However this response can virtually be eliminated with oral sedation dentistry!

The whole purpose of oral sedation is to make you as comfortable and relaxed as possible. It allows you to let your guard down, relax both your mind and body, and focus on feeling peaceful rather than anxious. Your apprehension and hypersensitivity to pain melt away, yet you remain awake and in control.

Sometimes referred to as “comfortable” or “relaxation” dentistry, these terms are used to describe the feelings most people perceive during their dental visits, which are produced by oral sedation……. Read more – Read Full Article in our library…

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Does your dentist see what you see — and vice versa? Can you really communicate how you want to change your smile?

While beauty is definitely in the eye of the beholder, a person’s own perception of what looks good is an important factor in achieving a satisfying result when enhancing someone’s smile. Most of us understand that we want our teeth to look wonderfully bright and natural, but not like ultra-white “Chiclets” all in a row.

While there are several ways modern dentistry can alter the appearance of a smile by changing teeth, ranging from composite resins to porcelain veneers and crowns, this article discusses how you as an individual perceive what looks natural and what doesn’t — and how to go about communicating with your dentist what you want to change in your teeth and smile.

Perceptions and the Art of Dentistry

Does your dentist see what you see — and vice versa? Can you really communicate how you want to change your smile? These are important questions — so let’s start by examining what information is available to us from research on this important issue. Recent studies address this critical subject regarding communication between the public at large as a non-professional group and dental professionals, who may or may not “get” what you are trying to say about what you see and want to change in your smile.

One study set out to determine the differences in perceptions of lay persons and dental professionals. The study looked at variations in tooth size and alignment and their relation to surrounding gums and other facial features that make up a smile. The results are very enlightening because they show that there are varying levels of differences, which can actually aid the dentist artistically when making specific treatment recommendations.

There is no doubt that dentists look at smiles differently than non-professionals — which actually makes perfect sense. Dentists as a group are (and should be) more discerning of issues such as crown (tooth) length, midlines (how the teeth line up with other facial features) and gum-to-lip distance, to name a few.

According to the same study, lay persons place more importance on other features of facial aesthetics. For example, individuals rated mouth expression and lip shape as more noticeable than other “strictly dental” characteristics..…. Read more – Read Full Article in our library…

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In this article, we go a step further and look at how the basics of nutrition, coupled with diet and exercise, affect life-long general and oral health.

The Surgeon General of the United States has stated emphatically that “You can’t be healthy without oral health.” And, as our last article explained, you can’t have good oral health without good nutrition.

We’ll expand on the idea that good nutrition is the key to overall health, both general and oral. In other words, what’s good for the whole body is good for your teeth, gums and other oral tissues. We need good nutrition and dietary practices throughout life, for the formation, development and continued health of our oral tissues and structures, as well as those in the rest of the body.

Clarifying the Terms of Nutrition

Food is not only our primary source of nourishment — it’s also a profound part of our society, culture and community. What we eat critically impacts not only overall health, but also our risks for several of the leading causes of death like coronary artery disease, stroke, diabetes and some types of cancer.…. Read more – Read Full Article in our library…

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San Francisco Dentist

The Art of Periodontal Surgery

Periodontal surgery is a plastic (reshaping) surgical procedure designed to restore and regenerate normal form and function to lost and damaged periodontal structures which support the teeth (the gum tissue, periodontal ligament and bone). This article is an overview of what a candidate for periodontal surgery can expect and a primer for further information and discussion. It follows an article entitled Understanding Gum (Periodontal) Disease in a previous issue of Dear Doctor magazine.

Periodontal Surgery in Perspective — What makes it work

An understanding of what periodontal surgery is designed to do, what makes it successful and what sustains the results over time is critical to successful treatment of periodontal disease. Periodontal surgery is not a cure, but rather an adjunct to making long-term treatment outcomes more favorable. Unlike surgery to take out an inflamed appendix, which removes the disease with it, the potential for the recurrence of periodontal disease still remains in susceptible individuals. The long-term goal of periodontal surgery is to increase the life expectancy of the teeth.…. Read more – Read Full Article in our library…

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Tooth decay — or dental caries — is an infectious disease process that causes damage to the structure of teeth. Cavities (hollowed out spaces or holes) are the most notable consequences of dental caries.

Left untreated, caries leads to pain, tooth loss — or, in rare cases, death. In this most extreme case, infection can advance to the “cavernous sinus,” an air cell behind the eye, from which it can then enter the brain. Tooth decay amounts to more than just the inconvenience of “drilling and filling”: it has the power to change a person’s diet, speech, quality of life and overall well-being.

This article — the first in a series about one of the world’s oldest and most widespread diseases — will explore the most current information about tooth decay. This and subsequent articles will provide you with all the information you need to know about tooth decay, its causes and its relationship to sugars and acids, detection, prevention, treatment and more. In future articles we’ll also discuss new diagnostic and detection methods, the role of fluoride in the prevention of dental caries, and the latest in other prevention and treatment options…. Read more – Read Full Article in our library…

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The best way to predict the future is to create it and lasers are beginning to offer some interesting alternatives in dentistry. Lasers constitute “cutting-edge” technology which can be used to help detect dental disease in its earliest stages, find tumors and perform both surgical and non-surgical procedures on the soft tissues of the mouth. And they do it with less pain and bleeding. They can even prepare small cavities for fillings by vaporizing decay often without a shot of anesthesia (numbing the teeth), or a drill.

Since May 1960 when Theodore Maiman demonstrated the first working laser at Hughes Research Laboratories, laser technology has spawned a multi-billion dollar industry. Lasers now affect everyday life and are in widespread use: in optical storage devices (which store computer data); spectrometers (which by color analysis detect and identify even the tiniest particles from tumors to explosives); CD and DVD players in personal computers and even bar code readers in your supermarket use laser technology. Lasers are used industrially for steel cutting; by the military for target identification and illumination for weapons delivery. And of course lasers today are used extensively in medicine for ophthalmology (eyes), internal surgery, dermatology (skin) and oral health to name but a few applications… Read more – Read Full Article in our library…

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