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SedationCanHelpanAnxiousChildRelaxDuringDentalTreatment

There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.

To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.

Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.

In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.

During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.

After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.

Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.

If you would like more information on making dental visits easier for kids, 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 “Sedation Dentistry For Kids.”

By Nathan Gelder DMD
April 28, 2021
Category: Dental Procedures
Tags: veneers  
YourTeensTeethMayNotBeReadyforVeneers

Teenagers can have the same smile-disrupting tooth flaws as adults. But not all cosmetic treatments available to adults are appropriate for teenagers—at least not until they get a little older. Dental veneers fall into that category.

A veneer is a thin porcelain shell custom-made by a dental lab, and bonded by a dentist to the face of a tooth to mask chips, stains, gaps or other imperfections. Because they're less invasive than other measures, veneers are highly popular as a cosmetic dental solution. They do, however, usually require some enamel removal so that they'll appear more natural.

This enamel removal typically won't impact an adult tooth other than it permanently requires it to have veneers or other restorations after alteration. But there is a risk of damage to a teenager's tooth, which hasn't fully developed.

Adolescent teeth usually have a larger pulp chamber (filled with an intricate network of nerves and blood vessels) than adult teeth. And because the enamel and dentin layers may not yet be fully developed, the pulp is much nearer to the tooth's surface.

We must be very careful then in removing enamel and dentin for veneers or we may penetrate the pulp and risk damaging it. Alternatively, there is the possibility of no-prep veneers which are very conservative but often are unable to be done because of the need to often remove tooth structure to make the veneers look natural.

Another cosmetic problem can occur if we place veneers on a patient's teeth whose jaws and mouth structures are still growing. Eventually, the gums could recede and an unsightly gap form between the veneer and the adjacent natural tooth.

Fortunately, there are other techniques we can use to improve a tooth's appearance. Mild chipping can be repaired by bonding composite resin material to the tooth. Some forms of staining may be overcome with teeth whitening. These and other methods can address a teenager's smile appearance until their teeth are mature enough for veneers.

Whether or not a tooth is ready for veneers will depend on its level of development, something that can often be ascertained with x-rays or other diagnostic methods. And if a tooth has already undergone a root canal treatment, there isn't as much concern. In the meantime, though, it may be better for your teen to wait on veneers and try other techniques to enhance their smile.

If you would like more information on dental restoration for teenagers, 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 “Veneers for Teenagers.”

By Nathan Gelder DMD
April 18, 2021
Category: Oral Health
Tags: oral health  
AnEatingDisorderMayShowItselfinTheMouth

Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.

Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).

Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.

It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.

A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.

For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.

The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.

An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.

If you would like more information on eating disorders and dental care, 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 “Bulimia, Anorexia & Oral Health.”

By Nathan Gelder DMD
April 08, 2021
Category: Dental Procedures
Tags: porcelain veneers  
VeneersCouldTurnBacktheClockonYourSmile

There's a lot to like about porcelain veneers, especially as you get older. For one, they can be less expensive and invasive than other cosmetic restorations. More importantly, though, they're versatile—they can solve a variety of dental appearance problems.

Veneers are thin shells of porcelain that are bonded to the front of teeth to alter their appearance—a work of custom art crafted by a dental technician to fit an individual patient's dental needs. They can turn back the clock on a less than attractive smile, and, with a little care, could last for years.

Here are some dental appearance problems you might encounter in your later years that veneers may help you improve.

Discoloration. As we get older, our teeth color can change—and not for the better. Teeth whitening temporarily brightens dull and dingy teeth, but the effect will fade over time. Additionally, there are some forms of staining, particularly those arising from within a tooth, for which external whitening can't help. Veneers can mask discoloration and give a new, permanent shine to teeth.

Unattractive shape. As we age, wearing on teeth can cause them to appear shorter and create sharper angles around the edges. Veneers can be used to restore length and soften the shape of teeth. Because veneers can be customized, we can actually create a tooth shape that you believe will improve your appearance.

Dental flaws. A lifetime of biting and chewing, not to mention a chance injury, can lead to chips, cracks or other dental defects. But veneers can cover over unsightly flaws that cause you to be less confident in your smile. Veneers can give you back the smile you once had or, if you were born with dental flaws, the smile you never had.

Misalignments. The biting forces we encounter throughout our lifetime can move teeth out of alignment, or widen gaps between them. You can undergo orthodontic treatment to correct these misalignments problems, but if they're relatively minor, we may be able to use veneers to “straighten” your smile.

If you're concerned about the effects of aging on your smile, veneers could help you look younger. Visit us for a full dental evaluation to see if a veneer restoration is right for you.

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: Strength & Beauty as Never Before.”

By Nathan Gelder DMD
March 29, 2021
Category: Oral Health
Tags: gum disease  
HeresWhyGumDiseaseCouldBeLurkinginYourMouthEvenNow

If you think periodontal (gum) disease is something that only happens to the other guy (or gal), you might want to reconsider. Roughly half of adults over age 30—and nearly three-quarters over 65—have had some form of gum disease.

Gum disease isn't some minor inconvenience: If not treated early, a gum infection could lead to bone and tooth loss. Because it's inflammatory in nature, it may also impact the rest of your health, making you more susceptible to diabetes, heart disease or stroke.

Gum disease mainly begins with dental plaque, a thin film of food particles on tooth surfaces. Plaque's most notable feature, though, is as a haven for oral bacteria that can infect the gums. These bacteria use plaque as a food source, which in turn fuels their multiplication. So, the greater the plaque buildup, the higher your risk for a gum infection.

The best way to lower that risk is to reduce the population of bacteria that cause gum disease. You can do this by keeping plaque from building up by brushing and flossing every day. It's important for this to be a daily habit—missing a few days of brushing and flossing is enough for an infection to occur.

You can further reduce your disease risk by having us clean your teeth regularly. Even if you're highly proficient with daily hygiene, it's still possible to miss some plaque deposits, which can calcify over time and turn into a hardened form called tartar (or calculus). Tartar is nearly impossible to remove with brushing and flossing, but can be with special dental tools and techniques.

Even with the most diligent care, there's still a minimal risk for gum disease, especially as you get older. So, always be on the lookout for red, swollen or bleeding gums. If you see anything abnormal like this, see us as soon as possible. The sooner we diagnose and begin treating a gum infection, the better your chances it won't ultimately harm your dental health.

If you would like more information on the prevention and treatment of 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 “How Gum Disease Gets Started.”





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