The old stereotype with the words “pain” and “dental work” in the same sentence is no more. Using local or general anesthesia (or a combination of both) we can completely eliminate the vast majority of discomfort during dental procedures.
But how do you manage pain in the days after a procedure while your mouth is healing? The news is good here as well — most discomfort after dental work can be easily managed with a family of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). In most cases, you won't even need prescription strength.
You're probably already familiar with aspirin, ibuprofen and similar pain relievers for the occasional headache or muscle pain. These types of drugs work by blocking prostaglandins, which are released by injured tissues and cause inflammation. By reducing the inflammation, you also relieve pain.
Most healthcare providers prefer NSAIDs over steroids or opiates (like morphine), and only prescribe the latter when absolutely necessary. Unlike opiates in particular, NSAIDs won't impair consciousness and they're not habit-forming. And as a milder pain reliever, they have less impact on the body overall.
That doesn't mean, however, you don't have to be careful with them. These drugs have a tendency to thin blood and reduce its clotting ability (low-dose aspirin, in fact, is often used as a mild blood thinner for cardiovascular patients). Their use can contribute to bleeding that's difficult to stop. Excessive use of ibuprofen can also damage the kidneys.
That's why it's necessary to control the dosage and avoid long-term use of NSAIDs, unless advised by a physician. Most adults shouldn't take more than 2,400 milligrams a day of a NSAID and only during the few days of recuperation. There's no need to overdo it: a single 400-milligram dose of ibuprofen is safe and sufficient to control moderate to severe post-procedural pain for about five hours.
Our aim is to help you manage any pain after a procedure with the least amount of pain reliever strength necessary. That will ensure you'll navigate the short discomfort period after dental work safely and effectively.
If you would like more information on pain management after 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 “Treating Pain with Ibuprofen.”
Before you consider cosmetic changes to your smile, ask yourself one question: how's your bite? How your teeth are positioned and aligned doesn't just affect their function — it also affects your appearance. A proper bite is foundational to a beautiful smile — and it deserves your attention first.
Here are 3 important steps for addressing your bite problem on your way to a more attractive smile.
Get an orthodontic evaluation. Only a dentist or orthodontist can determine if your teeth are properly aligned and working well with each other — and if not, why. With their knowledge and expertise they'll be able to tell you what specific bite problem (malocclusion) you have and the best treatment to correct it to support any future cosmetic enhancement.
Consider your tooth-movement options carefully. If you have a malocclusion, your dentist or orthodontist may recommend correction before undertaking other cosmetic work. In most cases, you'll have two choices. The first is traditional metal braces, which uses wires held in place and anchored by brackets cemented to the teeth. They're effective, but must be fixed in place and aren't considered attractive. The other choice is clear aligners, which use custom removable plastic trays worn in sequence to gradually move teeth. They're easier for oral hygiene and are hardly noticeable to others, but may not work in every bite situation.
Don't slack on the retainer phase of treatment. The day will come when the braces or aligners come out of your mouth for good. But your realignment project isn't over — you'll need to wear a retainer appliance for a while. Re-aligned teeth can relapse to their former positions, so it's essential you wear a retainer to keep them where they've been moved. Without a retainer, all the time and effort invested in your bite will have been to no avail.
In a nutshell: get the big picture about your bite, choose the treatment best for you and follow through on every phase. The end result will be a solid platform for the smile you've always dreamed about.
If you would like more information on orthodontic treatments, 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 Magic of Orthodontics: The Original Smile Makeover.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
You’re considering dental implants and you’ve done your homework: you know they’re considered the best tooth replacements available prized for durability and life-likeness. But you do have one concern — you have a metal allergy and you’re not sure how your body will react to the implant’s titanium and other trace metals.
An allergy is the body’s defensive response against any substance (living or non-living) perceived as a threat. Allergic reactions can range from a mild rash to rare instances of death due to multiple organ system shutdowns.
A person can become allergic to anything, including metals. An estimated 17% of women and 3% of men are allergic to nickel, while 1-3% of the general population to cobalt and chromium. While most allergic reactions occur in contact with consumer products (like jewelry) or metal-based manufacturing, some occur with metal medical devices or prosthetics, including certain cardiac stents and hip or knee replacements.
There are also rare cases of swelling or rashes in reaction to metal fillings, commonly known as dental amalgam. A mix of metals — mainly mercury with traces of silver, copper and tin — dental amalgam has been used for decades with the vast majority of patients experiencing no reactions. Further, amalgam has steadily declined in use in recent years as tooth-colored composite resins have become more popular.
Which brings us to dental implants: the vast majority are made of titanium alloy. Titanium is preferred in implants not only because it’s biocompatible (it “gets along” well with the body’s immune system), but also because it’s osteophilic, having an affinity with living bone tissue that encourages bone growth around and attached to the titanium. Both of these qualities make titanium a rare trigger for allergies even for people with a known metal allergy.
Still, implant allergic reactions do occur, although in only 0.6% of all cases, or six out of a thousand patients. The best course, then, is to let us know about any metal allergies you may have (or other systemic conditions, for that matter) during our initial consultation for implants. Along with that and other information, we'll be better able to advise you on whether implants are right for you.
If you would like more information on the effects of metal allergies on dental implants, 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 “Metal Allergies to Dental Implants.”
Dental caries (tooth decay) is a leading cause of tooth loss. But with prompt diagnosis and care we can often stop it before it causes too much damage.
The traditional treatment approach is simple: remove all diseased tooth structure and then restore the tooth with a filling. But this otherwise effective treatment has one drawback: you may lose significant healthy structure to accommodate a suitable filling or to make vulnerable areas easier to clean from bacterial plaque.
That's why a new treatment approach called minimally invasive dentistry (MID) is becoming more common. The goal of MID is to remove as little of a tooth's natural enamel and dentin as possible. This leaves the treated tooth stronger and healthier, and could reduce long-term dental costs too.
Here's how MID could change your future dental care.
Better risk assessment. MID includes a treatment protocol called caries management by risk assessment (CAMBRA). With CAMBRA, we evaluate your individual tooth decay risk, including oral bacteria levels, the quality of saliva flow to neutralize mouth acid, and sugar consumption. We then use our findings to customize a treatment plan that targets your areas of highest risk.
New detection methods. The real key to fighting tooth decay is to find it before it can destroy tooth structure with the help of new diagnostic technology. Besides advances in x-ray imaging that provide better views with less radiation exposure, we're also using powerful dental microscopes, lasers and infrared photography to show us more about your teeth than we can see with the naked eye.
"Less is More" treatments. In contrast to the dental drill, many dentists are now using air abrasion rather than a dental drill to remove decayed tooth material. Air abrasion emits tiny material particles within a pressurized air stream that leaves more healthy tooth structure intact than with drilling. We're also using new filling materials like composite resin that not only resemble natural tooth color, but require less structural removal than other types of fillings.
Using MID, we can treat tooth decay while preserving more of your natural teeth. This promises better long-term outcomes for future dental health.
If you would like more information on new treatments 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 “Minimally Invasive Dentistry: When Less Care is More.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.