Although we’ve made great strides over the last century making dental visits more pleasant and comfortable, many people still feel a little apprehension about them at one time or another. For a few, though, this apprehension escalates into high anxiety — so high they may even avoid important dental treatment altogether.
If you have a significant phobia regarding dental visits and treatment, here are some things you can do to reduce your anxiety and feel more comfortable when you undergo treatment.
Let us know about your feelings of anxiety. We’re conditioned by society to regard such fears as irrational or “silly,” and so we tend to hide our negative emotions. Dentists, however, have been trained to work with fearful patients to reduce their anxiety levels. Being honest with us about your fears and nervousness is the first step to developing an anxiety-reducing strategy that will make your visits more pleasant.
Counteract bad experiences with good. For most people the fear they have during dental visits stems from earlier unpleasant experiences at the dentist. The fear can be so ingrained that simply trying to convince yourself or to be told “there’s nothing to be afraid of” will have little to no effect. Instead, build a memory collection of positive and pleasant dental visit experiences that serve to counteract the unpleasant. To do this we might first get you acclimated to routine visits and then gradually transition to more invasive procedures. This may increase the normal time for dental treatment, but the reduction in anxiety is worth the extra time.
Consider sedation therapy. In addition to modifying your experiences, you may also benefit from sedation medications that reduce anxiety, especially in the early stages of treatment. Depending on your medical history and current status, we can prescribe a sedative for you to take an hour or so before your appointment to help you relax. We can also increase the level of anesthesia (from local to intravenous or gas anesthesia, for example) if your anxiety is especially acute.
Taking proactive steps to minimize dental visit anxiety will increase the probability that you’ll obtain needed dental care. Your teeth and gums will be healthier for it.
If you would like more information on coping with dental visit anxiety, 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 “Overcoming Dental Fear & Anxiety.”
After a long struggle with dental disease, you have finally lost the last of your remaining teeth.Â Like over a quarter of Americans in their 60s and 70s, this unfortunate development can have a profound impact on your health and self-image.
While there are a number of advanced methods for replacing lost teeth, there's one tried and true option that's centuries old — the removable denture. It's the option millions of people have chosen to lessen the impact of missing teeth.
Fashioned properly, removable dentures restore the form and function you once had with your natural teeth. The prosthetic (false) teeth are precisely placed in an acrylic, gum-colored base that closely follows the contours of your gums. Because they're removable, they're fairly easy to clean and maintain.
They do have a disadvantage, though, and it's related to bone health after tooth loss. Like other living tissues, bone has a life cycle: as older cells die, new cells form to take their place. The forces your teeth generate when you chew stimulate new bone growth. But without teeth to provide this stimulation, new bone won't keep up the pace of replacement at a healthy rate. As a result you may gradually lose bone, as much as a quarter of its normal width within a year of losing a tooth.
Dentures don't transmit any stimulation to the gum and bone from chewing. Furthermore, the compressive forces transmitted to the gum and underlying bone tissue contributes to bone loss. As the bone continues to diminish, your denture fit becomes looser to the point you will eventually need them relined with new acrylic material or have a new set made.
There is another alternative when patients loose all of their teeth: an implant-supported removable denture. Dental implants can be used to keep the dentures more secure and can also slow or even halt bone loss where the implants are placed. In this case we strategically place a few implants to serve as supports for a removable denture. The denture has connection points that join up with the implants to hold it more securely in place. As few as two implants are needed in the lower jaw, while the upper jaw does better with three or four implants.
Losing all your teeth can be traumatic, but there are effective ways to overcome it. With new technology, the traditional restoration of removable dentures may be the vehicle for achieving that.
If you would like more information on restoring missing teeth with dentures, 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 “Removable Full Dentures.”
With all the new tooth-colored fillings for cavities, it's easy to overlook metal amalgam. While this mainstay of dental care for over a century might not be as attractive as composite resins or glass and resin ionomers, it still has the advantage of strength and durability.
Amalgam is a stable metal alloy usually made up of silver, tin, copper and mercury. The metals are proportioned and mixed precisely to guard against “free” mercury molecules, which could pose a health hazard. The mixture is pliable at first, but then sets hard once molded into the prepared area of the tooth.
Besides strength, amalgam's other advantages include low cost, high resistance to wear and biocompatibility (not toxic to the body or allergy-producing). At the same time, it can require more tooth structure removal to accommodate a filling and cause higher sensitivity to temperature for a while after installation. Its main disadvantage, however, is appearance — it's now considered unacceptable from an aesthetic point of view to use it in visible areas like the front teeth.
Because of this, materials resembling natural tooth color are coming into vogue, especially as their strength improves. Still, dental amalgam continues to play a useful role, especially in less visible back teeth with higher chewing forces.
One past concern about dental amalgam is the inclusion of mercury in the alloy. As mentioned before, mercury is hazardous in a “free” form when not knit microscopically with other metals; as such it can emit a vapor that could enter the bloodstream and damage the nervous system. But after several studies by various organizations, the American Dental Association has concluded amalgam's precise mixture prevents the mercury from taking this form: although some vapor is given off during chewing it's far too low in concentration to pose any danger.
Dental amalgam continues to be an effective choice for fillings. Whether it's the right choice for you will depend on the type and location of a tooth to be filled, and whether durability is a higher concern than appearance. If we do recommend an amalgam filling, you can be assured it's a safe and lasting choice.
If you would like more information on your choices for dental fillings, 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 “Silver Fillings — Safe or Unsafe?”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Since their introduction over thirty years ago, dental implants have become the most popular choice for dental restoration. Their large variety of shapes and sizes — a far cry from the limited choices of the 1980s — has only served to increase their popularity.
In recent years there's also been an expansion in their applicability. Most people recognize them as replacements for individual teeth — but they can do much more. They're now playing a pivotal role in other dental restorations or situations.
Here are 3 of those “cutting edge” ways implants could change your dental health and smile for the better.
Fixed bridgework. In a traditional bridge, prosthetic (false) teeth use the natural teeth on either side of the empty space for support. In this updated version, implants become the support base for the bridge. For example, a bridge as small as three crowns can be supported by two implants attached to the outside crowns of the bridge. Four to eight implants can support a bridge as large as an entire arch of teeth.
Over-dentures. In cases of significant bone loss, a full or partial denture may be a better option than a fixed bridge. Traditional dentures, though, can contribute to even more bone loss, which can cause the dentures to eventually lose their fit. Implants not only can help stop further bone loss but can also stimulate increased bone density. Two or more standard or mini-sized-sized implants can support a full or partial denture.
Orthodontics anchorage. People with missing teeth aren't the only ones who can benefit from implants. While most bite repairs only require the back teeth to provide anchorage for braces, certain complex bites may need a different point of anchorage. Orthodontists can create a more feasible anchorage point with an implant or a temporary anchorage device (TAD) imbedded in the jaw. This can help isolate teeth that need to be moved from those on the arch that don't.
If you would like more information about how dental implants could improve your dental health and appearance, 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 “Dental Implants: Your Best Option for Replacing Teeth.”
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