Archives for November 2023

Restraints in Pediatric Dental Care

Posted on November 30, 2023 by writeradmin.

We recently relocated to another state. I am getting the children set up with their new caregivers. Normally, I just sign the papers they have me sign without reading them. I happened to skim them this time when I came across something that shocked me. It was asking my approval to use restraints on my children. I lied and told them I had a family emergency and left. Why would you ever need to use restraints on children at the dentist? I went to the dentist my whole life and not once were restraints even brought up. Is this a new thing?

Carrie

Dear Carrie,

This isn’t a new thing, but I think your potential pediatric dentist could have given some explanation. One of the most important things for you to look at when looking for a dentist for your children is for the dentist as well as the rest of the office to answer questions when you have concerns. Communication is so important when it comes to any type of medical care.

In dentistry, the are two basic types of restraints. The first is for the bite. The other for the body.

Pediatric mouth props

The materials pictured directly above are mouth props. These are essential and should be used even with a cooperative child. One of my colleagues told me a story from his dental school days. A fellow student was drilling a cavity on a child. Everything was going smoothly when the child suddenly bit down. This caused the drill to go through the pulp of the tooth. Now, instead of a simple filling this child had to undergo a full pulpotomy, which is the child’s equivalent of a root canal treatment. This was easily preventable had the child had a mouth prop in.

The second type of restraint is a pappose board (pictured directly above). This wraps a child up tightly as well as keeps their head still. While I wouldn’t go to a dentist who uses this as a matter of course, there are times when a child has a dental emergency but is not cooperative that this becomes essential. Most dentists who treat children prefer to find other ways of dealing with a fearful child. However, in emergency situations, this is an important back up option. In general, children, once they are in the papoose calm down completely.

If you have a child who is particularly anxious at the dentist and uncooperative, you may want to look for a pediatric dentist who also offers dental sedation. This will help with their anxiety.

This blog is brought to you by Portage, MI Dentist Dr. Susan Dennis.

12 Shots of Novacain and a Bone Spur

Posted on November 22, 2023 by writeradmin.

I had an awful dental appointment. First, it took twelve shots of Novacain before I even came close to numb. I wasn’t completely numb even then but just needed to get on with the appointment. Then, a few days after the appointment I developed a bone spur. Every time when even just my tongue hit that bone spur it sent a shooting pain. It took the dentists 30 minutes to remove the spur. Now, a week later, there is a sharp bone sticking out that is making everything I do uncomfortable. Is this normal? Is there anything I should be worried about with this ridge? I’ve sort of lost confidence in this dentist.

Brianna

Dear Brianna,

I am glad you wrote. Aside from the numbing situation, I don’t think you did anything really wrong here. It is fairly common for a sharp edge to appear after someone has a tooth removed. When the procedure first happens your gums are swollen so you don’t see these ridges. But, sometimes there will be a loose piece of bone, but he should have removed any of those. The bony ridge you currently have is normal. However, if it is bothering you, the dentist can and should smooth it over for you.

Difficulty Getting Numb at the Dentist

The one thing he didn’t quite get right is your Novocain. When a patient has trouble getting numb it is usually due to dental anxiety. This has an impact on your metabolism which burns up the numbing medication before it can do the job it was intended to do. What can prevent that is if you take a medication that relaxes you.

Your best option is to use a sedation dentist whenever you need a significant procedure done. They can provide you with dental sedation, which will completely relax you. Most dentists will provide you with two options of dental sedation. The lowest is nitrous oxide. This is sometimes called laughing gas because it gives you a floaty feeling.

A more potent option is oral conscious sedation. This is administered by a pill. However it is so strong that you will need someone to drive you to and from your appointment, as well as stay with you for a few hours after your appointment until you are lucid and steady on your feet. Some people call this sleep dentistry because you are able to sleep through your entire appointment if you want to. You will never have trouble with getting numb at an appointment again.

This blog is brought to you by Kalamazzo Dentist Dr. Susan Dennis.

For Dentures Do I See a Dentist or Oral Surgeon First?

Posted on November 15, 2023 by writeradmin.

I am in my late 40s and have always avoided the dentist because of anxiety. As a result, my teeth are in bad shape. Many of them are broken. A few are missing. This has kept me from socializing. I’d like to change that and think dentures will by my solution. One thing I am not certain about is whether I should go to a dentist first or an oral surgeon first to have the teeth removed. Is there a standard practice for this?

Robert

Dear Robert,

My suggestion is that you use a dentist who can do both the extractions and the dentures. It is not hard to do pre-denture surgery, so you should not have a problem with finding a dentist who can do that for you. One thing to be aware of, though, is you don’t want to hint to the office what you are looking for when you call around. Just ask them what the dentist’s normal procedure is when it comes to giving a patient dentures. This way you know whether or not they are in their comfort zone.

Given your dental anxiety, I would like you to also look for a dentist who offers oral conscious sedation. You can do an internet search for sedation dentists in your area and then make sure oral conscious sedation is one of their options. This is administered by a pill, but is strong enough that you will sleep through the procedure. In fact, some people call it sleep dentistry. Be aware that you will need someone to drive you to and from your dental appointment with this option.

A Warning about Long-term Dentures

From the moment you extract your teeth, your body will recognize that you no longer have any teeth roots in your mouth. Realizing it no longer has teeth to support, your body begins to resorb the minerals in your jawbone that help with bone support, to use elsewhere in your body. It does this in an effort to be as efficient as possible with your body’s resources.

The unfortunate consequence that results is that as the minerals are resorbed, your jawbone shrinks. In about ten or so years, you will no longer have enough jawbone left to retain your dentures. In dental circles, this is known as facial collapse.

There is a way to prevent facial collapse. Instead of just having removable dentures, you first get some dental implants placed that your dentures can be anchored to. This is sometimes called implant overdentures. Not only does this signal to your body that you have teeth roots there which need to be retained, but completely secure the dentures and you never have to worry about slips.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dentist.

How Can I Keep My Face From Collapsing?

Posted on November 9, 2023 by writeradmin.

I have recently been told that I have a severe calcium deficency. As a result, my dentist is suggesting that I just go ahead and extract all of my teeth. I am heartbroken about this because I am only in my 30s. I’ve been told by a friend that if I do that I will end up with my face collapsing at the bottom. I’m picturing my toothless grandmother who could not keep her dentures in. Is this what I have to look forward to? Is there any way to prevent this?

Alana

Dear Alana,

The condition your friend is referring to is known as facial collapse in dental circles. I’ve provided a picture directly above. Let me explain how this happens. When your teeth are first removed, your body recognizes that there are no longer any roots of your teeth in your body that it needs to support. As a means of being as efficient with your body’s resources as possible, it begins to resorb the minerals in your jawbone in order to use them elsewhere in your body. After about ten or so years, you will no longer have enough jawbone left to hold your lower denture in place.

While there is a way to prevent this, I would like you to get a second opinion on the saveability of your teeth. While a severe calcium deficiency during adulthood can lead to cramps, nerve problems, and even osteoporosis, it would have no impact on your teeth. By adulthood, your teeth are fully formed so the calcium deficiency will have not be a factor in their health. Some dentists are more interested in putting in extra work to save teeth than others. A second opinion may show you that your teeth can be saved after all and you will not need to have them extracted. That would be the ideal.

If for some reason your teeth cannot be saved and they do have to be extracted, there is a way to prevent facial collapse. Instead of just getting completely removable dentures, you will want to get dental implants, then your dentures can be anchored to them. The implants will serve as prosthetic tooth roots. This signals to your body that you still have teeth and it then leaves your jawbone completely intact.

I would definitely get that second opinion first before doing anything drastic such as having your teeth extracted.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.