What is Sedation Dentistry? The use of a Sedative drug to keep a patient calm throughout a dental procedure. Many patients do not need a sedatives to remain calm during dental appointments. Others will need “Sedation” for all dental procedures including dental cleanings. We provide: Full IV Sedation Oral Sedation Nitrous Oxide Sedation Do you […]
Category: Blog
The Importance of Breathing Through Your Nose (AKA Nasorespiratory Breathing)
We all know that breathing is central to life. So it’s not surprising that a chronic stuffy nose — or any obstruction that prevent you from breathing optimally – is more than just uncomfortable for you – it can actually cause health problems that will last a lifetime. And many of us have put up with obstructive breathing for years – even decades!
Fortunately, your dentist can help you breathe better and feel healthier. Using a comprehensive approach to dentistry, you can experience relief of you or your child’s symptoms in less time than you may think.
The basics. Optimum function of your respiratory system involves inhaling using the large muscle (diaphragm) at the base of your chest cavity, and drawing air in through your nose. Your nose has an important function in filtering, warming and humidifying the incoming air so that your lungs receive only clean, warm, moist air. This ensures that your body does not have to waste needless energy removing toxins from the lungs, as well as ensuring that critical delicate lung tissue is not traumatized or damaged.
Unlike most other tissues in the body, the lungs lack the ability to repair and rejuvenate themselves. Therefore, breathing through your nose is critical to the health of your lungs and, as a result, the functioning of your entire body. Loss of the ability to breathe through your nose can have a devastating long-term effect!
Symptoms and diagnosis. As part of your dental intake questionnaire and exam, your nasal breathing ability will be assessed. Due to environmental stresses (see TMJD), loss of healthy nasal breathing (partial or complete) is seen in greater numbers among the very young as well as in adults. One of the most common forms of this problem is seen in the phenomena of what is commonly referred to as Obstructive Sleep Apnea (OSA) – a condition where the tongue and palate collapse reducing oxygen supply to the vital organs, especially the brain.
In general, poor nasal breathing leads to mouth breathing – especially at night while sleeping. This often times leads to intermittent snoring and in some cases OSA. The vast majority of OSA cases are caused by the inability to breathe through the nose.
Sleep labs have sprung up all over the U.S. to assess and treat this disorder. As the level of carbon dioxide rises and oxygen falls in the blood, sensors in the blood vessel walls send off an alarm to the brain forcing the brain out of deep sleep. This action restores breathing but stresses the adrenal glands, robs the brain of deep recuperative sleep, elevates blood pressure and stresses the heart. In the adult, this process can and will shorten life span at the most and, at the very least, will cause extreme fatigue and accentuation of fatigue-related syndromes like fibromyalgia and other musculoskeletal disorders (see TMJD).
In children, reduced oxygen at night can seriously affect brain development at its extreme, and/or cause other related symptoms.
Symptoms and signs of poor nasorespiratory function in children:
– Snoring with possible OSA – Daytime fatigue
ADD/ADHD – Impaired school performance – Irritability
- Enuresis (bedwetting)
Orthodontic/ facial orthopedic disorders (see Orthodontics)
Deviated septum
- Poor posture, which perpetuates poor breathing and stress on the shoulders, back and hips
Poor exercise stamina – Reduced mental capacity – Chronic ear infections, colds, flu – Bruxism (grinding and clenching of teeth – especially at night)
Increased incidence of headaches, neck aches – Hypertension (seen only in the most extreme cases) – Increased dental gum irritation & dental decay
Symptoms and signs of poor nasorespiratory function in adults: Adults may experience all of what a child experiences with the exception of enuresis (bedwetting) and ear infections. In addition, adults who frequently experience the effects of long-term nasaorespiratory obstruction may also experience a magnification of musculoskeletal disorders, requiring increased dependency on therapists (chiropractors, physical therapists, cranio-sacral therapists, primary care physicians, alternative practitioners, etc.). Exacerbation of Fibromyalgia and TMJD is also common, and the kind of stress to the cardiovascular system that OSA causes is very serious and will ultimately lead to premature death.
Treatment options. The key to treatment is recognition of the problem. Screening by your dentist is performed along with possible X-rays and studies of the nasal passages to determine the nature of the obstruction. Potential referral to an ear, nose and throat specialist, allergist, or integrative physician may be the first step in treatment.
It is important to understand that this disorder in growing children can have a profoundly negative effect on facial growth and development (see Orthodontics). Early correction is recommended as soon as it is detected, as delay may result in irreversible alteration in the growth of the jaws that can only be resolved using radical therapies later in life that have poor chances of success.
Management of OSA in the adult is most successful when proper nasal respiratory function is improved. Conventional treatments include CPAP (a machine that forces air through the nose while sleeping) and, in extreme cases, a surgical procedure to remove the palate and some of the associated soft tissue structures.
Our goal is to treat you with a therapy that is not only effective, but will eliminate the need for invasive medical procedures. A viable alternative to these conventional treatments is the use of an oral orthotic (a specially designed “mouthguard” or sleep appliance), which when worn opens the airway during sleep. Not everyone that has OSA is a good candidate for such therapy. We can perform a specific dental examination to determine if you’re a candidate for an oral orthotic.
Problems With Stainless Steel Crowns and Their Alternatives
Alternatives to Stainless Steel Crowns
Alternatives to stainless steel crowns include resin-based fillings and all-porcelain crowns. These options avoid placing metal in the mouth. The filling material we use in our office is primarily comprised of porcelain particles and has minimal resin fillers, making it a safer dental material. For pediatric patients, if the cavity is small to moderate in size, we can usually use a filling to eliminate the cavity and rebuild the tooth. If the cavity is significantly larger, we may need to do a crown instead to fully encircle the tooth in order to protect it from fracturing and continuing to decay. In our office we only make all-ceramic crowns.
Types of Dental Crowns:
- Metals and Stainless Steel
Stainless steel crowns are inexpensive and practical. They are usually prefabricated and can be placed the same day in office; however, because they are prefabricated they may not have a perfect marginal seal, which may later cause bacterial seepage into the crown causing the tooth to become further decayed or infected. One other issue is that approximately 10-15% of the population has a metal allergy or hypersensitivity, so using metals in some patients may be contraindicated.
- Porcelain-fused-to-metal
Porcelain-fused-to-metal crowns used to be the most common type of crown placed a decade ago. They are relatively natural-looking although often can appear to opaque and sometimes can stand out. Another issue is that since the inside of it and rim of the crown are metal, over time, more of the metal can be exposed which can be unesthetic and also can feel jagged if a porcelain portion breaks off from the metal shell.
- All-resin
All-resin crowns do not exist in dentistry, but large all-resin fillings are done frequently. Teeth can have fillings when they have cavities but only to a certain size. If the cavity is too large, placing a filling may not be appropriate, in that it can weaken the tooth’s structural integrity if it’s too broad of an area, and in these cases a crown may be more appropriate.
- All-ceramic or all-porcelain
All -ceramic crowns are the most commonly used material for crowns today in dentistry. Ceramics have come a long way in the last decade. They originally were esthetic but not necessarily as long lasting as metal based crowns. Nowadays, because of material advancements, they have now become even more esthetic and just as strong, or even stronger than metals. All-ceramic crowns are both durable and blend in well with the shade of your natural teeth.
Does getting a crown hurt?
No, getting a crown does not hurt. You will be properly anesthetized and will feel cold water and vibration while we are working. While your crown is being fabricated in the laboratory, you will be wearing a temporary crown for a few weeks. In this time, you may experience some mild cold or chewing sensitivity, but once the permanent crown has been placed the sensitivity will calm down. We will make sure that the permanent crown has proper a fit and shade for you. We make sure to use biocompatable all-ceramic crowns and cements.
If you have cavities we are happy to assess what type of treatment you need. You can feel safe in our office knowing that we will properly diagnose and treat your cavities, and use only the safest and most biocompatable materials. Please call our office for a consultation 301-770-2270 or schedule an appointment here.
Does it Hurt to get Dental Implants?
Is it Painful to get Dental Implants?
Left: Titanium Implant with Zirconia Crown. Right: Zirconia Implant and Crown
Dental Implants are the biggest advancement to dentistry of the century. Dental implants have made it possible to replace teeth with equally functional replacement teeth. Dental implants replace the missing tooth’s root portion making a strong biological connection with the surrounding healthy jaw bone. You may have heard details about drilling and screwing of dental implants into the jaw. It sounds painful and seems like a major surgical procedure with associated trauma, pain and discomfort. In reality, placement of dental implants in your jaw bones is easy, simple and done with minimal trauma. Dental Implants are placed passively into the jaw. The jaw bone, grows new bone that surrounds and attaches to the newly “implanted” tooth root. It is not “screwed” into a strong position as people may assume or think. As compared to performing diseased tooth removal or carrying out root canal treatment procedures, implant procedure are simple, easy to sit through, short-lived and rather painless. During placement, Dental implants have been associated with no or little discomfort even under simple local anesthesia in a routine dental office setting. Newer techniques and implant kits have even made it easier. Often there is no need to make an incision. The ideal time to place a dental implant is at the time of tooth removal – immediate dental implant placement. During immediate implant placement there is no need to make a new bony hole because the implant can be placed by slightly modifying the extraction site.
Your dental health care provider will take complete history and a comprehensive visual and radiographic examination of the intended area for dental implant placement. CBCT imaging can be done for the evaluation of height, width, thickness and quality of jaw bones for achieving high success rates. Specialized imaging will also help in identifying the need for bone grafting and sinus lift procedures for minimizing discomfort and complications in the future. You will be thoroughly described all the aspects and steps of treatment procedure for getting an informed consent. After taking informed consent, topical anesthetic will be applied on oral soft tissues for minimizing needle prick followed by administration of profound local anesthesia. You will not feel pain and discomfort during the whole procedure.
For needle phobic patients or those who suffer from dental phobia, nitrous oxide conscious sedation is an ideal option. You will not feel any discomfort and the whole procedure will be performed in a calm and soothing environment. Feel free to visit your dental implant surgeon for the replacement of missing and lost natural teeth without any fear of pain. Dental implant procedures do not hurt and will restore your eating, chewing, biting, speech and smiles in the most ideal manner.
Dental Visits Every Six Months?
Dental Visits Every Six Months?
There’s no disputing the fact that Preventative Dental Care helps patients avoid tooth loss, and that’s the real name of the game here. Preventative Dental Care includes, regular tooth brushing, regular dental visits and dental cleanings and dental exams.
Research the topic of the importance of the six-month dental checkup and dental cleaning online, and it’s not hard to find testimonials from people declaring that they’ve only visited the dentist every other year or so, that they’ve never had a cavity, and so on.
It’s true. Some people are lucky. Everybody is different, and everybody’s set of teeth is different, as well. Dentists have been recommending that patients come in every six months, as a general rule of thumb, since the 18th century.
Some patients can ‘get away’ with less frequent visits, and some should actually see us a little more frequently. It’s a matter of genetics, and it’s a matter of personal hygiene habits.
Even for our patients who brush and floss regularly, it’s important to get the teeth cleaned every six months, because even the most careful brushers can experience a buildup of tartar on their teeth. Tartar is a hardened form of the sticky bacteria that can form on your teeth between brushings: You don’t want it in your mouth. It’s unsightly and can eventually lead to Gum Disease in some cases. Tartar aka calculus is formed when bacterial plaques in the mouth mix with calcium deposits from saliva, forming rock-hard precipitates. These “rock-hard” precipitates need to be scrapped of by a dental hygienist and cannot be removed with a tooth brush or dental floss. Calculus left on teeth will after 2-3 months, eat away at the gums and get down below the gum line and begin to eat away at tooth supporting bone. Eventually, a perfectly good tooth can become loose and need to be removed. Bone loss in this fashion is what we call gum disease or periodontal disease. It is more than about teeth, but also overall health, as any bacterium getting below the gum line will leak into your blood supply and may cause other health problems (the biggest example is cardiovascular disease or heart disease).
Again, though—prevention is really what we’re after when we send you a gentle reminder via email or text every six months. The sooner we spot a potential issue, the better. The more tooth or gum decay we prevent, the less work we have to do on your mouth. If the conditions are wrong, it can take as little as six months to get a cavity. At your six month visit we will find any cavities and have them fixed with conservative fillings. The longer cavities persist in teeth the bigger they get, and yes-more damaging to your tooth, more painful, more expensive…
While you’ll hear some people say they can get away with skipping visits to the Dentist, trust us when we say we’re a little more used to seeing people that shouldn’t have skipped that visit to the Dentist. Possibly, they’re just a little less vocal about it.
Seriously, though. Regular trips to the Dentist usually means that your Dentist is able to prevent potential tooth damage issues. To put it another way, regular trips to the dentist inevitably mean patients need fewer procedures and have to spend less money on dental work. It analogous to automobile oil changes…if you don’t do it something terrible may happen like your engine will seize-up and die, leaving you on the side of the road and out thousands of dollars. You get my drift.
Dental Visits Every Six Months? Yes! If you live in Rockville, find a dentist near Rockville to get a routine cleaning.