Posts for: August, 2014
Anxiety in a child during dental procedures could interfere with the care they need. But recent advances in sedation drug therapy can calm pediatric patients safely and allow us to perform more invasive procedures without general anesthesia.
In contrast to general anesthesia, conscious sedation allows a patient to relax and feel calm while still breathing normally on their own and able to respond to certain stimuli. Conscious sedation can be deep, moderate or minimal. Deep sedation is akin to sleep and will also cause the child not to remember details of the procedure when they awaken. At the other end of the spectrum is minimal sedation, the most common type used in pediatric dentistry, which allows patients to respond to touching or verbal commands. Deep sedation drugs are usually administered intravenously, while those used for minimal sedation are administered orally with syrup. Conscious sedation doesn’t prevent pain, so it must also be accompanied by local anesthesia or other pain-relieving methods.
After you arrive for your child’s procedure, we’ll normally conduct a pre-sedation evaluation to be sure there are no medical problems that might interfere with the sedation. We typically use Midazolam (under the brand name Versed) or Hydroxyzine (also known as Vistaril or Atarax) to achieve sedation. Both are very safe, fast-acting and exit the body quickly after treatment.
During the procedure, a designated member of our staff continuously monitors your child’s vital signs, including pulse and respiration rates, blood pressure, temperature, and blood oxygen level. After the procedure your child will remain in recovery until vital signs return to pre-sedation levels. You should then take your child home and monitor them for the remainder of the day — definitely no return to school until at least the next day.
Safety is a top priority when using any sedation therapy — dental professionals follow strict procedures and protocols, as well as adhere to certification requirements enforced by many states. Performed in this manner, conscious sedation can help ensure your child’s experiences in our office are pleasant, and will hopefully result in a greater willingness when they grow up to continue professional dental care.
If you would like more information on conscious sedation for children, 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.”
Though it's been a while since Olivia Newton-John sang her way into our hearts in the movie Grease, her smile is as radiant as ever. Today, Olivia is still singing, acting and busy with new ventures such as authoring a cookbook and raising money for the cancer center that bears her name in Melbourne, Australia. Whichever part of the world Olivia finds herself in, she protects that beautiful smile with an oral appliance that many find beneficial.
“I wear a nightguard to prevent wear on my teeth, custom-made by my dentist,” Olivia recently told Dear Doctor magazine. “I love it!”
Olivia's device, also referred to as a bite (occlusal) guard, is designed for people who clench or grind their teeth at night, or during stressful periods. Made of thin, wear-resistant plastic, it is custom-made to fit exactly over your top teeth. This allows the bottom teeth to slide gently across the top teeth without biting into them. Not only does this prevent excessive tooth wear, it also helps relax the muscles of the jaw.
Grinding or “bruxing,” as it's also called, can affect virtually any part of the oral system: the jaw joints or muscles, resulting in spasm and pain; the teeth themselves, resulting in wear, fractures or looseness; it can even cause an aching in the ears, head, neck or back.
If you are a teeth-grinder, you might not even know it unless a sleeping partner hears it or your dentist notices signs of wear. These habits are called “parafunctional” (para – outside, function – normal), meaning the biting forces it generates are well outside the normal range — sometimes as much as 10 times normal. So it's no wonder that damage to teeth can occur if they are not protected.
If you have any questions about grinding habits or nightguards, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Stress & Tooth Habits.”
The main strategy in fighting dental disease is to try to prevent it in the first place. The success of this strategy depends largely on effective oral hygiene with three essential elements: daily brushing, daily flossing, and semi-annual checkups with professional cleaning.
Many people have little trouble incorporating brushing into their daily routine; flossing, though, is a different matter for some. They may feel it’s too time-consuming or too hard to perform. Patients with orthodontic appliances especially may encounter difficulty navigating the floss around the appliance hardware.
Flossing, though, is extremely important for removing bacterial plaque, the primary aim of oral hygiene. This thin film of food remnant that builds up and sticks to the teeth is the breeding ground for bacteria that cause both tooth decay and periodontal (gum) disease. It’s important that as much plaque as possible is removed from the teeth and gum surfaces every day. While brushing removes plaque from the open surfaces of the teeth, flossing removes plaque clinging between teeth and around the gums that can’t be accessed with a toothbrush.
If traditional flossing is too difficult, there’s a viable alternative using an oral irrigator. Also known as a water flosser, an oral irrigator directs a stream of pressurized, pulsating water inside the mouth to blast away plaque in these hard to reach places. The hand applicator comes with a variety of tips that can be used for a number of dental situations, such as cleaning around braces or implants. In home use since the early 1960s, the latest versions of oral irrigators have proven to be very effective, especially for orthodontic patients — research shows an oral irrigator used in conjunction with brushing can remove up to five times more plaque than just brushing alone.
That being said, traditional flossing is also effective at plaque removal when performed properly. Sometimes, resistance to flossing can be remedied with a little training during dental checkups. We can work with you on techniques to improve your flossing activity, as well as train you to use an oral irrigator.
Whichever method you choose, it’s important for you to incorporate flossing (or irrigation) into your daily routine. Removing plaque, especially in those hard to reach places, is essential for reducing your risk of developing destructive dental disease.
If you would like more information on flossing or oral irrigation, 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 “Cleaning Between Your Teeth.”