Posts for: December, 2018
Like other healthcare providers, dentists have relied for decades on the strong pain relief of opioid (narcotic) drugs for patients after dental work. As late as 2012, doctors and dentists wrote over 250 million prescriptions for these drugs. Since then, though, those numbers have shrunk drastically.
That’s because while effective, drugs like morphine, oxycodone or fentanyl are highly addictive. While those trapped in a narcotic addiction can obtain drugs like heroine illicitly, a high number come from prescriptions that have been issued too liberally. This and other factors have helped contribute to a nationwide epidemic of opioid addiction involving an estimated 2 million Americans and thousands of deaths each year.
Because three-quarters of opioid abusers began their addiction with prescription pain medication, there’s been a great deal of re-thinking about how we manage post-procedural pain, especially in dentistry. As a result, we’re seeing a shift to a different strategy: using a combination of non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen and acetaminophen, instead of a prescribed narcotic.
These over-the-counter drugs are safer and less costly; more importantly, though, they don’t have the high addictive quality of an opioid drug. A 2013 study published in the Journal of the American Dental Association (JADA) showed that when two NSAIDs were used together, the pain relief was greater than either drug used individually, and better than some opioid medications.
That’s not to say dentists no longer prescribe opioids for pain management following dental work. But the growing consensus among dental providers is to rely on the double NSAID approach as their first-line therapy. If a patient has other medical conditions or the NSAIDs prove ineffective, then the dentist can prescribe an opioid instead.
There’s often hesitancy among dental patients on going this new route rather than the tried and true opioid prescription. That’s why it’s important to discuss the matter with your dentist before any procedure to see which way is best for you. Just like you, your dentist wants your treatment experience to be as pain-free as possible, in the safest manner possible.
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.
For over half a century, dentists have promoted a proven strategy for sound dental health. Not only is this strategy effective, it’s simple too: brush and floss every day, and visit your dentist at least twice a year or as soon as you see a problem.
Unfortunately, this strategy isn’t resonating well with people between the ages of 18 and 34, known more commonly as the “millennials.” A recent survey of 2,000 members of this age bracket found a startling number: over one-third didn’t brush their teeth as often as recommended, some going as long as two days between brushings. About the same number also reported fear of dental visits. Given all that, the next statistic isn’t surprising: tooth decay affects one in three people in the millennial age group.
This isn’t to pick on millennials, but to point out that good oral hygiene naturally leads to good oral health, regardless of age, gender or ethnicity. Here’s more about the dental care basics for better health.
Brush twice, floss once daily. The American Dental Association (ADA) recommends a thorough brushing with toothpaste containing fluoride twice a day. You also shouldn’t neglect a once a day flossing between teeth to remove plaque from areas brushing can’t effectively reach. Keeping plaque accumulation to a minimum is the best way to prevent diseases like tooth decay or periodontal (gum) disease.
Visit your dentist at least twice a year. Dental visits every six months (or more if your dentist recommends it) accomplish two things: a professional dental cleaning removes any buildup of plaque and tartar (calcified plaque) missed by daily hygiene. It also allows your dentist to inspect your teeth and gums for any signs of disease that may require treatment.
See your Dentist ASAP if you notice problems. You should also see your dentist sooner if you notice anything abnormal like unusual spotting on the teeth, tooth pain or sensitivity, or swollen, reddened or bleeding gums. These are all signs of disease, and the sooner it’s treated the less chance your teeth and gums will suffer serious harm.
Like other age groups, millennials know the importance of a healthy smile, not only for social and career interaction, but also for their own personal well-being. Sticking to a regular dental care program is the primary way to keep that healthy smile.