How medication and anesthesia can help make your visit to the dentist easier

Your dentist will do everything possible to make your visit as relaxed and comfortable as possible.

Depending on the treatment you are receiving, there are several medications available to help.

Some drugs control pain, some help you relax and others put you into a deep sleep during dental treatment.

The best approach will depend on the type of procedure being undertaken, your overall health – including any history of allergies – and the degree of anxiety you feel.

Some of the options your dentist might discuss include:

Analgesics: These are the most commonly used drugs for relief of toothache or pain following dental treatment. They includes aspirin, acetaminophen and anti-inflammatory drugs such as Ibuprofen. There is a separate category of narcotic analgesics – such as those containing codeine – which are used for more severe pain.

Local anesthesia: Topical anesthetics are applied to mouth tissues with a swab to prevent pain on the surface level. They may also be used to soothe mouth sores. Injectable local anesthetics prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain and numbing mouth tissues.

In other cases, your dentist many recommend sedation or general anesthesia.

Your dentist will discuss the best approach to suit your needs.

What is plaque and how does it affect your teeth?

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.

Root canal treatment

Root canal therapy is an important treatment that can save a tooth with a diseased nerve and which in the past would probably have needed to be removed.

Inside each tooth is the ‘pulp’ which runs like a thread down through the root and provides nutrients and nerves to the tooth. It is the soft tissue that contains nerves, blood vessels and connective tissue.

If the pulp is diseased or injured, the pulp tissue dies.

The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp.

So, if you don’t remove it, your tooth gets infected and you could lose it.

After the dentist – or endodontist (a dentist who specializes in problems of the pulp) – removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure involving one to three visits with little or no discomfort.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums and enjoy regular checkups.

Preventing tooth decay in babies and infants

The habits of good dental care should begin as early as possible and its important to take steps to avoid problems with infants and children.

Children need strong, healthy teeth to chew their food and baby teeth also keep a space in the jaw for the adult teeth.

If a baby tooth is lost too early, the teeth beside it may drift into the empty space. So, when it’s time for the adult teeth to come in, there may not be enough room. This can make the teeth crooked or crowded.

The name given to decay in infants and children is baby bottle tooth decay.

It can destroy the teeth and most often occurs in the upper front teeth – though other teeth may also be affected.

Decay can happen when sweetened liquids are given to an infant and are then left clinging to their teeth for long periods. Many sweet liquids cause problems, including milk, formula and fruit juice.

What happens is that bacteria in the mouth use these sugars as food and then produce acids that attack the teeth.

It’s not just what you put in your child’s bottle that causes decay, but how often. Giving your child a bottle of sweetened liquid many times a day isn’t a good idea.

Here are some tips to avoid baby bottle tooth decay in your children:
– After each feeding, wipe the baby’s gums with a clean gauze pad. Begin brushing your child’s teeth when the first tooth erupts. Clean and massage gums in areas that remain toothless, and begin flossing when all the baby teeth have erupted, usually by age 2 or 2.
– Never allow your child to fall asleep with a bottle containing milk, formula, fruit juice or sweetened liquids.
– If your child needs a comforter between regular feedings, at night, or during naps, give them a clean pacifier recommended by your dentist or physician. Never give your child a pacifier dipped in any sweet liquid.
– Avoid filling your child’s bottle with liquids such as sugar water and soft drinks.
– If your local water supply does not contain fluoride (a substance that helps prevent tooth decay), ask your dentist how your child should get it.

Start dental visits by the child’s first birthday and make visits regularly.

If you think your child has dental problems, take the child to the dentist as soon as possible.

Building a strong relationship with your dentist

You’ll give yourself the best chance of good oral health if you build a strong relationship with your dentist.

That can sometimes mean asking the right questions and helping them to assist you in the best way possible.

So you want to make sure you have a dentist who will first of all explain techniques that you should use to help prevent dental health problems. They should be willing to show you step-by-step what you need to do.

You should also choose a dentist who is willing to take time to answer your questions, especially when they are recommending a course of treatment.

If you don’t understand any part of what your dentist recommends, don’t be afraid to ask for more information.

You may want to ask if there are other options to the solution they recommend. For example:

– How do the options differ in cost?
– Which solution will last the longest?
– Do all the options solve the problem?

Ask the dentist which treatments are absolutely necessary, which are elective and Which are cosmetic.

Ask which procedures are urgently needed, and which ones are less urgent. Your dentist will help you prioritize between problems which need immediate attention and those that are less urgent.

Often, treatment can be planned over a period of time but make sure you understand any consequences of delaying treatment.

It’s naturally also important to make sure that you are given full information about fees and payment plans before treatment is scheduled.

How older adults can handle dry mouth and taste problems

Reduced saliva flow that results in a dry mouth is a common problem among older adults.

It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Some of the common problems associated with dry mouth include:
– Constant sore throat
– Burning sensation
– Problems speaking
– Difficulty swallowing
– Hoarseness or dry nasal passages

Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form.

Your dentist can recommend various methods to restore moisture. For example, sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

Another issue that can affect older adults is a loss of appetite due to a change in your sense of taste. Besides an age-related decrease in the sense of taste and smell, certain diseases, medications and dentures can contribute to a decrease in your sense of taste.

Whether you are suffering from dry mouth or problems with your sense of taste, your dentist will be able to make suggestions to help.

Solving the problem of bad breath

Bad breath – which is also known as halitosis – is a worrying problem that can also be embarrassing.

But theres no need to put up with it. If you suffer from bad breath, your dentist will be able to suggest a range of solutions.

Your dentist will be able to spot problems such as gum disease, dry mouth or other disorders. Thats why its important to maintain good oral hygiene, schedule regular visits to the dentist and have professional cleaning.

Make sure you brush your teeth twice a day and clean between your teeth each day using floss or interdental cleaners. Don’t forget to brush your tongue, too!

If your dental check up shows that your mouth is healthy, your dentist may refer you to your family physician as sometimes bad breath can be a sign of other health problems.

If the odor is due to periodontal (gum) disease, sometimes professional periodontal cleaning is needed to remove the bacteria and plaque that accumulate. And your dentist may recommend a special antimicrobial mouth rinse.

Keeping your mouth healthy and stopping periodontal disease are essential to reducing bad breath.

So make sure you schedule regular dental visits for a professional cleaning and checkup.

Why your routine dental cleaning is not routine

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appointment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a dental prophylaxis, or trophy and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

Choosing the right toothbrush for your needs

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.

The difference between canker sores and cold sores

Although canker sores are often confused with cold sores, there is a difference.

Canker sores occur inside the mouth, and cold sores usually occur outside the mouth.

Canker sores are small ulcers with a white or gray base and a red border. There can be one or more sores in the mouth. They are very common and often recur.

They usually heal in a week or two and rinsing with antimicrobial mouthrinses may help reduce the irritation.

Cold sores – also called fever blisters – are composed of groups of painful, fluid-filled blisters that often erupt around the lips and sometimes under the nose or chin.

Cold sores are usually caused by herpes virus type I and are very contagious. They usually heal in about a week.

Over-the-counter topical anesthetics can provide temporary relief and prescription antiviral drugs may reduce these kinds of viral infections.

The facts about oral cancer

Oral cancer is not as well known as other types of cancer but it can represent a life-threatening risk if not identified early.

– It strikes an estimated 35,000 Americans each year
– More than 7,500 people (5,200 men and 2,307 women) die of these cancers each year
– More than 25% of Americans who get oral cancer will die of the disease
– On average, only half of those diagnosed with the disease will survive more than five years
– African-Americans are especially vulnerable; the incidence rate is 1/3 higher than whites and the mortality rate is almost twice as high

Although the use of tobacco and alcohol are risk factors in developing oral cancer, approximately 25% of oral cancer patients have no known risk factors.

There has been a nearly five-fold increase in incidence in oral cancer patients under age 40, many with no known risk factors.

The incidence of oral cancer in women has increased significantly, largely due to an increase in women smoking. In 1950 the male to female ratio was 6:1; by 2002, it was 2:1.

The best way to prevent oral cancer is to avoid tobacco and alcohol use.

Unusual red or white spots can form in and around the mouth. These are often harmless but they can be cancerous or pre-cancerous.

Identifying and removing these early enough is a major factor in reducing the incidence of cancer.

So knowing the risk factors and seeing your dentist for regular examinations can help prevent this deadly disease.

The power of panormaic x-rays

X-rays are extremely valuable for helping dentists identify issues that may not show up on normal oral examination.

The three most common types of dental X-rays are the bitewing, periapical and panoramic X-rays.

Panoramic X-rays give a broad overview of the entire mouth – supplying information about the teeth, upper and lower jawbone, sinuses, and other hard and soft tissues of the head and neck.

Unlike other X-rays, where the film is placed inside the patients mouth, the panoramic film is contained in a machine that moves around the patient’s head. So they are very easy to use.

Panoramic X-rays are often used to check wisdom teeth but they will also reveal deep cavities and gum disease. They are also useful to help patients with past or present jaw problems or those who require full or partial removable dentures, dental implants, or braces.

They can also be valuable in assisting people who are suspected of having oral cancer or have had recent trauma to the face or teeth.

Panoramic X-rays play an important role in thorough dental examinations and are recommended at least every five years or so for most patients.

How dental x-rays help improve your oral health

Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth so an X-ray examination can reveal important additional information:

For example, X-rays can help show:
– Small areas of decay between the teeth or below existing fillings
– Infections in the bone
– Gum disease
– Abscesses or cysts
– Developmental abnormalities
– Some types of tumors

The way they work is that more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums). This creates an image called a radiograph.

Tooth decay, infections and signs of gum disease appear darker because of more X-ray penetration. The interpretation of these radiographs allows the dentist to safely and accurately detect hidden abnormalities.

The frequency of X-rays (radiographs) will depend on your specific health needs.

Your dentist will review your history, examine your mouth and decide whether you need radiographs and what type.

When you are a new patient, the dentist may recommend radiographs to establish how the hidden areas of your mouth currently look to help identify changes that occur later.

X-rays can help identify and treat dental problems at an early stage and so can save time, money and unnecessary discomfort.

How your oral health links with your general health

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

Common questions about dental insurance

Understanding what’s covered by your dental insurance is an important part of making sure you get the best oral care possible.

Here are some common questions that arise when people want to understand their cover better.

– If treatment my dentist recommends is not covered by my insurance, does that mean it’s not necessary?

Some plans make exclusions such as sealants, pre-existing conditions, adult orthodontics, and specialist referrals. This depends on your dental plan and you should not let the level of cover determine whether you need treatment.

– My dental benefit will only pay for a large filling but my dentist recommends I get a crown. Which should I choose?

Some plans will only cover the least expensive solution but it may not be the best option for your needs. You should decide based on your health needs and not on your insurance cover.

– My dental plan says it will pay 100 percent for checkups and cleanings but the insurance company says I owe for part of the dentist’s charge. How can this be?

Some plans provide cover based on a “customary fee” for each procedure. So, if your dentist’s fee is higher, your benefit will be based on a percentage of the customary fee instead of your dentist’s fee. Although these limits are called “customary,” they may not accurately reflect the fees that dentists charge in your area.

– Will my plan cover the care my family will need?
If your employer offers more than one plan, check the exclusions and limitations of the coverage as well as looking at the general benefits. It’s a good idea to discuss your family’s likely needs with your dentist before choosing a plan.

The plan document should specify who is eligible for coverage under the plan.

Plans offered by the same provider or employer can vary according to the contracts involved so your dentist will not be able to answer specific questions about your benefit or predict what the coverage for a particular procedure will be.

If you have specific questions about coverage, talk to your plan provider.

Why your routine dental cleaning is not routine

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appoinment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a “dental prophylaxis,” or “prophy” and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

Diabetes and your dental health: How your diet can affect your teeth

When diabetes is not controlled properly, high glucose levels in saliva may create problems that lead to an increased risk of tooth decay.

Your teeth are covered with plaque, a sticky film of bacteria. After you eat food that contains sugars or starches, the bacteria react with these sugars to release acids that attack tooth enamel. This can cause the enamel to break down and may eventually result in cavities.

Brushing twice a day with fluoride toothpaste and cleaning between your teeth with floss or an interdental cleaner helps remove decay-causing plaque.

Plaque that is not removed can eventually harden into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to clean thoroughly between teeth. This can lead to chronic inflammation and infection in the mouth.

Because diabetes reduces the body's resistance to infection, the gums are among the tissues likely to be affected.
Periodontal diseases are infections of the gum and bone that hold your teeth in place. Patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than those who have good control of their diabetes.

Because of the lower resistance and longer healing process, periodontal diseases often appear to be more frequent and more severe among persons with diabetes.

You can help reduce these risks through good maintenance of blood sugar levels, a well-balanced diet, good oral care at home and regular dental checkups.

The secrets of brushing and flossing your teeth effectively

Though many of us say we brush our teeth regularly, you get the best results by making sure you brush properly.

Here are the steps you should follow:

First, place the toothbrush at a 45-degree angle to your gums.

Then, move the brush back and forth gently in short (tooth-wide) strokes.

Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.

Use the “toe” of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.

Finally, brush your tongue to remove bacteria and freshen your breath.

As well as brushing your teeth, you should floss them every day. Heres how to floss for best results.

Break off about 18 inches of floss and wind most of it around one of your middle fingers.

Then wind the remaining floss around the same finger on the opposite hand. This finger will take up the floss as it becomes dirty.

Hold the floss tightly between your thumbs and forefingers.

Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.

When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.

Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.

Repeat this method on the rest of your teeth.

Don’t forget the back side of your last tooth.

If you have difficulty handling dental floss, consider other types of interdental cleaner such as special brushes, picks or sticks.

Your dentist or hygienist will be able to give your further tips on how to brush and floss for best results.

Your options if you have many missing or damaged teeth

People who have not followed adequate dental care for some years may have already lost most of their teeth and feel a little hopeless.

Sometimes they ask a dentist to remove the remaining teeth as they are often broken and have deep cavities.

It’s true that, sometimes, removal of the remaining teeth and replacing them with full dentures is the only option.

But more often there are other options available.

Some or all of the remaining teeth could be repaired and used in conjunction with a partial denture. While a full denture replaces all of the teeth on the upper or lower jaw, a partial denture replaces some of the teeth.

If only a few weak teeth remain on the upper jaw, it might be preferable to have them extracted and a full upper denture made. Full upper dentures can be more secure than lower ones as the upper denture gets added stability from the palate and is not easily dislodged by the tongue.

If only a few teeth remain on the lower jaw, however, the dentist will usually aim to save them and use a partial denture if necessary.

Ideally, all teeth that can be saved should be saved but this is not always possible – often due to finances.

In such cases, having teeth removed and dentures may be the only option.