Posts for: March, 2017
The best way to prevent dental visit anxiety in your children is start those visits around their first birthday, and continue with them through childhood. Age One visits are the best way to ensure they're comfortable with the dentist now and that they'll continue the habit into adulthood.
But in spite of your best efforts and those of your dental provider, there's no guarantee your child won't experience dental visit anxiety at some point. If that happens, we recommend conscious sedation.
Conscious sedation is the use of certain medications to help a patient relax. It's not the same as anesthesia, which eliminates pain by numbing tissues (local anesthesia) or inducing unconsciousness (general anesthesia). During conscious sedation a patient remains awake or at the most in a dream-like state, can still respond to touch or verbal commands, and although monitored doesn't require assistance in heart or lung function.
We can induce this relaxed state in a number of ways: orally, with medication given by mouth a short time before the visit; intravenously, the medication delivered through a drip directly into the bloodstream; or by inhalation, usually nitrous oxide gas mixed with oxygen and delivered by mask.
Oral sedation is the most common. On the day of the procedure, we'll give your child one or more sedative drugs, usually in syrup form. For best results we advise they eat a low-fat dinner the night before and not eat or drink any food or liquid afterward. We typically use Midazolam and Hydroxyzine, both of which are proven safe and fast acting.
During the procedure, we'll also assign a team member to monitor their vital signs while they're under the influence of the drugs. We may also employ special positioning or immobilization equipment to keep movement to a minimum.
After the procedure, we'll continue to monitor vitals until they return to pre-sedation levels. The child should remain home the rest of the day to rest and return to school the next day.
Conscious sedation is regulated by states: providers must be trained and licensed to administer sedation drugs with continuing education requirements. Even so, the use of sedation for children is becoming more widespread and helps to safely ensure they're getting the dental care they need.
If you would like more information on comfortable dentistry 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.”
Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.
“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.
Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.
Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.
Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.
If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.
When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.
Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.