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Who’s Afraid of a Little Dentistry?

 

It turns out that quite a few people are afraid of the dentist. Up to 75 percent of adults report that they experience some form of dental anxiety. For the vast majority of dental anxiety sufferers, it’s the more invasive procedures – such as oral surgery – that really sets them off, while more routine procedures are much easier to deal with and provoke only a mild sense of anxiety.

 

Up to 10 percent of those same adults lean towards phobic on the fear scale, to the point that they avoid dental work until it’s too late. This, of course can lead to more severe dental issues resulting in the necessity of more time in the dentist’s chair, which then results in … more fear of the dentist. A vicious cycle for anyone trying to avoid the dentist. What’s the alternative for someone who experiences anxiety when it comes to dentistry? One answer is; sedation dentistry.

 

What is sedation dentistry?

 

Sedation dentistry describes the use of medication to induce a sense of relaxation in patients during dental procedures. Most patients choose the mildest form of sedative, making it possible for them to be awake yet still very relaxed (Conscious Sedation Dentistry). The opposite end of that spectrum is general anesthesia which induces complete unconsciousness. The full range of options runs from minimal – awake and relaxed, moderate – more deeply relaxed (may not remember procedure), deep – still aware but on the edge of consciousness and can be easily awoken, to deep sleep under general anesthesia. Sedation dentistry may also be appropriate for people who:

 

  • Have a low pain tolerance or very sensitive teeth
  • Require extensive dental work
  • Have anxiety associated with needles

 

Patients who chose to remain fully to somewhat conscious during the procedure are undergoing what is generally called ‘Conscious Sedation’. Although patients are not completely unconscious while undergoing Conscious Sedation Dentistry, many patients are so relaxed that they may nap through the dental appointment and very few associate any unpleasant memory following the experience. Some added benefits of sedation dentistry may include;

 

  • A shorter treatment time
  • Less jaw pain following procedure (particularly in people who suffer from TMJ)
  • More dental work can be done in a session
  • Less back/neck/shoulder strain (sometimes associated with sitting in a dental chair)

 

For sedation dentistry, a prescription medication is administered which induces a drowsy, relaxed feeling. This medication can be administered orally or intravenously (IV), depending on the desired results. The use of any sedation medication – with the exception of nitrous oxide – requires the patient to have someone available to drive them to and from the dental office, due to the relaxing effects of the medication that tend to linger after the procedure.  The patient’s vital signs are monitored throughout any procedure involving sedation.

 

Most Common Sedatives Used in Dentistry

 

Inhaled minimal sedation (just takes the edge off). This form of sedation uses nitrous oxide (laughing gas) mixed with oxygen which is inhaled through a mask over the nose. The dental practitioner is able to control the amount of sedation, and the effects of the gas usually wears off quickly.

 

Oral sedation (unreliable, but acceptable). The level of sedation achieved using oral sedation can range from minimal to moderate. This involves the ingestion of a pill called Halcion, (related to Valium). This pill is usually taken about an hour before the procedure resulting in a drowsy wakefulness. A slightly larger dose produces a moderate level of sedation – the level most commonly associated with sedation dentistry. It is challenging to tell how much medication is needed the first time someone takes oral sedation. This is because everyone metabolizes medications at different rates. Therefore, the chance of oversedation and undersedation are higher. However, this is still a safe method.

 

IV moderate sedation (preferred). This requires the use of a sedative applied intravenously. It works quite rapidly and is readily adjustable by the dentist making it possible to regulate the dosage to a patients’ comfort level easier than some other sedation medications. Also, an additional dose can be given in small increments to get you the exact amount of sedation that you require.

 

Deep sedation and general anesthesia (not as common). Using the above method of application, medications are administered that result in near-to-total unconsciousness during the procedure. This is the stuff you would be given for big cases like heart surgery. While under general anesthesia the patient cannot be easily awakened until the effects of the anesthesia wear off, or until they are reversed with medication.

 

Who Should Avoid Sedation Dentistry?

 

As with any medication there is a risk in taking anesthesia. When administered by an experienced dentist who has pre-screened the patient for any potential complication, sedation dentistry is quite safe. Some high risk groups should talk to a doctor before undergoing any type of anesthesia, including those who have a known heart condition, are obese or who suffer from obstructive sleep apnea. Other known risk factors include;

 

  • High blood pressure
  • Recent heart health incident
  • Uncontrolled hyperthyroidism
  • Angina pectoris
  • People taking antidepressants, beta blockers or cocaine

 

SOURCES:

 

American Dental Association: “Guidelines for the Use of Sedation and Anesthesia by Dentists.”

Reviewed by Michael Friedman, DDS on November 29, 2015

© 2015 WebMD, LLC. All rights reserved.

 

Kleinknecht RA, Thorndike RM, McGlynn FD, Harkavy J (January 1984). “Factor analysis of the dental fear survey with cross-validation”. J Am Dent Assoc 108 (1): 59–61. PMID 6582116.

 

Correcting A Misaligned Bite Can Add a Youthful Look to Your Years

Do you suffer from nagging neck pain, persistently stiff jaw, severe headaches and/or do you habitually grind your teeth? If so, you may have a misaligned bite or ‘malocclusion’. A malocclusion exists when the teeth and jaw joints do not properly fit together. It manifests as an under-bite, overbite or spacing between teeth and overcrowding problems. These types of malocclusions can cause a wide range of dental and secondary issues, and dramatically impact facial esthetics – which can take a real toll on a person’s self-esteem. Seeing your holistic dental practitioner for a bite assessment can lead to a better profile, healthier teeth, more restful nights and fewer headaches.

Malocclusion vs. Misalignment

When a person’s bite is misaligned, an uneven distribution of pressure is put on both the teeth and jaw, particularly while chewing. This misalignment can cause many issues including tooth pain due to loose fillings, broken crowns or chipped and crooked teeth, recessed gums, TMJ (clicking and popping of the jaw), difficulty opening or closing the mouth and ringing in the ears. It can also lead to muscle strain which can cause frequent headaches or sinus pain, and difficulty or discomfort when biting or chewing.

A malocclusion is also considered one of the most likely culprits in patients who complain of teeth grinding and jaw clenching. Chronic headaches are a well-recognized symptom of malocclusion that results from the uneven pressure placed on the teeth and jaw. The poor alignment of the teeth can be a result of genetic factors combined with poor oral habits, can result from an injury or stem from several childhood factors including inadequate nutrition. A bite analysis conducted by a dental professional can help to determine the level of correction needed and the type of treatment options a patient and dentist might consider.

Why You Should Seek Treatment of Malocclusion and TMJ

When looking at malocclusion, holistic dentistry focuses on the relationships of the teeth, facial muscles and jaw as a way to bring the whole body into healthy balance. Proper functioning of the temporomandibular joint or ‘TMJ’ is important for a well-aligned bite and healthy teeth. When injury to the jaw occurs, or if a malocclusion has been diagnosed, TMJ dysfunction may result, and create any number of problems that can impact a person’s overall health.

Benefits of treating malocclusion are many and include; a reduced risk of tooth decay as a malocclusion often causes an uneven wear pattern on the teeth which can lead to early tooth erosion and decay; improved oral hygiene by reducing overcrowding and making it easier to clean the teeth and gums effectively. There is also a reduction in the risk of TMJ or temporomandibular jaw syndrome which is often linked to a malocclusion.  And, by realigning the teeth, pressure on the jaw is reduced, thereby eliminating many of the painful symptoms associated with malocclusion. Malocclusion correction can also improve facial aesthetics and lead to a greater sense of self-esteem.

How to Tell If You Have a Malocclusion

The best way to test for a malocclusion is by way of a bite analysis which is a relatively simple procedure that is done in a dental office. For this procedure, the patient bites down on the mouth piece of a handheld scanning device. This device measures the pressure and force of a person’s bite from all angles. It will reveal which teeth undergo more pressure, determine where upper and lower teeth do not meet, and if there is a misalignment of the teeth or jaw. A bite analysis is quick, simple and painless – and it can provide valuable information regarding oral health and reveal many complications associated with malocclusion.

Treating Malocclusions

The most ideal treatment for a malocclusion doesn’t involve painful braces, surgery or grinding on healthy teeth – and of course, the best treatment is non-surgical and non-invasive. For some patients, dental aligners such as Invisalign® is the preferred treatment. These braces are removable, invisible to the naked eye and work in much the same way as fixed dental braces, without distracting from the aesthetics of the smile.

A simple mouth guard may be the prescribed treatment in milder cases, and in some people, can make a significant difference at relieving symptoms of a misaligned bite.

Patients who have suffered from bite malocclusion for many years are often interested in the non-surgical treatment Face Lift Dentistry®. This exclusive treatment can reverse the appearance of years of aging while replacing old fillings, bridges and crowns with healthy biologically matching restorations that are made to idealize the bite and the shape of the patients face.

A preferred treatment for malocclusions is with the use of the functional osteopathic teeth straightening palate expansion device called Advanced Lightwire Functionals (ALF). This device addresses misalignment of teeth, facial bone reformation, TMJ pain, as well as troublesome sleep apnea. For many patients, the ALF orthodontic appliance helps to relieve chronic pain and remedy many of the common physical ailments associate with malocclusions. It offers far less discomfort than braces, is much less painful, and is easily removable for cleaning.

Resources:

Malocclusion and Orthodontics: