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Nitrous Oxide: A Quick Fix for Dental Fear

Sometimes it’s not enough to have a great dentist, caring dental staff and soothing office environment – you or your children may still feel anxious about dental visits. That’s why many dentists use nitrous oxide; it helps calm patients of all ages – from timid tykes to anxious adults. Nitrous oxide (also known as “laughing gas”) has been used by U.S. dentists since the late 1800s. Its benefits are many, and the risks are few.
Nitrous oxide is safe for all ages. Nitrous oxide is considered one of the safest anesthetics available. It is well tolerated by patients of all ages, can be adjusted in various concentrations and is non-allergenic.
It reduces pain and anxiety. The effect of nitrous oxide is often remarkable, for both kids and adults. It’s typical for an adult or child to be relaxed and calm just minutes after receiving nitrous oxide. And when you’re calm, that means a faster, more comfortable dental visit.
You remain conscious. With nitrous oxide, you remain completely conscious and in control of your reflexes. You can talk and respond to your dentist. The point of nitrous oxide is to help you relax.
Comfort comes fast. Nitrous oxide takes effect within minutes and lasts for as long as you’re inhaling. After treatment, oxygen is used to flush the nitrous from your system just as quickly as it entered.

It’s No Laughing Matter Or Is It?

Dentists often hear, “Don’t take this personally, but I don’t want to be here.” Or, “I’d rather give birth than go to the dentist.” Dental visits are anxiety producing for some individuals and result in uncomfortable stressful situations. The good news is that we have the “cure.” It’s been used safely for over 100 years and goes by many names such as Nitrous Oxide, Tranquilizing Air and Laughing Gas. The bottom line is that this sweet smelling blend of nitrous oxide and oxygen reduces anxiety, minimizes an overactive gag reflex, raises your pain threshold and helps make your dental visit pleasant and comfortable with its calming effect.

Nitrous Oxide is non-addictive, predictable, and reliable and is, perhaps, the safest sedative in dentistry. During the treatment, you remain fully conscious and have all your natural reflexes. Both adults and children can use it. In fact, 85% off all pediatric dentists use “laughing gas” with their patients. You quickly recover in about 5 minutes after the nitrous oxide is turned off, and you are switched to pure oxygen to breathe. It is safe to drive and return to your normal activities after the visit.

The nitrous oxide is administered through a “mask” or nosepiece that fits snugly over your nose. The amount you receive can be individually adjusted to satisfy your personal needs. A euphoric effect is produced that may be accompanied by a tingling in the hands and feet. Some report feeling giddy – thus the name laughing gas. The most common response we hear is “I’m aware of what is happening, but it doesn’t bother me.”

Contraindications to the use of nitrous oxide are pregnancy, if you are uncomfortable with something around your nose or if your have a respiratory condition that makes breathing through the nose difficult. It is recommended to refrain from eating for about 2 hours before treatment. Nitrous oxide is excellent for patients with a history of heart problems because it reduces tension and provides 2-3 times more oxygen than breathing normal air.

Nitrous oxide does not numb teeth, so most patients use it in combination with a local dental anesthetic. However, after being placed on nitrous oxide for several minutes, many patients report, ” I hardly felt the injection.”

Call our office to find out how nitrous oxide can dramatically help you.

What are Dental Implants?

Dental implants offer people an alternative to the traditional ways of replacing missing teeth. The actual implant is an artificial root [anchor] made from synthetic material, usually titanium metal. There are three phases to the implant process.

First, the dental implant is surgically placed into the jawbone. It takes 3-6 months to fuse with the bone [called osseointegration]. An abutment [post] is attached to the implant and protrudes above the gum tissue. A replacement restoration is cemented or screwed to the implant abutment. Depending on the situation, dental implants can support a fixed crown or bridge or act as a stabilizing base for a full denture. The procedure can take up to 9-12 months for completion and has a high degree of success.

Some individuals have had so much bone resorption [loss] that the remaining bony ridge is too thin to hold an implant. In many cases, synthetic or natural bone can be grafted [added] or grown to allow for dental implants as an alternative treatment.

Implants have a great advantage for people already wearing full dentures since they can support and stabilize the denture while minimizing further bone loss of the denture ridge.

Not everyone is a good candidate for dental implants. There are certain risk factors that may limit success including smoking, excessive alcohol consumption, chronic bruxism [grinding teeth], systemic problems such as diabetes and individuals with poor oral hygiene.

Dental implants offer a “second chance” to those who have lost all of their teeth. For people missing only one or several teeth, dental implants provide benefits as an alternative way to restore your mouth. To determine if implants are for you, a clinical examination, x-rays, study casts and other appropriate records and measurements will be necessary. Call our office if you have questions or would like to schedule an implant exam.

X-Rays: Yes or No?

While we share your concerns about potential risks from too much exposure to radiation, x-rays [radiographs] are a necessary part of the dental health process.

Our philosophy is that x-rays should not be routine but utilized when they will contribute to diagnosis or treatment of oral disease. Of course, we will cover you with appropriate body shielding prior to taking any x-rays.

Radiographs allow us to see and interpret signs of disease or potential problems that are not visible through direct observation. X-rays can be used to discover abscesses [pus-pocket], cysts, and/or tumors. They help us locate impacted, unerupted or extra teeth or determine congenitally missing teeth. Radiographs can demonstrate the presence or degree of periodontal [gum] disease. They can pinpoint the location and severity of cavities that are not visible to the naked eye. Basically, radiographs provide us with a view of the underlying structure and condition of your teeth, soft tissue and bone. Foregoing x-rays could result in an inaccurate diagnosis or incomplete treatment.

Usually, new adult patients will be given a full series of x-rays that will serve as a frame of reference for future changes or problems. The time frame between [6-18 months], type and number of follow-up x-rays will be determined by our assessment of your individual needs and the condition of your mouth. Growth and development are additional factors taken into account with young children. Certain situations such as root canal treatment necessitate several x-rays as part of the procedure. Patient with periodontal disease or implants will require radiographs at specific intervals to monitor their condition. As we are sensitive to your concerns, our office continues to keep abreast of ongoing radiological advances, and we utilize techniques and x-ray films that will minimize your exposure and maximize your excellent oral health.

Snoring: Can you do Anything about it?

Snoring is a widespread problem, affecting 30-45% of the population. When you take into account those that are disturbed by it, spouses and children, that number will double. It can have social consequences, disrupting marriages and roommate relationships. Snoring can also have medical consequences, preventing “a good night’s sleep” so individuals wake up fatigued, or more seriously, as a byproduct of obstructive sleep apnea, wherein the snorer momentarily stops breathing during sleep. To objectively identify the problem, an overnight sleep study [polysomnogram] needs to be administered by a medical doctor. The sound of snoring results from the uvula [tissue hanging from roof of soft palate] and the back of the soft palate vibrating. It is caused by a narrowing of the air passages in the throat due to a variety of factors – long uvula or soft palate, large tonsils, excess fat deposits, blocked nasal passages from cold or allergies and/or the relaxation [collapse] of the musculature of the throat and mouth during sleep. Presently, there are several methods that are reasonably predictable and will offer snorers relief. The most common utilizes a device called CPAP [continuous positive air pressure]. A stream of air is pushed through a tube connected to a mask that covers the nose. The continuous air pressure forces the airway to stay open during sleep. There are a large variety of dental appliances, similar to a mouthguard or orthodontic retainer, which are worn while sleeping. Some reposition the lower jaw [mandible] forward while others retain the tongue in a forward position. Essentially, they maintain an open, unobstructed airway in the throat. These appliances may be contraindicated in bruxers [people who grind their teeth]. Why suffer any longer? Any of these treatments can reduce or stop snoring. Call our office for more information.

Smoking And Your Mouth

It would be paradoxical to use the word “smoking” and the phrase “good oral health” in the same sentence. They just don’t go together. Not only does smoking leave brown stains and sticky tar deposits on your teeth or dentures, but it contributes to halitosis [bad breath]. It’s not uncommon to see red inflammation on the palate [roof of the mouth] from the high temperatures generated by cigarette, cigar and pipe smoking. Smoking is a major risk factor in periodontal [gum] disease. As shown by 20 years of research, smokers are 2-3 times more likely to develop periodontitis [bone loss]. Tooth loss is much more prevalent than in non-smokers. Studies have shown a higher rate of dental implant failures for those who smoke. Smoking leaves little room for error when it comes to oral cancer. There are 9,000 deaths a year in the U.S. from oral cancer and tobacco use accounts for 75% of them. Even second-hand smoke poses danger, especially for children. Smoke breathed in by children can affect the development and eruption of their permanent teeth. This process usually begins between ages 3-6 years old. The good news is that “kicking the habit” greatly reduces the risk of developing oral cancer. After 10 years of cessation, the risk is similar to a non-smoker. There are a number of ways to stop without experiencing extreme withdrawal symptoms including the nicotine patch, nicotine gum and nicotine spray or inhaler.

The Headache Question

Chronic symptoms of the head and neck can often be attributed to:

 Headache — the temporalis muscle (it closes and clenches the jaw)

 Sinus pressure and pain — the lateral pterygoid muscles (it moves the jaw side to side and/or forward)

 Neck stiffness and pain — trapezius muscle (it stabilizes the skull during jaw clenching and grinding)

Dental offices have treated and helped more and more people with their headache problems. For years, we assigned all of these names to headaches, like muscle tension headaches, neuralgia, migraine and so on, and it seems that many headache patients share one very common trait- They clench or grind their teeth at night!

Most medical research has shown that headaches, even people with classical migraine headaches, have no physical reason, no vascular problems and no neurological problems; in fact their physician’s exam will give no physical reason for the pain. Many patients have had CAT scans and MRI’s that were negative, and find that drugs really don’t help their problem; instead the medication makes them groggy and “drugged out.”

What we have discovered is that people who can control their nighttime clenching and grinding will get tremendous relief for their headaches and neck aches. Many people do so much unconscious clenching of their jaw muscles that when they wake up, their teeth are sore, their muscles are already tired, and they are set up for the beginning of a headache from the start of the day, if they don’t wake up with one.

One effective treatment utilizes an NTI appliance (short for nocioceptive trigeminal inhibition), a dental device that fits between the upper and lower front teeth. (Detailed information can be gotten from the website at http://www.headacheprevention.com/ ) The simple fact is that this device reduces the intensity of nighttime parafunction by 70 percent immediately, which can explain why so many patients wake up feeling better very quickly.

A traditional dental mouthpiece, or splint, reduces the resistance to side-to-side movement, thereby, reducing the effort and resultant strain to the jaw joint and sinuses (so long as clenching intensity isn’t too intense). However, the same splint also provides an ideal clenching surface, where maximum clenching intensity may increase and/or allow jaw joint problems to perpetuate.

Many patients run the gamut of the medical world’s attempts to control their headaches- with multiple drugs, injections and so on, without ever thinking that the pain might be muscular in origin. But just like back pain is often muscle spasm, the pain we call TMJ, as well as headaches of many sorts are very much caused by overuse of the muscles of closing the jaws.

We would recommend that if you or a loved one has chronic headache problems, that you go to the web site, or give us a call and let us take a look. It can do no harm, and it might very well make a huge difference in 

A Crowning Achievement

When too much tooth structure has been lost due to decay or fracture, the best treatment choice to restore the tooth to normal function and cosmetic appearance is often the fabrication of a crown [cap]. Crowns are usually made of porcelain fused to metal or all-ceramic depending on the situation and judgment of the dentist. The restoration of the damaged tooth becomes more of an esthetic concern if it is located near the front of one’s mouth. How we perceive our smile and appearance affects our self-esteem, our moods and how we function in social and business relationships. So, when this situation occurs, there is a sense of urgency.

The tooth is prepared to allow enough room for the crown to fit over the tooth without extending too far and interfering with the person’s occlusion [bite]. This procedure usually takes 2 visits, depending on the situation. A provisional acrylic crown is made and temporarily cemented over the tooth. In the second visit, the crown is “tried in” to see how accurately it fits and to check that the ceramic color chosen matches the surrounding teeth. If both the patient and dentist are satisfied, the crown is permanently cemented or bonded to the tooth. Call our office if you think you’re a candidate for this type of procedure.

Cranberries Have Unique Benefit For Women

A recent study at Rutgers University, and published in Phytochemistry, confirmed a long-held theory that ingestion of cranberries is helpful in protecting against harmful bacterial in the urinary tract. This is due to one of its natural compounds called proanthocyanidin [PAC’s], and its anti-adhesion effect.

The anti-adhesion property of cranberries prevents bacteria from sticking to the urinary tract, which is one of the most common regions for a woman to develop a bacterial infection. Half off all women will experience at least one urinary tract infection in their lifetime. E. coli, bacteria that cause urinary tract infections, are becoming increasingly resistant to common antibiotics. The study concluded that 80% of the antibiotic-resistant bacteria were prevented from sticking by the anti-adhesion property of cranberries. There is some conjecture that PAC’s found in cranberry may minimize stomach ulcers and gum disease by the same mechanism.

This study compared the action of PAC’s in cranberries to those in other foods such as grape and apple juice, dark chocolate and green tea. Apparently, not all PAC-rich foods have the same success or offer the same protection. By means of comparison, one eight-ounce glass of cranberry juice has the equivalent PAC’s as a cup of frozen or fresh cranberries, 1/3 cup of sweetened dried cranberries or 1/3 cup of cranberry sauce. Both this study and earlier research show that the benefits of one glass of cranberry juice kicks in about two hours after consumption and lasts for about 10 hours. So, it is recommended that you drink one glass of cranberry juice in the morning and one in the evening for the maximum protection. Remember, cranberry is a food and not a treatment. Keep in mind that anyone who suspects an infection should consult the appropriate health care practitioner.

What Can I Eat If I Am Wearing Braces?

The following substances will cause damage to the braces and should absolutely not be eaten: candy apples, caramels, hard and sticky candy, candy bars, aquarium gravel, gum balls, jaw breakers, chicklets, or other gum, popcorn, bones, nuts, ice, chips, chewable vitamins, or any other crunchy or sticky items.

Foods such as apples, carrots, celery, pretzels, French bread, bagels, waffles, and meats should be cut into small pieces and chewed with your back teeth. Keep pencils, fingernails, straws, etc. out of your mouth. Please realize that the use of sugar-containing candy, soda, gum, etc. also promotes tooth decay.

If a bracket falls off, the wire bends or anything else breaks or becomes loose, the patient needs to call right away so that an appointment may be made for the appropriate length of time (generally 30-45 minutes) that we need in order to make the repair. This is especially important even if the patient already has an appointment scheduled.

We know that loose bands, poking wires and other problems can occur with even the most careful and cooperative patients and we will work with you to accommodate your needs in every way we can.