Posts for: August, 2017

SedationCanHelpCreateaMorePositiveDentalExperienceforaChild

You may not be nervous at all about visiting the dentist. But put yourself in a child’s place — a routine dental visit could be an anxious experience for them, and even more so if it involves dental work.

Dental professionals recognize this and go to great lengths to make children’s visits as pleasant as possible. It’s common among pediatric and family dentists to see child-friendly exam rooms and a well-trained staff experienced with interacting with children.

While this helps, some children still struggle with anxiety. Dentists have one other technique that can ease a child’s nervousness: conscious sedation. This technique involves the use of pills, inhaled gas or intravenous drips to help patients relax.

Sedation is different from general anesthesia, which uses drugs to render a patient unconscious so they won’t experience pain. A sedated patient remains in a conscious but relaxed state: they can still breathe independently and, with the most moderate form of oral sedation, be able to respond to touch or verbal instructions.

Oral sedation may also be accompanied by other methods like nitrous oxide gas that also aid with physical discomfort. Many drugs used often have an amnesiac effect — the patient won’t remember details about the procedure, which could contribute to less anxiety in the future.

Typically, a child receives an oral sedative just before the procedure. Most drugs are fast-acting and leave the child’s system quickly afterward. A staff member monitors their vital signs (pulse, respirations, blood pressure, etc.) during the procedure and after in recovery. They’ll remain in recovery until their vital signs return to normal levels and then be able to go home. They should stay home the rest of the day under adult supervision, but should be alert enough the next day to return to their normal activities.

Relieving anxiety is an important tool to ensure your child receives the dental care they need. It also creates a positive experience that could encourage a young patient to continue regular dental care when they reach adulthood.

If you would like more information on conscious sedation 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.”


By Beltsville Dental Care
August 14, 2017
Category: Dental Procedures
TomHanksAbscessedToothGetsCastAway

Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.

“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”

That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.

Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!

The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.

If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”


TheTimelyUseofaPalatalExpanderCouldHelpCorrectaCross-Bite

While crooked teeth are usually responsible for a malocclusion (poor bite), the root cause could go deeper: a malformed maxilla, a composite structure composed of the upper jaw and palate. If that’s the case, it will take more than braces to correct the bite.

The maxilla actually begins as two bones that fit together along a center line in the roof of the mouth called the midline suture, running back to front in the mouth. The suture remains open in young children to allow for jaw growth, but eventually fuses during adolescence.

Problems arise, though, when these bones don’t fully develop. This can cause the jaw to become too narrow and lead to crowding among the erupting teeth and a compromised airway that can lead to obstructive sleep apnea. This can create a cross-bite where the upper back teeth bite inside their lower counterparts, the opposite of normal.

We can remedy this by stimulating more bone growth along the midline suture before it fuses, resulting in a wider maxilla. We do this by installing a palatal expander, an appliance that incrementally widens the suture to encourage bone formation in the gap, which over time will widen the jaw.

An expander is a metal device with “legs” extending out on both sides and whose ends fit along the inside of the teeth. A gear mechanism in the center extends the legs to push against the teeth on both sides of the jaw. Each day the patient or caregiver uses a key to give the gear a quarter turn to extend the legs a little more and widen the suture gap. We remove the expander once the jaw widens to the appropriate distance.

A palatal expander is an effective, cost-efficient way to improve a bite caused by a narrow jaw, but only if attempted before the bones fuse. Widening the jaw after fusion requires surgery to separate the bones — a much more involved and expensive process.

To make sure your child is on the right track with their bite be sure to see an orthodontist for an evaluation around age 6. Doing so will make it easier to intervene at the proper time with treatments like a palatal expander, and perhaps correct bite problems before they become more expensive to treat.

If you would like more information on treating malocclusions, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”