Doc, Is It Going To Hurt? (Part 2)

Last week, we talked about different technologies that help minimize, even eliminate, dental pain. We discussed the wand, a comfort injection machine, and topical anesthetics that are strong enough to make patients sufficiently numb. This week, we will discuss soft tissue lasers and our new E4D machine.

The use of soft tissue lasers in dentistry has revolutionized the way we practice dentistry. Soft tissue lasers can completely sterilize any area of the mouth.  We use it before and after invasive dental procedures to prevent infections, such as bacterimia (infections caused by bacteria in the blood).

We can desensitize teeth, desensitize and kill cold sores, and remove hemangiomas (a growth of endothelial cells on your lip). We can also relieve muscle pulls in the mouth that cause gum recession and teeth to shift, remove infected tissue surrounding wisdom teeth, treat gum disease, and even promote bone re-generation. Before the laser, we were either unable to treat some of these conditions or the condition would require the use of a scalpel and stitches, which may cause more discomfort.

The E4D is an in office cad-cam crown milling machine that has made the dental appointment more pleasant and convenient. In the past, patients who needed a crown would require two visits about two weeks apart. During the first visit, the tooth is prepared and the patient leaves with a temporary crown. On the second visit, the permanent crown has arrived from the laboratory and is inserted, which sometimes requires an injection. The E4D eliminates the need for a second appointment to insert a crown. Now, in under 1 ½ hours, we can mill and insert a crown the same day! This eliminates the need for any additional appointments, eliminates the possibility of the lab work getting lost or broken in transit, and eliminates the chances of the temporary crown falling off.  

These are two relatively new technologies I have implemented in Roselle Park Dental. If you have any questions, please contact me! Stay tuned next week for the last part of this topic.

Doc, is it going to hurt??

Question:  What's new in the world of dentistry to prevent or mitigate dental pain?

Everyday my patients tell me “it's not you doc, but I hate the dentist!”  When I ask my patients why they hate the dentist, they say, “because of the drill sound, the needle and THE PAIN!!!!”

The truth is, dentists don’t like causing their patients pain as much as patients don't like being in pain. I have heard the horror stories of the dentist who wouldn’t stop drilling even though the patient told him it hurt. Believe it or not, this is so extremely rare that it is only talked about because it happens so infrequently.

Technological advances have done a lot to prevent patients from feeling dental pain. This includes using a comfort injection machine (called the wand), super strong topical anesthetic, septocaine instead of novocaine, noise cancelling headphones, a soft tissue laser instead of a scalpel, a Cad-Cam (computerized) machine to make single day crown appointments, nitrous oxide, and oral sedation.

Let's talk about a few of the technological advances today, and I will continue with the others next week. The wand can comfortably numb a single tooth anywhere in the mouth without causing the cheek to feel numb. It is a remarkable machine and works about 60% of the time. When asked, most patients say “I don’t know what you did but I didn’t feel anything.”  I have performed crowns, extractions, fillings and even root canals with only using the Wand for anesthetic.

Septocaine is a super strong local anesthetic that ensures that most people are profoundly numb.  Instead of using multiple shots of lidocaine (what most poeple think is novocaine) septocaine can be used to achieve the same level of numbness.

Topical anesthetics (the gel we use before the needle) have come a long way.  We have found that due to the strength of these new topicals, a lot of times we can just use the gel instead of the needle.  We can perform some procedures with just our super strong topical, such as gum infection therapy, some fillings, and some soft tissue procedures. (More to come on soft tissue laser procedures next week).

Disclaimer: In my clinical experience, about one out of 500 people have a predisposition that makes it extremely difficult to get them numb.   If you are one of the unlucky ones, longer appointments (allows for anesthesia to work), nitrous oxide and oral sedation may be better options for you.

Why Do I Get Cavities Even Though I Brush and Floss Everyday?

I hear the question, "Why do I get cavities even though I brush and floss everyday?" all the time. Here's the skinny:

SIMPLE ANSWER:  The acidity of foods. The foods and drinks we consume have different levels of acidity. These foods/drinks include sugary sport drinks, soda, bananas, candy, and even certain bottled waters. Almost everything besides purified tap water contains enough acidity to be a potential threat.


THE SOLUTION:
The only true solution is prevention and education. Brushing and flossing are instrumental in the quest to fight cavities and gum disease.  They are the mechanical means to remove plaque from our teeth.  If done thoroughly and properly, one can significantly reduce the likelihood of getting a cavity and gum inflammation. Prevention also includes the use of fluoride and getting the hard to clean parts of the teeth sealed off with resin-based sealants (done by your dentist). 

If you are diligent about your brushing and flossing, then pat yourself on the back and keep up the good work. If you are not, please consider changing your habits. If you are on the go and can't get to a toothbrush you can swish some water in your mouth to dilute the more acidic foods. At Roselle Park Dental, we take pride in knowing that our patients leave our office with a better understanding of preventive measures.

TIP OF THE DAY: Read the labels on your food/drink!  If there are more ingredients on the label than you have fingers DON'T consume it.

Answer to Your Common Dental Questions

I often get asked questions about the best course of treatment to fix a broken or missing tooth. Dental terms can be confusing, so I've explained a few of them and offered the pros and cons of each item.

1. Implants- Made of the same titanium that are in joint replacements.  Can be used to retain dentures (instead of glue) or to replace 1 or all the teeth in the mouth.  Implants last the longest and should be used where indicated, as they are the preferred method to replace missing teeth.

2a. Bridge- Cuts down teeth adjacent to replace missing teeth and glues into the mouth.  A bridge stays in the mouth and can replace 1 or all missing teeth, but that depends on how many healthy teeth are present. A bridge consists of at least 3 crowns.

2b. Crown (aka a "cap")-  Restores broken down, decayed or fractured teeth in order for them to function properly. Can also be used for aesthetic reasons.

3. Denture (aka a "plate")- Replaces all teeth. It can be aesthetic but the jawbone underneath the denture remodels, affecting the fit and comfort of the denture. Implants should be used as indicated to preserve bone and provide a more comfortable, tighter fit.

4. Partial (aka a "plate")- Replaces some missing teeth. Partials should be only be used when implants or  bridges are not possible.  The only benefit is cost.

I hope this has helped you understand some dental terms and highlight the benefits of each procedure. The above post reflects my personal opinion, and it is always best to consult your dentist when deciding which course of dental treatment is best for you.