Dental Tips Blog


Hospital Dentistry

Hospital dentistry is a specialized type of sleep and sedation dentistry that provides dental services to those who cannot have dentistry in a traditional dental office setting.  Dentists who practice hospital dentistry receive additional training and education to prepare them to practice in this specialty area.

In hospital dentistry, all types of dental procedures including routine restorative procedures and more extensive oral surgeries are performed in a hospital operating room that has been equipped for dentistry.  A qualified anesthesiologist puts the patient under general anesthesia and monitors the patient while a specially trained dentist performs the necessary dental procedures.

Procedures are performed on an out patient basis.  After the dental procedures have been completed, the patient is awoken from general anesthesia and sent home after a brief recovery period.  The patient experiences no pain, discomfort, or anxiety during the procedure.

Hospital dentistry is an excellent alternative for a variety of different patients who are difficult to treat in a traditional dental office setting.  It is an excellent alternative for patients who suffer from debilitating dental phobia or anxiety and for those who are allergic to novocaine or who do not respond to novocaine.  Also, when a patient requires extensive dental work, hospital dentistry under full sedation can allow the work to be completed in a single visit.

One of the primary populations who can benefit from hospital dentistry are patients who suffer from a medical condition or physical or developmental disability that prohibits them from receiving dental care in a traditional setting.  Using full sedation under general anesthesia, a hospital sleep and sedation dentist can provide these patients excellent quality dental care without pain, discomfort, or distress.


Dentistry Under General Anesthesia

Many Americans do not get any dental care because they are unable to tolerate dental procedures performed in a traditional dental office setting.  For these people, local anesthesia such as novocaine or even mild sedation using nitrous oxide or oral medications are not sufficient for them to receive dental care.

Some patients suffer from severe dental anxiety while others are allergic to local anesthetics like novocaine.  In a few cases, novocaine is not effective.  These patients cannot get numb.   In addition, there are many patients who suffer from a medical condition, developmental disability, or physical disability that make it difficult, dangerous, or impossible for them to be treated in a traditional dental office setting.

These include Cerebral Palsy, Down’s Syndrome, Mentally Handicapped, Autism, Parkinson’s Disease, Heart Disease, physical deformities, brain stem injuries, stroke victims and other similar conditions.   This population has traditionally been underserved by dentistry which leads to poor oral health which can further complicate their condition.

Fortunately there are a growing number of dentists who have received advanced training and are qualified to provide dental care under general anesthesia.  This dental specialty is referred to as sleep and sedation dentistry and includes milder forms of sedation in addition to full sedation.  Sedation dentistry under general anesthesia is a safe and effective way to provide excellent, pain free dental care to people who would otherwise not be able to receive dental treatment.

Full sedation dentistry is performed by specially trained, highly skilled dentists like Dr. David Kurtzman, DDS, in a hospital operating room specially equipped for dentistry.  A qualified anesthesiologist and surgical nurses assist with the dental procedures.  The patient is fully sedated, feels no pain or discomfort, and has no memory of the procedure.  Sleep and sedation dentistry provides an opportunity for special needs patients to get the quality dental care they need.


Dental Care for Asberger’s Patients

Asberger’s Syndrome is a type of autism that is characterized by poorly developed social skills, obsessive or repetitive behavior, and some physical clumsiness.  People with Asberger’s can exhibit combative behavior and can suffer from increased anxiety levels.  It can be difficult for people with Asberger’s to tolerate even routine dental procedures in a traditional dental office environment.  Non-routine dental procedures are even more problematic.

An excellent alternative to traditional dental care for Asberger’s patients is sleep and sedation dentistry.   In this specialized area of dentistry, various levels of sedation are used to help the patient remain calm and relaxed during the procedure.  Sleep and sedation dentistry has proven to provide a safe, painless, and anxiety free means for Asberger’s patients to receive high quality dental care.

Dentists who practice sleep and sedation dentistry have additional training in sedation techniques.  They choose from a range of sedation levels to fit the needs of each case.  In some cases, a mild oral or intravenous sedative is administered in the dental office that places the patient in a drowsy, sleep like state.  Referred to as conscious sedation, the patient usually falls asleep during the procedure but can be awoken and can respond to questions.  The patient feels no pain or discomfort and rarely even remembers the procedure.

Other cases may require a deeper level of unconscious sedation under general anesthesia.  The procedure is performed in a hospital operating room and a qualified anesthesiologist administers the anesthesia and monitors the patient while the sleep and sedation dentist performs the dental procedures.  Full sedation is often the most safe and effective way to provide quality dental care to Asberger’s patients and others who cannot tolerate traditional dental care.


Severe Gagging Reflex

There is a small percentage of the population that avoids dental care because they suffer from a severe gagging reflex.  These patients have an uncontrollable gagging reflex that can even be caused by eating or brushing their teeth.  They cannot tolerate normal dental procedures because the involuntary gag reflex is caused by the dental instruments or even the dentist’s fingers.

These patients also often have dental anxiety because of poor previous experiences at the dentist due to their gagging reflex.  As a result, many of these patients will avoid going to the dentist.  The lack of dental care results in poor oral health that can also cause other health issues.

Fortunately, patients with a severe gagging reflex can get great dental care by visiting a dentist who specializes in sleep and sedation dentistry.  These dentists have additional training and certification in sedation techniques.  Not all dentists practice sleep and sedation dentistry.  Only a small percentage of dentists have this specialized training.

Depending on the severity of the gagging reflex and the length of the procedure, the dentist may use one or more sedation techniques.  For short procedures or very mild gagging, nitrous oxide, local anesthesia, and a numbing throat spray is often sufficient to allow the patient to complete the procedure comfortably.

For more severe cases, conscious sedation with oral or intravenous sedatives is an excellent alternative.  Conscious sedation thoroughly relaxes a patient and allows the patient to be treated in the dentist’s office easily and comfortably.  Although the patient is conscious, many patients drowse through the procedure and most have little or no memory of the treatment.

In the most severe cases, treatment under general anesthesia in a specially equipped hospital operating room is necessary.


Dental Anxiety

Many people avoid going to the dentist because of dental fear or anxiety.  In some cases, the fear and anxiety are so severe that it becomes dental phobia, a debilitating, uncontrollable reaction to even the thought of going to the dentist.

Studies report that about half the American population does not seek regular dental care.  An estimated 9 to 15% of Americans report that fear or anxiety about dentistry prevents them from getting dental care.  As a result, millions of Americans are putting their health at risk.  Poor dental care not only leads to poor oral health, but it can cause other medical problems as well.

The real tragedy of dental fear and anxiety is that it is entirely unnecessary.  No matter what the source of the anxiety, dental fear issues can be addressed by a caring dentist who specializes in sedation dentistry.  Dentists who practice sedation dentistry have received specialized training and certification in sedation techniques.

A sleep sedation dentist will use a level of sedation appropriate to the level of anxiety that the patient experiences.  For mild anxiety, a calm, soothing office environment combined with nitrous oxide and local anesthesia will usually relax a patient so that the dentistry procedure can be performed in the dental office.

For more severe anxiety, conscious sedation techniques are used to calm the patient.  These usually involve oral sedatives that leave the patient sedated, but conscious.  The patient will be so relaxed that they will sometimes sleep through the procedure and generally will not remember anything.

For the most severe cases of dental anxiety, the dental procedure is performed in a specially equipped operating room while the patient is under general anesthesia.  The patient is unconscious throughout the procedure.


Waterpik Sexy Smile Survey

With Valentine’s Day fast approaching, you may want to brush up on your oral hygiene to make a great impression on your date or significant other.  A recent survey conducted for Waterpik by Kelton Research reveals that good oral hygiene was far more important for a romantic evening than traditional mood setting techniques such as dimming the lights, romantic music, lighting candles, or wearing perfume.

According to the survey results, 59% of people surveyed said that they would be most disturbed by a partner who did not brush or floss their teeth for a week.  Only 24% of those surveyed chose chose not wearing deodorant as the most disturbing, and even fewer chose failing to comb your hair, trim your toe nails, or shaving as the most disturbing.

At the same time, the survey revealed that the flossing habits of most Americans leave a lot to be desired.  The majority of respondents gave themselves a low grade on efforts to floss daily and that they were most likely to floss just before visiting the dentist, if there was food caught in their teeth, or they had bad breath.

The bottom line of the survey was that American’s oral hygiene habits leave a lot to be desired.  Studies have shown that brushing your teeth twice a day and flossing once a day can prevent tooth decay and gum disease.  It also helps prevent bad breath and helps keep your teeth their whitest.

Combined with preventative dental services such as regular teeth cleaning, good oral hygiene habits can help you achieve a sexy smile that will last a lifetime.


Treatment of TMJ Disorder

Temporomandibular joint disorder is a complex disorder of the jaw bone, joint and the muscles and ligaments surrounding it.  Treatment for TMJ disorder begins with very conservative treatments.  Treatment is individualized for the client.  Currently, there are no recommendations on how to prevent TMJ disorder, and treatment is not the same for each person.  Whatever treatment is ordered for you, try to follow the directions as closely as possible and maintain good dental health.

If possible, try removing the stressors in your life.  After that, consult with your dentist for a thorough evaluation.

Night-time guards may be given to help re-align your bite or to keep you from grinding your teeth.  This splint will be worn to help reduce the stress on your jaw, and to reposition the joint correctly.  The splint will often times relieve the pain associated with TMJ disorder.  Splints can generally be made in your dentist’s office.

Medications may also be given to help reduce muscle spasms.  This will help correct the pain that is occurring from the disorder, and allow for further treatment to be performed.

In very severe cases, orthodontic work or other dental surgery may be performed to realign the temporomandibular joint and bite.  This is generally done after all other treatments have failed.  In most cases, this is covered by the cost of health insurances.  Surgery today is much less invasive today than it was years ago, and is often times performed in the oral surgeon’s or dentist’s office.  In other cases, a sedation dentist can performt the surgery in a hospital operationg  room while the patient is under general anesthesia.

If you have been diagnosed with TMJ disorder, or if you are having chronic jaw pain and fatigue, contact your local dentist for a complete evaluation.


About TMJ Disorder

If you have jaw pain in the morning or throughout the day, someone may have suggested to you that you have TMJ disorder.  TMJ disorder is a complex disorder of the jaw bone, joint, muscles and ligaments of the temporomandibular joint.

Symptoms of TMJ disorder include cracking or popping of the jaw when eating or opening the mouth, or pain or headaches upon rising.  Partners may complain that you are ‘grinding’ your teeth when you sleep.  Your jaw may simply feel tired or fatigued throughout the day.

To determine if you have TMJ disorder, a qualified general family care dentist will be able to screen you extensively.  He will ask you to open and close your mouth, take x-rays and perhaps even order a CT scan.  A mouth inspection will also be done to see if you have been grinding your teeth and if tooth damage has occurred.

Many things can cause TMJ disorder, including stress, anxiety, over-eating and drug use.  TMJ disorder can also be caused from a bite problem (an over or under bite) that should be corrected.  Poor posture has also been shown to cause TMJ disorder as additional stress is placed on the TMJ itself.  Fast eating and over eating have been shown to contribute to TMJ disorder.  Opening ‘too wide’ for a bite (taking bites that are just too big for you) or not fully chewing your food can also lead to TMJ disorder.  Cocaine and methamphetamine use have also been linked to TMJ disorder.  These drugs can cause tooth grinding and stress on the joint itself.

If you believe you have TMJ disorder, contact your local dentist for a complete examination and treatment.


Dental Implants

Posted in Dental Implants

If you have a missing tooth, the best treatment is a dental implant.  A dental implant is an artificial tooth that will replace your missing tooth.  This replacement will help prevent bone loss in the jaw.

The advantage of dental implants is that your smile is restored, it is easier to talk again, and eating and swallowing return to normal.  Dental implants are durable and can restore all functionality to the mouth area.  Dental implants are permanently placed.  Basically, you have a new tooth where the missing one used to be.

The first step in deciding if a dental implant is the best choice for you is to see your local dentist. The dentist will conduct a complete exam to help determine why the tooth was lost, and if there are any other teeth that are damaged.  When teeth have been lost from trauma the mouth should be examined to ensure that other teeth are safe and structurally intact.  Mandible fractures may have occurred during this time and will be screened for.  If any of these problems are noted, they will be corrected before the dental implant is done.

For teeth that have been lost because of tooth decay, a thorough examination is necessary to determine if jaw bone decay is present, or if there is gum damage or other teeth that show signs of severe decay.  If so, your dentist will want to correct these problems before beginning your tooth implant.

After the exam, your dentist will recommend the type of implant that is best for you.  To see if you are a candidate for a dental implant, contact your local dentist today.


Advantages of Composite Fillings

Dentists have been filling cavities with amalgam for over a hundred years.  Amalgam is the silver colored metal that your dentist uses to fill your cavity after he has removed all of the tooth decay.

Amalgam is made by mixing liquid mercury with powdered silver and other metals.  It forms a soft past that your dentist uses to fill the cavity in your tooth.  The amalgam then hardens in place.   Amalgam is durable, relatively inexpensive, and easy to work with although it hardens quickly which means that your dentist has to work fast once the amalgam mixture has been made.

However, amalgam has become somewhat controversial in recent years.  Some experts claim that the mercury in amalgam causes mercury poisoning, especially in children.  These experts say that a small amount of mercury leaches out of the filling and is either inhaled or ingested.

To date, there is little scientific evidence to support these claims of mercury poisoning and the American Dental Association, US Food and Drug Administration, and Center for Disease Control have all concluded that amalgam is a safe and effective substance for dental fillings for most patients.

Fortunately, there is an excellent alternative to amalgam.  Resin composites are made from a plastic material with hard fillers such quartz or silica.  Resin composites are just as strong as amalgam, but they are colored and can be made to exactly match the color of your teeth.  Also, they cure using light so your dentist has much more time to properly form the filling.  Finally, composites are glued into your teeth so they actually add support and help strengthen the tooth.

As your general family care dentist about using resin composites instead of amalgam for your next filling.

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