Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.
But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.
As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.
Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.
Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.
Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.
The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.
But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.
If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?”
A scoop of ice cream is one of life's little pleasures. But for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.
A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.
This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.
This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.
Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.
If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.
If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
Knowing what to do—and what not to do—when your child is sick can greatly affect their health and well-being. That's especially true with dental problems.
Here then are some Dos and Don'ts for 3 common problems children experience with their teeth and gums.
Teething. An infant's first teeth breaking through the gums is a normal but often unpleasant experience. Fortunately, teething episodes only last a few days. And, there's usually no need to see the dentist unless they have a fever or diarrhea while teething. In the meantime:
- Do: provide them chilled (not frozen) cloth or plastic items to bite and gnaw, and massage their gums to relieve painful pressure. You can also give them an age-appropriate dose of a mild pain reliever.
- Don't: rub any medication on their gums, which can irritate them and other soft tissues. Never use alcohol or aspirin to alleviate teething discomfort. And avoid using anything with benzocaine, a numbing agent which can be hazardous to young children.
Toothache. Whether a momentary sensitivity to hot or cold or a sharp, throbbing pain, a child's toothache often signals tooth decay, a bacterial disease which could eventually lead to tooth loss.
- Do: make a dental appointment at your child's first complaint of a toothache. Ease the pain with a warm-water rinse, a cold compress to the outside of the jaw, or a mild pain reliever.
- Don't: rub medication on the teeth or gums (for similar reasons as with teething). Don't apply ice or heat directly to the affected tooth or gums, which can burn them.
Bleeding gums. Gum bleeding from normal brushing or flossing, along with red or swollen gums, may indicate periodontal (gum) disease. Although rare in children, it can still happen—and it can put an affected tooth in danger.
- Do: see your dentist if bleeding continues for a few days. Continue to brush gently with a soft-bristled toothbrush around the gums to remove plaque, a thin-biofilm most responsible for gum infection.
- Don't: brush aggressively or more than twice a day, which could unnecessarily irritate and damage the gums. And don't stop brushing—it's important to remove plaque buildup daily to lessen the gum infection.
Love at first sight—it's an endearing notion found in movies and novels, but perhaps we're a little skeptical about it happening in real life. Then again, maybe it does once in a blue moon. According to supermodel Gisele Bündchen, something definitely happened the first time she met pro quarterback Tom Brady in 2006. And it all began when he smiled.
“The moment I saw him, he smiled and I was like, 'That is the most beautiful, charismatic smile I've ever seen!'” Bündchen said in an article for Vogue magazine. That was all it took. After a three-year romance, they married in 2009 and have been happily so ever since.
Both Brady and Bündchen have great smiles. But they also know even the most naturally attractive smile occasionally needs a little help. Here are three things our happy couple have done to keep their smiles beautiful—and you could do the same.
Teeth whitening. Bündchen is a big proponent of brightening your smile, even endorsing a line of whitening products at one point. And for good reason: This relatively inexpensive and non-invasive procedure can turn a dull, lackluster smile into a dazzling head-turner. A professional whitening can give you the safest, longest-lasting results. We can also fine-tune the whitening solution to give you just the level of brightness you want.
Teeth straightening. When Bündchen noticed one of her teeth out of normal alignment, she underwent orthodontic treatment to straighten her smile. Rather than traditional braces, she opted for clear aligners, removable trays made of translucent plastic. Effective on many types of orthodontic problems, clear aligners can straighten teeth while hardly being noticed by anyone else.
Smile repair. Brady is a frequent client of cosmetic dentistry, sometimes due to his day job. During 2015's Super Bowl XLIX against the Seattle Seahawks, Brady chipped a tooth, ironically from “head-butting” his Patriots teammate Brandon LaFell after the latter caught a touchdown pass. Fortunately, he's had this and other defects repaired—and so can you. We can restore teeth as good as new with composite resin bonding, veneers or crowns.
This superstar couple, known for their advocacy of all things healthy, would also tell you a beautiful smile is a healthy one. You can help maintain your smile's attractiveness with daily brushing and flossing to lower the risk of staining and dental disease, regular dental visits, and “tooth-friendly” eating habits.
And when your teeth need a little extra TLC, see us for a full evaluation. You may not be in the spotlight like this celebrity couple, but you can still have a beautiful smile just like theirs.
If you would like more information on ways to enhance your smile, please contact us or schedule a consultation.
If you live an average lifespan, you'll spend more than 200,000 hours in blissful slumber. It's not a waste, though: You absolutely need this much sleep to maintain optimum physical and mental health. That's why the National Sleep Foundation recognizes each March as Sleep Awareness Month to highlight the obstacles to a good night's sleep. One such obstacle is obstructive sleep apnea (OSA)—and if you have it, we may be able to help you reduce the harm it may be causing you.
OSA is the blockage of the airway during sleep, usually when the tongue relaxes against the back of the throat. As the oxygen level falls, the brain arouses the sleeper to restore airflow. This only takes a few seconds before the person slips back into sleep, but it can occur several times an hour.
As this scenario repeats itself night after night, the person becomes deprived of the deeper stages of sleep they need to stay healthy. The long-term effect can even be life-threatening: Besides chronic fatigue and “brain fog,” there's also an increased risk of high blood pressure, disease or other serious health conditions.
But there are ways to reduce chronic OSA, the most common being a therapy known as continuous positive airway pressure (CPAP). A CPAP machine, prescribed by a medical doctor, consists of a small pump that streams pressurized air into the mouth through a hose and facemask; the increased air pressure in the mouth helps keep the airway open. It's a proven method, but not always a favorite with some patients who find it uncomfortable and restrictive to wear every night.
If you're in that camp regarding CPAP therapy, an alternative may be possible: oral appliance therapy (OAT), which dentists can provide. Worn in the mouth during sleep, this custom-fitted mouthguard-like appliance repositions the tongue so that it doesn't block the airway. There is a variety of mechanisms, but most involve a hinge that positions the lower jaw forward, which in turn pulls the tongue away from the back of the throat.
These less invasive OAT devices may be an alternative to CPAP therapy for people who have mild to moderate OSA and find CPAP machines difficult to use. If you've been diagnosed with OSA and CPAP therapy hasn't been a good fit for you, speak with us about an OAT device. It could help you overcome this common disorder and get the deep sleep you need for a healthy mind and body.
If you would like more information about a dental approach to obstructive sleep apnea, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
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