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?”
Kill Bill fans have been pressing for a third installment of the stylized revenge tale since Kill Bill, Volume 2 hit the theaters in 2004. Finally, filmmaker Quentin Tarantino is talking about the long-awaited Volume 3 as if it might soon become a reality. The third movie in the franchise would most likely focus on the now-grown daughter of the character played by Vivica A. Fox in the first two. Vivica recently made known that should Kill Bill, Volume 3 go into production, she thinks 24-year-old actress and singer Zendaya would be perfect for the role.
Although Zendaya is a few inches taller than Vivica, the two women have a few things in common. Besides being talented movie and television actresses who have won awards for their roles, they both have camera-ready smiles. And both Vivica and Zendaya can thank their dentists for helping their smiles be their best.
In 2016, Vivica told Dear Doctor magazine that her smile needed a boost, so she opted for dental veneers to correct gaps between her teeth—and she's very happy with them. “I love my veneers!” she exclaimed. Zendaya also had help in achieving her Hollywood-perfect smile. In 2011, early in her career on the Disney channel, she wore clear orthodontic aligners to straighten her teeth. To further perfect her smile, she visited her dentist for professional teeth whitening in 2016, inviting a film crew along to show how easy and effective in-office tooth whitening is.
But you don't have to be a celebrity to enjoy smile-enhancing dental treatments. They are great options for anyone who wants to improve the look of their smile.
Teeth whitening. If your teeth are looking yellowed, in-office whitening can make them up to 10 shades brighter in one visit! Some people prefer professional at-home whitening kits, which produce great results more gradually.
Bonding or veneers. For small chips and cracks, cosmetic bonding can cover flaws by adding layers of a tooth-colored material over the tooth. For bigger flaws, heavy discoloration or gaps between teeth as Vivica had, dental veneers may be the answer. These custom-made thin porcelain shells cover the front-facing surface of the tooth, hiding imperfections to give anyone a Hollywood smile.
Orthodontics. Crooked teeth can detract from the look of a smile. While traditional braces are an option, many people with mild to moderate alignment issues find removable clear aligners the perfect way to get the smile they desire with minimal impact on their daily activities. Clear aligners are very subtle and can be removed for eating and cleaning as well as for special occasions—or for filming scenes, as Zendaya knows.
Contact us or schedule an appointment for a consultation to see if professional teeth whitening, cosmetic bonding or veneers, orthodontics, or another dental treatment could enhance your smile. You can also learn more by reading the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “How Your Dentist Can Help You Look Younger.”
Learning you're pregnant can change your life in a heartbeat—or now two. Suddenly, what was important to you just seconds before the news takes a back seat to the reality of a new life growing within you.
But although many of your priorities will change, there's one in particular that shouldn't—taking care of your dental health. In fact, because of the hormonal changes that will begin to occur in your body, your risk of dental disease may increase during pregnancy.
Because of these hormonal variations, you may find you have increased cravings for certain foods. If that includes eating more carbohydrates (especially sugar), bacteria can begin to multiply in your mouth and make you more susceptible to tooth decay and periodontal (gum) disease.
The hormones in themselves can also increase your risk of gum disease in particular. There's even a name for a very common form of gum infection—pregnancy gingivitis—which affects around two-fifths of pregnant women. If not treated, it could aggressively spread deeper within the gums and endanger both your teeth and supporting jaw bone.
The key to minimizing both tooth decay and gum disease is to keep your mouth clean of dental plaque, a thin bacterial biofilm most responsible for these diseases. You can do this by keeping up daily brushing and flossing and maintaining regular dental cleanings and checkups. Professional dental care is especially important during pregnancy.
You may, though, have some reservations about some aspects of dental care, especially if they involve undergoing local anesthesia. But many medical organizations including the American Congress of Obstetricians and Gynecologists and the American Dental Association recommend dental treatment during pregnancy. Even procedures involving local anesthesia won't increase the risk of harm to you or your baby.
That said, though, elective dental work such as cosmetic enhancements, might be better postponed until after the baby is born. It's best to discuss with your dentist which treatments are essential and should be performed without delay, and which are not. In general, though, there's nothing to fear for you or your baby continuing your regular dental care—in fact, it's more important than ever.
If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy.”
It's a common practice among people slowly losing their teeth to have their remaining teeth removed. They find dentures to be less costly than replacing one tooth at a time or caring for those that remain. On the other hand, it's usually healthier for the mouth to preserve remaining teeth as long as possible, replacing them only as necessary.
This latter strategy has up to now been difficult and expensive to achieve. But dental implants are changing that—using these imbedded titanium metal devices with a variety of restorations, we're able to better plan and implement staged tooth replacement.
Most people associate implants with single tooth replacements of a life-like crown cemented or screwed into an abutment attached to the implant post. This can play an early role in a staged replacement plan, but at some point, multiple single-tooth implants can become quite expensive.
Implants, however, have a much broader range of use. A few strategically placed implants can support a variety of restorations, including bridges and removable or fixed dentures. Four to eight implants, for example, can secure a fixed denture replacing all teeth on a jaw, far fewer than the number needed to replace the teeth individually.
Implants may also improve the function of traditional restorations. For instance, dentures can't stop the bone loss that often results from tooth loss—in fact, they will accelerate it as they rub and irritate the bony ridges of the jaw. By contrast, implants stimulate bone growth, slowing or even stopping the process of bone loss.
In a traditional bridge, the outer crowns of the restoration are bonded to the teeth on either side of the missing tooth gap (the middle crowns fill the gap). These support teeth must be permanently altered to accommodate the crowns. But an implant-supported bridge doesn't depend on other teeth for support, thus eliminating the need to permanently alter any teeth.
More importantly, previously placed implants often become part of the next stages of tooth replacement, like building on an addition onto an existing house. All in all, including implants in your ongoing dental restoration can help you enjoy the benefits of preserving your natural teeth for much longer.
If you would like more information on dental restoration options, 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 “Replacing All Teeth but Not All at Once.”
If you're thinking about getting dental implants, you may be curious about how long it might take. The answer depends on the health of your supporting bone.
Bone is an integral part of implant functionality as bone cells gradually grow and adhere to the newly placed implant to give it its characteristic strength. The implant also requires an adequate amount of bone to accurately position it for the best appearance outcome.
If the bone is sufficient and healthy, we can proceed with the surgical placement of the implant. The most common practice following surgery is to allow a few weeks for the bone integration described previously to take place before finally attaching the crown. With an alternative known as a “tooth in one day” procedure, we install a crown right after surgery, which gives you a full smile when you leave.
There's one caveat to this latter method, though—because the implant still requires bone integration, this immediate crown is temporary. It's designed to receive no pressure from biting or chewing, which could damage the still integrating implant. We'll install the permanent crown after the implant and bone have had time to fully mesh.
So, if your supporting bone is sound, the complete implant process may only take a few weeks. But what if it's not—what if you've lost bone and don't have enough to support an implant? In that case, the length of process time depends on the severity of the bone loss and if we're able to overcome it. In some cases, we can't, which means we'll need to consider a different restoration.
But it's often possible to regenerate lost bone by grafting bone material at the implant site. If the bone loss is moderate, it may take 2 to 4 months of regrowth after grafting before we can perform implant surgery. If it's more significant or there's disease damage to the socket, it may take longer, usually 4 to 6 months. It largely depends on the rate of bone regeneration.
In a nutshell, then, the health of your jaw's supporting bone has a lot to do with whether the implant process will take a few weeks or a few months. Regardless of the time, though, you'll gain the same result—new, functional teeth and a more attractive smile.
If you would like more information on dental implant restorations, 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 “Implant Timelines for Replacing Missing Teeth.”
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