Month: September 2014

Come On in To See the Dentist: How to Cope With Dental Anxiety

Many people have the anxiety when they see the dentist.  Fortunately, there are ways to cope with the anxiety and help you put on a smile at a dental visit.

People have dental anxiety because they are fearful of having pain.  They could be scared of the anesthetics injection and the various dental instruments which looks sharp and painful.  Or they could have bad childhood experience which haunts them even when they are adults.  Some of these discomfort associated with the dental procedures are realistic, but dentistry has progressed and dentists have various ways to minimize possible discomfort.

First of all, dentistry today is about newer and better technology and instrumentations.  Dentist can use new dental handpiece which is able to operate at a much lower noise level and also runs more smoother.  An efficient dental handpiece does not agitate the tooth as much as the older handpiece.  Also, newer handpiece can make immediate stop once the dentist takes his foot away from the foot pedal controlling the dental handpiece.  This makes the handpiece much safer because the dentist can precisely control the operation and can make emergency stop if the situation requires.  Second, new dental extraction tehcniques are about using less brute force to remove broken teeth by first separating the periodontal ligaments which attaches the tooth to the periodonteum.   Third, there are techniques in making injecting anesthetics more tolerable.  Dentist can first apply the topic anesthetics to pre-numb the injection site.  New knowledge in neural science explains that we can distract the brain from sensing the needle injection.  We can use the manual vibration of the adjacent tissue or use a special device called the Dentalvibe to apply the vibrating force.

In addition, to the above technical aspects of dentistry, patient and dentist can have effective communication so that patient will be able to have a sense of control and this help reduce the dental anxiety.  During the dental procedure, even though the patient is encouraged to sit still to help the dentist to do the dental treatment, patient can use some hand gestures to let the doctor know to temporarily stop the procedure and allow patient to communicate with the doctor.  Also, the patient can request the dentist to explain about the procedures so that the patient can have reasonable mental preparations and proper expectation as to what the next step of the procedure is going to be like.

Ways to do dentistry may have changed but good dentistry is still about providing quality care to patient in a little discomfort as possible.  If the general public can be educated about the newer ways to do dentistry, people can be more receptive of going to see the dentist for the dental care they need.  Instead of postponing necessary dental treatment and allowing the small decay to progress into large decay, people can be less anxious of seeing the dentist and have routine checkup to fix small cavities before they become too big.

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

 

 

Smoking Can Cause Oral Cancer

Smoking can cause cancer, especially lung and oral cancer.  Carcinogen, such as nicotine, in a ciagarette can accumulate within the cells in the lung and the oral cavity.  The effect can be slow and gradual.  Often, it goes undetected because the changes may not cause any symptoms.

Dentist is one of the first line health professionals who can detect any changes within the oral cavity.  This can be physical visual examination in combination of tactile palpating of the head and neck regions.  Dentist can discover if there is any abnormality in the oral-facial region.  Also dental X-ray radiograph such as panoramic radiograph can show the bone structure and the sinus airways.

If there is any abnormal changes, a further analysis such as brush biopsy and excisional biopsy can be performed.

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing Family Dentist

 

Dental Trauma and Blackened Tooth

Usually dental trauma causes no harm because teeth are resilient that it can readily recover with sufficient healing time.  However, if the trauma causes severe injury to the tooth that it affects the nerve within the tooth, the nerve will slowly die and the nerve is said to be necrotic.  The tooth won’t get the nutrient it needs.  Overly, the tooth will become darker in color because the deaden nerve causes intrinsic changes to the internal tooth structure and as the result, the tooth would lose its original luster.

This type of changes in tooth color is called intrinsic staining.  Simply external bleaching the tooth is not effective in alleviating the problem.  The deadened tooth needs root canal therapy and then dentist can use the internal bleaching technique to change the tooth color from the inside.  This internal bleaching could improve the appearance of the tooth.  However, for a more complete masking of the darkened color, dentist could put on a dental porcelain crown.

 

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.  Practicing Family Dentist

 

New Crown Replacement: Decay Under Existing Crown Margin

A typical crown can last a long time; however, there are some situations that a crown needs to be replaced by a new crown and one of the common reasons is decay.  Crown is typically placed to protect the weakened tooth.  Even though the tooth is covered by the crown, the tooth still needs to be cleaned and brushed just like any other tooth in the mouth.  If there is inadequate oral hygiene, bacteria can cause tooth decay under the existing crown.  Initially this tooth cavity goes undetected because it does not cause any symptoms.  The patient may not feel any pain until the tooth cavity has gotten bigger.

One way to prevent this from happening is to have a periodic dental checkup by a dentist.  I would periodically take xray images when patient comes in for checkup and cleaning visit.  The xray images would reveal if there is any cavity in between the teeth.  For example, the following xray image shows that the tooth #15 has a large cavity under the crown margin of an existing crown.  The crown margin is the interface between the crown and the tooth structure under the crown.  Often food can get stuck in between the tooth and decay develops at the margin of the crown.

 

Recurrent Decay under existing crown margin

Xray image shows decay under existing crown.

I recommend to patient that the tooth needs a new crown replacement.  Also I would recommend better oral hygiene and encourage patient to use dental floss to clean out food in between teeth.  I also advise periodic dental checkup and cleaning.

 

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.  Practicing General Dentist

 

Dentures Improve Appearance: Sunken Lips Problem

For edentulous individuals, dentures can improve the smiles and appearance.  Teeth has three main functions: chewing food, lip supports and speech.  Without teeth, the person cannot chew properly.  The lips will appear sunken because there is no teeth to support the lips.  For example, this lady has no upper teeth and her lips appear sunken before she wears her new dentures.

Edentulous Patient Facial view, Without Complete Dentures, Partial Dentures, Transitional Dentures, Immediate Dentures, Flippers, Denture Dental Office

Dentures help to support the lips. Without lip support, there are more wrinkles and the person appears older.

Notice her upper lips are sunken in and this causes many wrinkles to appear.

Upon examination, she has all upper teeth missing.

Upper Edentulous Patient Anterior view, Complete Dentures, Partial Dentures, Transitional Dentures, Immediate Dentures, Flippers, Denture Dental Office

Fortunately she has adequate bone.  I recommend a new set of dentures.  This is how she looks like after she wears her upper complete denture.

Complete Denture in Edentulous Mouth, Complete Dentures, Partial Dentures, Transitional Dentures, Immediate Dentures, Flippers, Denture Dental Office

With proper lip support by the upper denture, the patient appears younger.

 

The end result shows her new complete denture.  Her lips are now properly supported by her new complete denture.  The color and contour of her new denture teeth are harmonious to her face.  It looks as if the denture teeth are like her natural teeth.  Her lips now look fully and she looks younger and is able to smile.

 

 

Written by Daniel Tee, DDS, MS

Denture Dental Office in Tempe AZ —  Partial Dentures, Complete Dentures, Removable Dentures, Flippers

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.  Practicing General Dentist

 

Immediate Complete Denture

Immediate Complete Denture is a type of dentures that is given to patient to wear after the extractions are completed.  It is given immediately to patient on the same day the extractions are completed.  The fabrication process is virtually the same as the traditional complete denture.  The immediate complete denture serves three main purposes:

1.  The immediate complete denture serves as the “bandaide” for the wound where the teeth are extracted.  As soon as the teeth are extracted, the swelling and inflammation process will begin with the first 48 hours.  The immediate complete denture will hold the loose tissue in place and control the swelling process.  Dentist would recommend patient to wear the immediate complete denture for the first 48 hours continuously following the teeth extractions.  By wearing the denture immediately following the extraction, it helps to make sure that the tissue will conform to the contour and shape of the denture so that the denture will fit after the swelling subsides.  In contrary, if the immediate complete denture is not worn continuously for the first 48 hours, the tissue might have altered its contour due to the inflammation and the denture might not fit.

2.  Immediate complete denture addresses the issue of esthetics for patients who need to show their teeth and smile as part of their work or daily routines.  Immediate complete denture will allow patients to show their teeth as soon as the extractions are completed.

3.  Immediate complete denture addresses the issue of chewing food.  Following the extractions, the patient will not be able to chew.  The immediate complete denture helps restore some chewing capability of the patient.  It is understandable that the patient will be sore after the extractions.  Dentist generally recommends to chew on soft food initially.  Patient will return to the dental office for followup and adjustment of the denture as needed.

Patient will have to go through a period of time to getting adjusted to the immediate complete denture.  Throughout the healing of the tissue, patient will experience episode of swelling and then when the swelling is subsided, the immediate complete denture may become loose.  This is part of the healing process because the bone tissue will start to heal and may shrink after the extraction site is healed.  The healing process may take 4-5 months to get better.  By 4-5 months, the tissue and the bone will start to stabilize.  The dentist will then give more definite treatment to the patient.  A hard reline can be applied to the immediate denture so that the spacing caused by the bone shrinkage can be filled in with the hard reline materials.  The denture can become more adaptive to the tissue and the denture will become more retentive in the patient’s dental alveolar arches.

 

 

Written by Daniel Tee, DDS, MS

Denture Dental Office in Tempe AZ —  Partial Dentures, Complete Dentures, Removable Dentures, Flippers

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.  Practicing General Dentist

 

How Many Times A Day Should A Person Brush His/Her Own Teeth?

A person should brush his/her teeth after each meal.  Normally a person eats three meals per day: breakfast, lunch and dinner.  At minimum, one should brush three times a day.  In addition, it is recommended to brush after eating snack between each meal.  If it is not possible to brush after eating snack, it is still better to rinse with water than doing nothing at all.

Not only the timing of brushing teeth is important, the method and time duration of brushing also play an important role in dental hygiene.  There are many methods of toothbrushing.  One method I recommend to patient is to use vertical motion to brush each tooth.  Vertical movement will better clean off the plaque between two teeth.  Also make sure to brush the gum so to remove any plaque near the gum line.  Meticulous brushing is key to remove all plaque.  Make sure to brush the back teeth.   Completely brushing all teeth should take about three minutes.

Not only brushing is important.  Also I recommend to use the dental floss and mouth rinse after brushing.  Dental floss will remove any plaque/food debris left over that aren’t accessible to toothbrushes.   Also mouth rinse will help control the bacteria on teeth and within the gum pockets.

 

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.  Practicing Family Dentist

Cleft Lips and Cleft Palate

Cleft Lips and Cleft Palate is a neonatal developmental defect that causes splitting of the lips and upper palate.  It occurs in one out of 700 new born babies.  This condition is hereditary and currently our knowledge about this hereditary condition is not complete.  Luckily, the defective lips and palate can be surgically repaired with modern cosmetic surgery techniques.  The outcome of the plastic surgery depends on the severity of the defects.  If the defect only affects the lips, surgery can successfully repair the lips.  However, if the defect affects the upper palate, this can affect the child’s dental development and also may affect the speech learning.  In some rare instances, this clefting condition may affect the hearing.

To properly manage the clefting condition, a team of specialists from many medical specialties, including a dentist, will be working together to help the child.

 

Written by Daniel Tee, DDS, MS

Practicing General Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Dental Office in Tempe AZ