My Blog
By Natasha Lee DMD
August 11, 2018
Category: Oral Health
Tags: dental anxiety  
3WaystoTaketheJittersOutofDentalVisits

Dental anxiety is a common problem: it’s estimated that one in two Americans admits to some level of nervousness about seeing the dentist. On the extreme side of this statistic about 15% of the population even avoid or postpone dental care because of it. While comedy shows routinely make fun of people’s fear of the dentist, the consequences of not receiving needed dental care due to dental anxiety are no laughing matter.

Fortunately, visiting the dentist doesn’t have to be a nerve-wracking, butterflies-in-the-stomach experience. Here are 3 ways to make sure your next visit is more pleasant.

The right dentist. Dental care is more than technical—it’s also personal and relational. The most important element for reducing dental visit anxiety is a provider you’re comfortable with and that you trust. It’s especially important for high anxiety patients to find a dentist who also has compassion for how they feel and won’t judge them—instead, working with them to find just the right combination of techniques and possible medications that encourage relaxation.

Oral sedation. For many people nervous about dental visits the answer could be prescribed sedation medication taken an hour or so before their appointment. Typically a mild sedative, the dose is just enough to help them relax. It’s also often coupled with other methods like nitrous oxide or local anesthesia for a pain-free and unstressed experience.

IV sedation. For people with high levels of anxiety, it’s often beneficial to increase the level of sedation. One of the best ways to do this is with an intravenous flow of medication that will place a person in a deeper state of relaxation. Although this method requires careful vital sign monitoring during the procedure, it’s often the best way to calm patients with high anxiety so they can receive the dental care they need.

Working with your dentist, you can develop just the right mix of these and other methods for making your dental visits easier. No matter what your level of anxiety, you don’t have to avoid the dentist nor needed dental care.

If you would like more information on reducing anxiety during dental visits, 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 “IV Sedation in Dentistry.”

By Natasha Lee DMD
August 01, 2018
Category: Oral Health
Tags: gummy smile  
TheTrueCauseofYourGummySmileDeterminesHowWeTreatit

What makes a beautiful smile? The teeth, of course: bright, evenly shaped and precisely aligned with each other. But your teeth can be as perfect as can be and your smile will still appear unattractive.

The reason? Your gums show more than they should when you smile.

What's considered a gummy smile is largely a matter of perception that can vary from person to person. As a rule of thumb, though, we consider a smile “gummy” if four millimeters (mm) or more of the gums show.

Fortunately, we can minimize the gums' prominence and make your smile more attractive. But what methods we use will depend on why your gums stand out. And it's not always because of the gums themselves.

It could be your teeth didn't erupt normally during dental development. Mature crown (the visible part of the tooth) length is normally about 10 mm with a width about 75-85% of that. But an abnormal eruption could result in teeth that appear too short, which can make the gums stand out more. We can correct this with a surgical procedure called crown lengthening in which we remove excess gum tissue and, if necessary, reshape the underlying bone to expose more of the tooth crown.

Another potential cause is how far your upper lip rises when you smile. Normally the lip rises only enough to reveal about 4 mm of teeth. In some cases, though, it may rise too high and show more of the gums. We can modify lip movement in a number of ways, including Botox injections to temporarily paralyze the lip. A more permanent solution is a lip stabilization procedure. It sounds bad, but it's a fairly simple procedure to surgically reposition the muscle attachments to restrict movement.

Your gummy smile may also result from an upper jaw too long for your facial structure. We can correct this with orthognathic (“ortho” – straighten, “gnathos” – jaw) surgery. During the procedure the surgeon permanently positions the jaw further up in the skull; this will reduce the amount of teeth and gums displayed when you smile.

Discovering the true cause of your gummy smile will determine how we treat it. After a complete oral examination, we can then discuss your options to transform your smile into a more attractive one.

If you would like more information on treating gummy smiles and other cosmetic problems, 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 “Gummy Smiles.”

By Natasha Lee DMD
July 22, 2018
Category: Oral Health
Tags: oral health   gum disease  
WellHelpYouMaintainYourOralHealthAfterGumDisease

It’s been a long road back to oral health for you after periodontal (gum) disease. But after several plaque removal sessions and perhaps even surgical procedures to address deep infection, your gums have regained their healthy pink appearance.

But now you must face a hard reality: because you’ve had gum disease you’ll need to be extra vigilant with your oral hygiene to avoid another round with this destructive disease. But don’t worry—you won’t have to fight your prevention battle alone. We’ll continue to provide you care that reduces your risk of re-infection. We call that care periodontal maintenance (PM).

The heart of PM care involves regular dental visits for monitoring, cleanings and treatment when necessary. While most patients may visit their dentist at least twice a year, as a previous gum disease patient we may advise more frequent visits, especially if you’ve just finished periodontal treatment. Depending on the extent of your disease, we may begin with a visit every other week or once every two to three months. If your mouth continues to be disease-free we may suggest increasing the time between visits.

During your visit we’ll carefully examine your mouth, as well as screen you for any signs of potential oral cancer. We’re looking for both signs of re-infection or new issues with your teeth and gums. We’ll also assess the effectiveness of your oral hygiene efforts and advise you on ways you can improve.

If we find any signs of disease, we’ll then formulate a treatment plan to effectively deal with it. With frequent visits we have a better chance of discovering re-infection early—and the earlier the better to minimize any further damage. We may also need to take steps to make future PM care easier. This could include gum surgery to alter the tissues around certain teeth for easier access for examination and cleaning.

Our main focus with PM care is to look ahead: what can we do now to prevent a future bout of gum disease or at least lessen its effect? With continued monitoring and care we can drastically reduce your risk for further damage from this destructive disease.

If you would like more information on post-gum disease maintenance, 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 “Periodontal Cleanings.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

BeontheAlertforGumDiseaseWhileWearingBraces

On your way to a more attractive smile, you’ll have to deal with some inconveniences while wearing braces like avoiding certain foods or habits or dealing with possible embarrassment about your new “metal smile.” But there’s one consequence of wearing braces that could dramatically affect your dental health: the difficulty they pose for keeping your teeth clean of dental plaque.

Dental plaque is a thin film of bacteria and food particles that if allowed to build up on tooth surfaces could trigger tooth decay or periodontal (gum) disease. Brushing and flossing thoroughly every day helps prevent this buildup.

Unfortunately, metal brackets and wires can get in the way and cause you to miss areas while performing these hygiene tasks. This could cause plaque buildup in those isolated areas that could trigger an infection. And if you (or someone you love) are also a teenager, the natural adolescent surge in hormones can increase your infection risk.

If while wearing braces you notice your gums are reddened, swollen or bleeding when you brush, these are all signs of infection and the body’s inflammatory response to it. The longer the infection continues, the weaker the tissues become, causing them to gradually detach from the teeth. Along with bone deterioration (another effect of the disease), this can ultimately lead to tooth loss.

To prevent this from happening, you’ll need to be as thorough as possible with daily brushing and flossing. To help make it easier, you can use special tools like an interproximal brush that can maneuver around the braces better than a regular brush. For flossing you can use a floss threader to more readily guide floss between teeth or a water flosser that uses a pressurized stream of water rather than floss thread to remove plaque.

This extra cleaning effort while wearing braces can greatly reduce your disease risk. But you’ll still need to keep an eye out for any symptoms like swollen or bleeding gums, and see your dentist as soon as possible. If the symptoms become severe you may need your braces removed until the disease can be brought under control. The health and future vitality of your teeth and gums is what’s of primary importance.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”





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