Sedation Dentistry For Children
Children that are nervous for their dental procedure can have nitrous oxide sedation. The child breathes the completely safe gas through a nosepiece throughout the procedure. The gas helps to calm the child making the dental appointment less stressful. The gas is out of the child’s system by the end of the appointment.
When decay in your child’s tooth penetrates the enamel, and then the next layer, the dentin, it quickly approaches the innermost part of the tooth, the pulp. At this point, when the decay is close to or has barely penetrated the pulp, the nerve is still alive, but it is compromised. If left untreated, the decay will penetrate and spread throughout the nerve tissue in the pulp, which will lead to discomfort.
A pulpotomy is the surgical removal of irritated, inflamed nerve tissue (also called pulp) from within the crown portion of a primary (baby) tooth. The healthy nerve canals are left intact.
Primary teeth make space in the mouth for permanent teeth and can help children develop clear speech. Further, unhealthy primary teeth can spread bacteria to the unhealthy permanent teeth underneath.
Most pediatric dental procedures are able to be done in our office. However, if the child needs extensive work or is extremely anxious, you may be referred to a pediatric dentist.
A dental extraction is the removal of a tooth from the mouth. There are many reasons to remove teeth:
severe tooth decay, infected teeth, or necrotic (dead) teeth
severe gum disease or periodontal disease
in preparation for orthodontic treatment (braces)
teeth which cannot be restored endodontically (root canal treatment)
teeth involved with jaw fractures
teeth involved with pathologic lesions (i.e. cyst, tumor, etc.)
supernumerary, supplemental, or malformed teeth
teeth detrimental to the fit or appearance of dentures
receiving radiation to the head or neck may require extraction of teeth in the field of radiation
reduced cost compared to other treatments
Types of Extractions
Simple extractions are performed on teeth that are visible in the mouth. Usually the tooth is intact and has enough tooth structure above the gum to remove by loosening. Typically the tooth is loosened and lifted using an instrument called an elevator. Then dental forceps can be placed on the tooth to rock the tooth back and forth. This pressure put on the tooth separates or breaks the ligament that holds the tooth in the supporting bone. The bone that holds in the tooth is also made wider in order to make the tooth loose enough to remove. Contrary to popular belief, teeth are not “pulled”. Rather, teeth are removed by carefully and systematically applying controlled force and pressure in different directions until the tooth is removed.
Surgical extractions involve the removal of a tooth that is compromised or not fully visible. Teeth that have to be surgically extracted are usually broken, severely decayed, or have not fully erupted. Surgical extractions sometimes require an incision. The Dr. may move the gum tissues covering the tooth and may also remove some of the overlying and/or surrounding jawbone tissue with a drill. Sometimes a tooth is intentionally split into multiple pieces to facilitate easier removal and decrease the amount of pressure put on the jaw.
Root tip extractions are a subset of surgical extractions. Root tip extractions usually involve removal of teeth that have broken to or below the gum line. Sometimes if a tooth breaks on its own, there may be pieces of the root left behind that need to be removed. Incisions and removal of surrounding jaw bone are more frequently necessary with root tip extractions as compared to surgical extractions.
*Some extractions are performed at Zent Family Dentistry and others are referred to an oral surgeon. This depends on the individual tooth that needs to be removed.
Missing a tooth or teeth can be a daily embarrassment. It can also cause difficult in chewing or speaking. Bridges can help restore your smile.
Sometimes called a fixed partial denture, a bridge replaces missing teeth with artificial teeth and literally “bridges” the gap where one or more teeth used to be. This is done by preparing the teeth immediately behind and in front of the open space for crowns. Then the lab creates the bridge which is a single prosthesis consisting of an anchor tooth on each side of the open space and a “dummy” tooth or teeth in between to span the gap. Bridges can be made from gold, alloys, porcelain or a combination of these materials and are attached to surrounding teeth for support. Unlike a partial or denture, which you can take out and clean, a bridge is cemented in place.
Dental implants are a popular and effective way to replace missing teeth and are designed to blend in with your other teeth. They are an excellent long-term option for restoring your smile. In fact, the development and use of implants is one of the biggest advances in dentistry in the past 40 years.
Normally, each missing tooth should receive an implant. But in some cases, the dentist may not want to put an implant in a certain place in your mouth. There may not be enough jawbone to support an implant, or the location may be too close to a nerve or sinus cavity (located above your upper teeth). In that case, your dentist can avoid the area by placing implants on both sides of the space. An implant-supported fixed bridge will be placed on top. An implant-supported bridge also can be made similar to a traditional bridge, with a crown suspended between two implant-supported crowns.
The All-On-4 treatment concept is a joint surgical and restorative treatment that provides a full-mouth reconstruction for the edentulous patient – often in just one day. In this treatment, usually 4 dental implants are placed in the bone of the upper arch, lower arch, or both arches. Next a denture or full-arch zirconia bridge is screwed into the implants. This gives the patient a natural-looking smile that is non-removable allowing the patient to eat as if they had all their teeth and all of this in possibly just one day!
Dentures are removable appliances that can replace missing teeth and help restore your smile. If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, replacing missing teeth will benefit your appearance and your health. That’s because dentures make it easier to eat and speak better than you could without teeth—things that people often take for granted.
When you lose all of your teeth, facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to closely resemble your natural teeth so that your appearance does not change much. Dentures may even improve the look of your smile.
Types of dentures:
Conventional. This full removable denture is made and placed in your mouth after the remaining teeth are removed and tissues have healed, which may take several months.
Immediate. This removable denture is inserted on the same day that the remaining teeth are removed. Your dentist will take measurements and make models of your jaw during a preliminary visit. You don’t have to be without teeth during the healing period, but may need to have the denture relined or remade after your jaw has healed.
Overdenture. Sometimes some of your teeth can be saved to preserve your jawbone and provide stability and support for the denture. An overdenture fits over a small number of remaining natural teeth after they have been prepared by your dentist. Implants can serve the same function, too.
Screw Retained Denture. If someone without teeth chooses to have a few implants placed, the denture can actually screw into the implants. This would make the denture a fixed denture and only the dentist can unscrew and remove the denture. See the All-On-Four Dentures and Bridges section.
New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place. It is not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should go away. Follow-up appointments with the dentist are generally needed after a denture is inserted so the fit can be checked and adjusted. If any problem persists, particularly irritation or soreness, be sure to consult your dentist.
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases. Depending on your needs, your dentist will design a partial denture for you. A partial denture may have a metal framework and clasps that connect to your teeth, or they can have other connectors that are more natural looking. In some cases, a removable partial denture is made to attach to your natural teeth with devices called precision attachments. Precision attachments are generally more esthetic than clasps.
Crowns on your natural teeth are sometimes needed to improve the fit of a removable partial denture and they are usually required with attachments. Partial dentures with precision attachments generally cost more than those with clasps. Consult with your dentist to find out which type is right for you.
What to expect:
In the beginning, your new partial denture may feel awkward or bulky. This is normal, and you will eventually become accustomed to wearing it. Inserting and removing the partial denture will require some practice.
Follow all instructions given by your dentist. Your denture should fit into place with relative ease. Never force the partial denture into position by biting down. This could bend or break the clasps. Your dentist will give you specific instruction about how long the denture should be worn and when it should be removed.
Initially, you may be asked to wear your partial denture all the time. Although this may be uncomfortable at first, it's the quickest way to identify areas that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your dentist will adjust the partial denture to fit more comfortably. After making adjustments, your dentist will probably recommend that you take the partial denture out of your mouth before going to bed and replace it in the morning.
Eating should become a more pleasant experience with dentures. Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on both sides. Avoid foods that are extremely sticky or hard. You may want to avoid chewing gum during the adjustment period.
Partial denture can also help improve your speech. If you find it difficult to pronounce certain words, practice reading out loud. Repeat the words that give you trouble. With time, you will become accustomed to speaking properly with your partial denture.
Even if you wear full dentures, you still have to practice good dental hygiene. Brush your gums, tongue and roof of your mouth every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque. Like your teeth, your dentures should be brushed daily to remove food particles and plaque. Brushing also can help keep the teeth from staining.
Rinse your dentures before brushing to remove any loose food or debris. Avoid using a brush with hard bristles, which can damage the denture. Use a soft bristle toothbrush and a non-abrasive cleanser to gently brush all the surfaces of the dentures so they don't get scratched.
Clean your dentures by thoroughly rinsing off loose food particles. Moisten the brush and apply the denture cleaner. Brush all denture surfaces gently to avoid damaging the plastic or bending the attachments.
When cleaning a denture, it’s a good idea to stand over a folded towel or a sink of water just in case you accidentally drop the denture.
Do not use toothpaste since it can be too harsh for cleaning dentures. Some people use hand soap or mild dishwashing liquid to clean their dentures, which are both acceptable. However, most household cleaners are too abrasive and should not be used for cleaning dentures.
When brushing, clean your mouth thoroughly—including your gums, cheeks, roof of your mouth and tongue to remove any plaque. This can help reduce the risk of oral irritation and bad breath.
When you’re not wearing your dentures, put them in a safe place covered in water to keep them from warping. Occasionally, denture wearers may use adhesives. Adhesives come in many forms: creams, powders, pads/wafers, strips or liquids. If you use one of these products, read the instructions, and use them exactly as directed. Your dentist can recommend appropriate cleansers and adhesives; look for products with the ADA Seal of Acceptance. Products with the ADA Seal have been evaluated for safety and effectiveness.
A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. Your dentist can recommend the proper method for keeping your dentures in good shape. Don’t chew, swallow, or gargle with denture cleansers. Always thoroughly rinse the denture before placing it in your mouth.
If you have any questions about your dentures, or if they stop fitting well or become damaged, contact your dentist. Be sure to schedule regular dental checkups, too. The dentist will examine your mouth to see if your dentures continue to fit properly.
Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a poorly fitting denture.
Dentures that do not fit properly should be adjusted by your dentist. Poorly fitting dentures can cause various problems, including sores or infections. See your dentist promptly if your denture becomes loose, and maintain your regular visits, too. You may need to have your partial denture or full denture relined by a laboratory. Your dentist will usually take an impression with your current denture first and then send that to the lab. Many times the lab can have your denture relined the same day.
Remember: You can do serious harm to your denture and to your health by trying to adjust or repair your denture. Using a do-it-yourself kit can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture. If your denture breaks, cracks or chips, or if one of the teeth becomes loose, call your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.