Understanding Dental Anxiety and Fear

The overwhelming fear of dental appointments can be a common cause of anxiety.  Many people visualize a drill-wielding man in a white coat just waiting to cause pain and remove teeth.  The reality, however, is very different.  The comfort, relaxation, and happiness of the patient are the primary focus of any good dental practice.  The staff at the practice will do whatever they can to reduce anxiety, allay fears, and provide painless, quick treatments.

Recent technological advancements have meant that in many cases, dentists are able to replace noisy drills with painless laser beams.  There are also a wide variety of safe anesthetics available to eliminate pain and reduce anxiety during routine appointments.

Here is a List of Some of the Most Common Dental Fears:

How Can You Overcome Dental Anxiety?

Dental anxiety and fear can become completely overwhelming.  It is estimated that as many as 35 million people do not visit the dental office at all because they are too afraid.  Receiving regular dental check-ups and cleanings is incredibly important.  Having regular routine check-ups is the easiest way to maintain excellent oral hygiene and reduce the need for more complex treatments.

Here are Some Tips to Help Reduce Dental Fear and Anxiety:

Talk to us – Though it can be hard to talk about irrational fears with a stranger, we can take extra precautions during visits if fears and anxiety are communicated.

Bring a portable music player – Music acts as a relaxant and also drowns out any fear-producing noises.  Listening to calming music throughout the appointment will help to reduce anxiety.

Agree on a signal – Many people are afraid that the dentist will not know they are in significant pain during the appointment and will continue with the procedure regardless.  The best way to solve this problem is to agree on a “stop” hand signal.  Both parties can easily understand signals like raising the hand or tapping on the chair.

Spray the throat – Throat sprays (for example, Vicks® Chloraseptic® Throat Spray) can actually control the gag reflex.  Two or three sprays will usually keep the reflex under control for about an hour.

Take a mirror – Not being able to see what is happening can increase anxiety and make the imagination run wild. Watching the procedure can help keep reality at the forefront of the mind.

Sedation – If there is no other way to cope, sedation offers an excellent option for many people.  There are several types of sedation, but the general premise behind them is the same: the patient regains their faculties after treatment is complete.

Ask about alternatives – Advances in technology mean that dental microsurgery is now an option. Lasers can be used to prepare teeth for fillings, whiten teeth, and remove staining.  Discuss all the options with us and decide on one that is effective and produces minimal anxiety.

If you struggle with dental anxiety or fear, we can help. Richland Smiles is dedicated to helping patients get the care they need, while working with any concerns you have. We’ll work together to create a plan that works for you. Call our Richland, WA / Tri-Cities dental office today for an appointment.

General dentistry encompasses a broad range of diseases and disorders of the oral and maxillofacial region. Everyone should see a general dentist for routine oral health examinations, twice-yearly cleanings, and treatment of routine oral health complications, such as minor tooth decay. General dentistry is as much about prevention as it is about treatment. Patients who visit a general dentist can expect professional oral health care, as well as education and advisement about self-care between office visits.

Did you know…

that the American Dental Association recommends that every American visit a general dentist a minimum of one time every six months? Doing so can aid in the detection of decay, oral disease and other dental health problems before the progress and become severe. If you are at risk for certain complications or have a history or periodontal disease and advanced decay, you may need to visit your general dentist on a more frequent basis. Patients who visit their dentist regularly and as recommended are more likely to retain their natural teeth and enjoy a lifetime of good oral health.

Frequently Asked Questions

Do I need to visit a general dentist?

Yes. Even if you are not currently experiencing any symptoms of tooth decay or gum disease, it is important to visit your dentist for a thorough examination and cleaning. Despite daily brushing and flossing, your teeth can still accumulate tartar that can harbor bacteria. These bacteria can lead to gum disease and tooth decay if not professionally removed at your dentist’s office.

What should I expect during my dentist visit?

Your visit will begin with a general inspection of the condition of your teeth. If you have not been to the dentist in a while, your dentist may order x-rays. An oral hygienist will then use special metal instruments to gently scrape away tartar along your gum line. Later, your dentist will review your x-rays and discuss any symptoms you may have been experiencing. He or she will then make a recommendation for treatment (if applicable) and answer any questions you may have.

Are there any special instructions I need to follow after seeing my dentist?

Based on the results of your dental check-up, your general dentist may recommend that you return for treatment or follow a special at-home oral care plan. You may also be referred to a dental specialist for treatment of advanced oral health conditions.

The term “periodontics” refers to the dental specialty that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone.  The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place.  Periodontists have completed several years of extra dental training and are concerned with maintaining the function, health and aesthetics of the jawbone and tissues.

Reasons for periodontal treatment

Periodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis.  It is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously.  Periodontal disease (often called gum disease) is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.

Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful.  Eventually, this infection will cause the jawbone to recede and the tooth to become loose.

There are several reasons why periodontal treatment may be necessary:

In the case of mild/moderate periodontal problems, the focus of the periodontist will be on curing the underlying bacterial infection and then providing advice on the most appropriate home cleaning methods.

Sometimes a deep scaling is needed to remove the bacterial plaque and calculus (tartar) from the teeth and tissues.  Where periodontal disease is advanced and the jawbone has regressed significantly, more intensive cleaning may be recommended and loose teeth that cannot be saved will be removed.

The periodontist is trained in all aspects of dental implant procedures, which can restore functionality to the mouth when teeth have been affected by periodontitis.

Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection.  Your dentist will be happy to advise you on effective cleaning methods and treatment options.

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Periodontal disease is the leading cause of bone loss in the oral cavity, though there are others such as ill-fitting dentures and facial trauma.  The bone grafting procedure is an excellent way to replace lost bone tissue and encourage natural bone growth.  Bone grafting is a versatile and predictable procedure which fulfills a wide variety of functions.

A bone graft may be required to create a stable base for dental implant placement, to halt the progression of gum disease, or to make the smile appear more aesthetically pleasing.

There are several types of dental bone grafts.  The following are the most common:

Reasons for bone grafting

There are a wide variety of reasons why bone grafting may be the best option for restoring the jaw bone.

Dental implants – Implants are the preferred replacement method for missing teeth because they restore full functionality to the mouth; however, implants need to be firmly anchored to the jawbone to be effective.  If the jawbone lacks the necessary quality or quantity of bone, bone grafting can strengthen and thicken the implant site.

Sinus lift – A sinus lift entails elevating the sinus membrane and grafting bone onto the sinus floor so that implants can be securely placed.

Ridge augmentation – Ridges in the bone can occur due to trauma, injury, birth defects, or severe periodontal disease.  The bone graft is used to fill in the ridge and make the jawbone a uniform shape.

Nerve repositioning – If the inferior alveolar nerve requires movement to allow for the placement of implants, a bone grafting procedure may be required.  The inferior alveolar nerve allows feeling and sensation in the lower chin and lip.

What does bone grafting treatment involve?

Bone grafting is a fairly simple procedure that can be performed under local anesthetic; however, if large amounts of bone area need to be grafted, general anesthetic may be required.

Initially, the grafting material needs to either be harvested or prepared for insertion.  A small incision is made in the gum tissue and then gently separated from the bone.  The bone grafting material is then placed at the affected site.

The bone regeneration process may be aided by:

The gum is sutured in place and a follow-up appointment will need to be made within 10 days to assess progress.  Bone grafting is a highly successful treatment and a good base for further periodontal restorations.

The field of orthodontics is most commonly associated with treatment for pre-teens and teenagers, but an increasing amount of adults are choosing to correct jaw irregularities (malocclusions) and misaligned teeth with orthodontics. It is now estimated that approximately one third of all orthodontic patients are adults. The major advantage of treating irregularities at a young age is that orthodontic appliances are widely accepted in youth and ideal alignment can be achieved before adulthood. Most orthodontists agree, however, that it is never too late to get braces.

Aside from the pleasing aesthetic of a beautifully straight smile, correcting malocclusion and teeth misalignment with braces is beneficial for a number of other reasons:

Reduced Tooth Decay – Misaligned teeth can make maintaining adequate oral hygiene incredibly difficult. Hard-to-reach spaces can become breeding grounds for the oral bacteria that cause tooth decay.

Reduced Wear and Tear – Chewing capability is impacted by malocclusion. Improper alignment means that as food is chewed, force is not evenly distributed. This can lead to flattened teeth and lopsided wear and tear on dental enamel.

Relief of Jaw Pain – Not only does a comfortable bite distribute pressure evenly across teeth, it can also create smooth, pain-free dental function. Patients with malocclusion experience jaw joint disorders (TMJ dysfunction) that create clicking, popping, and discomfort when opening and closing the mouth.

What Types of Misalignment Require Braces?

An oral health professional can successfully treat jaw irregularities and teeth alignment issues with orthodontic braces. Here is a brief overview of the most common types of issues and alignment irregularities that require braces:

Overbite – An overbite occurs when the maxilla (upper jaw) protrudes further than the mandible (lower jaw). This condition can give the chin a sunken appearance and make the smile look toothier than normal.

Underbite – An underbite occurs when the mandible protrudes further than the maxilla. This condition may be the result of growth irregularities and can make the chin look overly large.

Overcrowding – Overcrowding occurs when there is insufficient room for the adult teeth to erupt and align. In some cases, a tooth or several teeth may need to be extracted to provide room on the arch for proper alignment.

What Kind Of Braces Will I Need?

Dental braces tend to fall into two major categories: fixed and removable. Before recommending a specific course of treatment, your dental professional will visually examine your mouth, take x-rays and form bite impressions. Once a firm diagnosis has been made, a discussion regarding treatment options can take place to determine the quickest and best procedure.

Here is a brief overview of some common types of braces:

Fixed Dental Braces – These dental braces have two major components: brackets and an archwire. A metal, clear or ceramic bracket is glued to each tooth and an archwire is used to link them. During adjustment appointments, the orthodontist will gently tighten or replace wires to train the teeth into the desired position.

Lingual Braces – These braces are fixed yet invisible because they are fitted behind the teeth. Lingual braces are effective for straightening teeth, but on occasion cause minor speech problems and tongue discomforts due to their positioning.

Invisalign® – This system of removable aligners is favored by many adults because of its natural appearance. A series of plastic trays are used to gradually move teeth into proper alignment.

Retainers – When realignment is complete, measures need to be taken to ensure that the teeth do not shift back into the old alignment. Retainers hold teeth in the desired position, allowing bone to form around teeth’s new position.

Orthodontics is a branch of dentistry specializing in the diagnosis, prevention, and treatment of jaw, face and bite irregularities (malocclusions*).  Orthodontic treatment is provided by an oral health care provider known as an orthodontist, who has completed two to three years of additional training beyond dental school. 

Recent years have brought about many changes within the dental industry, specifically with regards to orthodontic treatment and care.  Now more than ever patients are experiencing fewer incidences of cavities and missing teeth due to the heightened awareness of fluoride use and preventative dentistry.   This increasing awareness on the health and look of a patient’s smile has fueled the desire for many to seek out orthodontia not only as a medical necessity, but for cosmetic reasons as well.   

Whether it’s traditional braces or custom made removable appliances, orthodontics can help you have the healthy, straight, beautiful smile you’ve been waiting for!

Give us a call today and schedule your orthodontic consultation!

*Malocclusion is the technical term for teeth that don’t fit together correctly.  Malocclusions not only affect the teeth, but also the appearance of the face.  Most malocclusions are inherited; however some are due to acquired habits such as thumb sucking and tongue thrusting.  The spacing left from an adult tooth being extracted or an early loss of a baby tooth can also contribute to a malocclusion.

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Prior to your dental surgery you will have the opportunity to address any concerns you might have during your pre-op appointment. We encourage you to ask questions and make us aware of any fears you might have. Our main goal is to create a secure, comfortable environment for our patients on the day of surgery so the more you communicate with us, the easier we can accommodate your needs. The following guidelines are meant to serve as reminders in helping you prepare for your dental surgery. If you have any questions, feel free to contact our practice.

Leading Up to the Day of Surgery

            – Cardiac medications
            – Pulmonary medications
            – Steroids
            – Anti-seizure medications
            – Anti-Parkinson’s medications

Day of Surgery

If you have any change in health the morning of you appointment, please contact the practice immediately. A cold or fever with chest and sinus congestion may dangerously affect surgery so it is imperative that our practice is made aware of the situation. If it is necessary to reschedule your appointment, we will notify you.

Dental emergencies are quite frightening and often painful. Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.

Sometimes, teeth become fractured by trauma, grinding, or biting on hard objects.  In other cases, fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to contact our office immediately. The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.

Types of dental emergency and how to deal with them
Avulsed tooth (tooth knocked out)

If a tooth has been knocked clean out of the mouth, it is essential to see a dentist immediately.  When a tooth exits the mouth, tissues, nerves, and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

  1.  Call our office.
  2.  Pick up the tooth by the crown and rinse it under warm water.  DO NOT touch the root.
  3.  If possible, place it back into its socket – if not tuck it into the cheek pouch.
  4.  If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort.  It is important to keep the tooth from drying out.
  5.  Get to our office, quickly and safely.

We will try to replace the tooth in its natural socket.  In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy might be necessary.

Lost filling or crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that we can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When we are not immediately accessible, here are the steps to take:

  1.  Apply clove oil to the tooth to alleviate pain.
  2.  Clean the crown, and affix it onto the tooth with dental cement.  This can be purchased at a local pharmacy.
  3.  If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
  4.  DO NOT use any kind of glue to affix the crown.

We will check the crown to see if it still fits.  If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

Cracked or broken teeth

The teeth are strong, but they are still prone to fractures, cracks, and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme.  Fractures, cracks, and breaks can take several different forms, but are generally caused by trauma, grinding, and biting.  If a tooth has been fractured or cracked, there is no alternative but to schedule an appointment as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

  1.  Call our office.
  2.  Rinse the tooth fragment and the mouth with lukewarm water.
  3.  Apply gauze to the area for ten minutes if there is bleeding.
  4.  Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
  5.  Cover the affected area with over-the-counter dental cement if you cannot see us immediately.
  6.  Take a topical pain reliever.

The nature of the break or fracture will limit what we are able to do.  If a fracture or crack extends into the root, root canal therapy is often the most effective way to retain the tooth. In the case of a complete break, your dentist will usually affix the fragment back onto the tooth as a temporary measure.

Dislodged/loose teeth

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth still attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call our office immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain.  Your dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy might be required.

Sedation Dentistry for Dental Fear and Anxiety in Richland, WA

A significant number of Americans do not visit the dentist for regular checkups because they are too fearful or suffer from dental anxiety. Sedation dentistry offers an excellent way to provide a safe, anxiety-free, dental experience to those who are afraid of the dentist.

Sedation dentistry is often mistakenly thought to induce sleep. In fact, most sedatives allow the patient to stay awake during the procedure.  Sleepiness is a side effect of some medications, but nitrous oxide, oral conscious sedation and IV sedation only work to calm anxiety throughout the dental visit.

Sedation dentistry is popular because most sedatives can be taken by mouth, meaning no injections, no anxiety and no pain.  Some sedatives work so effectively that even the smells and details of the procedure cannot be recalled afterwards.  Safety and compliance are two important aspects of treatments, so sedation dentistry offers both the individual and the dentist the best alternative.

Whatever the form of sedative, it is essential to be accompanied by a caregiver.  Sometimes, sedatives are provided the night before the dental visit, which means that driving to or from the appointment is not advisable.

Some Advantages Associated With Sedation Dentistry:

What Kinds of Sedatives Are Available?

The most popular types of dental sedatives are nitrous oxide, oral conscious sedation, and IV sedation.  Different levels of sedation (mild, moderate and deep) can be utilized depending on individual needs.  Before administering any sedative, the dentist must analyze the full medical history of the patient, taking note of any current medications.

Here is an overview of some of the most common types of dental sedatives:

Nitrous Oxide

Nitrous oxide, or “laughing gas,” is used as a mild sedative.  It is delivered through a nose hood, and is administered throughout the entire procedure.  Nitrous oxide elevates the general mood and can evoke a general sense of well-being.  Most importantly, it relieves anxiety and reduces pain during the procedure.  In addition, some tingling and numbness may be felt. There are few side effects associated with nitrous oxide, and it has been safely used in dentistry for many years.

IV Sedation

Intravenous sedation is a moderate type of sedation.  Patients who have previously experienced IV sedation often report feeling like they slept through the entire procedure.  Generally, IV sedation is used for shorter treatments.  It is administered via direct injection into the bloodstream, which means the effects are immediate.  Sometimes patients feel groggy and sleepy when the IV sedatives are withdrawn.  This is why it is important to bring a designated driver for the drive home.

Oral Conscious Sedation Dentistry

Oral conscious sedation is an excellent choice for people who fear needles.  Oral medication is provided prior to treatment in order to induce a moderate state of sedation.  Though oral sedatives do not cause sleep, they usually dull the senses.  This means that most patients cannot remember the pain, smells or noises associated with the procedure.  Usually, a dose of medication is taken prior to the appointment, and then topped up during the procedure as required.

What Types of Drugs are Used in Oral Conscious Sedation?

Most of the drugs used in sedation dentistry are classified as benzodiazepines.  Benzodiazepines reduce anxiety, muscle spasms, insomnia and seizures.  Each medication has a different half-life, meaning that the effects last for varying amounts of time.  The estimated length of the procedure determines which type of drug is going to be most effective.

Some of the Most Common Drugs Used in Oral Conscious Sedation Dentistry Include:

Do you suffer from dental fear or anxiety? Do you have some medical conditions that make visiting the dentist difficult? Sedation dentistry may be the answer. Call Richland Smiles today for a consult.

Endodontics is a specialized branch of dentistry that deals with the complex structures found inside the teeth. The Greek word “Endodontics” literally means “inside the tooth” and relates to the tooth pulp, tissues, nerves, and arterioles.  Endodontists receive additional dental training after completing dental school to enable them to perform both complex and simple procedures, including root canal therapy.

Historically, a tooth with a diseased nerve would be removed immediately, but endodontists are now able to save the natural tooth in most cases. Generally, extracting the inner tooth structures, then sealing the resulting gap with a crown restores health and functionality to damaged teeth.

Signs and symptoms of endodontic problems:

Reasons for endodontic treatment

Endodontic treatment (or root canal therapy) is performed to save the natural tooth. In spite of the many advanced restorations available, most dentists agree that there is no substitute for healthy, natural teeth.

Here are some of the main causes of inner tooth damage:

Bacterial infections – Oral bacteria is the most common cause of endodontic problems. Bacteria invade the tooth pulp through tiny fissures in the teeth caused by tooth decay or injury. The resulting inflammation and bacterial infection jeopardize the affected tooth and may cause an abscess to form.

Fractures and chips – When a large part of the surface or crown of the tooth has become completely detached, root canal therapy may be required. The removal of the crown portion leaves the pulp exposed, which can be debilitating painful and problematic.

Injuries – Injuries to the teeth can be caused by a direct or indirect blow to the mouth area.  Some injuries cause a tooth to become luxated or dislodged from its socket. Root canal therapy is often needed after the endodontist has successfully stabilized the injured tooth.

Removals – If a tooth has been knocked clean out of the socket, it is important to rinse it and place it back into the socket as quickly as possible. If this is impossible, place the tooth in special dental solution (available at pharmacies) or in milk. These steps will keep the inner mechanisms of the tooth moist and alive while emergency dental treatment is sought. The tooth will be affixed in its socket using a special splint, and the endodontist will then perform root canal therapy to save the tooth.

What does an endodontic procedure invlove?

Root canal therapy usually takes between one and three visits to complete. Complete X-rays of the teeth will be taken and examined before the treatment begins.

Initially, a local anesthetic will be administered, and a dental dam (protective sheet) will be placed to ensure that the surgical area remains free of saliva during the treatment. An opening will be created in the surface of the tooth, and the pulp will be completely removed using small handheld instruments.

The space will then be shaped, cleaned, and filled with gutta-percha.  Gutta-percha is a biocompatible material that is somewhat similar to rubber. Cement will be applied on top to ensure that the root canals are completely sealed off. Usually, a temporary filling will be placed to restore functionality to the tooth prior to the permanent restoration procedure. During the final visit, a permanent restoration or crown will be placed.

If you have questions or concerns about endodontic procedures, please contact our office.

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