Cosmetic Dentistry – Fill That Gap!

There are several ways that a cosmetic dentist can fill gaps in the mouth where teeth have had to be extracted or even knocked out!

Teeth Implants
Teeth Implant dentistry is the most advanced therapy available to replace teeth. In addition to looking and feeling like real teeth, teeth implants allow you to:

    * Improve your smile
    * Eat the foods you enjoy
    * Restore your confidence

Dental Bridges
A dental bridge is fixed to the remaining natural teeth by the cosmetic dentist restoring aesthetics and function. There are two types of dental bridge-:

    * Fixed – dental bridges fitted over prepared abutment teeth. A secure and long-lasting option.
    * Adhesive – A sticky dental bridge which is bonded to natural teeth and requires minimal tooth preparation.

Having a fixed bridge can make a fantastic improvement to the quality of your life and the treatment can be completed by the cosmetic dentist in two weeks!

Dentures
There are two types of dentures used in cosmetic dentistry: -

    * Acrylic (or plastic) dentures
    * Cobalt Chromium (or metal based) dentures – only advised when some teeth are present.

The advantages of cosmetic cobalt chromium dentures are: -
    * Better chewing (more stable; less movement of denture)
    * Food more enjoyable (less coverage of the palate)
    * Stronger (metal is very hard, plastic can fracture)
    * Lighter and thinner (plastic is more bulky)
    * More healthy (less gum coverage)

Treatment Planning
The cosmetic dentist at our dental practice strive to diagnose dental problems accurately. Duplicate models of your mouth, x-rays, special gum measurements and the bite pattern are some of the factors we assess during a complete mouth examination. A treatment plan is then made giving you options and good advice as to which treatment best suits your individual needs.

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Marijuana affects brain functioning during visual stimuli

Washington: An Indian origin scientist and his team have found that different ingredients in marijuana appear to affect regions of the brain differently during brain processing functions involving responses to certain visual stimuli and tasks.

Sagnik Bhattacharyya, MBBS, MD, PhD, at the Institute of Psychiatry, King’s College in London, and colleagues studied 15 healthy men, who were occasional marijuana users, to examine the effects of 9-tetrahydrocannabinol (9-THC) and cannabidiol (CBD) on regional brain function during salience processing, which is how people perceive things around them.

The authors used functional MRI images to study each participant on three occasions after administration of 9-THC, CBD or placebo. Study participants performed a visual oddball task of pressing buttons according to the direction arrows on a screen were pointing, as a measure of salience processing.

“Pairwise comparisons revealed that 9-THC significantly increased the severity of psychotic symptoms compared with placebo and CBD whereas there was no significant difference between the CBD and placebo conditions,” the researchers said.

9-THC had a greater effect than placebo on reaction time to non-salient relative to salient stimuli.

This was associated with modulation of both prefrontal and striatal function by 9-THC, augmenting (increasing) activation in the former region and attenuating (weakening) it in the latter.

“Moreover, in the present study, the magnitude of 9-THC’s effect on response times to non-salient stimuli was correlated with its effect on activation in the right caudate, the region where the physiological effect of 9-THC was linked to its induction of psychotic symptoms,” they wrote.

They concluded that “collectively, these observations suggest that 9-THC may increase the aberrant attribution of salience and induce psychotic symptoms through its effects on the striatum and lateral prefrontal cortex.”

When the effects of CBD were contrasted with 9-THC and placebo with respect to the visual task there was a “significant effect” in the left caudate with CBD augmenting (increasing) the response and 9-THC attenuating (weakening) it.

“These effects suggest that CBD may also influence the effect of cannabis use on salience processing – and hence psychotic symptoms – by having an opposite effect, enhancing the appropriate response to salient stimuli,” the researchers added.

The findings appeared in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

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The Basics of Braces

Braces are used to correct misaligned jaws or teeth that are out of place. They’re most commonly applied to children, whose jaws are still growing and can thus be guided into proper alignment. But thanks to advancing orthodontic technology, it’s becoming increasingly possible to use braces to correct jaw alignment issues (also known as “malocclusions”) in adults. If you suspect that you or your child may need this procedure, here are some important things to know.

Are braces important?

One of the most common reasons cited for getting braces is to improve one’s appearance. While this is undoubtedly important, it is far from the whole story. When malocclusions are present in the teeth and jaw, it can make it difficult to maintain proper hygiene at sensitive spots in the mouth, which can lead to tooth decay and gum disease. Plus, when malocclusions prevent one from chewing food properly, this can lead to digestive problems.

Who can apply braces?

Only certified orthodontists are qualified to apply braces. Orthodontists are essentially dentists with a couple of extra years of training in advanced practices. Standard dentists without this advanced training are not qualified to work with braces.

What are the signs that braces might be necessary?

If any of these conditions are present, you might want to talk to your orthodontist about the possibility of braces:
• teeth that are crowded or out of position
• frequent cheek biting
• severe over-or under-bite
• difficulty chewing or swallowing
• an off-center bite
• teeth growing in behind others
• teeth out of proportion with others
• a too-prominent or too-weak chin
• strange teeth position as a result of tooth loss
• noises in the jaw
• large spaces between the teeth

What causes misaligned teeth?

Genetics play a large role in determining how the teeth grow in, but other factors such as finger sucking, pacifier sucking, poor toothbrushing, gum disease, and early loss of baby teeth can also contribute to malocclusions.

How do braces work?

Braces work by applying slow and steady pressure to the teeth and jaw over a period of months or years. In children, as the teeth naturally grow, the braces harness that growth to guide the teeth into a proper position. In adults, the braces themselves have to apply the pressure, and it usually takes a much longer time for the benefits to be seen.

When should children visit an orthodontist?

Orthodontic organizations recommend that children should have their first consultation by the age of 7. However, if you suspect that your child may have an orthodontic problem, it’s never too early for a checkup. Remember that orthodontics is a preventative field, so the earlier a problem is caught, the more chance there is of correcting the problem.

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Dentists in Murrieta and Temecula Practicing Deception?

(Healthy Times Newspaper) In recent years, I have noticed a shift in our ethics as a society and a change in what people believe they can get away with.  I have noticed the actions of companies such as Enron, home loans corporations, as well as fluctuations in insurance costs lead to a sense that profit at any cost is more important than the consequences to consumers, employees, or patients.
This profiteering mentality has trickled down to our everyday lives and I feel it is responsible for our current economic woes.  As a dentist, I have seen this quest for profits arise in the field of dentistry, too, and with little regard for the needs of the patient.

In dentistry, we take an oath that we will follow a certain standard when treating patients.  Dentists are sworn to uphold a very high standard of care.  This is something that we spend countless hours learning to understand and practice before receiving a California license to practice dentistry.

More recently, there has been a change in dentistry, even with dentists in Murrieta and Temecula, in which profits come before patients. High pressure sales tactics and even deception have come into play.  Perhaps it is due to changes in healthcare, the rise of managed care, or the entrance of large corporate ownership of dental practices.  It may be hard to believe, but in these saturated markets, dentists are being paid less and less for the dental work they do and at the same time, the price of doing business increases.
Many a mom and pop store has succumbed to larger corporations.  The same is happening with dentists in Murrieta, Temecula and all over Southern California.  As a result, a conflict of interest has arisen where companies must answer to the bottom line–shareholders and CEOs.  I have noticed many of these offices stray from the standard of care that is taught in dental schools, or rather modify the standard toward selling the procedure that costs the most. Many smaller dental offices, feeling the need to follow suit, have caught on to these policies.


Dental patient “A” comes into my office in tears.  She says they were going to charge $700 for a cleaning that included a deep cleaning and irrigation.  They were rude and used pressure.  She claims to floss everyday and has had regular checkups.  She is worried her teeth will fall out because that is what they told her would happen if she did not do the work they prescribed.  Upon my examination, her gum tissue is healthy and there is little to no tartar.  Following a standard of care, I explain to her that she needs a regular cleaning or prophylaxis.  She is relieved and says she thought it was odd that her son received the same exact $700 diagnosis.
Dental patient “B” comes into my office from a large group. She says she paid $20,000 in dental treatment including crowns and veneers on the front teeth.  Many of the crowns/veneers are mismatched yellow shades, like heirloom corn.  One of the veneers has come off.  Upon my examination, the preparation looks nothing like any veneer preparation I have ever seen.  The dentist clearly had no training in veneers.  She said they keep falling off and then she was charged again to have them redone, each time with a different dentist in the same office.
I wouldn’t be surprised if many of you reading this have encountered or know someone who has encountered these kinds of offices.  It has become too common these days at all levels of dentistry.  I’m not suggesting that all dentists act this way, but that these kinds of practices have become more common.
The diagnosis made by your dentist must be appropriate to your needs as a patient. This is a standard of care that all dentist must follow.

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Root Canal: When Your Tooth May Need It

 Chronic tooth pain is among the most difficult body aches and pains for anyone to deal with. But how do you know if the pain can be dealt with utilizing a root canal? After all, the process costs a lot of money, so you need to know which situations actually require root canal treatment.

The basic symptoms that usually suggest a need for root canal therapy is a chronically painful tooth coupled with gum tenderness or swelling in the area right next to the tooth, or both tenderness and swelling occurring at the same time. Then again, not every tooth that calls for root canal can have the same visible symptoms. This is why it requires a dental expert to identify which teeth need to be treated.

The first way that dentists can discover the need for root canal in the absence of pain is by routine X-rays. Sometimes, the death of a nerve of a tooth may not be a painful occurrence, with the nerve tissue inside the tooth degenerating without resulting in any outward symptom. This means the need for root canal treatment can stay unknown, sometimes even for years.

In this case, the infection inside the tooth is not that dramatic and perhaps your body’s defense mechanisms are able to keep it under control, even without totally clearing up the infection. In the X-ray, this infection shows up as a dark spot at the tip of the root of the tooth, which shows a reduction in bone density surrounding that area. This comes about because of the infection kept inside the tooth which might have leaked out, and your body responded to the infection.

The second way that dentists require root canal is if a current dental work results in an exposure of a nerve tissue from your tooth. When this happens, you may feel a prick of pain, but other times, the patient has no idea that a nerve has been exposed. This exposure can cause a degeneration of the nerve tissue. In this case, the dentist may decide to go on with a root canal at this point instead of risking future complications, which may include painful tooth abscess.

The third symptom that dentists watch for is a recurring or persistent pimple developing on the gums. A lesion or pimple can sometimes form on the gums of a person whose tooth nerve has died. These pimples, called fistulous tracts, can appear and disappear, but they are technically drains for pus. This is why they normally produce a bad taste. Sometimes dentists may discover this kind of pimple during a routine checkup.

Lastly, teeth that have suffered trauma in any accident may sometimes be candidates for root canal. The nerve tissue of these teeth can deteriorate. Of course, not all teeth that have been bumped in a traumatic event can deteriorate, because sometimes they may do fairly well for many years. The usual hint that the nerve tissue in a tooth is degenerating is that it appears darkened compared to its neighbors.

In any case, a routine checkup should set your fears at rest, as your dental practitioner can help you pinpoint a need for root canal as soon as possible.

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Scientists from the Yale University School of Medicine found changes in mouth bacteria preceded the development of the inflammatory lung condition in hospital patients.

The team followed 37 subjects over a month. They found patients on ventilators who developed pneumonia had experienced a significant shift in the 'bacterial composition' in their mouths beforehand.

"Our findings may improve the way we prevent pneumonia in the future by maintaining the bacteria which live within our mouths," the Daily Mail quoted lead author Dr Samit Joshi as telling ELS Global Medical News.

Although further research is required, the British Dental Foundation said the latest study is not the first to associate poor oral health with respiratory diseases.

Bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs and earlier studies suggested people were more likely to die from pneumonia if they had higher numbers of deep gum pockets.

Nigel Carter, chief executive of the British Dental Health Foundation, said the latest research backed their findings that looking after your teeth boost your overall health.

"During the winter months we're all susceptible to colds, coughs and chesty viruses due to the drop in temperature," said Dr Carter.

"What people must remember, particularly those highlighted as vulnerable, is that prevention can be very basic. Systemic links between gum disease and overall health have been well documented, and at this time of year keeping up good oral health can really help stave off illness," he stated.

He added that dentists recommended brushing teeth for two minutes twice a day using a fluoride toothpaste, cleaning in between teeth daily with interdental brushes or floss and avoiding sugary foods.

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Dental Phobias

In practice, I often encounter (or don’t encounter) patients with dental phobias.  A phobia is defined as an “irrational fear.” It is easy to label this behavior as irrational, but to the patient it is very rational and is usually the result of a childhood trauma at the hands of a dentist who was rough or due to the days before Novocain, when there was no numbing involved.
The dentist would just go to town on the tooth with a hand piece.  Chances were that the hand piece was a slow relic and the burs not as sharp as the industrial diamonds we have today.  It was similar to cutting steak with a butter knife.

Through the years, I have only had 3 patients who preferred not to be numb, and I think there was something different about their wiring. One of them would just laugh as I drilled, the other felt like they were getting a “high” off of the drilling.  One patient, who had been in the military, did not allow himself to feel any pain.

Then there are other patients who are simply terrified and have never been to the dentist.  Perhaps it is fear of the unknown and someone sticking things in their mouth in a clinical setting.  I have had people with piercings and tattoos who said they could deal with pain anywhere but not in the mouth.  Mothers have told me that visiting the dentist hurt more than childbirth.  In one famous film, a person is tortured by drilling into his teeth without anesthetic.  No wonder people have a fear of the dentist!

The problem is that the fear is keeping some people from getting the dental care that they desperately need.  And by the time they do come to the office, in pain, the years of damage and neglect can end up being quite involved and very expensive.

Having said all this, how has dentistry changed to address dental phobias?  First of all, Novocain has evolved over the years.  Some of the new anesthetics are stronger and longer lasting.  A lot of the patients that come in saying “they couldn’t numb me” have been able to get numb.  Sometimes the previous doctor just doesn’t get the right landmarks in the mouth. There are at least three to four different anesthetics that we have to choose from with different strengths and durations.  Topical anesthetics can be left in place to numb the tissue before an injection.

The subject of anesthesia can extend to breathable gases such as nitrous oxide, oral conscious sedation, and IV sedation.  With nitrous oxide, patients breathe in a mixture of oxygen and nitrous which has a relaxing effect.  It can be quite effective with patients and children and is considered safe, with no lasting effects.  The patients leave the office fully conscious as the nitrous is flushed out of the patients system completely before they leave the office.

Oral conscious sedation had become more popular in recent years, where the patient is given a crushed pill placed under the tongue.  The patient’s vital signs are monitored continuously, making the procedure quite safe.  The dentist practicing oral conscious sedation must have adequate training and the administration of the drugs monitored by the proper authorities.

IV sedation usually falls in the realm of dental anesthesiologists.  These are dentists who usually study at least two years after receiving their dental degree or are dental specialists such as oral surgeons.  The idea is that when you wake up, you won’t remember the experience you just had, such as the pulling out of wisdom teeth.  It is also helpful when a patient needs a lot of work and doesn’t want to have to keep coming back.

Hopefully, I have shed some light on the advances and options a person has that may help to alleviate some dental phobia.  Of course, a dentist’s chair side manner is a good place to start in making the patients’ experience more bearable.

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