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Cosmetic Dentist - Antioch
5357 Mt. View Road
Antioch, TN 37013
(615) 731-8960

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Posts for: October, 2009

By drglasmeier@nashvillefirstimpressions.net
October 15, 2009
Category: Uncategorized

Question: I have a tooth that has sensitivity to cold drinks and sometimes sweets but I don't think I have a cavity or ever had the tooth filled? What could cause this?

 

Answer: Great question! 4 out 5 patients have sensitivity somewhere in there mouth without really knowing what could cause it. Excluding the obvious reasons for sensitivity like cavities, infections and broken teeth, the one that I see most frequently is a phenomenon called "toothbrush abrasion". It is the result of brushing the tooth too hard where the tooth meets the gumline. Overaggressive toothbrushing around this area can cause the gum to pull away from the tooth (i.e. "recede"). When this occurs the underlying root surface is exposed promoting brief, but sharp sensitivies to cold, sweet. If this is the case, typically the patient will get a procedure called "laser desensitization" where the root surface is lasered to eliminate the sensitivity. Patients report tremendous success with this and often times get multiple teeth lasered to eliminate the sensitivity. While there are other methods to treat the sensitivity, the laser treatment is the most conservative and definitely the most inexpensive.


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By drglasmeier@nashvillefirstimpressions.net
October 15, 2009
Category: Uncategorized

Question: My child needs extensive dental work done and is quite nervous. What options are available to my child for sedation?

 

Anwer: That can really depend on certain factors such as age, weight, medical history, previous dental experiences, etc. The majority of the time, nitrous oxide(laughing gas) is sufficient to help calm the child down and eliminate anxiety. Nitrous is great because the onset of effect takes ~ 2-3 minutes and laughing gas is completely removed from the body following several minutes of administrating oxygen. If a child is unresponsive to laughing gas and will not cooperate, I would then recommending the patient be referred to a pediatric dentist. Pediatric dentists have more extensive training in sedation techniques for children such as oral sedation or even general anesthesia.


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By drglasmeier@nashvillefirstimpressions.net
October 11, 2009
Category: Uncategorized

Question: Who is not a candidate for oral and IV sedation?

 

Answer: The following is a list of individuals who would not be candidates for sedation and includes but not limited to:

 

1. Diabetics- unless blood sugar is well controlled and patient is compliant with dietary and prescription regimens. Type II are typically better candidates as patients with Type I (insulin dependent) typically experience larger fluctuations in blood sugar and need a quicker response to this fluctuation.

 

2. Liver and kidney diseases. Patients with liver and kidney disorders are usually not great candidates for sedation because their ability to metabolize drugs is altered or compromised. These metabolism deficiencies can lead to patients hypo or hyperresponding to medications and will also shorten or prolong the response to the medications. Patients with these disorders need clearance from their physician prior to sedation.

 

3. Thyroid and adrenal disorders. Patients with altered responses to stress, altered metabolisms can affect the response to sedation. Patients that are taking steroids on a regular basis can also have adverse reactions because their body is not conditioned for stressful situations. Patients with these disorders or anything else endocrine in origin should consult their dentist and physician for any proposed sedation treatment.

 

4. Pregnancy- Patients who are pregnant are not good candidates due to the teratogenic properties of sedation medications but also due to the altered metabolic demands of a fetus on a mother's body. If absolutely necessary, the 2nd trimester is the best choice but I would prefer to defer sedation or any unnecessary dental treatment until after pregnancy.

 

5. Medications/recreational drugs- Patients that take mind altering medications such as antidepressants and anti-anxiety medications can also respond very erratically or not at all to sedation medications. Patients typically don't respond as well because the body has been conditioned to process mind altering medications that fall along the same categories of sedative medications. Recreational drugs is a huge contraindication as the response is totally unpredictable and could be potentially life threatening.

 

6. Respiratory- This is the biggest and most frequent complication I run into. Factors such as Asthma, COPD, sleep apnea, sickle cell disease, bronchitis, sinus infections, etc. All sedation medications have some sort of respiratory depressing effects that control a person's breathing. Sedation medications can severely hamper the body's ability to maintain normal breathing and furthermore should be taken with caution. An example of someone who is not always a good candidate is someone that snores on a regular basis as this is already an indication of someone who may be developing respiratory problems.

 

While this is not an all inclusive list, these are the most frequent disqualifying conditions for sedation dentistry!

 

Dr.Glasmeier


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By drglasmeier@nashvillefirstimpressions.net
October 01, 2009
Category: Uncategorized

Question: Are there ways to do dentistry with out the pain or a needle or sound of a drill?

 

Answer: Yes there are, but they are somewhat limited in what they can treat. For example, to not need a needle for treatment either the cavity has to be very small or the dentist uses something called "Air Abrasion" or "Laser Dentistry". These are technologies that enable the dentist to fix cavities without using a needle or drill however they are not as effective when the cavities are deep (close to the nerve) or the tooth is sensitive.

 

I think an injection is much better for pain control and is better for eliminating the "what if I feel this". An injection can almost be next to painless and the discomfort can be controlled by

1. The strength of the topical gel

2. The manner the injection is given by the dentist.

 

I have a very simple rule...if I can't get you numb, I will not work on you that day...sometimes people just don't numb up well and it's hard to explain why but rest assured that if you are uncomfortable then I am too so I will not make you do anything that is uncomfortable! We generally have great success in getting you more than adequately numb which gives you a very comfortable, pleasant experience. Nitrous oxide(laughing gas) will often help drown out some of the sounds of the drill and also with analgesia(pain relief) during the procedure.

 

Regarding the sounds of the drill, we always play music while we are working..I don't like the sounds any better than my patients do? I love music from the 80s and 90s so there is always music in the background or we will play whatever music you like. We also play movies if you prefer to listen to a movie and if that's not enough...I might even sing or dance for you!

 

Back to the original question, the use of injections(i.e. the needle) as well as the handpiece(i.e. drill) is sometimes unavoidable no matter how gentle we are. If this is a concern, then sedation dentistry may be a great way of assisting in eliminating the apprehension/anxiety of these procedures as well as waking up and not remembering what happened.


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By drglasmeier@nashvillefirstimpressions.net
October 01, 2009
Category: Uncategorized

Question: Can you get a cavity around a crown?

 

Answer: Yes even though the tooth is "covered" by a crown, it can still get a cavity. You can get a cavity around a crown much like you can around a filling. The reason is that the interface between the crown and the tooth, which dentists refer to as "margins" has potential to get decay, or collect food. While crowns do minimize the tooth fracturing and help decrease the chances of getting another cavity, decay can still form around the edges of the crown right around the gum line. Hygiene becomes especially important for brushing and flossing to prevent decay from developing.


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Dental - Antioch, First Impressions Family Dentistry , Antioch TN, 37013 (615) 731-8960