Yes, dental sedation has been and will continue to be a great modality to help with patient comfort. Sedation dentistry will help patients cope with anxiety, be able to sleep better the night before, create amnesia which eliminates knowledge of the procedure, and certainly provide pain control so the patient has a comfortable visit. Talk to your dentist about dental sedation and how it can improve your next dental visit!

Under NO circumstances can you drive with any sedation drugs in your system. Sedation drugs not only relax your muscles but it can impair your judgement, your reflexes, and awareness. Operating heavy machinery, exercising, decision making is discouraged while potentially under the influence of sedation drugs.

What if I am only taking a valium? My dentist used to give me a valium the night before, can I still drive myself?

Valium is used as a sedative and sometimes as a sleep agent therefore not recommended. If you were involved in an accident and were under the influence of valium, you would be liable/responsible regardless of how you feel. Think of it like only having 3 beers and saying           "I feel fine....I can drive home". Do NOT take any sedatives/sleep agents if you plan to drive yourself to a dental appointment.

Are you afraid that years of not going to the dentist is going to result in an uncomfortable experience?

Do you need a good experience with the dentist from a bad experience as a child?

Are you short on time and have very limited time away from work or home?

If the answer is YES to any of these questions, then you are likely a candidate for Sedation Dentistry. Dr.Glasmeier is an expert sedation dentist trained in N2O, oral and IV Sedation. He has received extensive training in the Air Force as well as receive very thorough, up to date training from DOCS, one of the leading authorities on dental sedation for dentists. Dr.Glasmeier can evaluate you and determine what sedation would be your best option and provide you a pain free, memorable experience that will motivate you to come back on a regular basis to see the dentist. Come see us today and ask about how sedation dentistry can benefit you!

There are advanced techniques dentists like Dr.Glasmeier use to help detect cavities before they can be visibly seen?

Enter the Diagnodent: a laser cavity scanner...

  A laser cavity scanner can find cavities years earlier than normally could be detected. Thats right...no painful poking, scraping, and prodding involved! Dr.Glasmeier invested in this amazing tool to support his commitment and understanding of dental cavities. This tool is used routinely used to keep this patients healthier and to detect cavities before they can create a major problem and to defray the costs of a cavity turning into a fractured or infected tooth. Detecting decay early can also prevent the onset of tooth sensitivity as well as it spreading!

See Dr.Glasmeier and have your teeth laser scanned for cavities!

 1. You have a fear of needles

 2. You can't tolerate the sounds and smells of dentistry

 3. You prefer to have no memory or recollection of the procedures that you require.

 4. You are limited on time and prefer to get ALL work done in one visit

 5. You have medical problems that complicate your ability to get the work done that you need.

 6. You have issues with keeping your jaw open or have a bad gag reflex

While these are the common reasons for seeking sedation dentistry, there are others that patients seek Dr.Glasmeier for dental sedation in Nashville, TN. Visit Dr.Glasmeier to discuss your fears and concerns and see if the sedation is RIGHT for you!

Are you tired of wearing a partial denture that uses wires to clasp around your teeth?

Tired of acrylic going across the roof of your mouth affecting your taste and speech?

Tired of using adhesive and glues to hold something in to replace your missing teeth?

Wishing you could not only replace missing teeth but enhance your existing smile?

Do you wish you could get something that eliminate all these issues? The answer is YES...A Snap On Smile is a partial denture that snaps over the existing teeth...

    WITHOUT wires....

    WITHOUT acrylic.....

    WITHOUT adhesives and glues....

Ask Dr.Glasmeier how a Snap On Smile can replace your old partial denture and give you the smile you always wanted along with the comfort!!!

What can a Snap On Smile fix?

   1. Missing Teeth

   2. Severely Discolored Teeth

   3. Severely crooked Teeth

   4. Space between Teeth

 In one appliance, you can make the teeth look whiter, close the spaces between teeth, give the appearance of straighter teeth and replace teeth that are missing. For less than the cost of 2 crowns, 1/4 the cost of orthodontics, 1/2 the cost of replacing one missing teeth, the Snap On Smile delivers with ease, expediency and perfection! Ask Dr.Glasmeier, your Nashville dentist, about getting a Snap On Smile today!

Answer: Metal free crowns are a great alternative to the more traditional gold crowns and porcelain fused to metal crowns we have seen over the past 20 years. The reason is due to the esthetics as there is no metal in the crown and no darkening of the tooth can occur. Color matches tend to be better and also are typically more stable since they are made of 1 material versus multiple materials. Many patients with porcelain fused to metal crowns(aka PFM crowns) will see a gray line at the gumline over time as the gum recedes or pulls away from the tooth. This can lead to very unsightly esthetics over time. Even if the gum does recede, a metal free crown will not yield a gray line because their is no metal present. Although esthetics are exceptional, there are limitations on where they can be placed such as the bite. Patients that have a "tight" or "deep" bite may not have sufficient room for these type of crowns. If the crowns are placed anyways, they are more susceptible to fracture. Metal free crowns are more at risk for fracture if the patient is a severe grinder or clenches their teeth often. Talk to Dr. Glasmeier about metal free crowns!

Answer: While valium remains a medication used in oral sedation dentistry, its effectivess as well as the longevity it provides makes it not the best choice. Valium is typically part of a prescription regimen that is used but not used exclusively. Most dentists will prescribe valium the night before the dental appointment to help the patient sleep the night before; however, Triazolam (aka Halcion) is usually given the day of the dental appointment to help heighten the level of anxiolysis/sedation for the patient. Adding additional sedatives to the regimen also warrants that the dentist is monitoring specific vital signs such as blood pressure, pulse, respirations and O2 saturation.

 1. Is the sensitivity brief or lingering? Lingering refers to more than 30 seconds.
 2. Is the sensitivity all the time or occasional?
 3. Does the sensitivity happen when you do something or does it happen on its own?
 4. Does it hurt when you chew or when its exposed to hot or cold or both?
 5. Do you have receding gums? Receding gums can make teeth more sensitive?
 6. Is there a filling already present on the tooth?
 7. Is there a cavity present on the tooth?
 8. Does the sensitivity keep you up at night?
 9. Do you have to use OTC meds to help with sensitivity?

These are several questions a dentist will use to assess not only the problem but also the severity of the problem. Come visit Dr.Glasmeier to find out the source of the sensitivity and to assess if treatment is needed.

      If your tooth is chipped tooth, it is likely because there is tooth decay present. True and False. While tooth decay(cavities) are the most common reason for a chipped tooth, there are many other ways a tooth can chip or crack.
     A tooth is more susceptible to fracture regardless of decay if: large filling already present, parafunctional habits exist, patient is a grinder, tooth has been fixed multiple times, and malalignment of the teeth. Tooth decay will either exacerbate a preexisting condition or can alone cause fracture of a tooth.

 True or False?
   

     If a tooth is chipped but there is no cavity, then I should not be concerned. Depends. Assuming your hygiene is good, you do not grind your teeth and you are getting regular checkups, your risk for problems is decreased. The biggest concern is that bacteria can flourish around fractured areas if they are not kept clean and cause bigger problems.
   
 True or False?

     A filling should last forever and never need replacement. False. Most fillings at some point require replacement or maintenance to prevent further problems. Good hygiene can certainly offset the need for replacing a filling but much like everything else in life, fillings will likely need to be replacement for reasons such as new decay, leakage, chipping due to grinding forces.

 True or False?

     All silver filling should be replaced with tooth colored fillings. Absolutely false. If you know the expression "If its not broke, don't fix it", then you know my practice philosophy. Replacing a filling that has no issues can potentially create new issues. So when would we replace a filling? When tooth decay is present, filling is leaking, filling is chipped and/or patient is having symptoms.

Answer: This is very common question especially since monitoring was not alway considered a standard until recently. Most patients that undergo sedation typically are administered multiple medications for not only preparation for the visit but during the visit. A common example is a patient who elects for oral sedation and is prescribed Valium the night before and Triazolam/Vistaril the day of the appointment. In this particular situation, the Valium is used to assist with sleep the night before since most patients have a great deal of anxiety leading up to the appointment. The valium, too, will stay in your body much longer than some of the other medications which can help prolong and strengthen the level of sedation when given with other medications.

The triazolam/hydroxyzine is typically given the day of the apppointment which increases the level of "anxiolysis" or sedaton effects for the patient. While the valium alone does not typically have much effect on the patient in re: vital signs and level of consciousness, additional meds such as triazolam can heighten the sedation to a point where we can see changes in a person's breathing or blood pressure. As the sedation becomes greater the more relaxed a patient can become but also the muscles in the airway and others used for breathing. This is the answer to the original question because sedation can affect the respiratory ability of a patient, it is absolutely imperative that patients are monitored to detect for even the smallest of changes.

By monitoring blood pressure, pulse, oxygen saturation, respirations and sometimes heart rhythms, we can deliver safe levels of sedation to a patient without being as concerned about what may happen in response to the administration of multiple oral medications. Monitoring is an ABSOLUTE must!

Hope this helps!

Dr.G

If your dentures hurt when you eat or chew or fall out when you speak then implant dentures may be for you! Our practice have found that some denture wearers suffer pain, bad breath, and even embarrassment when their dentures move unexpectedly during speaking or chewing. Mini dental implants to stabilize loose or poorly fitting lower dentures often brings relief and solves these common problems.

How is the Procedure Performed?

This procedure is virtually painless can usually be completed in just one office visit. First, an exam and xray will determine if you are a candidate for dental implants, which require a sufficient base of jaw bone for their placement. Using local anesthesia (just like fillings or extractions), several implants will be placed into the bone. Once the implants are secure, we will adjust/modify your denture so that it attaches with your new implants. The result is that your upper or lower denture is now firmly in place and you can speak and eat with confidence.

A Fix for Common Denture Problems
We have found that some denture wearers suffer physical discomfort, unpleasant breath, and even embarrassment when their dentures move unexpectedly during speaking or chewing. Using mini dental implants to stabilize loose or poorly fitting lower dentures often brings relief and solves these common problems.

So if your denture is loose and are having a hard time eating the foods you love to eat, talk to Dr.Glasmeier about mini implants for dentures!

1.All OTC (over the counter) teeth whitening products are the same.
False. There are many variations in how products are distinguished:
1. % Strength
2. Type- Carbamide peroxide vs Hydrogen peroxide
3. Delivery- Tray, Strips, Paint-On- Gel
4. Preservatives- Will Alter the Shelf life of the Product
5. ADA seal- Should have this seal to verify its safety.

2. People with sensitive teeth are not candidates for teeth whitening.
False. While teeth whitening can produce hot/cold sensitivity, is often brief and temporary. People with large cavities and periodontal(gum) disease must use great caution when using these products. Talk to your dentist about what is the best product for you and why.

3. Patients that have cavities are not candidates for teeth whitening.
False. When used properly, even patients with cavities can whiten teeth. In fact, there is very new research showing that teeth whitening can help prevent or reduce cavities when used appropriately.

Talk to Dr.Glasmeier about teeth whitening and what is best for you!

Dr.Glasmeier offers oral sedation for children who are fearful and/or have extensive dental needs that require measures to help relax/calm the child. By using oral sedation, the child can put be into a very relaxed, pain free statethat enables the dentist to accomplish the dental treatment successfully with thecooperation of the child. Oral sedation has been shown to be very helpful with children that are very nervous or have difficulty cooperating throughout the dental treatment.The end result is a more relaxed child with a pain free visit and very little recollectionof his/her dental visit(amnesia). Talk to Dr.Glasmeier about how oral sedation can help with your child's dental care!

Your dentist may have not been able to effectively communicate your treatment options. Specifically, you may have been advised that an aggressive and complicated treatment plan is necessary. You may want to explore whether a less expensive, alternate treatment plan is possible. You may simply want more information regarding your diagnosis.

More and more dental patients are obtaining second opinions prior to undergoing dental surgery or other dental treatment plans, just the same as they would get a second opinion before medical surgery or other medical problems. Low cost second opinions, which may be subsidized by conventional dental insurance, can potentially save you time, money, and multiple visits or procedures.

Honestly, dental work is expensive. For most people, dental insurance is not always a viable option. When it comes to dentistry, the thing that puts people off is the expense. The cost may vary depending on what services you need performed and also varies between dentists. Shopping around will help you find lower cosmetic dentistry costs but be wary about low prices that are too good to be true. Always ask the dentist what the price will include and ask if there will there be extra fees. Some practices will include aftercare, while others do not include any follow up after your treatment.

It's been said that 'you are what you eat', but when it comes to oral hygiene, you are what you drink. And if you drink a lot of coffee and wine, you may be putting your smile at risk.

When most people worry about the 'damage' done to teeth by their favorite beverages - coffee and wine - they generally think in terms of the unsightly stains left behind. Now, staining, in and of itself, does not necessarily pose a true risk to the health of your teeth or your gums. But if you have stained teeth, it probably means that you've been 'playing hooky' when it comes to seeing your dentist and you may have unhealthy plaque on your teeth.

When plaque forms and hardens, it causes a calculus build-up known as tartar. Tartar is more easily discolored by coffee and wine than healthy enamel and that turns your smile from white to yellow or brown. But there's more to the problem than just discoloration. Plaque and tartar irritate the gums, leading to gingivitis and gum disease.

That's just the beginning...

Coffee is an acidic drink. That acidity is just as harmful to the health of your teeth as it is to the lining of your stomach, eating away the surface bit by bit. The more coffee you drink, the more acidic your mouth becomes. When that happens, calcium and phosphate can be pulled directly out of your tooth enamel.

The problem is that people have a tendency to drink coffee all day long, often adding a spoonful of sugar or two of sugar into each cup. And even those who are conscientious about brushing after meals often don't think to grab a toothbrush after those caffeine 'fixes.' The result is a double-whammy: the acid breaks down the structure of the teeth and the sugar promotes decay.

Can dentures be far behind???

Wine can be equally destructive. White wine has been shown to lead to the loss of tooth enamel, a condition which cannot be reversed. According to one study at Johannes Gutenberg University in Germany, adult teeth soaked in white wine for a day lost calcium as well as phosphorous up to a depth of 60mm in the enamel surface of the teeth. (Red wine is not known to promote rapid tooth erosion)

Are there any safeguards to help prevent tooth enamel loss without having to give up your favorite vintage? Yes! One tip is to be sure you eat when you drink.

Eating while drinking promotes the production of saliva, this in turn fights against the erosion of tooth enamel. Cheese is an ideal food to pair with white wine, for flavor and dental health. Cheese is a rich in calcium, which can counteract the acidity level of white wines.

And while it may seem counter-intuitive, you should refrain from brushing your teeth immediately after drinking white wine. Brushing too soon after consuming a very acidic beverage may damage the tooth's structure, says Mark Wolff, a professor and chairman of the department of comprehensive care at NYU's College of Dentistry. "Saliva has the capability of re-mineralizing the tooth structure and neutralizing damage, so give it 40 minutes to an hour before you brush your teeth," he says.

The good news is that despite the negative effects they may have, it's not really necessary to cut down on white wine or coffee if you enjoy them. But it is necessary to pay more attention to your dental hygiene.

Coupled with professional cleanings, timely brushing and regular flossing will allow you to eat, drink, and be merry without worrying about tooth or gum disease.

Parents know that taking care of small children is a full-time job - and along with diaper changes, bath time, and medical checkups, parents also need to take care of their children's teeth.

Birth to 18 months: no toothpaste required

Start cleaning your child's teeth as soon as the teeth begin to come in - but you don't need toothpaste at first. For babies younger than 18 months, the best way to clean your child's teeth is with a wet cloth or gauze - without toothpaste. Gently rub your child's teeth and gums with a cloth over your fingertip - this, along with nursing and/or drinking water, is all the oral hygiene that your child needs at the infant stage. Once your child has more of a "full set" of teeth, you can use a small, soft toothbrush to brush your child's teeth with water.

When to start toothpaste? 18 months

In general, children should not use toothpaste until they are at least 18 months old - and when you do start using toothpaste, make sure it is a safe "children's toothpaste" made especially for young ones. Young children have different dental needs than grown-ups - and children's toothpaste is made for this purpose.

What to look for in a children's toothpaste:

-Safe to swallow: Most young children tend to swallow while brushing, rather than spitting out the toothpaste - so make sure that your children's toothpaste is formulated with this in mind.

- Use only a pea-sized amount: Don't use too much toothpaste - just squeeze a small, pea-size (or smaller) amount onto the toothbrush. Your child doesn't need much toothpaste to be effective, and you don't want your child to swallow too much toothpaste.

- Consider low-fluoride children's toothpaste: Fluoride is an important element of keeping teeth healthy and strong, but too much fluoride can be harmful for young children. Talk to your dentist if you have concerns about fluoride in your child's toothpaste - several varieties of children's toothpaste have lower amounts of fluoride or are fluoride-free.

- Fun flavors: Try some different flavors of toothpaste and see what your child likes. Some children - especially at the toddler stage - are very picky about flavors and might be reluctant to use a certain flavor of toothpaste. So be prepared to buy a few different varieties of children's toothpaste and see which one is your child's favorite.

Remember: brushing your child's teeth is part of parenting, and you need to start at a young age. By taking the time each day - before bedtime and in the morning - to clean your child's teeth with a specially-formulated children's toothpaste, you will be helping to create a lifetime of healthy dental habits and happy smiles.

Should I use Fluoride?

Some people have concerns about fluoride - either in their toothpaste or in their drinking water. Let me do what I can to help relieve you of those concerns. Fluoride is a naturally-occurring chemical compound that is used in dental care as a way to prevent tooth decay. Most toothpastes contain fluoride, and many visits to the dentist will include a fluoride treatment. In addition to its use in dental products, many communities across the U.S. adjust the fluoride levels of their drinking water supplies as a way to bolster the oral health of the public.

The American Dental Association (ADA) stands in favor of using fluoride as an essential component of public health and as a way to reduce the harm caused by tooth decay. Simply put: fluoride results in fewer cavities and lower long-term dental care costs.Is fluoride safe?The American Dental Association (ADA) has been a big supporter of fluoride in drinking water (and fluoride in toothpaste and other dental care products) for many years. Several decades of peer-reviewed scientific research has demonstrated that fluoride is one of the most essential components of improving the oral health of Americans during the past 50 years. Simply put, as best as we can tell from the available, credible scientific research, fluoride is safe and is beneficial - the improvements in the health of our teeth far outweigh any risks of using fluoride.

What about people who say that fluoride is dangerous?

During the past 60 years, fluoride has proven to be a big success in reducing tooth decay and cavities, and dentists are big fans of fluoride. In recent years, some activist groups have been making some claims about the supposed health risks of fluoride and objecting to the use of fluoride in drinking water. Many of these fluoride opponents are using suspect research or scare tactics, or are just opposed to chemicals as a matter of principle - and many of the fluoride opponents' arguments are based on myths and misconceptions. Is fluoride "unnatural?"Isn't it a chemical? Fluoride is a chemical, but it is naturally occurring. There are small amounts of fluoride that occur naturally in drinking water, food, and many other substances that people live with every day. There's nothing "unnatural" about fluoride.

In fact, some communities have to actually reduce the level of fluoride in their drinking water in order to reach the optimal level to improve dental health - often, when a community fluoridates its water, there's no "adding" of fluoride at all.Should children use fluoride? Parents of small children should be careful not to let their children use too much fluoride - when young children swallow too much fluoride, it can cause dental fluorosis, a type of tooth discoloration. (This is one of the reasons why we teach kids not to swallow their toothpaste.) Use a specially-formulated children's toothpaste that has a lower amount of fluoride. According to the ADA, fluoride in drinking water has not been proven to be the cause of fluorosis - as there are a number of possible causes. Fluorosis occurs in rare cases and usually only results in minor complications - and again, the consensus among dental health professionals is that the benefits of fluoride far outweigh these rare complications.

Where can I get more information? The American Dental Association has a detailed article called Fluoridation Facts with all of the relevant research, questions and answers about fluoride and dental health. This is a great resource if you have any concerns about fluoride and want to learn more - it's a fair, evenhanded look at the issues and the facts.

According to the National Institutes of Health, poor oral hygiene is the most common reason for bad breath. And all the mouthwash, breath mints, and breath fresheners in the world can't banish bad breath when the source is bacteria rather than the food you eat.

If you've been having trouble keeping your mouth feeling fresh and smelling good, this article will help you locate the real source of the problem...and it may not be the onions you ate at lunch.

How do you know if your breath smells bad? If you're lucky, someone may have the courtesy (and courage) to tell you to your face. But more often than not, other people will simply flinch, turn away, or step back a pace when you're talking to them.

To avoid the embarrassing situations described above, you can use these two techniques to give yourself a breath checkup and help you determine what's making your mouth smell so unpleasant to yourself and others.

- Breath Test #1 - Front (Anterior) Tongue Test - Lick your wrist. Then wait about five seconds while the saliva dries somewhat. Smell your wrist. If it smells bad, you have probably recently eaten something stinky. Simply brushing your teeth and rinsing your mouth with mouthwash, or popping a breath mint should take care of the problem. Chewing on fresh parsley is another effective way to fight temporary bad breath

- Breath Test #2 - Back (Posterior) Tongue Test - Take a spoon, turn it upside down, and use it to gently scrape the very back portion of your tongue. (It's common that this test can cause an automatic 'gag' reaction, so be prepared.) A thick whitish material will be on the spoon. Give it a sniff. If the smell is sharp and unpleasant, you most likely have halitosis, the kind of 'bad breath' that is caused by poor oral hygiene and that won't respond to simple brushing and mouth wash.

If you failed Breath Test #2, you're not alone. A research study conducted by the University of Buffalo in New York concluded that one in four adults has halitosis, and some estimates suggest that as many as 90 million Americans have bad breath related to oral hygiene.

When the white substance on the back of your tongue smells bad, the likely culprit is a bacteria associated with gum disease is. The bacteria's name is actinomyces, and it feeds on protein particles on the teeth and gums, producing foul-smelling sulfur gases in the process. Actinomyces is also the bacteria responsible for giving soil its 'dirt' smell and envelopes your mouth a sharp, pungent aroma.

Bacteria growth occurs when you fail to pay attention to your oral hygiene. In fact, flossing daily and brushing your teeth and tongue twice a day can greatly reduce bad breath as well as make it more difficult for bacteria to grow. BUT...

The same bacteria that cause gum disease, tooth decay, and abscessed teeth are also responsible for halitosis. Regular check-ups and professional cleanings are the only way to really ensure that your mouth is healthy and your breath is sweet-smelling.

Receding gums are one of the most common dental problems - especially after the age of 40. So if your dentist tells you that you have "receding gums," don't feel bad - you are not alone!Thing of receding gums as being similar to having a "receding hairline" - it means that your gums are slipping backward, away from their regular position. ("Receding hairlines" are also more common after the age of 40.) Receding gums are a problem because they result in the nerves of your teeth getting exposed - and this can lead to pain and infection. Here are several common causes of receding gums, and ideas for what to do about them: - Overly aggressive brushing. If you're one of those people who likes to scrub your teeth really hard, this could be the reason why your gums are retreating. When you brush too hard, it scares away your gumline - and this can lead to the same dental problems that you were trying to avoid by brushing!

What to do: Lighten up. Use a toothbrush with softer bristles. Or buy an electric toothbrush that will provide a steady, consistent brushing motion.- Not enough brushing and flossing. The opposite end of the dental care spectrum can also lead to receding gums. If you don't brush and floss often enough, bacteria can build up between your teeth, leading to problems with the underlying bone structure of your mouth. What do do: Brush, brush, brush - and floss, too. A lot of people neglect to floss because they feel like they don't have time, or because they don't know how. You've got to discipline yourself to make oral hygiene a regular part of your day. Every night before bed and every morning when you wake up - brush your teeth. Your gums (and your fellow human beings) will appreciate it!

- Gum disease. Often, receding gums can be a sign of a more serious problem like gingivitis or other diseases of the gums. What to do: Make sure to see your dentist regularly - every six months for a checkup. If you're a regular visitor to your dentist's office, he/she can help you keep track of the health of your gums, and can help to correct any serious issues. If you do have gum disease, you might need to be referred to a periodontist, a dental professional who specializes in diseases of the gums.

Other causes. Do you have braces, or are you undergoing other orthodontic work? This can contribute to receding gums, especially for older adults. Do you have any piercings in the lip or tongue? These piercings can rub against the gums, causing the gums to recede. Do you chew tobacco? This can be harmful to the gums as well. Finally, receding gums can also be a sign of eating disorder - repeated vomiting can damage the gums and cause them to recede.

What to do: Talk to your dentist if any of these causes sound familiar - receding gums can be caused by a number of complex factors; it's not always just a matter of changing to a softer toothbrush. What if none of these solutions work? What else can I do to help solve my problem with receding gums? If your receding gums are creating severe discomfort and inconvenience in your life, and none of the other solutions seems to help, you might ask your dentist about "gum grafts." Gum grafts are a type of surgical treatment for extreme cases of receding gums. In a gum graft surgery, a periodontist takes some tissue from the roof of the patient's mouth and implants it onto the area of the gumline that is receding. Another treatment that is still being researched is called "Guided Tissue Regeneration," or GTR. This involves taking some blood cells from the patient and creating a collagen-based membrane which is then placed over the affected area of the gumline. Results from a recent Tufts University study have been promising, but this treatment is not yet widely available. So if you have receding gums, don't worry - it's a common dental problem and there are a number of options for treatment.

Talk to Dr.Glasmeier about how you can be treated for receding gums.

When you need to make a good first impression, make sure your teeth are working for you and not against you.

Have you ever heard the expression 'a million dollar smile'? It's been applied to everyone from movie stars (like Angelina Jolie) to motivational speakers (like Tony Robbins). And that's because a great smile can be worth a million dollars as far as making a great impression.

In Psychology Today magazine, Paul Ekman, professor of psychology at the University of California Medical School in San Francisco, and a pioneer of research on facial expressions, revealed the importance of smiling. "We (respond to) a smile from 30 meters away," he says. "A smile lets us know that we're likely to get a positive reception, and it's hard not to reciprocate."

In other words, when you smile at someone, they want to smile back at you. That immediately sets up a positive interaction, even before a word is spoken. What a great way to start off a job interview!

All Eyes Are On Your Mouth

It's a simple fact of life: how you present yourself to others is essential to your success in both personal and professional situations. When you meet a prospective employer or have a chance encounter with a prospective 'love connection,' the other person will form a first impression of you in a matter of seconds.

Your smile can be an important tool for making that first impression a good one.

In a job interview or on a first date, you'll almost certainly be talking. And as well as focusing on your words, the person on the other side of the conversation will also be focusing on your mouth. With a brighter smile, you instantly stand out from the crowd. Others will be drawn to you and want to listen to every word you have to say.

A bright white smile and a set of healthy, well-cared for teeth and gums say many things about you. Perhaps the most important thing they convey to others is that you take pride in your appearance and care about your health.

Speak with Confidence

People with teeth that are stained, discolored or otherwise not 'in shape,' may feel self-conscious. So they refrain from speaking freely. Or they may unconsciously put their hands in front of their mouths when they talk. But when your teeth and gums are healthy, you have the confidence to express yourself. And confidence is a very appealing characteristic.

Missing, crooked, and broken teeth are problems for lots of people. Sadly, many of them don't take the time and effort to do anything about it. And that's a shame because modern dentistry has so many amazing techniques and procedures that can help.

It really starts with regular check-ups and cleanings. That's the baseline of a healthy, happy smile. After that, there's practically no end to what can be done to make your mouth look and feel great.

Tooth whitening can banish coffee stains and remove the yellow left behind from smoking. Invisible braces can remove gaps and get your teeth in line. Perhaps you're a candidate for an 'extreme makeover' with dental implants or veneers. Whatever you choose, you can be certain that the investment you make in a 'million dollar' smile will pay for itself a thousand times over.

Did you know that a healthy mouth means a healthy body...a healthy heart...even a healthy sex life? It's true! And just by changing certain habits related to oral hygiene you can improve the health of your mouth and teeth and lessen your risk for a whole host of illnesses.

"You cannot be healthy with an unhealthy mouth any more than one can be healthy with an infected foot," says Richard H. Price, DMD, spokesperson for the American Dental Association and a former clinical instructor at the Boston University Dental School.

He's absolutely right.

Researchers at the ADA have found that periodontitis (the advanced form of periodontal disease that can cause tooth loss) is linked with health problems, such as cardiovascular disease. It appears that bacteria in the mouth may cause inflammation throughout the body, including the arteries. Gingivitis (oral inflammation due to bacteria) may also play a role in clogged arteries and blood clots, possibly increasing your risk of a heart attack or stroke.

Healthy Mouth, Healthy Love Life

There's nothing like bad breath to turn off the opposite sex. 22-year-old UK superstar Joss Stone famously remarked, "There's nothing worse than bad breath. I've snogged people with bad breath who smelt of (cigarettes) and beer and it made me feel sick.

Joss isn't alone. A report from a US mouthwash company revealed that nearly three quarters of the people polled said they wouldn't let a person they found attractive kiss them if they had bad breath. Plus, simply worrying about your partner smelling and/or kissing your malodorous mouth can take the joy and spontaneity out of your sex life. Good oral health literally 'takes the worry out of being close' as they used to say in the Ban deodorant ads. So improving your sex life means doing things that improve your blood flow, and that means taking care of your teeth and gums.

Attention Mothers-to-Be

Pregnant women with periodontitis may be at increased risk of delivering preterm and/or low-birth-weight infants. The theory is that oral bacteria release toxins, which interfere with the growth and development of the baby. At the same time, oral infection can cause a mother to produce labor-triggering substances too quickly, potentially triggering premature labor and birth.

And some studies suggest that periodontitis can make it more difficult for people with diabetes to control their blood sugar!

Yikes!

Your Dentist is Also Your Doctor

Your mouth is a window into what's going on in the rest of your body, detecting the early signs and symptoms of systemic disease -- a disease that affects or pertains to your entire body, not just one of its parts. Many diseases, including diabetes, often first become apparent as oral problems. In fact, according to the Academy of General Dentistry, more than 90% percent of all systemic diseases produce oral signs and symptoms.

So what does the health of your mouth have to do with your overall health? In a word, plenty. It's just one more reason that regular dental check-ups are so important.

Answer: Depending on the cause for the sleep apnea, there are many dental appliances available. It is recommended that a patient who suspects they have sleep apnea or are a chronic snorer should seek medical advice from their physician. Typically patients will undergo a sleep study to determine the level of snoring, sleep apnea, as well other variables that present. Assuming the level of sleep apnea is mild or snoring is the main concern, a dentist can make several different appliances to eliminate snoring. The majority of dental sleep apnea appliances target either moving the jaw and/or tongue which in both cases will enlarge the patient's airway furthermore reducing airway resistance. The increase in airway diameter will allow easier breathing and negate most snoring sounds often associated with a constricted airway. Talk to your dentist about sleep apnea appliances and how they can help you with snoring.

Answer: Both are forms of sedation that help provide relaxation to the patient that will decrease the anxiety to the dentistry that is to be performed. Laughing gas tends to work well for decreasing the patient's perception of pain but less "sleepy" properties. The oral sedation, on the other hand does less for a patient's pain threshold but typically will make the patient more relaxed and can sometimes promote amnesia so that the patient cannot remember the experience.

Depending on the situation, Dr.Glasmeier will often use a combination of oral and inhalation sedation to help address the pain threshold issue while promoting relaxation and possibly amnesia for the patient. Residents of Nolensville and Cain Ridge trust Dr.G with their sedation needs! Talk to Dr.Glasmeier about sedation dentistry and how it can benefit you!

Question: How do I fix my bad breath?

Answer: It depends on what the source of the bad breath is. This

question is like asking, my car won't drive, what do I do to fix it?

Obviously it needs to be examined to see what it could and could

not be. The most frequent causes of bad breath are:

1. Halitosis of the tongue

2. Periodontal(Gum) Disease

3. Tooth Decay

4. Dry Mouth

5. Chronic Usage of Alcohol Based Rinses/Mouthwashes

6. Diet

7. Oral Hygiene

8. Medical history (e.g. Diabetics)

9. Chronic Sinusitis (Heavy Congestion from Sinuses)

While this list is not all inclusive, this represents some of the major

causes of bad breath. While all can contribute to unpleasant odor in

the oral cavity, treatment will vary on this based on the source of the

problem. Talk to Dr.Glasmeier about the cause of your bad breath

and how it may be corrected!

Answer: Valium and Triazolam have different lengths of activity as well as time of onset. Likely the dentist prescribed the Valium the night before to help the patient sleep as well as promote some initial sedation that will linger due to its "half life" being much longer than Triazolam. Triazolam is short acting but works very quickly, therefore this is given the day of or 1 hour prior to procedure to help improve/deepen the level of sedation. The prescription of these sedatives is determined by: medical history, type of procedures involved as well as length, level of anxiety and others (e.g. gag reflex). Talk to Dr.Glasmeier about what sedatives are needed for oral sedation dentistry!

Answer: No, being unconcious for sedation dentistry would imply general anesthesia. General anesthesia is not commonly used in dentistry for adults but more frequent in children in a hospital settings. Being unconscious implies not being able to maintain your airway. Most of the sedation dentistry techniques are designed to put the patient in very relaxed state yet the patient still has a patent airway. The patient can still breathe(ventilate), move their limbs, and respond to verbal command (i.e. yes or no answers). There are different levels of sedation that provide deeper relaxation as well as increasing the likelihood of amnesia following treatment. Talk to Dr.Glasmeier about how sedation dentistry can relax you!

Answer: Depending on the type of sedation you receive, you will likely not be able to drive home. With the exception of laughing gas, you will not be able to drive home on your own. For oral and IV sedation, are you required to have an escort accompany you to the appointment, drive you home and stay with you for the remainder of the day. In addition to not being able to drive, you are restricted from going to work that day, operating heavy machinery, making major decisions while under the influence, and being alone. It is for these reasons that you must have a responsible escort be with you at all times for the duration of the day.

Answer: No, local anesthesia is still necessary to provide pain control. Sedation dentistry helps promote anxiolysis, the reduction of anxiety before a dental procedure. While it helps with anxiety, it does not prevent pain, only the anticipation of pain. Interestingly, sedation dentistry has been shown to decrease the typical amount of local anesthesia needed to provide pain control. There are many patients who pursue sedation dentistry because they have difficulty getting numb or simply do not like discomfort of the injections. Talk to your dentist about how sedation dentistry can help decrease the fear of injections while providing superior pain control.

It varies from insurance company to insurance company and from procedure to procedure. Most dental insurance companies will cover multiple extractions under IV sedation and certain surgical procedures; however, routine dentistry such as cosmetic work and fillings are not typically covered. Insurance companies will also only cover up to a certain amount of time so if you had dental work that would take 3 hours...your insurance company may only be responsible for 1-2 hours leaving the patient responsible for the remaining time.

Talk with your dentist about your coverage and or contact the insurance company. Questions you should ask your insurance company:

1. Is oral, IV, or laughing gas sedation a covered service?

2. If so, are there limitations on sedation based on procedures and amount of

work that is needing to be done?

3. Is there a frequency or time duration limit on the sedation?

4. Do they require preauthorization before treatment is performed?

5. What is my financial responsbility for the sedation portion of the dental work.

Most dental procedures can be performed safely under sedation such as fillings, crowns, root canals, deep cleanings, extractions etc. The more important limiting factor is the amount of work that needs to be accomplished as the type of sedation will determine how much work can be completed. For example, more extensive work can be performed acceptably and much safer under IV sedation versus oral sedation or laughing gas. The type of sedation prescribed to the patient is based on medical history of the patient, level of anxiety and the amount of dental work needed!

There are many myths about teeth whitening that Dr.Glasmeier will help clarify.

Myth- All teeth in the mouth will whiten.

Natural teeth will naturally whiten with bleaching material but tooth colored fillings, crowns, bridges, dentures (anything artificial) will not respond.

Myth-All bleaching materials are the same.

There are different types of bleach and different concentrations. The two most common are carbamide peroxide and hydrogen peroxide. They both whiten teeth but at much different rates.

Myth- 10% carbamide peroxide is the same as 10% hydrogen peroxide are the same.

Absolutely not! 10% carbamide peroxide is only 3.5 % hydrogen peroxide while 10% hydrogen peroxide is 10 % hydrogen peroxide.

Myth- 10% hydrogen peroxide works better than 10% carbamide peroxide because only a small percentage is hydrogen peroxide.

Both materials will whiten the teeth equal but the exposure times differ between the two materials.

Myth- OTC whitening products are as effective as in office.

Materials dispensed by the dentist are typically stronger and have more research behind them warranting them as better choices.

Myth- Using boil and bite trays to whiten teeth is as effective as custom trays by the dentist.

Boil and bite trays can help whiten teeth but are more hazardous because if the material is held in secure, the patient can develop severe tissue burns on the gums and tongue.

Myth- Children cannot whiten teeth due to their age.

Dr.Glasmeier will allow children to whiten their teeth down to age 10 but a thorough assessment of the child's hygiene, temperament, and previous dental history dictates whether or not they would be a candidate.

Myth- OTC mouthrinses and toothpastes can whiten teeth.

Yes but not by the mechanism everyone thinks. Most of these products do have a peroxide ingredient which provides the chemical whitening. Majority of products claim whitening based on their ability to remove surface stain not by whitening! Just at look at the back of product!

Myth- People in braces cannot whiten their teeth.

Patients in braces can whiten their teeth around brackets and there are preliminary studies out showing that whitening while in braces can decrease the incidence of cavities

The three most common options are:

1. Bonding/Composite/Tooth Colored Fillings

2. Orthodontics/Invisalign

3. Veneers/Crowns

Bonding refers to chemically attaching tooth colored filling material to the existing teeth in order to eliminate spacing. It is conservative in that it requires little to no preparation ("filing down of the teeth") and can be accomplished in a very short amount of time. It is the most inexpensive option, however does have limitations. Bonding can stain a lot easier around the outside edges of the material and is more brittle and can potentially chip or fracture with hard, crunchy or sticky foods.

Orthodontics/Invisalign is another method that can treat the spaces by orthodontically (via braces) moving the teeth into more favorable positions to close the space. It is conservative in that it also requires no preparation or filing down of the teeth. It can also help address other spaces or crowding in other areas of the mouth. It is more comprehensive in that all issues with spacing and crowding can be addressed at the same time. The disadvantages is that the cost is significantly more and does take more time typically anywhere from 6-18 months depending on the situation.

Veneers/Crowns are the most commonly used method for closing spaces. Veneers and crowns are porcelain restoration (aka "facings") that are glued over the existing teeth. By using porcelain, the dentist can modify the shape, color, length and size of the teeth to accommodate the spacing. Esthetically, it is a great option and takes much less time than doing orthodontics. The disadvantages is that the teeth almost always require light to moderate preparation of the teeth in order to create the room needed to glue veneers/crowns over the teeth. It is moderate in cost when compared to orthodontics and bonding but nevertheless continues to be the most highly sought out option.

Talk to your dentist about what option is best for you to close spaces between the teeth!

Answer: Having your teeth whitening by a dental professional without a doubt will yield safer and more effective results. Assuming the basics are being done to whiten such as:

1. Brushing on a daily basis

2. Moderating your intake on coffee,tea,wine, etc.

3. Using a whitening toothpaste

In office whitening or custom bleaching trays will demonstrate much better results due to the concentrations that the dentist can prescribe. Peroxide is typically the best ingredient for teeth whitening and most OTC products are limited to 20-25% whereas in office products can reach up to the realm of 35-45%. While this is also much more effective, it can be more harmful if not managed appropriately. This is why the dentist will spend more timely isolating all the tissues around the teeth to help minimize tissue burns and promoting thermal sensitivity.

Talk to your dentist about what are the best teeth whitening options for you!

Dr.Glasmeier

Answer: There are multiple ways a dentist can screen for and detect cavities or tooth decay:

1. Visual- The dentist looks for unusual discolorations, stains and dark spots found along different surfaces of the tooth. The most obvious occur along the biting surfaces of the teeth and are found more commonly on the molars.

2. Feel- The dentist uses an instrument called an "explorer" trying to feel for "stickiness" or catches along the surface of the tooth. The stickiness is often found along the grooves and fissures of the tooth and represents an area where the enamel coating of the tooth has been compromised.

3. Xrays- Digital xrays allow a dentist to see cavities not only along the biting surfaces but the flossing surfaces between the teeth. Not only do xrays provide insight to the presence or absence of a cavity, but it can convey the extent or depth of the cavity. A dentist can use xrays to determine how deep the cavity is and if there is nerve involvement.

4. Laser- Using a device called a "Diagnodent", a dentist can use a special laser that measure the damage that is left behind as a result of cavity or tooth decay. While this is not a primary means of detection, it will typically reinforce the presence of absence of a cavity if there is suspicion.

So the next question is, if there are multiple ways a cavity can be detected, what is the best way?

While there are many ways to detect tooth decay, one way is not more advantageous than the other. Simply put, the dentist should use as many ways as possible to help assess. All four ways can give the dentist tremendous insight into cavity assessment and provide the patient confidence that nothing was missed during an exam!

Answer: Lower dentures have been and will continue to be difficult for patients who desire to eat the foods they used to enjoy. Patients with lower dentures are always fearful that their denture may dislodge while talking, speaking, laughing, etc. Lower dentures are much harder to fit and remain stable due to the lack of tissue that supports (or helps retain) the denture. Unlike an upper denture, the amount of tissue needed to support a denture is much less on a lower denture.

The typical results are a lower denture that has large amounts of denture cream/adhesive to hold it in. The other is just the patient simply does not wear it and struggles to eat without the denture.

Loose dentures, specifically lower dentures, have become a pastime. Now with mini implant dentures, you can enjoy secure eating comfort again. You can smile again and no longer about a loose fitting denture coming out when you talk to your friends or laugh watching a funny movie. In one short procedure (typically less than 1 hour), you can have a stable denture with no surgical sutures, mimimal bleeding, minimal discomfort and the typical months of healing that is needed with implant surgery.

Ask about mini implant dentures so you no longer have to worry about yours!

Answer: Yes, sedation can minimize and often times completely eliminate it completely. The gag reflex refers to the response cause when the tissue in the back of the throat is irritated. There are multiple nerve endings located in the back of the throat and the "uvula", the flap of tissue that hands down in the throat and vibrates when a person says "ahhhhh". When foreign objects come in contact with this area such as impression material, filling material, cotton, the gag reflex is stimulated further producing a vomiting response. There is a great deal of variety of the intensity in gag reflex from person to person.

There are multiple treatment modalities to help improve or lessen the gag reflex. Topical anesthetic spray can be used at the back of the throat producing numbness or suppression of the gag reflex within seconds and up to 15-20 minutes. Nitrous oxide, aka laughing gas, can also work on the higher centers of the brain to also help with reducing gagging. If topical spray and laughing gas are not sufficient, oral and/or IV sedation can likely remove all the normal gag reflex reactions. With sedation, the muscles in the mouth and throat are more relaxed decreasing the likelihood of a gag reaction.

With sedation, routine dentistry, impressions, extractions, etc. can be accomplished in a short amount of time while minimizing the gag reflex often encountered in patients.

Answer: Almost always you would want to whiten prior to commencing with your dental treatment. Modern teeth whitening techniques are designed to remove external stains from natural tooth structure. It is well known that there a variety of successful brands and techniques available that can help whiten stained and darkened teeth. However, in spite of the technological advancements, whitening materials have no effect on existing restorations in the mouth.

Restorations such as crowns, bridges, fillings, etc. will not respond to whitening. Because of this, it is encouraged to whiten before any major restorations are placed or there could be some discrepancies in the tooth colors.

Answer: The answer is ABSOLUTELY. It is important to understand what cavity is and how it affects the tooth. A cavity simply refers to "hole" that is commonly found on a tooth. It is a result of bacteria that normally occupy the mouth becoming "opportunistic" meaning when given an opportunity in the right conditions, they can cause destruction to the tooth. The reason why we discourage sodas and sweets is that the bacteria in your mouth can take this sugar and metabolize it into an acid that can dissolve the enamel from the tooth. Enamel loss is characterized by holes, or dark stains, or identifiable softness within the tooth.

The problem with small cavities is that when the cavity is in the enamel, you cannot feel it. It typically does not occur until the cavity reaches the "dentin" which is tooth structure under the enamel. When the cavity reaches the dentin, sensitivity begins. The tooth will become hot/cold sensitive, bite sensitive, can periodically throb and is also more susceptible to fracture. The longer the cavity persists the deeper it gets, and the deeper it gets, the closer it gets to the nerve.

Once it gets to or close to the nerve, the sensitivity changes. Now the tooth become lingering cold sensitive and throbs eratically without any warning and without any stimulation. The tooth at this point can keep you up at night and be very unpredictable. If the cavity gets any further, the nerve becomes infected and the result is an abscess. An abscess is characterized by swelling, excruciating pain, pain to biting, pain to touch, pain when laying down, etc. When a tooth gets to this point, the only two options to resolve this pain is an extraction or root canal.

Why is this important to know? The reason is that something simple like a filling can prevent an onslaught of problems that become more time consuming, painful and costly. For example a small filling that costs $150 may appear to be costly but when compared to other options it is actually very inexpensive. A cavity that never gets filled can become a root canal, filling and crown that now costs $2000-2500 or an extraction + a permanent bridge which is typically $2500-3000.

This definitely puts a small filling into perspective.

It is important not to delay treatment that needs to be completed. Delaying treatment can become painful, costly and very time consuming. I like to think "an ounce of prevention keeps away a pound of problems".

Please call our office if you have any questions and as always, we appreciate your dedication to your oral health as well as your loyalty to our office!

Dr.Glasmeier

Answer: Oral piercing has become fashionable over the last decade. While oral piercing can involve the lips,cheek, uvula, the tongue remains to be the most commonly pierced. Tongue piercing involves placing a "barbell"-type stud through the tongue.

There are several common risks associated with tongue piercing.

Infection- This is possibly due to nonsterile techniques and/or improper care after the piercing. Treatment can include antiobiotic therapy, localized cleaning and oral hygiene instructions. Serious infections, involving the tongue, jaw and chin can require emergency medical treatment.

Chipped or Broken Teeth- Usually occurs through biting the barbell especially in new piercings with the initial longer barbell. To minimize the risk, a shorter barbell or made of acrylic/plastic should be worn.

Enamel Loss- Most commonly occurs at the back of the teeth through repeated rubbing against the jewelry. A shorter barbell or one made of non-metallic material can also be worn to prevent enamel loss.

Gum recession- Over time, repeated contact between the tongue ring and the gums can lead to receding gums especially with long stem barbells. Smaller tongue rings can reduce the risks of receding gums.

Future considerations for the tongue ring user:

1. Replacing metal barbell with a shorter, plastic based barbell.

2. Using antiseptic mouthrinse, such as Listerine on a daily basis and brushing the tongue regularly.

3. Exercise conscious control of the movement of tongue jewelry during chewing or speech.

Please contact Dr.Glasmeier if you have any questions re: tongue rings.

Answer: Yes, even though sedation will relax the patient (perhaps even make them sleep) and cause an amnesia-like effect, injections are still often necessary. Sedation does not eliminate the perception of pain therefore the patient will still need to be numb. The combination of the sedation and the injections provide the best pain free and relaxing situation for a fearful patient.

Despite the injections, however, the sedation will lessen the anxiety about the injections as well as promoting more comfortable injections. Most patients have no recollection of injections or the procedure!

Answer: Yes and no. Dental Sedation is very safe and most of the time very predictable in the response you will get. While there are multiple forms of providing sedation such oral, IV, IM, IN, inhalation, some forms are safer than others. The type of sedation to be used is tailored to the patient that desires it as well as fitting the comfort level of the provider.

For example, IV sedation is an excellent treatment for adults that have a great deal of anxiety yet not recommended in treatment for children.

Why is this?

Determining the proper type of sedation is not just evaluating the medical history of the patient, but evaluating previous dental experiences, assessing the compliance or willingness of the patient to forego treatment, and ensuring the patient has been educated about what is being done, why and how.

Back to IV sedation, children are not candidates for IV due to their inability to understand what is going on and they are less likely to be compliant to the situation. Nitrous oxide (laughing gas) or oral sedation are better options for the child because of their noninvasive nature.

The majority of patients I encounter in my practice are good candidates for sedation dentistry. The more important question is what kind of sedation do they need and what will help them achieve the experience they desire. The answer to this lies in the evaluation by the dentist. Spend time with your dentist, discussing your fears, past experiences, medical history, family history as well as your goals and expectations. The combination of all of these will establish whether or not you are a candidate for sedation!

Dr.Glasmeier

Absolutely not. I kind of like the "If it's not broke, don't fix it" attitude. But I will try and explain further. There are many dentists who are urging patients to replace all the silver fillings in their mouth without a reasonable explanation why. There is a lot of controversy and literature that suggests the harmful effects of silver fillings can cause multiple health problems. More specifically, critics state the small amounts of mercury in the silver restorations can be potentially harmful leading to neuropathies.

Neuropathies are nonspecific disorders that can affect the nervous system and brain which alter things such as vision, memory, sense of smell and taste, etc. While mercury has been shown to demonstrate potentially harmful effects if exposed in large amounts, there is not enough conclusive evidence to deter dentists from still routinely placing silver fillings. If in doubt, you can consult the American Dental Association and the FDA as they still support the use of silver fillings as an acceptable restoration in dentistry.

So why should silver fillings be replaced?

Silver fillings should be replaced if they develop cavities around them. If the silver fillings(amalgams) chip, fracture, break, or develop symptoms such as cold/biting sensitivity, then it is acceptable to replace the fillings. In these cases, a tooth colored filling (aka "composite") would typically be used to restore the tooth back to function.

Is there any harm in replacing my silver fillings if they don't bother me?

Depending on the size of the filling and location, there is always a chance of sensitivity developing following replacement of the filling as with any other filling. This should be discussed at detail with your dentist prior to replacements. If the filling is more than 50% of the tooth, then a crown may be necessary to restore the tooth back to function as well as recreating an esthetic appearance.

If silver fillings are safe then why do you not do them on a regular basis?

Two simple reasons:

1. There are environmental hazards associated with disposing of silver filling material in the garbage. This is one of the few dental materials that has specific instructions for disposal requiring special filters/traps as well as pickup services that is not only expensive but time consuming.

2. Most patients simply do not want them! Less than 5% of the general public prefer silver fillings or the tooth colored kind. It becomes a supply and demand issue where there is no demand.

What happens if I whiten my teeth following my white fillings being placed?

Tooth colored fillings, much like crowns, dentures, bridges and veneers will not respond to teeth whitening like natural teeth. It is for this reason that tooth colored fillings that will be placed on the front teeth will typically follow teeth whitening so that the fillings will not have to be redone. Back teeth have less issues with esthetics simply because of their position, therefore not as critical.

Answer: Typically sedation is not recommended during pregnancy due to the effects of the sedative drugs but also from local anesthetics. It is known that some sedatives can potentially be "teratogenic" which refers their negative effects on the fetus. Any medications that can possibly pass over the placenta can cause potential problems with normal development and nutrition. It is because of this that sedation as well as most dental treatment is typically deferred to the 2nd trimester.

It is not recommended during the 1st trimester because of early fetal development and also contraindicated late in the 3rd trimester due to the stress of the drugs/treatment than can promote premature labor. The 2nd trimester is typically the safest of the 3 trimesters but I prefer to defer all treatment until after pregnancy.

The exceptions to this is cleanings, exams and emergency treatment that would be more harmful if actually deferred. Talk to your dentist about what treatment is safe and achievable during pregnancy. If the dentist in unsure, he may consult your OB/GYN for treatment recommendations. Re: sedation, nitrous oxide is the only form of sedation/analgesia I would be comfortable administering during pregnancy.

Dr.Glasmeier

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.

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.

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

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.

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.

Answer: The word phobia is described as an irrational and sometimes disproportional fear that causes the sufferer to avoid the feared experience. In this case the feared experience is the dental visit or the actual treatment. Depending on the severity of the phobia, physical symptoms can be present. Such symptoms might include nausea or "butterflies", increased heart rate, sweating and the inability to concentrate. In rare instances, it can even be to the point where even the chair cannot be reclined. Some people may even experience a full-blown panic attack at the thought of visiting a dentist.

The most common fears of the dental patient are pain, lack of control, and the unknown. Many patients present to the dentist either in pain or endured a painful dental visit in the past. This could involve the actual injection, or the treatment or even the events that follow the treatment. Some patients are nervous and fearful that they have no control over the situation and cannot participate or be interactive in the decisions of the treatment. Others simply are scared because they do not know what to expect and have nothing to compare the upcoming experience with. No matter what the issue

While it's true that phobias can be overcome, treating a phobia can be a long process. It often makes more sense to take care of much-needed dental work and deal with issues of fear as time allows. Extreme fear or phobia associated with dental care could make you the perfect candidate for sedation dentistry!

Answer: Oral Sedation involves the use of oral medications in the form of a pill/tablet to relieve mild to moderate anxiety. The most commonly prescribed medications are Halcion, Ativan and Valium, all of which produce a high level of drowsiness but not a complete sleep. The medicine is generally administered one hour prior to treatment but sometimes is also administered the night before the dental appointment as well. You will, however, remain awake and alert throughout your dental treatment and be able to breathe on your own without the fear and anxiety you might other- wise experience. One downfall to oral sedation is that since every patient exhibits different levels of tolerance to drugs and different digestion times, there is no way to measure how much medication has been directly absorbed into the stomach. It is not effective or safe to try to make the patient more relaxed by giving more pills if the initial dose was not effective to relieve the patient's anxiety. Depending on the patient and the treatment being provided, sometimes laughing gas is used in conjunction with oral sedation to help assist with anxiety and pain control. Oral sedation is typically much more effective than laughing gas alone, but not nearly as effective as IV sedation or general anesthesia.

anxiety?

Answer: Nitrous Oxide is a sweet smelling gas administered through a inhaler mask that is placed over a patient's nose. The patient simply breathes in the laughing gas and almost immediately(within 2-4 minutes) experiences a relaxed state. Nitrous oxide is administered to patients requiring relatively short dental procedures and for those with mild anxiety. Recovery time for patients receiving nitrous oxide is very brief, as the effects subside within minutes, allowing patients to drive themselves home if necessary. This is the only form of sedation that the patient can drive to and from their dental appointment. Nitrous oxide works very well with children and does well with adults but less predictable.

What percent of patients do you see have anxiety or fear going to the dentist?

Answer: Approximately 10 million Americans avoid going to dentist due to fear and anxiety. I would say 40-50% of my patients have had or do have some fear of the dentist. This fear usually stems from a bad experience or not understanding what is going on. By simply educating the patient, much fear is eliminated when the patient knows exactly what the problem is, how to fix it, and what it takes to fix it. I take pride in most of the services I offer but the one I take the most pride in is the one you don't see listed--helping you CONQUER your fear of dentistry. I am confident I can help you not only conquer your anxiety but help you establish a routine of regular dental care that prevents you from needing frequent amounts of dental work and be proud of your oral health and smile!

Answer: When you have tooth decay or gum disease, you can get infection deep within the tooth or gum. This infection is an abscessed toot and can be very painful. If it is not treated, the infection can spread and you can lose your tooth or have other health problems.

What causes an abscessed tooth?

Damage to the tooth, an untreated cavity, or gum disease can cause an abscessed tooth.If a cavity is not treated, the inside of the tooth (called the pulp) can become infected. Bacteria can spread from the tooth to the tissue around it, creating an abscess.

Gum disease causes the gums to pull away from the teeth, leaving pockets. If food builds up in one of these pockets, bacteria can grow, and an abscess can form. Over time an abscess can cause the bone around the tooth to dissolve.

What are the symptoms?

You may have:

* Throbbing pain, especially when you chew.

* Red, swollen gums.

* A bad, foul smelling taste in your mouth.

* Swelling in your jaw or face.

* A fever.

* A bump (gumboil) that looks like a pimple on the cheek side or tongue side of the gum near the tooth.

Over time as the infection spreads, the bone in your jaw may begin to dissolve. When this happens, you may feel less pain, but the infection will remain. If you lose too much bone, your tooth will become loose and may have to be removed.

If you have a severe toothache or notice drainage of pus, call your dentist right away. You may have an abscessed tooth. If it is not treated, the infection could spread and become dangerous.

How is it treated?

If you have an abscessed tooth, your dentist will give you antibiotics to kill the bacteria causing the infection. Antibiotics may help for a while. But to get rid of the abscess, your dentist will need to get rid off the source of infection. This is done by making hole in the tooth or gum to drain the infection. Usually this will relieve your pain. If the inside of your tooth is infected, you will need a root canal or to have the tooth removed. A root canal tries to save your tooth by taking out the infected pulp. If you don't want a root canal or if you have one and it doesn't work, the dentist may have to remove your tooth. You and your doctor can decide the best step to take.

You may be able to reduce pain and swelling from an abscessed tooth by putting an ice pack wrapped in a towel against your cheek. You can also try over-the-counter pain medicine, including aspirin, acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin). But you still need to see your dentist for treatment.

How can you prevent an abscessed tooth?

You can prevent an abscessed tooth by preventing bacterial infections in your mouth. The best way to do that is to take good care of your teeth and gums:

* Brush your teeth 2 times a day, in the morning and at night, with fluoride toothpaste approved by the American Dental Association.

* Use dental floss to clean between your teeth every day.

* See your dentist for regular dental cleanings and checkups.

* Eat a healthy diet, and limit between-meal snacks.

Some people have a very dry mouth. This can cause deep dental cavities to form quickly, which can infect the pulp of a tooth and lead to an abscess. You may be able to prevent these problems by taking frequent sips of water, chewing gum, or sucking on sugarless candy. If you have severe dry mouth symptoms, you may need to take medicine to treat the problem. Many medicines can cause a dry mouth, including some medicines used to treat depression and high blood pressure.

Contact Dr.Glasmeier today if you have an tooth abscess or infection!

Answer: A bridge is a permanent dental restoration that replaces one or more teeth. It is permanent in that it is permanently glued in and cannot be taken in and out of the mouth like a denture. It often follows after a hopeless tooth has been extracted(removed). To put in a bridge, I have to prepare and reshape the teeth on both sides of the missing tooth. The bridge consists of the replacement tooth and two crowns (caps) on each side. The crowns will fit over the prepared teeth to support the replacement tooth. This typically requires two appointments and you will be placed in temporaries at the end of the first appointment until the lab fabricates your bridge. While this is one way to replace missing teeth, there are other ways to replace missing teeth such as removable partial dentures and implants.

Answer: This depends on several things. If the child has severe dental problems that require substantial amount of chair time, then a pediatric dentist might be better. Certainly, if the child has a great deal of anxiety, or a history of combativeness, or unwillingness to cooperate for simple tasks such as a cleaning, then a pediatric dentist is warranted. One major advantage of a pediatric dentist is that they can sedate children at a more concentrated level than the general dentist (oral sedation or general anesthesia)--this is a great treatment modality for children that are very young, require an extensive amount of work or have a complicated medical history. I always recommend bring your child to the general dentist first and then we can make a decision together whether or not a pediatric dentist is needed. Have faith in your child as they may do better than you think! I typically will perform exams on children as young as 3 years old but any younger, they definitely would be better for a pediatric dentist. I refer out less than 10% of the children that enter my practice because most children will do very well given the right environment.

Dr.G

With more sophisticated procedures, dentists are helping people keep their teeth longer. Because people are living longer and more stressful lives, they are exposing their teeth to many more years of crack-inducing habits, such as clenching, grinding, and chewing on hard objects. These habits make our teeth more susceptible to cracks.

How do I know if my tooth is cracked?

Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain may come and go, and your dentist may have difficulty locating which tooth is causing the discomfort.

Why does a cracked tooth hurt?

To understand why a cracked tooth hurts, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is the inner soft tissue called the pulp. The loose pulp is a connective tissue that contains cells, blood vessels and nerves. When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.

How will my cracked tooth be treated?

There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and extent of the crack.

Craze Lines

Craze lines are tiny cracks that affect only the outer enamel. These cracks are extremely common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearances.

Fractured Cusp

When a cusp (the pointed part of the chewing surface) becomes weakened, a fracture sometimes results. The weakened cusp may break off by itself or may have to be removed by the dentist. When this happens, the pain will usually be relieved. A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed. Your tooth will usually be restored with a full crown by your dentist.

Cracked Tooth

This crack extends from the chewing surface of the tooth vertically towards the root. A cracked tooth is not completely separated into two distinct segments. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your dentist will then restore your tooth with a crown to hold the pieces together and protect the cracked tooth. At times, the crack may extend below the gingival tissue line, requiring extraction. Even with high magnification and special lighting, it is sometimes difficult to determine the extent of a crack. A cracked tooth that is not treated will progressively worsen, eventually resulting in the loss of the tooth. Early diagnosis and treatment are essential in saving these teeth.

Split Tooth

Vertical Root Fracture

A split tooth is often the result of the long term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth cannot be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In rare instances, endodontic treatment and a crown or other restoration by your dentist may be used to save a portion of the tooth. Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs and symptoms and may therefore go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment may involve extraction of the tooth. However, endodontic surgery is sometimes appropriate if a portion of the tooth can be saved by removal of the fractured root.

After treatment for a cracked tooth, will my tooth completely heal?

Unlike a broken bone, the fracture in a cracked tooth will not heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases. The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your Dr. Glasmeier about your particular diagnosis and treatment recommendations. He will advise you on how to keep your natural teeth and achieve optimum dental health.

What can I do to prevent my teeth from cracking?

While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.-

Don't chew on hard objects such as ice, unpopped popcorn kernels or pens.- Don't clench or grind your teeth.

If you clench or grind your teeth while you sleep, talk to your dentist about

getting a retainer or other mouthguard to protect your teeth.

Wear a mouthguard or protective mask when playing contact sports.

I dropped mine, since the dentist repaired it I now have a space between my two front teeth I've never had. The dentist said if you don't get too close you don't notice it so much. What!! The inside of the plate is rough. I have a toxic taste of what acrylic smells like. And when I talk I have a lisp. He took an impression so it would be right and it does clip on as it should, that aside .....it doesn't fit. Do I have to live with this as he said? I feel like I was written off and I don't know where to turn. Do you have any advice?

Answer: Sounds like the dentist attempted to perform a lab repair and the broken pieces were not reapproximated correctly. Depending on how bad the denture fractured, it can be a very difficult to repair and sometimes impossible. If there is a space between the teeth that was not there, it means the broken pieces are not bonded back together correctly. The rough surface is due to newly formed acrylic and may possibly not be 100% compatible with the acrylic in your exisitng denture.

If you are having issues with phonetics, esthetics and fit issues, I would go back to your dentist and voice your concerns over the repair. I, often times, will not do repairs as they can be very difficult and very unpredictable. As a result I often advise having a new one made based on the extent of the fractures as well as the age of the denture.

Hope this helps!

Dr.Glasmeier

I get this question a lot as one would think if there is replacement what is the big deal? The big deal is that the baby teeth need to be thought of as "space holders" for the permanent teeth. If a baby tooth is lost prematurely, a permanent tooth can come in a different position which can further alter the development of the rest of the adult teeth. An adult teeth can also be affected if an infected baby tooth left untreated can cause disturbances of a permanent tooth's growth and development. In some cases I have seen an abscessed baby tooth that caused an adult tooth to become infected before it had a chance to even erupt!

Once again, an ounce of prevention can prevent a ton of problems...it is much more conservative(and cheaper) to have a cavity fixed on a baby tooth rather than "letting it go" only to find out then that the child could lose a permanent tooth or have major crowding issues with the permanent teeth(much more expensive!!). Having said this, if the baby teeth has a cavity but is within 3-6 months of coming out anyways, then a filling may not be necessary. Please consult the dentist before you try to make that determination as we are knowledgeable when a child will lose a particular baby tooth. Don't let your child miss out on school and other activities due to a toothache!

Dr.G

My son is 9 years old and has a big space between his front teeth and it seems bigger than his siblings' spaces. I want to know if this will resolve on his own or he is going to need dental work to correct this space?

Answer: Spacing between the two front teeth (known as a "diastema") is a very common finding not only in children but adults as well. Children who have baby teeth with type of spacing is actually a good situation however if this occurs with the eruption of the permanent teeth, this is quite different.

There are many different factors that can contribute to abnormal spacing between the two front teeth. The one I most commonly see is what is called a "low frenum attachment". The frenum is the soft tissue that attaches the inside of your lip to the gums above or below your teeth. Normally the frenum attaches high up above the tooth but it can also much lower on the gums between the teeth. When the gum attaches between the teeth, it can result in a diastema(space between the teeth).

When this occurs, typically two things must happen to close the space:

1. Patient needs to be evaluated to determine whether or not

orthodontics(braces) will be necessary to close the space or if they can be

closed by other means (e.g. veneers).

2. Patient will likely require a frenulectomy, where the soft tissue attachment

between the teeth is removed or reduced. There are multiple ways this is

accomplished but the most common is with a laser. With a little local

anesthesia and a laser, this procedure can be accomplished in several

minutes pain free and with little, if any postop pain. Most children have no

pain or discomfort the next day!

So back to your question, yes it can be treated but he needs to be evaluated the best way to accomplish this. Consult your dentist for the course of treatment necessary!

Best of luck!

Dr.G

If there is no plaque, what are the chances of getting only gum diseases. Also, how does floride toothpastes help,if any, to avoid gum swelling or minor gum problems like gum bleeding?

Answer: Great question! That is complicated question because plaque is only

factor that can contribute to gum disease. There are many other things that can contribute to gum disease such as:

1. Poorly fitting dental restorations

2. Medical History (Smoking, diabetes, autoimmune diseases)

3. Genetics

4. Grinding and clenching teeth, etc.

These are only a few of factors that can promote gum disease. The big misconception is that your hygiene is the only thing that determines gum disease and this is simply not true! Regarding fluoride toothpaste and its effects on gums--the fluoride is more geared for preventing cavities and minimizing thermal sensitivity that can develop on the teeth. The abrasive additives in the toothpaste in combination with brushing is what helps reduce plaque/tartar from forming on the teeth than can setup problems with gum disease. So to answer your question, the fluoride is more for the teeth than the gums. There are prescription mouthrinses that made to help prevent and/or control gum disease but most of them are prescription.

Hope this helps!

Dr.G

I had composite fillings done 2 weeks ago. Soon after, I was put on amoxicillin for an infection on the top tooth that was filled. Now that I have finished the medication, I still have aching in not only the top but also the bottom teeth that were filled. Is this normal? I've never even had to take OTC pain meds after a filling in the past, and now that I no longer need Vicodin for the terrible infection pain, I am still taking ibuprofen for the aching. Is this normal? Should I go back to see my doctor? Thank you!

Answer: Hi there, yes if it has been two weeks then you should return to your dentist for further evaluation. Typically composite fillings, aka "tooth colored fillings" can present with some localized soreness to biting along with some brief cold/sweet sensitivity. However, this type of sensitivity should resolve typically within 7-10 days. I am a little confused why an antibiotic was given for a tooth that received a filling unless that tooth has become infected. If this is the case, then you will need additional treatment beyond an antibiotic, such as a root canal.

Re: pain on top and bottom teeth..is it possible your bite could be "off" or "high" from the new filling. Sometimes if the bite is changed by a "high" filling, it can cause biting sensitivity that can progress to thermal sensitivity. I would go back to the dentist and have them evaluate the bite but also rule out that you are developing an infection around that tooth.

Good luck!

Dr.Glasmeier

Answer: The porcelain fused to metal(PFM) crowns have been around much longer than all porcelain crowns. They are known for strength and I typically do these on back teeth. They do work well on front teeth but can be more challenging to make them look esthetic. I would talk with your dentist about doing the PFM crowns but it will be much more difficult to match the esthetics that you had with all porcelain crowns. I like the all porcelain better but if done correctly the PFM crown can be acceptable as well. My biggest concern is that if they are designed corrected or even if your gums even slightly recede, you can possibly see dark line or metal hue around where the gum has receded. If you have ever seen someone smile and you see a dark color or gray hue around the gum, it is likely it is PFM crown. With an all porcelain crown, even with recession it is not as visible. All porcelain is typically my choice, if and only if your bite will allow it.

Dr.G

I have no idea what to do. After receiving a cosmetic dentist referral from Lumineers, ten months ago I had eight top teeth done for about $8500.00. Three days after the Lumineers were applied, one fell off. Since then I've had all but one of the original set of eight replaced, mostly due to the Lumineer breaking. I pretty much expect that last one will also fracture before long. I have been in the dentist chair 17 times and never known a single month in the last ten months - not once - when I had all eight Lumineers on at one time. I have always been waiting for a replacement or I was on my way into the office to get a mold taken to get the replacement.

I've nearly lost my job for all the time I had to take to accommodate the dentist's schedule, I've suffered unbelievable embarrassment when one will break and fall into someone else's drink or plate of food while out in public and I've always had a gap of one tooth or another while it was on order. The dentist tries to be nice, but he has reminded me a million times that "something like this has never happened before." A member of his office staff says he's only done 10 sets thus far (he told me hundreds during the consultation.) I know I am stuck with this office as far as the Lumineers warranty goes, and thus far none of the second set have cracked or popped off. I have absolutely no faith in this product and know I have no recourse, if the first set of Lumineers was defective as Lumineers keeps an ironclad "no compensation for anything" policy after 30 days. But this has gone on for ten months and will continue for another one (at least) as I have another replacement to get a mold taken and ordered yet. I could not be more unhappy with the whole Lumineers experience.Do you have any advice for me? Any at all? I would be so grateful, you just don't know.

First Lumineers, or also known as "no prep or no drill veneers" are a nice conservative way of reshaping and correcting color and esthetic issues with teeth that are in otherwise healthy condition. They require little to no drilling and no injections/anesthesia.

Answer: Sounds like there are some bite issues that are preventing the Lumineers from being successful. I don't do many Lumineers unless the conditions are right. You have to have a certain bite to be able to do those. There are other things that can cause them to fail, but they are fairly foolproof since there is no tooth preparation and the procedure for cementing them in very easy. I doubt its the Lumineers as much as you not necessarily being a good candidate for Lumineers. I would get a second opinion before you have them redone and would investigate whether or not you grind your teeth as this could be contributing to the problem as well. Not everyone is a candidate for no prep veneers and the dentist should be evaluating not only the physical appearance of the teeth but also analyzing your bite and ruling out that you grind or clench your teeth.

Good luck!

Dr.Glasmeier

Yes, it is likely that when the wisdom tooth was removed that the root of the tooth in front of it could have become exposed as a result of the surgery. An exposed root can cause thermal sensitivity to things such as cold and sweets. It not an infection and should calm down within several weeks...if it does not, consult your dentist. You may need to have the exposed root desensitized with medicaments or laser treatment. Dry sockets can be sensitive to cold but that is not typical as there are other things that present with dry socket such as deep throbby pain, foul odor, and pain no matter what you do but it typically goes away fairly quickly.

Dr.Glasmeier

Great question..I am assuming you had fillings done on the lower jaw. It is very uncommon to have to numb the entire side of the jaw where the tooth receiving the filling is located. When the jaw is numbed, the following are also numbed: teeth, gums, jaw, tongue, and lips. The tongue is actually a good side that the dentist numbed you adequately.

Depending on the dentist injected you, how many injections they gave you and the tye of anesthetic they gave you, it could could range form 30 minutes to 8 hours. It is unlikely you have swelling and the numbness will subside as your body metabolizes it. I would only be concerned if it lasts longer than 1 day. Time is on your side!

Dr.G

Your dentist is probably right. "Dents" or missing enamel around the gumline can be caused by different things. Please visit my website to read about abrasion, erosion and abfraction as these are all phenonenoms that can contribute to this. Your dentist wasn't concerned because it is a very common finding and unless you are having symptoms (cold, touch, sweet sensitivity), he probably treatment was not necessary.

What he was eluding to is that if you brush too hard or use a hard bristle brush, you can physically wear away the enamel off the tooth down by the gumline. I call this "toothbrush abrasion" and I see it on 4 out of every 5 patients. Brushing too hard can setup these areas for sensitivity and increased the chances of cavities.

Talk with your dentist as they might be able to put a filling on the area to make the surface smoother and prevent sensitivity!

Dr.G

Hi Mark,

Great question!! While I like oral sedation and I use it all the time, my biggest concern is patient safety. How many times have you heard of a child, or even an adult for that matter, swallow more pills that they were supposed to. As a result, you have no idea what to predict or how the person react. Some will just make theirself purge or in extreme circumstances have their stomach pumped.

Oral sedation can work well but not necessarily be as predictable in seeing the outcome. Some will barely be sedated, some not all, others will be completely "snowed" over and there are many variables that can determine this: age, height, weight, medical history, male vs female, level of anxiety, etc. Oral sedation works relatively well but I would recommend having your dentist do a test run if you have inadequate results with oral sedation. I, sometimes, will due to a test appointment with the medications with my patient and not do any treatment but more less assess how the patient will respond. Being able to see this helps ascertain what treatment we can do and how much.

Its because of this that I prefer IV sedation, where I have more control over what goes on, and I can reverse the process quickly if I am not happy with how it is going. It tends to be more predictable, faster acting, and ultimately safer. You won't find any oral surgeons who would prefer oral or IV sedation due to the same reasons!

Hope this helps!

Dr.G

Acid reflux can wreak havoc on the teeth. This is also includes bulimia or any other disorder that allows stomach acid to escape the stomach. This causes two major problems....

1. Erosion of the esophagus can occur leading to bleeding.

2. Erosion of the teeth due to the acid dissolving the enamel on the backs of

the teeth.

Back to your question, there are many cosmetic options such as crowns or veneers that help cover the teeth that provide additional strength as well as cosmetic options however we are overlooking the initial problem:

THE ACID REFLUX!!

You have to get this under control first. Highly recommend you consult your physician and get on medication that will assist controlling this as there is no dental restoration that will prevent you this erosion completely without controlling the reflux.

Fix the reflux and then go consult a dentist about how to esthetically control your teeth that are chipping.

Good luck!

Dr.Glasmeier

They are miniature titanium screws/anchors that are placed into the jawbone to help with various dental procedures such as:

1. Improving the fit of dentures

2. Help replace small, missing teeth.

3. Assist in orthodontics to move teeth into more favorable positions.

The implant simulates a root of a tooth and has a ball that sits on the top of implant that articulates with a denture or a crown. It works similar to a ball and socket joint that provides excellent retention and resistance form. It is most useful in denture applications to help provide resistance against lifting forces.

Mini implants are placed under local anesthesia and are quite pain free when compared to something like a root canal or an extraction of a tooth. There are not incisions, no cutting of the bone, and no long healing times. After placement, the ball of the implant will be sticking out of the gum tissue and will be the only visible portion of the implant. Because they are minimally invasive, there is very little healing period and dentures can be stabilized the same day the implants are placed. Depending on the situation, sometimes a new denture is made against the new implants or the existing denture can be refit ("retrofitted") to the new implants.

So who is a candidate for mini implants?

-Ill-fitting or poor fitting dentures

-Patients that cannot eat foods like corn, apples, steak, crackers, etc.

-Someone who is afraid to laugh, smile or speak for fear of their denture

coming out.

-Patients that want pain-free, immediate results and not long healing times.

Ask Dr.Glasmeier about mini implants and how they can help make your dentures better!!

If tooth loss is unavoidable, there are various options for replacement that can effectively restore your smile. Dental implants are artificial tooth roots that can be surgically anchored to the jaw to hold a replacement tooth or a bridge in place. Implants are permanent and stable, and they look and feel just like natural teeth. Dental implants may also be used in addition to a denture for better stabilization.

Dentures are removable replacements for missing teeth and adjoining tissues.

Partial dentures are an option if you have some natural teeth remaining, as they fill in the spaces created by missing teeth and prevent other teeth from shifting position. Full dentures are appropriate if you have lost most or all of your teeth. "Immediate" dentures are inserted immediately following removal of the natural teeth, while "conventional" dentures are placed in the mouth about eight to 12 weeks after tooth removal.

A dental bridge is a false tooth that is fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place are attached onto your teeth on each side of the false tooth and the bridge is not removable because it is secured into place.

Dr.G

Treatment Overview

Early treatment of gum disease is very important. The goals of treatment are to prevent gum disease from permanently damaging tissues, control infection, and prevent tooth loss. For treatment to be effective, you will need to:

• Keep your teeth clean by brushing twice a day and flossing once a day.
• See your dentist regularly for checkups and cleanings.
• Avoid all tobacco use. Tobacco decreases your ability to fight infection, interferes with healing, and makes you more likely to have serious gum disease that results in tooth loss.

Treatment for early-stage gum disease

If you have early-stage gum disease (gingivitis), you may be able to reverse the damage to your gums:

• Brush your teeth twice a day, in the morning and before bedtime.
• Floss your teeth once a day.
• Use an antiseptic mouthwash, such as Listerine, or an antiplaque mouthwash.

Your dentist will want to see you for regular checkups and cleanings. Professional cleaning can remove plaque and tartar that brushing and flossing missed. Once you have had gum disease, you may need to see your dentist every 3 or 4 months for follow-up.

Your dentist may prescribe antibiotics to help fight the infection. They can be applied directly on the gums, swallowed as pills or capsules, or swished around in your teeth as mouthwash. Your dentist may also recommend an antibacterial toothpaste that reduces plaque and gingivitis when used regularly.

Treatment for advanced gum disease

Early-stage gum disease (gingivitis) that is not treated promptly or that does not respond to treatment can progress to periodontitis. Periodontitis requires prompt treatment to get rid of the infection and stop damage to the teeth and gums, followed by long-term care to maintain the health of your mouth.

• Your dentist or dental hygienist will remove the plaque and tartar both above and below your gum line. This procedure, called root planing and scaling, makes it harder for plaque to stick to the teeth.
• Your dentist may give you antibiotics to kill bacteria and stop the infection. They may be applied directly on the gums, swallowed as pills or capsules, or inserted into the pockets in your gums.
• You may need surgery if these treatments don't control the infection or if you already have severe damage to your gums or teeth. Surgery options may include:
• • Gingivectomy, which removes and reshapes loose, diseased gum tissue to get rid of the pockets between the teeth and gums where plaque can accumulate.
  • A flap procedure, which cleans the roots of a tooth and repairs bone damage.
  • Extraction, to remove loose or severely damaged teeth.
• After surgery, you may need to take antibiotics or other medicines to aid healing and prevent infection.

After treatment, you will need to keep your mouth disease-free by preventing plaque buildup. You will need to brush carefully and thoroughly after all meals and snacks and floss daily. Your dentist will probably prescribe an antibacterial mouthwash.

Your dentist will schedule follow-up appointments every 3 to 4 months for cleaning and to make sure that the disease has not returned.

P.S. Thanks for serving our country!!

Good question and the answer is yes and no. It is very common to see teenageers come out of braces and have cavities that have developed in the process. To describe it as "enamel erosion" is a little ambiguous however. Typically there are 2 common areas to see cavities when a patient has their braces removed:

1. Lip/cheek side surface of the teeth where the brackets were bonded on the teeth.

2. Also occur between the teeth where you normally floss but very difficult when in braces.

Back to your question...erosion and cavities are two different things. I would ask the dentist to clarify what has happened. Erosion can lead to cavities but they are 2 separate situations. There is a chance he will need fillings where the erosion/cavity occurred. I would have him focus on their hygiene and also consider getting on a Fluoride prescription until everything stabilizes. The other question I would ask the dentist would be were any of these present during the past couple recall/cleaning appointments as cavities don't typically occur that quickly unless it had been a while since his last checkup. Hope this helps!

Dr.G

The common and most obvious ones are cavities and infections which is directly due to the cavity(tooth decay) getting close to the nerve. Fractures in the tooth, or the filling or both can also cause sensitivity in regards to cold, sweets, and biting.

The one that I see even more than these are sensitive teeth due to root exposure. 4 out of every 5 patients have at least one area where they have root exposure and cold or sweets will create what I call a "zinger". Patient will often report an area on a tooth and state that it is sensitive when they touch the surface with their fingernail or toothbrush bristles.

So what causes root exposure? Several things but the most common are periodontal(gum) disease, receding gums, aggressive toothbrushing, and heavy grinding of the teeth. All of these can cause root surfaces to become exposed and cause a great deal of sensitivity. While it typically is a "tolerable" discomfort, it can be very frustrating and self limiting.

What are the the treatments for sensitivity due to root exposure? It can range as simple as a fluoride topical application to a root surface filling to a gum surgery to help cover up the root surface. The newest type of treatment that I use on a daily basis is called "Laser Desensitizing". Using a special laser, I can "zap" the root surface with laser energy and totally eliminate the cold and sweet sensitivity in a matter of minutes. The advantages of this treatment is that you get instant results(i.e. instant pain relief) and is virtually pain free. Patients have great results from laser desensitization and it is becoming the most cost efficient/conservative treatment available?

Ask your dentist about sensitive teeth and what the causes are and what the recommended treatment is!

Dr.G

Hello.I have cerebral palsy.I have a few metal crowns.over time my bite has become off and I ground at night.I didn't take care off this right away like I should have and now my teeth are severely worn.Do you think if I got posts and metal crowns they would last in my mouth?the few crowns I have seem to have done well over time.would the new zirconia crowns be as durable as the metal? Thank you for your time and consideration. Kurt

Answer:

Hi Kurt,

This unfortunately is a very loaded question that I cannot give you a good answer for the following reasons:

1. Posts do not make teeth stronger...they more less help hold in the foundations that the crowns sit on so they are more for retention, not strength.

2. There are crowns with different properties for different situations, so it is hard to say what is best for you as there many things that need to be evaluated such as:
1. Cavities present?
2. What kind of bite do you have?
3. Condition of existing crowns?
4. How heavy you grind?

These are several questions that would need to be answered before telling you what kind of crowns you need. Having said that, zirconia crowns are showing promise in strength and certainly have esthetic advantages over metal crowns but they are not indicated in all situations. I would recommend getting evaluated to further determine this.

Good luck!
Dr.Glasmeier

A crown is a restoration that I prescribe to fix badly broken teeth or a tooth that has been root canal treated. A crown is cemented over top of the tooth after it has been prepared. Badly broken teeth can result from large cavities, root canal treatment and trauma as well. Sometimes crowns are placed on teeth that are cosmetically unacceptable by the patient. By doing a crown, I can alter the shape, contour, color and bite of the original tooth so that patients are happy with its function as well as its appearance.

Crowns also sometimes require additional procedures based on the existing condition of the tooth such as a root canal, crown lengthening surgery, and teeth buildups. Please consult me if you have any questions about crowns or bridges. Crowns can be made of gold, porcelain, or metal/porcelain which is called a porcelain fused to metal crown(PFM). The decision on the material is based on the position of the tooth, the demand for esthetics, and what type of chewing forces the crown would be subjected to. Ask your dentist about the benefits of crowns and well as what is most suitable for your situation!

Typically there is a combination of medications(sedatives and narcotics) used to achieve sedation in order eliminate anxiety as well as providing pain control. The types and amounts greatly depend on the length of the procedure, the medical history of the patient, and the types of procedures.

Usually a combination of sedative(benzodiazepines) such as Versed or Valium will be given to help with anxiety control. In addition, a pain medicine is administered along with the sedative to help with pain control but to also further assist with the sedation process. Usually, Demerol or Fentanyl are the pain medications administered IV.

Other IV meds sometimes used in IV sedation are Phenergan(to offset nausea from the other medications), and Dexamethasone (steroids that control postoperative swelling/inflammation). Propofol, is also a commonly used IV medication to assist with the sedation but is only indicated in very short procedures and has very limited use in dentistry because of the dangers if not used appropriately.

IV sedation is very safe an in fact, is much safer than oral sedation as IV sedation relies on medications being placed through the IV so the effects can be felt much faster, be better controlled, and easier to reverse should an emergency occur. Ask your dentist about the types of sedation he/she offers and how it can benefit you!

Types of Sedation

There are 3 main types of sedation:

1. - The lightest form of sedation is nitrous oxide (laughing gas). This produces a mild sense of relaxation.

2. - Oral sedation is a moderate form of sedation. This form of sedation typically uses two pills taken before the dental visit to produce a deep state of relaxation. It is best used for short appointments, because once the drug reaches its peak state of relaxation it slowly begins to wear off.

3. - The deepest form of sedation is IV sedation (sleep dentistry). This form of sedation uses pain relieving and sedative drugs to create a sleep like state where the patient is virtually unaware of the dentistry being preformed. Most patients have little or no memory of the visit.

Only about 4% of dentists have the training and licensing to provide IV Sedation.

Some dentists have access to all of the above forms of sedation to help a patient feel comfortable before, during and after treatment.

Sometimes patients do not require injections for fillings. It depends on how large and how deep the cavity(decay) is and where is sits in relation to the nerve. I like to think of a tooth like an M&M peanut. The outer candy shell is the enamel, which has no nerve endings. The inner chocolate layer is the dentin, which does have nerve endings and then there is the peanut, aka the "pulp" or nerve of the tooth.

Cavities that form only in the enamel tend to not cause sensitivity therefore do not need to be numb to be fixed. However when the cavity penetrates into the second layer, the dentin, hot/cold/sensitivity begins. Decay into dentin will require local anesthesia(injections) to put the tooth into a comfortable state so the cavity can be removed. When cavities get into the nerve, thats when we speak of root canals. Once decay(bacteria) have penetrated into the nerve, an onslaught of symptoms begins. Ranging from cold sensitivity to throbbing, sharp pain to biting pain to gum tenderness, the nerve will require removal to eliminate the infection and sensitivity.

So to summarize, the need for being "numb" relies on how far the cavity got into the M&M peanut :)

A filling is a material that your dentist uses to fill a cavity after the tooth decay has been removed.

To fill a tooth, I will:

* Numb your teeth, gums, tongue, and surrounding skin. I will first put a jelly substance directly on the area to start the numbing process and then inject an anesthetic to complete it. Sometimes we will give you nitrous oxide gas (laughing gas) to reduce your pain and help you relax.

* Sometimes we use a small sheet of rubber on a metal frame (rubber dam) to target the decayed tooth and to stop liquid and tooth chips from entering your mouth and throat.

* Drill out all the decay and replace it with a filling.

Fillings can be made from many types of material. Talk to your dentist about which type would be best for you.

* Amalgam is the easiest material for a dentist to use. It is the fastest and least costly choice. Amalgam is a mixture of mercury, silver, tin, or other metals. I do not use this material anymore due to patient preference and because it is expensive and difficult to expose of.

* Composite resins are tooth-colored fillings. This process is sometimes referred to as "bonding" if it is on a front tooth. This is standard nowadays for the cosmetic dentist. It is the most esthetic(cosmetic) material and the newer materials have longevity comparable to the amalgam silver fillings. Composite resin is easier than gold for a dentist to work with and generally is less expensive than gold.

* Ceramics are costly tooth-colored fillings. They require special equipment and may require dental lab support. You may need several appointments. These are used in much larger fillings where the tooth is in between needing a filling or a crown.

What To Expect After Treatment

After I filled the cavity, your lips and gums may remain numb for a few hours until the numbing medicine wears off. Avoid chewing on your numb lip or cheek to avoid injuring your mouth.

Why It Is Done

You need a filling when tooth decay has caused a hole (cavity) to form on a tooth surface. If you don't get a filling, the cavity will get worse and lead to more severe problems, such as bone loss.

How Well It Works

A filling repairs the tooth and stops tooth decay. Over a long period of time, you may need to replace a worn-out filling.

Your filled tooth may be sensitive to heat and cold for days to weeks after you get the filling. Talk to your dentist about toothpastes that may help you with this discomfort. Tell your dentist if your teeth are too sensitive after you get a filling, because you can usually treat this problem.

Risks

There is almost no risk involved in having a cavity filled.

Some dental work can cause bacteria in the mouth to enter the bloodstream. These bacteria can cause infections in other parts of the body. People who have difficulty fighting infections may need to take antibiotics before and after dental surgery. Such people include those who:

* Have heart valve problems, such as endocarditis.
* Were born with heart defects.
* Have an impaired immune system.
* Have liver disease (cirrhosis.
* Have artificial joints, such as a hip that has been replaced.

What To Think About

It is important to start treatment before tooth decay becomes worse. More severe decay may cause pain and tooth loss and may require a costly crown, a root canal, or tooth removal (extraction).

Some dentists now use a laser system to remove tooth decay and prepare the tooth for filling. The laser is quiet, does not vibrate like a drill, and is usually painless, so medicines to deaden pain often are not needed. Laser treatment is a relatively new choice for dental treatment. Two dental laser systems have been cleared by the U.S. Food and Drug Administration (FDA). These systems are under review by the American Dental Association. I do not use this type of system at this time due to it being a relatively new technology but the current research shows much promise in this innovation. Depending on the size, I can use air abrasion, which is a drill-less instrument to remove the cavity before filling. This is preferred as it is less noisy and more comfortable but only used when the filling is relatively small.

Wisdom teeth, often times, have to be removed for several reasons such as inability to keep clean, more prone to getting cavities, can cause shifting of teeth, can develop unusual pathology such as tumors, and can cause diffuse pain in the jaw as well as the jaw joints. Wisdom teeth can fully erupt through the gums, or partially erupt, or never erupt (called an impacted wisdom tooth). Depending on the level of eruption, a general dentist may be able to take the wisdom teeth and often times I refer to an oral surgeon who specializes in taking out more difficult teeth.

Because wisdom teeth are typically more difficult to take out, one can experience more discomfort and pain following. Again the level of eruption will determine how difficult it will be to remove which further determines how much discomfort afterwards. I typically recommend sedation for wisdom teeth in 3 different options:

1. Nitrous oxide (laughing gas during procedure)
2. Oral sedation(oral medication before procedure)
3. IV sedation ("put to sleep" with medications through an IV). Ask your dentist what is most appropriate for you.

The advantage to oral and IV sedation is also that it can cause amnesia which prevents the patient from remembering the procedure. Most patients wake up without any recollection of what happened, how long it lasted and how the procedure went. So yes I would recommend removing wisdom teeth ~85% of the time and I would recommend sedation for the procedure.

Its too bad that wisdom teeth are most likely the most "unintelligent" teeth in the mouth. How's that for irony!

Tooth decay is the process that results in a cavity (dental caries). It occurs when bacteria in your mouth make acids that eat away at a tooth. If not treated, tooth decay can cause infection and tooth loss.

You can easily prevent tooth decay by brushing and flossing your teeth regularly, seeing your dentist for teeth cleaning and checkups, and avoiding foods that are high in sugar.

What causes tooth decay?

The combination of bacteria and food causes tooth decay. A clear, sticky substance called plaque that contains bacteria is always forming on your teeth and gums. As the bacteria feed on the sugars in the food you eat, they make acids. The acids attack the teeth for 20 minutes or more after eating. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.
What are the symptoms of tooth decay?

Tooth decay usually does not cause symptoms until you have a cavity or an infected tooth. When this occurs, a toothache is the most common symptom.
How is tooth decay diagnosed?

Your dentist diagnoses tooth decay by:

* Asking questions about your past dental and medical problems and care.
* Examining your teeth, using a pointed tool and a small mirror.
* Taking X-rays of your teeth and mouth.

How is tooth decay treated?

Treatment for tooth decay depends on how bad it is. You may be able to reverse slight tooth decay by using fluoride. To fix cavities caused by mild tooth decay, your dentist will fill the cavities with another substance (fillings). For more severe tooth decay, you may need a crown or root canal. In extreme cases, your dentist may have to remove the tooth.

I would encourage you go to my sedation tab to read further regarding sedation. Bottom line is there are many different options to help make you more relaxed but the recommended choice is based on your past experiences, the work that needs to be done as well as the amount of work to be done, your medical history. More patients fear going to the dentist because of a bad experience or because they simply don't understand.

Having said that, picking a dentist just because "he can sedate you" is not enough. When looking for a dentist, you need to ask yourself several questions:

Does he understand my fears and concerns and did he offer me solutions?

Does he have up to date equipment and properly trained staff?

Did he explain everything in a manner that you understand...that is can you make an educated decision based on what he has advised you on?

Was he gentle? If you had a cleaning, was the hygienist gentle?

Was the front desk gentle and receptive to your needs?

I believe with a friendly staff and a dentist who takes the time to explain your problems as well as what caused them, offer solutions and alternatives along with the pros and cons, is just as important for helping with anxiety and fear.

I recommend bring your child as soon as they get their full complement of baby teeth, which is approximately 2-3 years of age. While this age is young, and very little dentistry can often be accomplished, it establishes a couple things:

1. The dentist is able to count all the teeth to verify that all the teeth are present as well as checking for cavities. The dentist can also determine and assess for further problems such as crowding issues or potential diastemas(spaces between front teeth).
2. By establishing a routine early, the child will typically have more positive experiences and be comfortable with future visits.
3. Enables the dentist to help the parents establish a good system of oral hygiene to prevent further problems.

At ages 2-3, typically the teeth will be counted and will be checked for cavities and any other abnormalities. X-rays are not usually taken unless a problem is discovered and the child may or may not receive a cleaning depending on the child's temperament. By ages 4-5,the child will get the same treatment as an adult which involves an exam, x-rays and a cleaning. It is VERY important to have your child assessed before their permanent teeth start to come in as there could be preexisting problems that may affect the permanent teeth. An ounce of prevention provides defense against a ton of problems!

Whitening for Life is a program designed to reward patients who join our office and commit to getting regular checkups and cleanings to promote good oral health.

With our Whitening for Life program, you receive:

* One set of customized upper and lower trays with starter kit at minimal charge to cover cost of
materials and time needed to fabricate the custom trays
* One tube of whitening gel at every recall exam appointment at no charge. Additional tubes are available for purchase.

To be eligible for the program, you must meet the following criteria:

* Be a patient of record or become a new patient of record
* Have had a complete dental examination by Dr. Glasmeier with
recommended x-rays.
* Do not have active, untreated disease, gum (periodontal) disease, decay
(caries), root sensitivity, oral cancer, etc
* Agree to and sign Whitening For Life consent form
* Stay current in keeping with your recommended cleaning appointments
(prophylaxis(cleanings), periodontal maintenance)
* Must not have any outstanding balances or previous bad debts

Please Remember:

* We are here to help you with your health and have a wonderful smile!
* Whitening isn't for everyone
* Your oral health conditions may not make whitening a wise choice
* Whitening procedures may not be effective on some teeth
* Regular cleanings/checkups as well as prescribed home care are the foundation to whiter teeth while teeth whitening is a supplement.

Ask us about becoming a Whitening For Life Member!!

Laser dentistry in an up and coming discipline in dentistry that involves performing dental procedures that would conventionally require instruments for drilling and cutting. Depending on the type of the laser, they can be used to remove decay from decay as opposed to the normal drilling of a cavity. They can be used to treat periodontal disease by reducing the bacteria in the gums, reshape the bone around the teeth, and even reshape the gums for cosmetic reasons.

What makes laser dentistry so interesting is its noninvasive nature and the healing time that follows these procedures. Lasers typically are less painful and yield less postoperative discomfort than conventional methods previously used. Some of the procedures that lasers can be used for are the following:

1. Removing decay from teeth

2. Reshaping gums or assisting in treating gum disease

3. Frenectomy (clipping muscle attachments that cause conditions such as

tongue tied or diastema)

3. Root desensitation (eliminate thermal discomfort on root surfaces)

4. Removal of lesions of the mouth such as apthous ulcers or herpetic ulcers

that recur in the mouth

5. Teeth Whitening

These are some of the uses for lasers as there many other uses that the dental profession is utilizing to deliver the same kind of dentistry in a more noninvasive manner. Ask your dentist if he does laser dentistry!

Almost always when a posterior (back) tooth has to receive a root canal for whatever reason (cavity, broken, infected), a crown is typically recommended following completion of root canal therapy. The reason is that the tooth is compromised from previous factors such as cavity, fracture lines, big filling, etc. The foundation of the tooth has been greatly compromised not to mention a root canal is essentially creating a hole down the middle of the tooth further weakening an already compromised tooth. A root canal also involves removing the nerve from the teeth which cuts away some of the blood and nerve supplies which can lead to desiccation or "drying out" of the tooth. Put this all together and a tooth with previous work + root canal= a tooth that will potentially fracture.

Unfortunately when these teeth fracture, they tend to do it catastrophically and sometimes to the point where they are not fixable and need to be extracted. A crown provides additional protection to the tooth as it helps splint the remaining tooth structure together and offsets some of the stresses that occur while eating, chewing, grinding, clenching etc. Depending on the situation, there are different kinds of crowns that can be used and will be discussed at a later date. Ultimately, a crown is very important following root canal therapy to minimize the changes of breaking and fracturing.

What is the major difference between a conventional and a immediate denture?

The major difference is the time at which the denture is placed. An immediate denture is delivered at the time of the extractions or when all the remaining teeth are removed. A conventional denture typically follows an immediate denture by 6-12 months or when the gums are done healing from the extractions. The advantages of an immediate denture is exactly what it implies----the patient will have teeth to wear as soon as the teeth are taken out so there is no time that they have to go without the teeth. Patients willing to go without teeth for 6 months can go straight to a conventional denture without the immediate however most patients prefer getting an immediate denture for cosmetic reasons. This is with the understanding that they will have another denture 6-12 months down the road due to reasons what will be mentioned in an upcoming blog. Talk with your dentist about what kind of denture is best for you.

What is the difference between oral and IV sedation?

An ABSOLUTE ton!! While I do all forms of sedation in my dental practice, I would much prefer IV sedation over oral sedation. Before I discuss the differences, I will discuss the similarities:

1. Both will put the patient in a more relaxed state with possible "sleepiness"
2. Both will produce some amnesia so that the patient has very little recollection of what happened.
3. Both will dull a patient's perception of noisy drills, painful injections, and having your mouth open for a long time.

So oral sedation can work roughly the same as IV sedation except:
1. It takes much longer to produce sedation through oral (1 hour to 2 hours) versus
IV sedation (3 min to 10 min).
2. Oral sedation can last much longer than needed where IV sedation can end as
quickly as the procedure is done so the patient is not incapacitated for the
duration of the day.
3. It is much easier to treat an emergency or reverse a sedation with an IV vs oral
sedation. In oral sedation, each person will metabolize oral medications
differently, so it is difficult to predict what it will take to make the patient
comfortable. Also, the patient can be oversedated with oral sedation and much
more difficult to reverse since an IV is not started.

These are significant differences between oral and IV sedation. While oral is an acceptable way to provide relaxation to the patient, IV sedation is more efficient, does not last as long, and is ultimately more safer than other forms of sedation. This is also why the majority of specialists such as oral surgeons use IV sedation as a preferred method of sedation!!

Many times patients present in my office with a compromised tooth either due to cavities, fractures or even gum disease and often times it can be very questionable about the best decision to make for saving a tooth. Often times I am asked what information do I use to make the best decision. Here are some simple guidelines I use to help patients make informed decisions?

1. Front or back tooth? This plays a huge variable in re: to esthetics...how much will this affect my smile?

2. Function? How is this tooth used? Do you eat with this tooth or is it just a placeholder? Does it have a history of having problems? Do you grind your teeth?

3. Does this tooth affect other teeth around it? Gum disease can affect adjacent teeth as well as infection. Is there a tooth beside it than can help take some of the stress of that one not being there?

4. How much work is involved to get the tooth healthy again? Will it require multiple procedures? What is the long term prognosis of the tooth if I fix it? What sort of investment is needed to rehabilitate this tooth? What kind of investment is needed to replace the tooth if I have it removed?

5. What does the xray say about the tooth? What kind of symptoms are we having with this tooth? Have we had this problem with other teeth?

The message is simple: there are many things a dentist looks at to help make an educated decision on what is best for the patient. Typically there are different options available but you must consult a dentist to see what is best for you. Keep in mind, we do not make our decisions on what insurance covers, we make our decision on what we do if it was one of our loved ones was in this situation.

Does your gumline appear purple or gray?

Do you have an old gold crown or a porcelain crown that is chipped with metal showing?

Do you have a history of breaking teeth and/or crowns or have a habit of grinding/clenching your teeth?

     If the answer is yes than the Brux-Zir crown is for you! The Brux zir crown is a porcelain-like crown that has the appearance of a metal free crown yet has the strength of a gold or metal crown. They are prepared fairly similar to traditional crowns except the material is virtually unbreakable and scratch proof. They are more unique in that they are often times fabricated by a computer giving excellent precision and long term stability.

Ask Dr.Glasmeier about Brux-Zir crowns, the metal free crown most popular in Nashville, TN!

  replace teeth?

  change the colors/shapes of teeth?

  close spaces?

  fix crowding?

The two most common barriers for achieving these goals are:

  1. Cost

  2. Fear/anxiety of shots/pain from procedures

Enter the Snap On Smile!!!!

   .....a new age way of providing a cosmetic smile makeover in 2 visits that eliminates shots, drilling on teeth, having to wear temporaries and certainly significantly less costly than "traditional" dentistry. Talk to Dr.Glasmeier about the Snap On Smile, the leading provider for this outstanding makeover appliance!!

Enter the Componeer....a same day veneer than can be placed for an instant smile makeover! The componeer is a special veneer made of composite(similar to white fillings) and are prefabricated that will allow for the dentist to contour and adjust specific to the patient. The results are amazing and more importantly, immediate! Here are typical questions I see about the Componeer:

 1. Do I have to be numb or be drilled on? While not absolutely necessary, it is recommendeded to get the ideal result. The prepping of the teeth is very minimal(contact lens thickness) but there is alot of recontouring of the veneer on the tooth as well as around the gumline.

2. How are they different from porcelain veneers? They are made a composite material which is more similar to how we place fillings.The advantage of this is that you can visualize results before they are even finished, they can be repaired much more easily, and the there is no lab bill which means more less cost to the patient. The downside of porcelain veneers is having to have a lab make the veneers which is costly not to mention the patient has to wear temporaries for several weeks until the real veneers come in and the possibility of them not fitting after they come back to the lab. The Componeers are quicker, comparably as strong, easier to fix and immediate results.

3. How long do they last? It really depends on many variables that your dentist can discuss with you such as your bite, your hygiene, your diet, your compliance at the dentist, positions of the teeth, etc. The average life expectancy on these should be 4-6 years and longer if the conditions are correct?

4. What is the cost of this type of veneer? Traditional porcelain veneers range from $1000-1,200 per veneer. Because they are done chairside and do not involve a labm the cost of the Componeer is roughly half. They are much more cost effective with very similar results.

5. How do I know if I am a candidate? Talk to your dentist and have  a thorough evaluation performed to see if you are a candidate! We're sure you love the results you can achieve making over your smile with Componeers!

Talk to Dr.Glasmeier about same day veneers!

How is it different from a traditional porcelain veneer? There is no lab bill so the cost is reduced significantly and you get immediate results. There is very minimal prepping(drilling) of the tooth and no impressions or temporaries. Chairside veneers are easier to repair.

Do I need to have my teeth drilled or do I need shots? To get the most esthetic outcome, the answer is typically yes but in certain circumstances(position of the teeth) you can get the veneers without numbing or drilling. It is typically determined on a case to case basis.

Can I get chairside veneers if I grind my teeth? Yes you can because the facing is bonded to the front of the tooth. The front of the tooth does not participate in biting so they are safer from “grinders and clenchers”.

What is the approximate cost of a chairside veneer? Cost is ~ ½ the cost of a porcelain lab veneer which is around $600-800/veneer.

How long do chairside veneer last? Much like fillings and traditional veneers, chairside veneers should last around 6-8 years assuming good hygiene and regular checkups.

Talk to Dr.Glasmeier about Chairside veneers!