Posts for: September, 2018
Shingles is a painful viral infection that could potentially recur in sufferers for years. It causes painful skin rashes, general nerve pain, fever and fatigue. In extreme cases, it can cause blindness if the eyes become infected. And because it’s highly contagious, it could affect your dental treatment.
Formally known as herpes zoster, shingles is a recurrent form of chicken pox. If you contracted chicken pox in childhood, the shingles virus could lay dormant for several years. In fact, most people who contract shingles are over 50.
Because it acutely affects the nerves around the skin, the disease’s most common symptom is a belted or striped rash pattern that often appears on one side of the body and frequently on the head, neck or face. While the severity of symptoms may vary among patients, shingles can be a significant health threat to certain people, especially pregnant women, cancer patients or individuals with compromised immune systems.
In its early stages, the shingles virus can easily pass from person to person, either by direct contact with the rash or by airborne secretions that others can inhale. Because it’s highly contagious, even a routine teeth cleaning could potentially spread the virus to dental staff or other patients. Because of the significant health threat it potentially poses to some people, your dental provider may decline to treat you if you’re showing symptoms of the disease.
To stay ahead of this, let your dentist know you’re experiencing a shingles episode if you have an upcoming dental appointment, in which case you may need to reschedule. In the meantime, you should seek medical attention from your physician who may prescribe antiviral medication. Starting it within 3 days of a shingles outbreak can significantly reduce your pain and discomfort as well as its contagiousness.
And if you’re over sixty or at risk for shingles, consider getting the shingles vaccine. This readily available vaccine has proven effective in preventing the disease and could help you avoid the pain and disruption this viral infection can bring to your life.
The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.
But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.
Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.
There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.
Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.
After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.
The best way to prevent dental visit anxiety in your children is start those visits around their first birthday, and continue with them through childhood. Age One visits are the best way to ensure they're comfortable with the dentist now and that they'll continue the habit into adulthood.
But in spite of your best efforts and those of your dental provider, there's no guarantee your child won't experience dental visit anxiety at some point. If that happens, we recommend conscious sedation.
Conscious sedation is the use of certain medications to help a patient relax. It's not the same as anesthesia, which eliminates pain by numbing tissues (local anesthesia) or inducing unconsciousness (general anesthesia). During conscious sedation a patient remains awake or at the most in a dream-like state, can still respond to touch or verbal commands, and although monitored doesn't require assistance in heart or lung function.
We can induce this relaxed state in a number of ways: orally, with medication given by mouth a short time before the visit; intravenously, the medication delivered through a drip directly into the bloodstream; or by inhalation, usually nitrous oxide gas mixed with oxygen and delivered by mask.
Oral sedation is the most common. On the day of the procedure, we'll give your child one or more sedative drugs, usually in syrup form. For best results we advise they eat a low-fat dinner the night before and not eat or drink any food or liquid afterward. We typically use Midazolam and Hydroxyzine, both of which are proven safe and fast acting.
During the procedure, we'll also assign a team member to monitor their vital signs while they're under the influence of the drugs. We may also employ special positioning or immobilization equipment to keep movement to a minimum.
After the procedure, we'll continue to monitor vitals until they return to pre-sedation levels. The child should remain home the rest of the day to rest and return to school the next day.
Conscious sedation is regulated by states: providers must be trained and licensed to administer sedation drugs with continuing education requirements. Even so, the use of sedation for children is becoming more widespread and helps to safely ensure they're getting the dental care they need.
If you would like more information on comfortable dentistry for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”