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My Blog
Posts for: November, 2015
A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.
But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.
Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.
Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.
Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.
The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.
If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation.
Professional basketball player Lamar Odom is sometimes known as “the candyman” because of his notorious fondness for sweets. But when his sweet tooth finally caught up with him — in the form of a mouthful of decayed teeth — the six-foot-ten-inch, 230-pound hoops star admitted that he had been avoiding treatment… because he was afraid of going to the dentist!
It took two Kardashians (Khloe and Kim) and a painful toothache to finally persuade Odom to sit in the chair. Once he did, it was found that he needed a root canal, a wisdom tooth extraction, and several fillings. Yet the fretful forward sailed through the whole set of procedures in a single visit, and walked out with a big smile afterward. How did his dentists make that happen?
Put it down to the “magic” of sedation dentistry. With anxiety-relieving medications that can be delivered orally (in pill form or by gas) or intravenously (into the bloodstream), the techniques of sedation dentistry can help even the most fearful patients get the dental care they need. That’s good news for about 50 percent of the population, who admit they’re at least somewhat afraid of the dentist — and even better for the 15 percent who avoid dental care completely due to their fear.
Dentists have a number of ways to ease apprehensive patients through a dental visit. An oral anti-anxiety drug can be given in pill form about an hour beforehand. Nitrous oxide (sometimes called “laughing gas”), which is administered by a mask placed over the mouth or nose, may also be used to relieve anxiety. The calming effects of these medications help make any nervousness melt away — and in many circumstances, mild sedation is all that’s needed to ease the fear.
For lengthier or more complex procedures, intravenous (IV) sedation may be recommended. Unlike deeper (unconscious) sedation, IV sedation doesn’t cause “sleep.” Instead, it puts you in a comfortable semi-awake state, where you can still breathe on your own and respond to stimuli… but without feeling any anxiety. And when the procedure is over, you probably won’t have any memory of it at all.
IV sedation can be administered by dentists who are specially trained and equipped with the proper safety equipment. While sedation is being provided, you will be monitored at all times by a dedicated staff member; when it’s over, you will rest for a while as the medication quickly wears off. Then (as is the case with oral sedation), you’ll need another person to give you a ride home.
Does sedation dentistry really work? Lamar Odom thinks so. “I feel so much better,” he said when his 7-hour procedure was over. “I feel like I accomplished something.”
If you would like more information about sedation dentistry, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine article “Oral Sedation Dentistry.”