My Blog
By Barbara Preussner, DMD
February 09, 2022
Category: Oral Health
Tags: medicine  
NSAIDs-SafeandEffectiveDrugsThatManagePost-DentalWorkDiscomfort

There's a good chance you have an over-the-counter pain reliever in your medicine cabinet right now. They're handy for safely and effectively coping with mild to moderate pain, swelling or fever. They could also prove an invaluable resource after your upcoming dental work—your dentist may recommend one of these common drugs to help you manage your recovery period.

These particular drugs are non-steroidal anti-inflammatory drugs or NSAIDs. The most common sold under various brand names are aspirin, ibuprofen and naproxen. Unlike narcotics (opioids), which depress the central nervous system to control pain, NSAIDs block substances in the body called prostaglandins, which are released when tissues become inflamed or damaged. This in turn reduces pain, swelling or fever.

There's another significant difference between NSAIDs and narcotics—NSAIDs aren't addictive like opioids. Because they're also milder, NSAIDs don't require a prescription except for stronger formulations. With the trend to limit the use of narcotics in both dentistry and medicine, dentists are turning to NSAIDs as their primary means for managing dental pain.

There are, of course, some situations where narcotics are the preferred course. But dentists are finding NSAIDs are just as effective for managing discomfort following most dental procedures. They've also found that combined doses of ibuprofen and acetaminophen greatly amplifies the pain relieving effect.

Although NSAIDs are much safer than narcotics, they do have potential side effects. For one, they can reduce the blood's ability to coagulate, especially when taken consistently over several weeks. This could make it difficult to stop bleeding due to injury or illness.

NSAIDs can also irritate the stomach lining in some people over an extended period of use, leading to ulcers and other digestive issues. Prolonged use has also been linked to major problems like kidney damage, miscarriage or heart attacks.

But NSAIDs are still a safe alternative to narcotics: Their side effect risks are quite low when taken in proper dosages—between 400 and 600 mg for adults—within a limited amount of time like a few days. Their temporary use can help you cope with discomfort after a dental procedure and get you well on the road to full healing.

If you would like more information on managing discomfort after dental work, 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 “Treating Pain With Ibuprofen.”

By Barbara Preussner, DMD
January 30, 2022
Category: Dental Procedures
Tags: dental implants  
3EmergingTechnologiesThatImproveDentalImplants

Historically speaking, implants are a recent blip on the centuries-long march of dental progress. But few innovations in dentistry can match the impact of implants in its short history on dental function and appearance.

Dental implant therapy has already established itself as a restoration game-changer. But it also continues to improve, thanks to a number of emerging technologies. As a result, implant restorations are far more secure and life-like than ever before.

Here are 3 examples of state-of-the-art technologies that continue to improve this premier dental restoration.

CT/CBCT scanning. Functional and attractive implants depend on precise placement. But various anatomical structures like nerves or sinuses often interfere with placement, so it's important to locate these potential obstructions during the planning phase. To do so, we're increasingly turning to computed tomography (CT). This form of x-ray diagnostics is the assembly of hundreds of images of a jaw location into a three-dimensional model. This gives us a much better view of what lies beneath the gums.

Digital-enhanced planning. Implant success also depends on careful planning. And, it isn't a one-sided affair: The patient's input is just as important as the dentist's expertise. To aid in that process, many dentists are using digital technology to produce a virtual image of a patient's current dental state and what their teeth may look like after dental implants. This type of imaging also allows consideration of a variety of options, including different sized implants and positions, before finalizing the final surgical plan.

Custom surgical guides. To transfer the final plan details to the actual implant procedure, we often create a physical surgical guide placed in the mouth that marks the precise locations for drilling. We can now produce these guides with 3-D printing, a process that uses computer software to produce or "print" a physical object. In this case, the 3-D printer creates a more accurate surgical guide based on the exact contours of a patient's dental arch that's more precise than conventional guides.

Obtaining a dental implant is a highly refined process. And, with the aid of other advances in dental technology, it continues to provide increasing value to patients.

If you would like more information on restoring teeth with dental implants, 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 “How Technology Aids Dental Implant Therapy.”

AlthoughNotDangerousaDrySocketAfterSurgicalExtractionCanBePainful

Of the millions of teeth removed surgically each year, the vast majority of them have few if any complications. A small number of patients, however, do experience a particularly discomforting one known as dry socket.

This condition occurs when the blood clot that normally forms in a socket after an extraction fails to form or is lost. The clot helps protect the bone and nerves underneath the socket, so losing it exposes the area to temperature variations, food particles and fluids. As a result, some unpleasant symptoms can develop.

Usually manifesting around the third or fourth day after surgery, these symptoms include a bad odor or taste in the mouth and aching, throbbing pain. Fortunately, the symptoms, which usually fade in one to three days, don't pose a threat to your health. Nevertheless, you could be in for a rough time while it lasts.

So, if it happens, why you? To be honest, some people are simply more susceptible to developing dry socket, especially smokers or women who use certain contraceptives. You're also more likely to develop a dry socket if the tooth in question experienced higher than usual trauma because of difficulties in removing it. And, you could damage the forming clot if you vigorously chew or brush your teeth too soon after your procedure.

To avoid this, dentists usually recommend rinsing your teeth the first day after surgery rather than brushing the extracted area, and to chew gently, preferably on soft foods using the other side of the mouth. You might also avoid hot liquids and smoking for a few days.

If despite your best efforts you do develop a dry socket, give your dentist a call. Your dental provider can irrigate the socket and apply a medicated dressing that can speed up healing (you'll have to change every few days until symptoms abate). The dressing will provide pain relief to dramatically reduce your discomfort within just a few minutes, which you can supplement with ibuprofen or similar medication.

In time, the pain and other symptoms associated with a dry socket will subside. In the meantime, you and your dentist can take steps to make sure you're as comfortable as possible.

If you would like more information on dry socket, 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 “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”

By Barbara Preussner, DMD
January 10, 2022
Category: Dental Procedures
ARoutineDentalProcedureSavesThisMLBStandoutsBrokenTooth

During this year's baseball spring training, Minnesota Twins center fielder Byron Buxton got into a row with a steak dinner—and the beefsteak got the better of it. During his meal, the Gold Glove winner cracked a tooth.

Fortunately, he didn't lose it. Buxton's dentist rescued the tooth with a dental procedure that's been around for over a century—a root canal treatment. The dependable root canal is responsible for saving millions of teeth each year.

Dentists turn to root canal treatments for a number of reasons: a permanent tooth's roots are dissolving (a condition called resorption); chronic inflammation of the innermost tooth pulp due to repeated fillings; or a fractured or cracked tooth, like Buxton's, in which the pulp becomes exposed to bacteria.

One of the biggest reasons, though, is advanced tooth decay. Triggered by acid, a by-product of bacteria, a tooth's enamel softens and erodes, allowing decay into the underlying dentin. In its initial stages, we can often treat decay with a filling. But if the decay continues to advance, it can infect the pulp and root canals and eventually reach the bone.

Decay of this magnitude seriously jeopardizes a tooth's survival. But we can still stop it before that point with a root canal. The basic procedure is fairly straightforward. We begin first by drilling a small hole into the tooth to access the inner pulp and root canals. Using special instruments, we then remove all of the infected tissue within the tooth.

After disinfecting the now empty spaces and reshaping the root canals, we fill the tooth with a rubber-like substance called gutta percha. This, along with filling the access hole, seals the tooth's interior from future infection. In most cases, we'll return sometime later and bond a life-like crown to the tooth (as Buxton's dentist did for him) for added protection and support.

You would think such a procedure would get its own ticker tape parade. Unfortunately, there's a cultural apprehension that root canals are painful. But here's the truth—because your tooth and surrounding gums are numbed by local anesthesia, a root canal procedure doesn't hurt. Actually, if your tooth has been throbbing from tooth decay's attack on its nerves, a root canal treatment will alleviate that pain.

After some time on the disabled list, Buxton was back in the lineup in time to hit his longest homer to date at 456 feet on the Twins' Opening Day. You may not have that kind of moment after a root canal, but repairing a bothersome tooth with this important procedure will certainly get you back on your feet again.

If you would like more information about root canal therapy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”

By Barbara Preussner, DMD
December 31, 2021
Category: Oral Health
Tags: gum disease   nutrition  
CurbYourCarbConsumptiontoBoostYourDefensesAgainstGumDisease

You're doing the right things to avoid the return of gum disease: brushing and flossing every day, dental visits on a regular basis and watching for symptoms of another infection. But while you're at it, don't forget this other important part of gum disease prevention—your diet.

In relation to oral health, not all foods are alike. Some can increase inflammation, a major factor with gum disease; others strengthen teeth and gums. Carbohydrates in particular are a key part of this dynamic.

The body transforms these biomolecules of carbon, hydrogen and oxygen into the sugar glucose as a ready source of energy. But glucose levels in the bloodstream must be strictly controlled to avoid a harmful imbalance.

When elevated the body injects the hormone insulin into the bloodstream to bring glucose levels into normal range. Eventually, though, regular injections of insulin in high amounts in response to eating carbs—known as "spikes"—can increase inflammation. And, inflammation in turn increases the risk and severity of gum infections.

So, why not cut out carbohydrates altogether? That might be akin to throwing out the proverbial baby with the bath water. A wide range of carbohydrates, particularly fruits and vegetables, are a rich source of health-enhancing nutrients.

It's better to manage your carbohydrate consumption by taking advantage of one particular characteristic: Not all carbohydrates affect the body in the same way. Some cause a higher insulin response than others according to a scale known as the glycemic index. It's better, then, to eat more of the lower glycemic carbohydrates than those at the higher end.

One of the latter you'll definitely want to restrict is refined sugar—which also happens to be a primary food source for bacteria. You'll also want to cut back on any refined or processed foods like chips, refined grains or pastries.

Conversely, you can eat more of a number of low glycemic foods, most characterized as "whole", or unprocessed, like fresh fruits and vegetables, or whole grains like oatmeal. You should still, however, eat these in moderation.

Better control over your carbohydrate consumption is good for your health overall. But it's especially helpful to your efforts to keep gum disease at bay.

If you would like more information on nutrition and your oral health, 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 “Carbohydrates Linked to Gum Disease.”





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