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Posts for: October, 2018

By Gregory Palmer, D.M.D. Family & Cosmetic Dentistry
October 30, 2018
Category: Oral Health
Tags: local anesthesia  
GettheRealFactsAboutLocalAnesthesia

A lot of people don’t like dental work because they believe it will be painful or uncomfortable. There’s an anatomical reason to back up that concern — the mouth with its dense network of nerves in the teeth and gums is one of the most sensitive parts of the human body.

But modern dentistry has helped solve much of the problem of pain with advances in local anesthesia. Using substances that temporarily block electrical impulses within the nerves of a selected area of oral tissues, there’s a good chance you’ll feel little to no discomfort even during moderately invasive procedures.

Unfortunately, you might have heard some complaints from others about local anesthesia that might make you wary of it. Many of these complaints, however, aren’t fully based on all the facts. So, let’s set the record straight about local anesthesia and what you can expect.

No need to be afraid of needles. Nobody enjoys the painful prick from an injection needle, and some people are highly fearful of them. But although it’s necessary to use a needle to deliver anesthesia to deeper levels of tissue, it’s possible you won’t feel it. That’s because we’ll typically apply a topical numbing agent to the skin surface that deadens the top layers where we insert the needle.

That numb feeling afterward won’t last long. One of the chief complaints in the past about local anesthesia was the irritating numbness that could long linger after a procedure. Today, however, with more advanced anesthetics and formulae, we’re better able to gauge the duration of the medication’s effect.  This has greatly reduced the length of time afterward your mouth might have that awkward numbing sensation.

Anesthesia isn’t necessary for every procedure. Unless you have hypersensitive teeth, a lot of dental procedures don’t require anesthesia. Your enamel, for example, has no nerves and actually serves as a kind of “muffler” for sensations to lessen their effect. Cleaning your teeth or removing portions of the enamel can normally be performed without the need for numbing medication.

For procedures, though, where pain could be a factor, local anesthesia can make all the difference in the world. In these cases, anesthesia is your friend — it can help you receive the dental care you need without the discomfort.

If you would like more information on pain-free dentistry, 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 “Local Anesthesia for Pain-Free Dentistry.”


By Gregory Palmer, D.M.D. Family & Cosmetic Dentistry
October 20, 2018
Category: Oral Health
Tags: tooth decay  
MinimallyInvasiveDentistryANewApproachtoPreventingandTreatingDecay

Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.

The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.

MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).

With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.

MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.

The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.

MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.

If you would like more information on the benefits of the MID approach, please contact us or schedule an appointment for a consultation.


By Gregory Palmer, D.M.D. Family & Cosmetic Dentistry
October 10, 2018
Category: Dental Procedures
Tags: dental implants  
WhatYouShouldKnowAboutAntibioticTherapyBeforeImplantSurgery

Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.

To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.

While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.

But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.

But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.

Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.

If you would like more information on antibiotics before implant surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”




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