My Blog
By Alexander Korwek, DDS, PC
July 23, 2019
Category: Oral Health
Tags: sedation dentistry  
SedationcanMakeDentalTreatmentEasierforHighAnxietyPatients

Most dental procedures today only require local anesthesia to numb just the affected area. It's a safer approach than general anesthesia: the unconscious state created by putting someone "to sleep" can lead to some unpleasant complications.

But patient comfort involves more than preventing physical pain during a procedure. There's also the emotional factor—many people experience nervousness, anxiety or fear during dental visits. It's especially problematic for an estimated 15% of the population whose dental visit anxiety is so great they often try to avoid dental care altogether.

One option is to use general anesthesia for patients with acute anxiety rather than local anesthesia. This removes them consciously from their anxiety, but they must then be monitored closely for complications.

But there's a safer way to relax patients with high anxiety called intravenous or IV sedation. The method delivers a sedative medication directly into a patient's bloodstream through a small needle or catheter inserted into a vein. The sedative places the patient in a relaxed "semi-awake" state, taking the edge off their anxiety while still enabling them to respond to verbal commands.

Coupled with local anesthesia, they won't experience any pain and very little if any discomfort. And many of the sedatives used also have an amnesiac effect so that the patient won't remember the procedures being performed.

IV sedation does require monitoring of vital signs, but the patient won't need help maintaining their breathing or heart function. And although the medication can be adjusted to reduce any lingering after-effects, a patient will still need someone to accompany them to and from their visit.

For lesser anxiety or nervousness, dentists sometimes prescribe an oral sedative to take just before a visit. This can help take the edge off your nerves and help you relax. With either method, though, sedation can help you overcome fear and anxiety and have a more pleasant treatment experience.

If you would like more information on IV sedation, 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 “IV Sedation in Dentistry.”

By Alexander Korwek, DDS, PC
July 13, 2019
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Alexander Korwek, DDS, PC
July 03, 2019
Category: Oral Health
3WaystoProtectYourTeethintheGreatOutdoors

It’s July—and that means it’s National Park and Recreation Month! If you’re like a lot of families, you might already be planning a trip to one of the nation’s 58 national parks, or one of the thousands of state outdoor recreational areas across the country.

Temporarily escaping the stresses of daily life in the great outdoors is a wonderful way to refresh both the soul and the body. But that’s not an excuse to neglect all your responsibilities. That includes making provisions to care for your teeth while you’re away from home—you are bringing them with you, aren’t you?

Here are three ways you can take care of your teeth during your outdoor getaway.

Keep up your daily hygiene. While you’re packing extra socks, granola and moleskin, be sure to include your toothbrush, toothpaste and floss. Just a few days of neglecting your regular oral hygiene can give bacterial plaque a chance to build up. You could even come back from your trip with the beginnings of gingivitis, an early form of gum disease. If you’re trying to pack light, take along travel-size toothpaste tubes or pre-threaded floss picks to make it easier.

Eat dental-friendly snacks and food. Escaping your usual dietary choices doesn’t mean you should take a vacation from good nutrition. Whether you’re in camp or on the trail, eat whole fruits, grains or cheeses, and avoid snacks and foods with added sugar that feeds disease-causing bacteria in the mouth. The same goes for beverages—keep your intake of sodas and sports or energy drinks (all loaded with added sugar and acid) to a bare minimum. Instead, hydrate with water.

Be prepared for emergencies. Exploration through hiking, canoeing and other physical activities is a great part of the outdoor park experience. But it also increases your risk of injury, especially in rough terrain. Before you head out, take some time to research medical and dental resources near your vacation destination in case you or a family member will need immediate care. Having that information handy can save time in the event of an emergency.

An outdoor park trip can be the experience of a lifetime. Just be sure to follow these simple tips to care for and protect your teeth. Doing so will help ensure that your memories of this summer’s outing will be pleasant ones.

If you would like more information about caring for your dental health at home or away, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

PrimaryTeethareCriticaltoFutureDentalHealthandWorthPreserving

Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.

Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.

But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.

In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.

We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.

If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.

Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.

If you would like more information on the care and treatment of baby teeth, 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 “Importance of Baby Teeth.”

By Alexander Korwek, DDS, PC
June 13, 2019
Category: Oral Health
Tags: x-rays  
HowDentistsProvideYourChildtheBenefitofX-RaysasSafelyasPossible

X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.

At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.

But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.

While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.

To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.

A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.

This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.

If you would like more information on safety precautions using x-rays with 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 “X-Ray Safety for Children.”





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