Lansing's Dental Discussion
By Holly Scott-Hetchler DDS
May 21, 2022
Category: Oral Health
Tags: anxiety  
4ThingsYouCanDotoKeepAnxietyFromRobbingYouofNeededDentalCare

For most people, dental visits are as routine as a trip to the supermarket, but this is not the case for everyone. Some can become so overwhelmed, anxious, or nervous about seeing the dentist that they might put off their visit, even for a serious dental condition.

This kind of anxiety, often rooted in early childhood, shouldn't be dismissed or ignored. If it prevents you or someone you love from receiving needed dental care, it could disrupt your oral health—not to mention your overall well-being for years to come.

In recognition of Mental Health Awareness Month this May, here are 4 things you can do to prevent dental anxiety from robbing you of the dental care you or a loved one needs.

The right dentist. The partnership between dentist and patient may be the most important element in addressing dental anxiety. It's important to find a provider that accepts and understands your anxiety, and who won't dismiss it with trite aphorisms like, "Your fear is all in your head." Finding a dentist who listens and who will work with you in allaying your concerns is often the first step toward overcoming dental anxiety.

Facing anxiety. It's common for people to try to ignore their inner turmoil and focus instead on "getting their teeth fixed." But as sensible as that sounds, it's not really effective. It's better instead to acknowledge and be forthright about your feelings of nervousness and apprehension. With it out in the open, you and your dentist can then include managing your anxiety as a part of your overall treatment plan.

Sedation therapy. It often takes time to overcome deep-seated phobias like dental anxiety. In the meantime, though, your teeth and gums may still need care. Your dentist can help relieve your anxiety, albeit temporarily, using one or more sedation therapy techniques to help you relax during your visit. These therapies may include an oral sedative taken just before your appointment or gas or IV sedation that helps you relax completely during a treatment session.

Cognitive Behavioral Therapy. Psychotherapists have long used CBT to help patients overcome mental and emotional problems like depression, eating disorders, or phobias. CBT helps people change deep-seated patterns of thinking or behavior regarding a troublesome issue by confronting it and seeking to understand the "why" behind the patterns. Recently, a review of dental patients who underwent CBT for dental anxiety showed a number of positive results.

Overcoming dental anxiety can be a long journey requiring patience, courage, and understanding, but it can be done! With the techniques and methods dentists now have to address it, anxiety over dental treatment no longer need interfere with a person's ability to receive the dental care they need.

If you would like more information about dental anxiety and what to do about it, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Overcoming Dental Fear & Anxiety.”

WantToBuyaDentalCrownTheKingofRockandRollsIsUpforSale

Although Elvis Presley left us more than four decades ago, he still looms large over popular culture. It's not uncommon, then, for personal items like his guitars, his revolver collection or even his famed white jumpsuit to go on sale. Perhaps, though, one of the oddest of Elvis's personal effects recently went on auction (again)—his gold-filled dental crown.

It's a little hazy as to how the "King" parted with it, but the crown's list of subsequent holders, including a museum, is well-documented. Now, it's looking for a new home with a starting bid of $2,500.

The interest, of course, isn't on the crown, but on its original owner. Dental crowns weren't rare back in Presley's day, and they certainly aren't now. But they are more life-like, thanks to advances in dental materials over the last thirty years.

Crowns are an invaluable part of dental care. Though they can improve a tooth's cosmetic appeal, they're more often installed to protect a weak or vulnerable tooth. In that regard, a crown's most important qualities are strength and durability.

In the early 20th Century, you could have utility or beauty, but usually not both. The most common crowns of that time were composed of precious metals like silver and, as in Presley's case, gold. Metal crowns can ably withstand the chewing forces teeth encounter daily.

But they simply don't look like natural teeth. Dental porcelain was around in the early days, but it wasn't very strong. So, dentists devised a new kind of crown that blended durability with life-likeness. Known as porcelain-fused-to-metal (PFM) crowns, they were essentially hybrids, a metal crown, which fit over the tooth, overlayed with a porcelain exterior shell to give it an attractive appearance.

PFMs became the most widely used crown and held that title until the early 2000s. That's when a new crown leader came into its own—the all-ceramic crown. In the decade or so before, the fragility of porcelain was finally overcome with the addition of Lucite to the tooth-colored ceramic to strengthen it.

Additional strengthening breakthroughs since then helped make the all-ceramic crown the top choice for restorations. Even so, dentists still install metal and PFM crowns when the situation calls for added strength in teeth that aren't as visible, such as the back molars. But for more visible teeth like incisors, all-ceramic usually stands up to biting while looking life-like and natural.

For a star of his magnitude, Presley's crown was likely state-of-the-art for his time. In our day, though, you have even more crown choices to both protect your tooth and enhance your smile.

If you would like more information about crown restorations, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”

By Holly Scott-Hetchler DDS
May 01, 2022
Category: Oral Health
Tags: sensitive teeth  
UncoveringtheCauseistheFirstSteptoRelievingToothSensitivity

For one out of three Americans, a bite of ice cream or a sip of hot coffee can set off a sudden jolt of pain. Fortunately, there are ways to reduce these painful episodes of tooth sensitivity and their severity.

To understand the primary reasons that people experience tooth sensitivity, we must first consider a little tooth anatomy. Just below a tooth's outer enamel is a layer of tooth structure called dentin, composed of tiny tunnels or tubules that transmit sensations of temperature or pressure to the nerves in the central pulp. These tubules are analogous to conduits through which electrical wires pass.

Enamel on the crown, along with gum tissue and a thin material called cementum covering the roots, help muffle sensations so as to prevent an overload on the nerves. But if either of those protective areas become compromised the nerves could in turn experience the full brunt of these sensations.

As such, softened and eroded enamel from tooth decay could expose the dentin. Receding gums, commonly caused by gum disease, can also expose dentin near the roots since the remaining cementum offers little protection. In either case, nerves in the pulp may become subject to extreme sensations caused by temperature or while biting down, which then causes them to fire off pain signals to the brain.

Thus, to treat sensitive teeth we must first determine whether it's the result of tooth decay, gum disease or some other condition, and then treat any underlying disease. If it's decay-related, we'll want to repair any cavities with a filling, or perform a root canal if the infection has spread deeper into the tooth.

For receded gums, we'll first want to treat any lingering gum disease. Once we've brought the infection under control, it's possible then for the gums to heal and regenerate, eventually treating the roots with desensitizing products. In some cases, though, we may have to surgically graft new tissue to the receded area to cover the roots.

The good news is that you can lower your chances of tooth sensitivity by preventing these dental diseases. To do that, be sure you're brushing and flossing daily to remove disease-causing plaque, and visiting your dentist at least twice a year for professional cleanings and checkups.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”

By Holly Scott-Hetchler DDS
April 21, 2022
Category: Dental Procedures
Tags: dental implant  
WhatsInvolvedinGettingaDentalImplant

Although the term "surgery" is broad enough to drive a proverbial truck through, we can roughly categorize procedures as either major or minor. Installing an implant is decidedly in the minor column.

Akin to having a tooth extraction, implant surgery can be done painlessly in a dentist's office with very little discomfort afterward. If you're considering a dental implant, going through this surgical procedure shouldn't worry you.

Still, it's hard not to feel a little nervous about any type of surgery, even one as minor as getting an implant. That's where shining a little more light in the way of information can help dissolve any lingering anxiety. Here, then, is an overview of dental implant surgery from start to finish.

First, a little planning. Preparation beforehand helps eliminate any potential snags during surgery. During earlier visits, your dentist will completely map out the procedure with x-rays or CT scanning of your jaws to locate any obstacles, followed by the preparation of a surgical guide placed in the mouth to direct drilling.

Numbing the pain. The dentist begins the surgery by completely deadening the area with local anesthesia. This is usually done with an anesthetic swab of the surface gums to numb the needle prick, which is then used to deliver the remaining anesthetic to the deeper tissues and bone.

Creating the channel. After ensuring the area is fully anesthetized, the dentist will expose the bone by making small incisions in the gums. Then, using the surgical guide, they'll drill a small hole, incrementally enlarging it until it matches the size of the implant post.

Installing the implant. After drilling, the dentist removes the implant from its sterile packaging and directly places it into the prepared channel. The dentist then ensures the implant positioning is correct, often checking with additional x-rays. They'll then suture the gums back into place to protect the implant.

You may initially have a few days of mild discomfort, usually manageable with over-the-counter pain relievers. Over the next few weeks new bone cells will form and adhere to the implant to create a durable bond. You'll then be ready for the attachment of a life-like crown.

Surgery is one step in a long process. But it's an important step—and with the resulting smile outcome, well worth it.

If you would like more information on 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 “Dental Implant Surgery.”

ThisTemporaryRPDCouldSustainYourSmileWhileYouWaitForImplants

Dental implants are often the ideal choice to replace missing teeth. Unfortunately, "ideal" and "affordable" don't always align simultaneously for people. Even if implants are right for you, you may have to put them off to a more financially appropriate season.

In the meantime, though, you're still missing teeth—and perhaps some of them are right square in the middle of your smile. What can you do now, even if temporarily?

The solution might be a flexible removable partial denture (RPD). These newer types of RPD fit somewhere between the lightweight "flipper" and the more traditional rigid plastic appliances often made for permanent use. The flexible RPD is made of nylon plastic (technically known as a super-polyamide), which although lightweight, is highly durable.

Super-polyamides change their shape under high heat, a characteristic dental technicians take advantage of by injection molding heated material into flexible denture bases, to which they then attach the replacement teeth. Like other RPDs, a flexible RPD is custom-designed for the individual patient to match their jaw contours, as well as the types and locations of their missing teeth.

Flexible RPDs also differ from other RPD types in how they stay in place. While the more rigid RPD depends on metal clasps that grip to some of the remaining natural teeth, a flexible RPD uses finger-like extensions of the nylon material to fit around teeth near the gum line where they're difficult to see. As such, the flexible RPD is both comfortable and securely held in place.

A flexible RPD, like their counterparts, does require regular maintenance. Any RPD can accumulate dental plaque, a thin biofilm buildup on teeth that causes dental disease. For this reason, wearers should regularly remove their RPD and clean it thoroughly with an antibacterial soap (never toothpaste). All RPDs should also be removed at night to limit bacterial growth.

With a little care, a flexible RPD could last for several years. It could be just the solution to buy you time while you're waiting to obtain dental implants.

If you would like more information on restoration options for missing 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 “Flexible Partial Dentures.”

By Holly Scott-Hetchler DDS
April 01, 2022
Category: Oral Health
EmmaRobertsConfessestoHavingaMajorSweetToothWhileExpecting

Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.

In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.

So, if you're expecting a baby, what can you do to minimize your risk for dental disease?

Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.

Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.

Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.

Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.

Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.

If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”

By Holly Scott-Hetchler DDS
March 22, 2022
Category: Dental Procedures
Tags: dental implants  
4ReasonstoChooseDentalImplantstoRestoreMissingTeeth

Many of your friends and family—and perhaps even your dentist—tell you that dental implants are the way to go replacing your lost teeth. Even so, you're still hesitant about choosing them.

For one thing, you're anxious about undergoing the surgical procedure needed to place and secure the implant (although it's relatively minor, and usually only requires local anesthesia). It could also be weeks, perhaps months, before you complete the process. Last, but not least, dental implants are more expensive than other dental restorations.

Is it really worth the time, effort and expense to obtain dental implants? Here are 4 reasons why the answer is a resounding yes.

They look and feel like real teeth. Unlike other restoration methods, a dental implant replaces the root as well as a tooth's visible crown. This gives them more of the feel of real teeth when you're biting or chewing. And with its root replacement design, we're better able to achieve good positioning that makes the final tooth look incredibly natural and life-like.

They're strong and durable. After surgical placement, the implant begins to integrate with the surrounding bone. Bone cells "like" titanium, the most commonly used metal in implants, and readily grow and adhere to the implant surface. This integration process results in an incredibly strong hold that can last for several years, if not decades.

They're adaptable to other restorations. People missing multiple teeth often shy away from implants for financial reasons. It's true: Replacing multiple teeth individually with implants can be extremely expensive. But we can also use a few strategically placed implants to support a bridge or denture. Not only is this often a more cost-effective option, the implants may also improve the traditional restoration's stability.

Long-term costs may actually be lower. While it's true an implant's initial costs are usually higher than other restorations, it could cost you less over time. Because of their durability, more than 95% of implants are still intact after ten years, and most last much longer. You may find maintenance and replacement costs for other restorations could eventually exceed what you'll pay with dental implants.

If you would like more information on 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 “Dental Implants.”

By Holly Scott-Hetchler DDS
March 12, 2022
Category: Dental Procedures
Tags: tooth decay  
TreatingDecayedBabyTeethProtectsFuturePermanentTeeth

Primary ("baby") teeth may look cute and adorable, but they're a big player in your child's dental health. A primary tooth lost prematurely could eventually lead to a major bite problem.

Primary teeth fulfill a number of functions, most notably enabling young children to eat solid foods, speak and relate to people with a normal smile. But they also serve as placeholders and guides for future permanent teeth developing within the gums.

Problems arise, though, when a child loses a primary tooth early due to disease or trauma, leaving an open space on the jaw. Nearby teeth tend to drift in to fill the space intended for the permanent tooth, leaving little to no room for it when it's time to erupt. This can cause it to erupt out of position, which in turn could force other teeth out of alignment. The end result is a poor bite.

You can, however, avoid this costly outcome by either treating and preserving a decayed baby tooth, or preventing other teeth from drifting into a vacancy left by a lost primary tooth until the permanent tooth comes in.

Depending on the level of decay, treating a diseased primary tooth can include fillings, crowns or modified root canal therapy. For children at high risk for decay, a dentist may also apply sealant to the teeth to inhibit plaque buildup. Although some of these procedures can be extensive, they're often worth the time and effort to prevent a poor bite.

If, on the other hand, we eventually lose the tooth, we can still intervene by installing a space maintainer. This is essentially a loop of wire securely attached to a tooth on one side of a gap, while the other end of the loop butts up against the tooth on the other side. This prevents either tooth from migrating into the space until the permanent tooth is ready to come in.

Primary teeth may not seem all that important, but in the greater picture, they truly are. By taking care of them, you'll be doing your child's soon arriving permanent teeth a favor.

If you would like more information on pediatric dental care, 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 Holly Scott-Hetchler DDS
March 02, 2022
Category: Oral Health
Tags: oral health  
UnderstandingDentalInsuranceThe3TypesofPlans

Health insurance is an important part of life, helping to even out the high costs of medical treatment. Without it, many of us would find it extremely difficult to financially weather physical illness or injury.

But many also view health insurance as frustratingly complicated, including policies that cover dental care. Regarding the latter, people often view it as medical insurance's identical twin—which it's not. While insurance for clinical services and hospitalization manages cost in a comprehensive manner, the majority of dental plans function more like a discount coupon.

The great majority of dental policies today are paid for by employers as a salary benefit to their employees. There can still be differences in policies and it's important to know what kind of plan your workplace has provided you. Here's a rundown of the three basic types of dental insurance plans.

Fee-for-Service. This is the most common dental plan in which the employee is able to choose their dentist and the insurance company pays the dentist for services rendered. Each individual policy outlines the treatments covered, as well as the percentage of payment.

Direct reimbursement. With this approach, the employer pays employees' dental bills directly out of company funds. Even so, an insurance company is often still involved, but as a paid administrator for the employer, reimbursing the dental provider on behalf of the company.

Managed care. An insurance company may also create a network of dental providers that all agree to a set schedule of fees for services rendered. These dental health maintenance organizations (DHMOs) or preferred provider organizations (PPOs) can reduce patients' out-of-pocket expenses. But covered patients can only use dentists within the DHMO or PPO network to receive benefits.

You can, of course, purchase dental insurance as an individual rather than receive it as an employee benefit. If so, you'll need to weigh what you pay out for the policy and what you receive in benefits with what you would pay out-of-pocket without it to see if you're truly realizing any savings.

Either way, understanding a dental insurance plan can be a challenge for the average person. Fortunately, most dental offices are well experienced with these plans. Your dentist's staff can be a valuable resource for helping you get the most out of your insurance benefits.

If you would like more information on the financial side of dental care, please contact our office. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Insurance 101.”





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