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Posts for category: Dental Procedures

By Joseph R. Hendrick, Jr., DDS, PA
June 21, 2020
Category: Dental Procedures
SedationCanHelpaChildReceiveNeededDentalCareNowandintheFuture

You have a wonderful pediatric dentist who's great with kids. Their dental office is a children's wonderland with cheerful colors, toys and a staff that tries to make things fun. But no matter what you do—including rewards and positive praise—it's not enough to calm your child's anxiety during dental visits.

Even with the most conducive clinical environment and parental efforts, some children still have an inordinate fear of seeing the dentist. Their anxiety could be a roadblock to getting the treatment they need to maintain good oral health and development. And if that fear carries over into adulthood, they may get into the habit of postponing needed care.

But dentists have an important tool they can use to help children relax: conscious sedation therapy. Using proven sedation medication, dentists can place patients in varying degrees of suppressed consciousness.

Although often used in conjunction, sedation is not the same as anesthesia. The latter is used to eliminate pain during dental procedures. Sedation, on the other hand, aims to calm the negative emotions generated by dental anxiety. A child under sedation can still breathe normally without assistance and respond to physical stimulation or verbal commands.

Sedation medications can be administered orally, usually in syrup form, or with an intravenous (IV) drip. Two of the more popular drugs are Midazolam and Hydroxyzine, both of which act fast and then leave the body quickly after the procedure. These types of sedation drugs have a very low risk of side effects compared to general anesthesia.

While under sedation, the child's vital signs (heart rate, respiration, blood pressure, etc.) are continuously monitored. Afterward, they'll wait in recovery until their vital signs are back to their pre-sedation levels. They can then go home to rest for the remainder of the day, and then usually return to school or other normal activities the following day.

Besides making it easier for a child to receive needed dental care, conscious sedation can also make the overall visit more pleasant, and lead to more positive memories of the experience. This may indeed help them later in life to overcome any lingering anxiety and continue regular dental care throughout adulthood.

If you would like more information on reducing your child's dental visit anxiety, 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 “Sedation Dentistry for Kids.”

By Joseph R. Hendrick, Jr., DDS, PA
June 01, 2020
Category: Dental Procedures
LadyGagaWasntBornThisWay

Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"

"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.

The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.

Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.

Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).

The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.

Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.

So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”

By Joseph R. Hendrick, Jr., DDS, PA
May 12, 2020
Category: Dental Procedures
PracticeDailyHygienetoAvoidGumSwellingWhileWearingBraces

Straightening your smile doesn't happen overnight—it can involve months or even years of orthodontic treatment. And although the end result is well worth it, the long process can make it difficult to keep your gums healthy, especially while wearing braces.

Gum swelling in particular is a common problem for braces wearers with two potential sources. First, orthodontic hardware makes it difficult to keep teeth clean of dental plaque, a thin bacterial film that can cause gum disease. Plaque and its hardened counterpart tartar can trigger a gum infection, which in turn triggers inflammation. As a result, affected gums appear swollen and red, and can easily bleed.

Gum tissues may also react to braces pressing against them and develop hypertrophy (or hyperplasia), an increase in individual tissue cell growth. If this overgrowth occurs, it may not get resolved until after your braces have been removed.

As long as the hypertrophy doesn't appear to have weakened gum attachment with the teeth, it's usually not a big concern. But what is a concern is that hypertrophy could increase a braces wearer's difficulties with oral hygiene and give rise to a true gum infection that could endanger dental attachment. Advanced cases could require surgical correction or removal of the braces altogether to adequately treat the infection.

The best way to avoid a worst case scenario is to be as diligent as possible with daily brushing and flossing. Fortunately, there are several tools that can make it easier with braces. Interproximal brushes, tiny brushes that can fit into the narrow spaces between the teeth and the braces, can be used in conjunction with your regular toothbrush.

Flossing is also easier if you use a floss threader or a water flosser. The latter utilizes a pump to emit a pulsating jet of water to break loose plaque between teeth and flush it away. Clinical studies have shown the effectiveness of water flossers for removing plaque in braces wearers as opposed to not flossing at all.

A faithful daily hygiene practice and twice-a-year cleanings and checkups with your regular dentist can help minimize your chances of gum swelling. Doing so will help ensure you'll complete your orthodontic treatment on the way to healthier and more attractive smile.

If you would like more information on teeth and gum care while wearing braces, 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 “Gum Swelling During Orthodontics.”

By Joseph R. Hendrick, Jr., DDS, PA
April 22, 2020
Category: Dental Procedures
WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By Joseph R. Hendrick, Jr., DDS, PA
March 23, 2020
Category: Dental Procedures
BracesTakeAdvantageofTeethsNaturalAbilitytoMove

There are many new and exciting ways now to transform an unattractive smile into one you'll be confident to display. But not all “smile makeover” techniques are new — one in particular has been around for generations: using braces to correct crooked teeth.

Braces have improved the smiles (and also dental health) for millions of people. But as commonplace this orthodontic treatment is, it wouldn't work at all if a natural mechanism for moving teeth didn't already exist. Braces “partner” with this mechanism to move teeth to better positions.

The jawbone doesn't actually hold teeth in place — that's the job of an elastic gum tissue between the teeth and bone called the periodontal ligament. Tiny fibers extending from the ligament attach to the teeth on one side and to the bone on the other. In addition to securing them, the dynamic, moldable nature of the ligament allows teeth to move incrementally in response to forces applied against them.

To us, the teeth feel quite stationary (if they don't, that's a problem!). That's because there's sufficient length of the tooth roots that are surrounded by bone, periodontal ligament and gum tissue. But when pressure is applied against the teeth, the periodontal ligament forms both osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells) causing the bone to remodel. This allows the teeth to move to a new position.

Braces take advantage of this in a controlled manner. The orthodontist bonds brackets to the outside face of the teeth through which they pass a thin metal wire. They attach the ends of the wire to the brackets (braces), usually on the back teeth. By using the tension placed in the wire, the orthodontist can control the gradual movement of teeth to achieve proper function and aesthetics. The orthodontist continues to monitor the treatment progress, while making periodic adjustments to the tension.

It takes time, but through this marvelous interplay between nature and dental science you'll gain a more healthy and beautiful smile.

If you would like more information on improving your smile with orthodontics, 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 “Moving Teeth with Orthodontics.”



Dentist in Shelby, NC
Joseph R. Hendrick, Jr., DDS, PA
511 N. Morgan Street
Shelby, NC 28150
(704) 484-0077
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