To sleep or not to sleep, that is the question. Sedation dentistry can be very helpful for fearful patients or for procedures that require extensive work without the patient feeling or remembering it. Sedation does not necessarily mean that you are asleep but it can help put you in a calm state of being. Oral consciousness and IV sedation can be used in general dentistry or in speciality offices.

If the thought of getting a filling sends you reeling in fear, an oral sedation might help you out. Normally, oral sedation is medication used to help calm or relieve some stress of going to the dentist. It is a popular treatment option for many people because it does not require the use of a needle. Medication is prescribed to you to take the night before the appointment. This ensures that you have a good night’s sleep and can make you very calm before the appointment. Sometimes, the dentist can pair the oral medication with nitrous oxide (laughing gas). This air inhalant can further the feeling of relaxation. The best part of this form of sedation is that it can be cleared out of your body before your appointment is over. Even though the laughing gas is out of your body, you still need to have someone drive you to your appointment and drive you home.

All the same rules apply for IV sedation. IV or intravenous sedation achieves the calm state but can be quick acting. A needle and tubing is placed into your arm and anti-anxiety medication can be administered directly into your bloodstream. The nice thing about this form of sedation is that the medication can be adjusted during the procedure so that you can remain comfortable at all times. The not so nice thing is that if you are afraid of needles, this may not be the avenue for you. Unfortunately, needles are still involved in the appointment either way. The dentist needs to use local anesthetics to get the teeth numb so that your are completely comfortable throughout the appointment.

If these two forms of sedation still cannot relax you during your procedures, then general anesthesia needs to come into play. This is the true “sleep dentistry.” A dental anesthesiologist or an oral surgeon can administer this type of sedation. You are completely asleep while the needed treatment is performed on you in only one appointment. It is very effective but there are risks to this type of sedation, most notably the need for assisted breathing.  While sleep dentistry is an acceptable form of sedation for the dentist, it can take a toll on your wallet. Most dental insurance companies do not cover the cost of having general anesthesia and it can be expensive. However, this may be the only way to get work done, if oral medication or IV sedation is not an option.

Sedation dentistry can truly make your visit a pleasant one, rather than a white knuckle fearful one. Doctorbase can help you search for a local dentist that specializes in sedation dentistry.

-Alissa

The Real Housewives of Orange County do it. Heck, Heidi Montag from MTV’s reality TV show The Hills did it 10 times in 1 day at the age of 23. But plastic surgery isn’t just for the rich and famous anymore. Just because you didn’t win the genetic lottery doesn’t mean you can’t look like you did. That’s right kiddies, even YOU can have a new rack, the butt of an 18 year old gymnast, or a look of complete apathy even when you’re smiling from ear to ear.

Whether your motivation is to keep up with Jones’s or to simply have your 65 year old face match your 18 year old inner-self, here are some safeguards to take before voluntarily going under the knife:

Make sure your surgeon is licensed AND board certified. You can find this information by visiting your state’s medical board website. In California, the site will provide you with information regarding if and when the surgeon was licensed,  any board certifications they hold, any disciplinary action that has been taken against the surgeon, where the surgeon went to medical school, and where they currently practice.

Get referrals by asking around. This is not the time to use the Yellow Pages. You can, however, use the DoctorBase database to find a surgeon with rave reviews that been verified. You can also ask neighbors, friends, co-workers and anyone else you know.   Luckily, you won’t have to trust their word. The proof will be written all over their face, or body, depending on what procedures they’ve had done.

Shop around. Go to more than one doctor and ask to see the before and after photos of their work. Talk to them, see how thorough they are when discussing options, possible complications and fees. If you get a nagging feeling that something’s just not right, listen to yourself and run like the wind.

If you follow the above recommendations you’ll be well on your way to finding a reputable, talented and legitimate surgeon to fit all your plastic surgery needs.

Good luck and happy new you!

-Jenna

If you are like most adults over the age of 18, you’ve probably had your wisdom teeth removed.  If you have, then you most likely saw an Maxillofacial Surgeon. Surely they must do more than pull teeth, and they do. Oral and Maxillofacial Surgeons care for patients with problem wisdom teeth, facial pain, and misaligned jaws. They treat accident victims suffering facial injuries, place dental implants, care for patients with oral cancer, tumors and cysts of the jaws, and perform facial cosmetic surgery. Oral and maxillofacial surgeons are the surgical specialists of the dental profession. In addition to earning their degree in dentistry, they also complete four to six year surgical residencies that specifically train them in anesthesia administration including local anesthesia (shots), laughing gas, I.V. sedation and general anesthesia.  All of this extra education makes the Maxillofacial Surgeon highly qualified  to diagnose, treat and manage the conditions, defects, and injuries of the mouth, teeth, jaws and face. Among the conditions and symptoms treated by oral and maxillofacial surgeons are:

Diagnosis and management of impacted teeth and tooth extraction
The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow at an angle relative to the other teeth, partially emerge from the gum, or even remain trapped beneath the gum and bone.

Facial pain, including problems related to issues relating to temporomandibular joint disease (TMJ)
The temporomandibular joint (TMJ) is a unique joint that is located in front of the ear where the skull and the lower jaw meet. It allows the lower jaw to move and function. Temporomandibular joint (TMJ) dysfunction may present a variety of symptoms such as earaches, headaches, neck pain, and limited mouth opening. People may also complain of joint noises such as clicking or grating sounds, or pain when opening and closing the mouth.  TMJ treatment may range from conservative dental and medical care to complex surgery.

Diagnosis and removal of oral cancers
Maxillofacial Surgeons can treat cancers in the head and mouth region, by performing biopsies and other tests and procedures that are required to diagnose the problem and develop an appropriate treatment plan.

Treatment and repair of injuries to the face, jaws, mouth and teeth caused by trauma
Oral and maxillofacial surgeons are experts in treating trauma, including fractures of the upper and lower jaws and eye sockets, and the cosmetic management of facial injuries.

The Oral and Maxillofacial Surgeon is an important member of your dental team of specialists due to their advanced training in anesthesia, their surgical and dental background and their ability to reconstruct facial structures damaged through trauma and/or cancer.

-Cheryl

You have nothing to be afraid of!

Going to the dentist is not one of the most exciting things to do in your day. Yet you go, get a cleaning, an exam with the dentist, and a goody bag and you’re good to go. Most people can handle this and other dental procedures, but there are some that can’t. A dental phobia is very real and can be very debilitating. There is some apprehension to having someone stick their gloved hands in your mouth, ask you a question with sharp instruments in it, and a glaring light in your face. It isn’t the most fun, but should not be something that causes phobia.

As a child, every adult seems large in size compared to themselves. When children visit the dentist for the first time, the dentist and their hands reaching toward their small mouths probably seems like a giant’s. If the dentist is not sensitive to a child, that child can grow up with an irrational fear of a dentist. I have heard many times in my chair that adults are afraid of the dentist because of a negative childhood experience. In the past, it was not common practice for dentists to use anesthesia on a child. Some dentists would tell parents that baby teeth have no feeling and that they would not need to numb them for certain procedures. We now know that simply is not true. So now we have a large generation of people as adults,that have this fear when visiting the dentist.

Some people never had a phobia as a child, but had one bad experience as an adult. This lone experience can cause people to not return to the dentist at all. If teeth are left to their own devices, they can have a cavity party! That is not a good thing for a dental phobic. Regular visits can prevent cavities and an emergency in the future.

So what is a phobic to do about the daunting task of going to the dentist? There is always an answer but it depends on the person and how severe the fear is. General dentists can start with talking to a phobic patient. Sometimes just knowing what is going to happen before it happens can put people at ease.

If talking doesn’t calm the nerves, then medication definitely can. Dentists can prescribe a light sedative to patients. They usually take it before the appointment but need to be driven home once the procedure is finished. If all else fails, there are dentists that specialize in sedation dentistry. There are various way a sedation dentist can deliver the drugs, either intravenous (IV) sedation through a tube that goes into the arm or hand or a strong oral sedative. Many times tranquilizers, anti-anxiety medications and depressants are combined with nitrous oxide in the office. These levels of sedation can be safe but not a great way to always receive dental care.

At some point the phobia needs to be dealt with. Present day dentistry is not what it was thirty years ago. The modalities have improved and so have the dentists. People know that going to the dentist is not the most comfortable thing to do, but offices are trying very hard to make it as comfortable as possible. There are offices now that consider themselves “Spa Dental Offices.” They offer great dental care along with spa like amenities.  Some have massage chairs, aromatherapy towelettes, and even a masseuse to massage your back and feet. If you need a little more TLC than a massage, then searching for a sedation dentist is easier then the click of a mouse. Doctorbase has a great way to search for a sedation dentist and even narrow down the search close to your house. Dental phobias are real but they don’t have to be a real pain.

-Alissa

Relax!

Imagine being crushed by 250 pounds! YOWZERS! Well, you may be one of the 30 million Americans who grind, clench and gnash your teeth on a nightly basis. Clenching and grinding are medically known as bruxism and for all you bruxers out there, you are unknowingly exerting a range of 100 to 600 pounds per square inch of force on your poor little teeth!

Many people do not realize they grind their teeth. Bruxism usually occurs during the night and may become strident enough to awaken their sleep partner. Some tell-tale signs are associated with TMJ disorders such as soreness near the ears when yawning or chewing, tenderness of the jaw muscles, clicking or popping of the jaw and headaches. Additional symptoms may include worn down, flattened, fractured, loose or chipped teeth; chewed-up cheek tissue; increased tooth sensitivity and ultimately tooth loss.

What triggers bruxism?

Unfortunately, the exact cause of bruxism is unknown. However, stress and anxiety are believed to be the chief cause…so calm down and RELAX! An abnormal bite and missing or crooked teeth are thought to elicit grinding and clenching as well. Children are often prone to bruxism as grinding may be related to growth and development of the jaw and teeth. Conversely, juvenile bruxism will usually disappear by adolescence.

Specific treatments for bruxism should be determined by your dental practitioner. In many cases, bruxism can be treated by a custom-made mouth guard or splint prescribed by your dentist. In other circumstances, clenching and grinding may be successfully treated by specialized behavior modifications which involve relaxing the tongue and lips. Other reported treatments include daily exercise, alcohol and caffeine reduction and hypnosis. To sum it up, decreasing your tension and stress will not only prolong the life of your teeth, but your life in general!

-Katie

MYTH #1: The only people who get gum disease are the people who don’t clean their teeth well.

It’s true that brushing and flossing are very important for reducing your risk for getting gum disease, but seeing your dentist and dental hygienist on a regular basis for a professional cleaning is what is important to keep your smile healthy.  Also, keep in mind that if you are a smoker, take certain medications, or have a family history of gum disease, you may be at a higher risk for developing gum problems.

MYTH #2: Bleeding when I brush is normal and is nothing to worry about.

Ok,  so let me ask you this – if your scalp bled every time you brushed your hair, would you be concerned?  Would you go to your doctor to find out why?  I hope so!  So, the same goes for your gums.  Bleeding when you brush and/or floss is NOT NORMAL.  Bleeding is an important  warning sign that you may have gum disease.  Normal, healthy gums should not bleed when you brush and floss.  Don’t be afraid to tell your dental professional if you notice bleeding gums.

MYTH #3: I will be able to tell if I have gum disease.

Like high blood pressure, most people will not be able to tell if they have gum disease–especially during the early (gingivitis) stages when the symptoms may be silent and not noticeable.  Again, it is important to see your dentist/hygienist on a regular basis so that if you do have gum disease, it can be detected and treated early.

MYTH #4: I can take care of my gum disease all by myself.  All I need to do is brush and floss more.

Gum disease is a bacterial infection that can cause permanent damage such as bone and tooth loss if left untreated.  Sometimes brushing and flossing more may not be enough. Professional treatments such as scaling and root planing (deep cleaning), and non-surgical laser therapy may be what is needed to get below the gumline and fight the infection at its source.

If you would like to know if you are one of the millions of Americans who may be at risk for gum disease, the AAP has a little test that you can take.  Then check out the highly qualified dentists who can diagnose and treat any of you dental needs.

Here is a very informative video about gum disease:

-Cheryl

Your smile is worth a million bucks...literally?

We all want perfect teeth, but at what cost? There are certain procedures that can be performed that can completely change the way your mouth looks, but it’s going to cost you!

Implants
If you have a missing tooth and want the replacement to look very natural, an implant is your best bet. Implants can be very expensive but is the most cost effective in the long run. Basically, an implant replaces the root and crown of a tooth. A post (or pin) is placed in the bone and usually made of titanium. The bone and the titanium post have to osteointegrate, which means the bone and post have to mesh together in order to be successful. Once that is complete, a crown that looks very much like a real tooth, is screwed into the post above the gum. And there you have it, a “new” tooth. The reason it is cost effective is that it only effects one tooth, as opposed to a bridge. A bridge normally involves three teeth, the tooth that is missing, and two teeth on either side of it. Studies have shown that an implant lasts much longer than a bridge. So, if you are missing a tooth and have money saved, this is for you.

Veneers
Do you envy the movie star smile? Do you wish you had straight, white teeth but don’t want to wear those metal braces? Then veneers are for you! Veneers are a shell of a crown, and affix to teeth usually in the front. They give the appearance of many different outcomes. It can make teeth look longer, wider, whiter, straighter, and all around different. But it comes at a cost. Veneers are not covered by dental insurance, because they are considered a cosmetic procedure. Again, if you have the money or can finance, veneers give a wonderful natural look to a new you.

Gum Surgery
You may not want the new you to involve gum surgery, but sometimes it is needed rather than wanted. Gum and bone disease are serious issues and need serious attention. The surgery can be expensive because it takes great skill in order to be performed properly. The down side is that once you have been diagnosed as needing gum surgery there is no getting around it. You can certainly put it off, but it is inevitable. Most people have negative comments about it, but once it’s done, you are healthy and can move on to the more “fun” procedures like bleaching!

Bleaching
Ahhh nothing like a pearly white grin to start the day! But bleach!? No, it’s not the bleach you use to get those whites white in the wash! It’s a special dental bleach that makes virgin teeth whiter. Now virgin teeth are teeth that do not have any crowns on top of them, any fillings on them or have been stained from the inside out. If you have teeth like that, particularly in the front of the mouth, then bleaching is not for you. But if you drink a lot of coffee or want to brighten that smile for a date then sign right up. There are three different ways to bleach and three different price tags. The first and most cost effective is over the counter bleaching strips. They can be messy and take up to 14 days to achieve the whiteness you desire. The second is bleaching trays from a dental office. You can have trays made especially for your mouth and you place bleach given to you by the dentist in them. The bleach concentration is a bit stronger than over the counter but can also take up to 14 days as well. The big hitter and the fastest way to a blindingly white mouth is doing an in-office bleach. It is expensive but you can have the desired whiteness done in about an hour. There are two different ways, ZOOM whitening system or BriteSmile system.

Braces
When thinking of braces, does it conjure up thoughts of horrible adolescent memories of being teased for having a metal mouth? Well, those days are long gone. Traditional braces, metal, can look pretty amazing in 2010. There are now clear braces, gold braces and you can pick any color under the sun to cover the brackets. And now the new trend is to use Invisalign. They are considered braces, just another way to straighten your teeth without the teasing. These procedures can be very expensive but so worth it in the long run. Parents want to see their children have straight teeth, but as a dental health professional I see braces as a way to stay healthy. When teeth are crowded it can make it difficult to brush them properly. If they are very crowded then flossing can seem impossible. If left crowded, over time the bone holding teeth in can be damaged and diseased. Conversely, if teeth are spaced too much, food can be jammed in between. This can be very annoying over time. Many people feel embarrassed by their spacing as well. Crowded or spaced, braces can solve the problems. Many general dentists are doing orthodontia now, so if you don’t want to go to an orthodontist, ask your dentist!

All of these dental procedures are expensive. It may seem daunting or aggravating to spend a lot on your mouth. Yet, these procedures take great knowledge and know how to be performed. Think of your mouth as a part of your overall health. Having the best person do the best job, affects your health!

-Alissa

X-rays, and fillings, and crowns! Oh, my! If you have dental insurance then consider yourself fortunate. Nevertheless, do you know precisely what your dental insurance covers, and what it doesn’t?

Alright, before we get started let’s talk UCR fees to reduce any confusion. Most dental insurance companies utilize a “Usual, Customary and Reasonable” (UCR) fee guide to determine the portion of the dental treatment they will pay.  In other words, insurance companies decide the price based not on what a dentist actually charges, but on what the insurance company believes is a “usual, customary and reasonable” fee for dental service. With that in mind, the insurance companies break down their coverage types into 3 main groups- Preventative, Basic and Major.

Preventative – Preventative dental services include routine cleanings, examinations, x-rays, sealants, and fluoride treatments. But wait, here’s the confusing part! Some of these items are considered preventative OR basic so it depends upon your insurance company. The good news is that the majority of insurance companies will cover 80-100% of UCR fees for these services!

Basic – Basic and restorative services include fillings, fixing chipped teeth, simple tooth extractions, periodontal treatment and occasionally crowns and root canals.  Once again, this depends upon the insurance provider. Typical insurance coverage is around 80% of UCR fees.

Major – Major dental services are exactly that- major. These generally include crowns, bridges, dentures, partials, surgical tooth extractions and any other large, expensive dental procedures. On average, the insurance coverage is around 50% of UCR fees.

So, what do insurance companies NOT cover?

Well, basically anything considered to be “cosmetic dentistry”. This includes porcelain veneers, bleaching trays or tooth whitening procedures, tooth bonding to correct spaces between teeth and some dental implants.  Overall, it is vital to analyze your insurance policy’s premiums, deductibles, and annual maximums specific to your dental insurance that meets your unique needs.

-Katie

Yelpers use stars based on their experience. So, if someone did not like the way the dentist said hello or he did not wash his hands long enough before putting on gloves, that dentist could potentially get a low rating. That low rating in turn, turns people off to that particular dentist. What other Yelpers may not know, is that dentist could be the best dentist in the state. There are many dentist rating sites, but your best bet, if you like to do research before meeting a dentist, is to review all the sites. You can find incredibly detailed dentist reviews on DoctorBase, then try finding the same dentist on another. If they have good reviews on both or they have qualities that are appealing to you, then try them out.

The great thing about being a patient is that YOU have the choice of who you want your dentist to be. There is no law that says you have to stick with the first dentist you find on Yelp. In fact, a great dentist would encourage someone to find a second opinion – it only shows they are confident in their work. In my opinion, a great dentist would explain all needed procedures, explain the pros and cons of different procedures, allow the patient to have a say and ultimately allow the patient to make their own dental decisions. A great way to know if a potential dentist is an excellent dentist is to ask them when they last went to a continuing education class and what it was. Dental professionals must continue their education beyond graduation. If a dentist is on the cutting edge and is responsible to keep up with their profession, they will actively go to continue education.

Remember, Yelp is still a good way to find dentist reviews, but if you need more accurate reviews do some searching, that is the great thing about Google, there is always a site for something. I don’t know how I would rate this dentist…

Don’t forget to floss!

-Alissa

Thanks to advances in dental technology, visits aren't like this.

Dentistry has come a long way since Moe pulled out Curley’s tooth with a pair of pliers while Larry held Curley down. If this image of dentistry has kept you from getting the smile you want, then you will be happy to hear that dentists now have a variety of tools that they can use to make the entire dental experience more pleasant than in the past.

Quiet hand drills and Isolite suction
Imagine a trip to the dentist with no high-pitched whining drills, no needles, and no water going down your throat. The Waterlase by Biolase Technology, Inc. can perform a variety of dental treatments without a dentist’s drill. The Waterlase combines a laser with water to cut the tooth or gums without the pain and numbness associated with traditional dental treatment. The Waterlase can remove cavities and even gum disease.

To help your dentist in removing saliva and water from your mouth during dental treatment, Isolite Dental has created a dental device to light up the mouth, hold back the cheek, and remove water and saliva. The Isolite system is composed of a soft, flexible mouthpiece that the dentist can use to see the top and bottom teeth at the same time while protecting the tongue and cheek. With the Isolite system, you won’t have to worry about keeping your mouth open while having saliva and water building up at the back of your throat.

Sedation dentistry and one-day crowns
Dentistry does not have to be painful or scary. Sedation dentistry offers safe, effective, and comfortable dental treatment to anxious and fearful patients. Whether it is a broken tooth that needs to be fixed, yellow teeth that need to be whitened, or pain that needs to be eliminated, dental sedation can help you have the fabulous smile you’ve always wanted. In fact, any dental procedure can be performed while you are sedated.

Here’s how it works: You are given a prescription sedative the night before your appointment. The day of your appointment, the dentist provides medication to you that have been safe and effective for decades. Your certified sedation dentist will make sure that you are being monitored throughout your whole sedation appointment. The result is you remember little to nothing of your time in the dental chair. Hours pass like minutes and more dentistry can be performed in a single visit because the dentist is able to work more efficiently.

While you are sedated, or if you need a new crown fast, Sirona has invented Cerec, which is an all porcelain crown that can be done in one hour. Most crowns require two dental appointments before you have your new crown. The Cerec machine does this entire process while you wait, saving you that second appointment. The Cerec crown is made with a CAD/CAM machine using an infrared photo of the tooth without messy, uncomfortable impressions. Cerek crowns look natural, with no dark gum line.

Intra-oral technology and DIAGNOdent
Most people value healthy and attractive teeth. The key to this is early detection and care. An intra-oral camera is a camera that has been designed to be used in the mouth for the purpose of taking video or still photography. For the dentist or hygienist it is helpful to be able to show the patient exactly what is going on inside their mouths and explain areas where attention may be needed. In addition, cameras can be used to take clear visual records for patient files, which can be used for discussion and consultations with other dental specialists.

The DIAGNOdent by KaVo uses reflected laser fluorescent light to determine if a tooth has decay. An audio signal alerts the operator and patient that there is a cavity in the tooth. The dentist no longer needs to use a dental pick to check for cavities. The DIAGNOdent is 90% accurate, simple, fast, and painless. It removes doubt from teatment and can even find small cavities at their earliest stage. With intra-oral cameras and DIAGNOdent, your dentist can offer the best and most conservative treatment for any of your dental needs.

So as you can see, with modern dental technology, your trip to the dentist can be quiet, more comfortable, stress-free, and painless while providing you, the patient, with healthy teeth and gums that you have always wanted. To find a dentist that provides these services and more, check out DoctorBase.com.

-Cheryl