Posts for: January, 2019
Like other healthcare providers, dentists have relied for decades on the strong pain relief of opioid (narcotic) drugs for patients after dental work. As late as 2012, doctors and dentists wrote over 250 million prescriptions for these drugs. Since then, though, those numbers have shrunk drastically.
That’s because while effective, drugs like morphine, oxycodone or fentanyl are highly addictive. While those trapped in a narcotic addiction can obtain drugs like heroine illicitly, a high number come from prescriptions that have been issued too liberally. This and other factors have helped contribute to a nationwide epidemic of opioid addiction involving an estimated 2 million Americans and thousands of deaths each year.
Because three-quarters of opioid abusers began their addiction with prescription pain medication, there’s been a great deal of re-thinking about how we manage post-procedural pain, especially in dentistry. As a result, we’re seeing a shift to a different strategy: using a combination of non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen and acetaminophen, instead of a prescribed narcotic.
These over-the-counter drugs are safer and less costly; more importantly, though, they don’t have the high addictive quality of an opioid drug. A 2013 study published in the Journal of the American Dental Association (JADA) showed that when two NSAIDs were used together, the pain relief was greater than either drug used individually, and better than some opioid medications.
That’s not to say dentists no longer prescribe opioids for pain management following dental work. But the growing consensus among dental providers is to rely on the double NSAID approach as their first-line therapy. If a patient has other medical conditions or the NSAIDs prove ineffective, then the dentist can prescribe an opioid instead.
There’s often hesitancy among dental patients on going this new route rather than the tried and true opioid prescription. That’s why it’s important to discuss the matter with your dentist before any procedure to see which way is best for you. Just like you, your dentist wants your treatment experience to be as pain-free as possible, in the safest manner possible.
Dental veneers, thin layers of porcelain bonded to chipped, stained or slightly crooked teeth, are an effective and affordable way to transform your smile. Their color, translucence and shape blend so well with the rest of your teeth that it's often difficult to tell them apart.
But traditional veneers have one drawback: although they're less than a millimeter in width, they can still appear bulky on unprepared teeth. To help them look more natural, we often have to remove some of the enamel layer from the tooth surface. Enamel doesn't grow back, so this alteration is permanent and the prepared teeth will require a restoration from then on.
But you may be able to avoid this—or at least keep the alteration to a minimum—with no-prep or minimal-prep veneers, two new exciting choices in cosmetic dentistry. About the width of a contact lens, we can bond these much thinner veneers to teeth with virtually no preparation at all or, in the case of a minimal-prep veneer, needing only an abrasive tool to reshape and remove only a tiny bit of the enamel.
These ultra thin veneers are best for teeth with healthy enamel, and can be placed in as few as two appointments. And besides being less invasive, the procedure is reversible—we can remove them and you can return to your original look without any follow-up restoration. One caveat, though: because of the strong bonding process used, it's not always easy to remove them.
Although their thinness makes it possible to avoid or minimize alterations, there are some dental situations like oversized teeth that may still require extensive tooth preparation. With some poor bites (malocclusions) orthodontic treatment to straighten the teeth may also be needed first.
All in all, though, no-prep or minimal-prep veneers could help you avoid the permanent tooth alteration that usually accompanies their thicker cousins. What's more, you'll have the beautiful, transformed smile that veneers can achieve.
If you would like more information on minimal or no-prep veneers, 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 “No-Prep Porcelain Veneers.”
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”