Dradeledoherty’s Weblog

Dental amalgam was recently banned throughout Norway. The AGD has resources available to help you with questions from your patients. You can read the AGD’s position on dental amalgam   or  read the consumer article on the ban. Also, a fact sheet focusing on amalgam will be published in the March issue of AGD Impact.  We will bring it to your attention.

* Courtesy of Academy of General Dentistry (http://www.agd.org).

Some jaws are narrow and sometimes with a V-shape  palate that may have adverse effects on sequential eruption of teeth and proper positioning in the mouth.  Many parents are worried about such situations for their children and may seek help from orthodontist or general dentist or pediatric dentist that incorporates functional appliances into his/her practice.  One of the well-known laboratories in the US that fabricate such appliances is Space Maintainers Laboratory.  This laboratory will work with your dentist to produce appliance that your child can wear.

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http://www.appliancetherapy.com/Global_Center/sml/MemRx.aspx

One of such appliance is known as *MemRx E appliance which features lateral expansion via unique Memory Expansion Screws. The special Memory Screw allows for multiple adjustments to be made at the time of seating the appliance. Expansion is achieved through the Memory Springs, which are integrated in the screw. This serves to increase patient comfort and compliance as well as less chair time in the doctor’s office, not to mention fewer patient appointments.  If this appliance is right for your child, ask your doctor.

Starting in March 2008, we will begin a new segment that will deal with myths, old tales and stories about dentistry and dental care.  For example, it is believed in some quarters that a woman would lose at least one tooth on pregnancy.  This is certainly not true!!!!!!!!!!!!

You can also send in your own stories, myths, old tales, etc and all refined stories, tales, etc shall be published. Let’s have some fun!!!!!!!!!!!!!!!!

Sleepy & Ready for Dental Work! Back in the 1800s, a young dentist, Dr. Horace Wells was determined to make dental care as painless as possible.  He experimented on a number of techniques sometimes medical to find a way to ameliorate pain and discomfort during dental procedure.  He adopted many other health field’s techniques to dentistry and he was indeed very creative and energetic.  He even used himself as guinea-pigs in most of his experiments.  His original practice was in Hartford, CT and he introduced the use of nitrous oxide in pain management during dental treatment.  This discovery changed the field of dentistry and medicine forever and paved the way for the development of anxiolysis, conscious sedation and general anesthesia.  Dr. Wells was only 33 years old when he took his life and was honored  for his contribution to modern anesthesia by an honorary membership of the world-renounced Medical Society of Paris and both the American Dental Association (ADA) and the American Medical Association  (AMA) recognized him as a giant in the field of general anesthesia.

General dentists and many other dentists now offer adult oral sedation to their fearful patients.  This offers many advantages to the fearful patients including getting the much needed dental care without stress and depending on the medication used to achieve sedation, patients often do not even remember.  Patients get more dentistry done in one single visit instead of requiring several returns to the dentist’s office. 

Some of the common medications used by dentists to achieve conscious sedation include valium (diazepam) which was first introduced in 1963, it is a benzodiazepines.  It has a half-life of between 20 and 100 hrs.  The problem is patient may not be able to return to regular routines after 24 hrs. such as driving.  Sonata (zaleplon) is a non-benzodiazepine but acts as if it were.  It has a most rapid onset and a half-life of just one hour so if you are planning to have extensive dental work done at one visit, this may not be for you.  Ativan (lorazepam), it has a half-life of 12-14 hours and it is widely accepted in the dental circle because it is safe and effective as an anxiolytic agent.  Xanax (alprazolam) is a moderate benzodiazepine with two active metabolites that extend the half-life to 11-12 hrs. in adults.  Interestingly, the half-life doubles in obese patients.  Halcion (triazolam), the blue pill is considered by many in the dental community as the “ideal” oral sedative because it has a fast onset, short-acting, anxiolytic, amnesic; half-life of 2-3 hrs., large margin of safety, and reversal agent is readily available.

So the millions of patients avoiding recommended and needed dental treatment due to fear, can now relax and look forward to relaxation dentistry.  With availability of safe and effective oral sedation dentistry protocols, the dental team can help these patients get care they need and deserve.  Dentists often consider patient variability as an important risk factor in deciding which anxiety-free protocol to use.  Indidivudal variables such as weight, anxiety level, age, and underlying disease states are often considered by the treating dentist.