Friday, September 26, 2008

Is This Going to Hurt?

"Is this going to hurt?", is one of the most common questions presented to dental professionals today. Long gone are the days of "cowboy dentistry" where a good shot of whiskey and white knuckling the dental chair were your only means of coping with dental procedures. Long gone are the days of foot pedaled and belt driven "drills" assaulting your senses with the incessant whine, the astrid smell of barbecued tooth and the oh so popular repetitive expectorating into the cuspidor. Yes, dentistry has indeed come a long way.

Painless dentistry is the new wave of the future! Dental anesthetics are by far more effective now, then ever. Patients are presented with a plethora of options to suit their comfort needs. Local anesthetics ( previously known as "Novocaine") are offered and at most times highly suggested with almost all dental procedures. They work faster and last longer to insure the maximum level of comfort for both patient and the dentist. Now, some exceptions do apply. In fact, there are quite a few dental procedures that are regularly done with no anesthetic because there is rarely an opportunity or occurrence for discomfort. (IE., bleaching, sealants, routine name a few.)

General anesthesia is becoming another common practice among specialists and some general dentists when performing more difficult and invasive procedures such as extractions, periodontal (gum) surgeries and implant placements. This allows the patient to comfortably "fall asleep" prior to the dental procedure and awaken after with very little memory of the experience. This can be done intravenously and sometimes orally.

For those dental phobics out there that can't seem to bring themselves to face the dentist because of their "horrific childhood experience", "needle phobias" and "level of pain intolerance", many dentists now offer oral sedatives and nitrous oxide to help calm those dental jitters and make your dental experience a pleasant one.

"How bout after the work is done?"

Lets face it, you are more likely to experience some sort of sensation after dental treatments. The intensity of the sensations you may feel will depend on the level of invasiveness of the procedure you are having done. For example:

Fillings: In most cases patients may experience mild soreness in the injection site more so than in the tooth. It is common, however, to experience mild to moderate sensitivity to cold for a short period of time after a filling is placed. Again, this sensitivity will depend on the type of filling placed, the depth of the cavity and its proximity to the nerve of the tooth. (IE., teeth with large deep fillings may feel more intense cold sensitivity for a longer duration than a small shallow filling.) Fillings that may feel "high" can also make the tooth and surrounding bone feel bruised because of the constant heavy contact during eating. This causes the ligament surrounding the tooth to become sore. With a simple adjustment by the dentist, this problem is usually remedied in a few days.

Extractions: Patients often say that the extraction site is mildly sore after the tooth is removed. This being one of the most invasive and non-reversible dental procedures, that shouldn't come as a surprise. A lot of healing takes place after a tooth is extracted and if you follow the post operative procedures given to you by your dentist, this healing should go off without a hitch. On the rare side, dry sockets and bone chips can cause discomfort, however, these are also easily treated by your dentist to help speed the healing along.

Root Canals: Oh the horror stories we have all heard! The fact here is, once the nerve is removed from a tooth, the tooth itself has no feeling. Patients will still feel sensations from biting pressure, but that's because the bone and tissue around the tooth still have feeling. One of the most common things I've heard after patients have had a root canal is, "the tooth doesn't hurt, but my jaw is sore." Well, again this makes sense. The tooth has no feeling, therefore it shouldn't hurt, and you've been propped open for over an hour during the root canal so your jaw muscles are fatigued and they become sore. In most cases, some basic over-the-counter pain relievers keep this discomfort in check. Again, on the rare side, sometimes teeth have little side canals or extra canals that can't be seen visually or on a radiograph and they don't get cleaned out. When this happens, it is common for the tooth to begin to ache and a subsequent visit to the dentist is necessary to retreat the tooth. Most dentists do prescribe mild pain relievers in conjunction with procedures like that to help keep your discomfort at bay.

Now these are just a few example of common reactions to the dental procedures listed above. Every mouth is different and every person's pain tolerance is as well. Don't be hesitant about asking your dentist what type of anesthesia and pain management would work best for you. By discussing your options and your tolerances, both you and your dentist should have a pain free experience!

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