Getting Numbed (Our Way)
For some people, the most anxiety inducing part of a dental visit is the numbing.
If I had a nickel for every time someone told me “I hate the numbing Doc! Can we not do it. Please?” I’m ok with not numbing at the patients request only if I feel it’s possible to do the work without hurting the patient. But sometimes it is required because it will hurt a great deal more if we don’t numb.
Numbing with the Mosquito Technique
I basically use the mosquito technique. Although mosquitoes are annoying and cause itchy marks (at least dental injection don’t itch) sometimes you don’t remember when you are bitten. That is because mosquitoes actually inject anesthetic immediately after they puncture the skin. Then they wait for the area to become numb before they proceed to fill up their tank.
For all my injections I use the same protocol. I use the smallest sized needle (gasp! I used the red zone word!) to puncture the area to be numbed and I place a drop of anesthetic. Then we wait a few seconds until the area goes numb before we give you more and stretch the tissues (which is the main reason injections hurt). My way of providing anesthetic is the least painful and I hear about it – positively, many times over: “I didn’t even feel that, Doc!” That is when I know I have done a good job. That is the goal every time.
There is a subset of people that don’t hate the injection as much as they hate the feeling of being numb afterwards. For those people I make sure to use short acting anesthetic that goes away more quickly. Also, there is the option of giving an anti-anesthetic injection that reverses the numbing and makes you unnumb. If you are in this subset, I will discover that in our initial interview process and deliver care catered to your needs.
If I had a nickel for every time someone told me “I hate the numbing Doc! Can we not do it. Please?” I’m ok with not numbing at the patients request only if I feel it’s possible to do the work without hurting the patient. But sometimes it is required because it will hurt a great deal more if we don’t numb.
Numbing with the Mosquito Technique
I basically use the mosquito technique. Although mosquitoes are annoying and cause itchy marks (at least dental injection don’t itch) sometimes you don’t remember when you are bitten. That is because mosquitoes actually inject anesthetic immediately after they puncture the skin. Then they wait for the area to become numb before they proceed to fill up their tank.
For all my injections I use the same protocol. I use the smallest sized needle (gasp! I used the red zone word!) to puncture the area to be numbed and I place a drop of anesthetic. Then we wait a few seconds until the area goes numb before we give you more and stretch the tissues (which is the main reason injections hurt). My way of providing anesthetic is the least painful and I hear about it – positively, many times over: “I didn’t even feel that, Doc!” That is when I know I have done a good job. That is the goal every time.
There is a subset of people that don’t hate the injection as much as they hate the feeling of being numb afterwards. For those people I make sure to use short acting anesthetic that goes away more quickly. Also, there is the option of giving an anti-anesthetic injection that reverses the numbing and makes you unnumb. If you are in this subset, I will discover that in our initial interview process and deliver care catered to your needs.
Mind over Matter
We live in a world that is governed by the principles of science and logic. In no other field is this truer than in healthcare. Does a particular treatment work against a symptom of disease? To answer this question, scientists and researchers devise experiments to try to illuminate the truth. Yet, there is one truth that cannot be ignored, but is hard to measure.
It is the same truth that allows a placebo to work just as well as a real drug in pharmaceutical experiments. This truth is the effect of perception on reality.
In many cases, it has been proven that people who believe a positive outcome will occur in a treatment are more likely to experience those positive effects. Conversely, it has also been proven that people skeptical of a treatment outcome experience neutral or negative effects. In other words, if you believe a treatment will help you, it more likely will.
It is a mystery of our universe. Our perception and belief have the ability to shape the world. It’s not just that positive people feel better. The measurable factors that determine successful treatment actually are better for people who expect positive outcomes. The observer has an effect on the observed. This principle also rears its head in quantum physics.
So what does this have to do with teeth? My observation is as follows:
People who are neutral or positive in their perception of the outcome of a treatment, whether it be for a root canal or a cosmetic makeover, usually experience a better outcome than those who think something is sure to go wrong. Those who believe that treatment will hurt usually have a much worse experience than those who are neutral or believe the opposite. It’s an energy thing. I can’t explain it the way science explains things. But I firmly believe this to be true.
Shahen Rostamian DDS
* The Tender Dentist uses composite white fillings instead of mercury fillings. Mercury is a toxic, non-radioactive and naturally occurring substance that can affect your digestive system, emotions, energy levels, your head, heart, lungs, muscles, joints, nerves. throat, and nose.
It is the same truth that allows a placebo to work just as well as a real drug in pharmaceutical experiments. This truth is the effect of perception on reality.
In many cases, it has been proven that people who believe a positive outcome will occur in a treatment are more likely to experience those positive effects. Conversely, it has also been proven that people skeptical of a treatment outcome experience neutral or negative effects. In other words, if you believe a treatment will help you, it more likely will.
It is a mystery of our universe. Our perception and belief have the ability to shape the world. It’s not just that positive people feel better. The measurable factors that determine successful treatment actually are better for people who expect positive outcomes. The observer has an effect on the observed. This principle also rears its head in quantum physics.
So what does this have to do with teeth? My observation is as follows:
People who are neutral or positive in their perception of the outcome of a treatment, whether it be for a root canal or a cosmetic makeover, usually experience a better outcome than those who think something is sure to go wrong. Those who believe that treatment will hurt usually have a much worse experience than those who are neutral or believe the opposite. It’s an energy thing. I can’t explain it the way science explains things. But I firmly believe this to be true.
Shahen Rostamian DDS
* The Tender Dentist uses composite white fillings instead of mercury fillings. Mercury is a toxic, non-radioactive and naturally occurring substance that can affect your digestive system, emotions, energy levels, your head, heart, lungs, muscles, joints, nerves. throat, and nose.
How to help Kids not be afraid of the dental visit
Kids don’t like to get shots. I mean, every time a dentist dons a pair of gloves or a mask, kids sense they are about to be poked or prodded and they are just plain opposed to the idea. Pain and fear are great learning tools, and kids do learn quickly.
So when they come to the dentist and they are told they are going to get a shot some kids will freak out and start to imagine the worst. It’s a situation that can be managed much better if the adults involved in the process do certain things. First and foremost we do not use the word shot under any circumstances. Because truly, the anesthetic used in dental procedures is very different from a shot. Shots hurt and keep hurting, while sleepy juice (what we call anesthetic for the kids in our office) is a small pinch. Numbing our patients the gentle way is the final act, but getting the child to be calm and peaceful before and during the actual procedure is a delicate process. We ask that you NOT use buzz words like shot, pain, owy, won’t hurt, and other such well meaning words and phrases that only produce anxiety. Parents that are nervous about dental procedures will transfer their anxiety to the child.
Conversations that cause harm go something like this: “Ok, Julie, tomorrow we are going to the dentist and don’t worry it’s not going to hurt.” The child is only hearing the word hurt. My suggestion is to talk about other topics and avoid the dental talk altogether. We’ll be happy to craft the message to your children to ensure a happy and smooth experience before, during, and after their appointments.
When you and your children walk into our dentist office, we will engage you with energy and a fun attitude that will help you relax. We like to be the center of attention so we ask parents, if possible, to sit outside of the child’s view. It’s important that your children know you are there; we just want to be able have their full attention while they’re sitting next to us in the dental chair. We will continue to engage the children, disarm them, and explain to them all of the steps we’re taking to make sure that their teeth are healthy. We will use (or sing) child-friendly terms like water-whistle instead of drill or sleepy juice instead of anesthetic. If anesthetic will be required, we like to administer it (just a quick pinch) and then we’ll show them the needle so they see that they were able to tolerate it and that it was really not a big deal in the first place. We are re-enforcing the fact that they didn’t receive a “shot” just a pinch and we feel that they need to know that. Once a complete trust is formed, our experience tells us that a healthy relationship with dentistry ensues which also promotes better oral health throughout their lives because they won’t avoid the dentist. We are a team – parents, children, and me – and together we make dentistry relaxing and even enjoyable.
We all were kids at one time. Although for some of us it seems a long time ago, as a dentist I find that I go back to being a kid whenever I have a young person in my chair. Frankly it’s fun. For most of the kids that come for dental cleanings and some dental work, it is also quite fun. For others, however, it’s more of a challenge.
If a child is afraid of the dentist, it’s important to be mindful of and address the factors that make them uncomfortable.
If a child is afraid of the dentist, it’s important to be mindful of and address the factors that make them uncomfortable.
Home Care for Your Gums
Because microbes are at the root of the problem severe dental problems, just flossing and brushing is not enough for people who have been diagnosed with gum disease. We must keep killing those bacteria on a regular basis because they usually come back. Flossing helps because it gets rid of the food source and makes the bacteria weak. But they are not dead. So when there is a bit of food, they get strong again and multiply. Also they don’t go through a dating service and mate with other bacteria. They just split in half and become 2, 4, 8, 16, 32, etc. So they can number in the millions in a few days.
So, I recommend using an antiseptic such as peroxide to kill the bacteria. What’s also important is delivering the bacteria killing substance to the deepest part of the pocket which could be up to 8 mm deep. Just rinsing your mouth is not enough. This is why I advocate using a Waterpik. It will deliver medicine to the depths of the pocket.
So, I recommend using an antiseptic such as peroxide to kill the bacteria. What’s also important is delivering the bacteria killing substance to the deepest part of the pocket which could be up to 8 mm deep. Just rinsing your mouth is not enough. This is why I advocate using a Waterpik. It will deliver medicine to the depths of the pocket.
Waterpik Water Flosser
There are many types of bacteria that live in people’s mouths. It is essential that there be some bacteria there, preferably ones that don’t cause disease of course, because if bacteria aren’t there, fungi (yeast) or viruses will take over.
Streptococcus mutans is the type of bacteria that can cause cavities. Sugar and plaque are the other essential ingredients. Once there are enough S. Mutans on a tooth the acids they excrete cause decalcification and eventually a cavity or hole. The bacteria then enter the tooth don’t need outside food sources anymore.
Porphyromonas gingivalis is another anaerobe (which means bacteria that can live without oxygen). This one however causes gum inflammation and eventually leads to tooth loss if left untreated.
Other microbes that can live in people’s mouths are amoeba and viruses. For severe periodontal disease, we have to make sure we kill all the harmful pathogens as we proceed with treatment.
The overall strategy is clear, get rid of these harmful critters and you get a much healthier mouth. The challenge lies in making sure they stay away. I have many natural products and home care steps you can take to keep them away once we bring you back to a good equilibrium.
Streptococcus mutans is the type of bacteria that can cause cavities. Sugar and plaque are the other essential ingredients. Once there are enough S. Mutans on a tooth the acids they excrete cause decalcification and eventually a cavity or hole. The bacteria then enter the tooth don’t need outside food sources anymore.
Porphyromonas gingivalis is another anaerobe (which means bacteria that can live without oxygen). This one however causes gum inflammation and eventually leads to tooth loss if left untreated.
Other microbes that can live in people’s mouths are amoeba and viruses. For severe periodontal disease, we have to make sure we kill all the harmful pathogens as we proceed with treatment.
The overall strategy is clear, get rid of these harmful critters and you get a much healthier mouth. The challenge lies in making sure they stay away. I have many natural products and home care steps you can take to keep them away once we bring you back to a good equilibrium.
Once you have received your dental treatments, follow these simple steps to prevent the return of gum disease and gum infection. They will help keep bacteria away and help prevent bleeding and bone loss around your teeth!
Buy a Waterpik
This is what a Waterpik looks like. It can be ordered online or found at the following retailers in the Woodland Hills are: Walmart, Target, Costco, Rite Aid.
Buy something that kills bacteria, to put in the water.
Grapefruit seed extract, peroxide or prescription mouthwash are some options.
Use your Waterpik to massage the gums 2 to 3 times per week.
Make sure to point the Waterpik tip into the gums in the trouble areas we’ve pointed out to you.
Maintain a regular tooth cleaning and gum evaluation appointment schedule
Keep your biannual or annual evaluation and cleaning appointments with The Tender Dentist to keep track of the health of your gums and stay healthy!
Buy a Waterpik
This is what a Waterpik looks like. It can be ordered online or found at the following retailers in the Woodland Hills are: Walmart, Target, Costco, Rite Aid.
Buy something that kills bacteria, to put in the water.
Grapefruit seed extract, peroxide or prescription mouthwash are some options.
Use your Waterpik to massage the gums 2 to 3 times per week.
Make sure to point the Waterpik tip into the gums in the trouble areas we’ve pointed out to you.
Maintain a regular tooth cleaning and gum evaluation appointment schedule
Keep your biannual or annual evaluation and cleaning appointments with The Tender Dentist to keep track of the health of your gums and stay healthy!
Benefits of Straight Teeth
People like having straight teeth, usually because they want a nicer looking smile. I agree that is a good reason, but there are some compelling reasons to consider aligning teeth besides the good looks they provide.
Breaking and Chipping Teeth Can Be Avoided
Function during biting and chewing pressures is very much related to the orientation of the upper and lower teeth. If there is a balanced and even bite on both sides and on the top and bottom, your teeth will be much less likely to break or chip over time. If the bite is uneven then the pressure is higher where the teeth bang against each other. In other places, there might be an open bite which doesn’t contribute to the balance. Correcting bite-balance issues can save the teeth from excessive wear for many years.
Crowding and Gum Disease Go Hand in Hand
When the root orientation of the teeth doesn’t allow for proper spacing for the gums we get gum disease. The gums will become inflamed and bleed easily where there is crowding. Over time, that inflammation leads to bone loss. When we correct crowding, we also prevent problems for the gums. Decreasing teeth and root crowding is the best way to avoid gum surgeries and other unpleasant dental treatments.
My benefit to you as your Woodland Hills dentist is to safeguard the short-term and the long-term. I pride myself on projecting 10 to 20 years into the future offering you foresight and knowledge to help prevent problems from occurring. Straightening teeth and balancing the bite is the most beneficial dental treatment because they reduce wear and tear and make it easier to maintain a healthy mouth overall.
Remember, straighter teeth aren’t just about a nicer smile.
Breaking and Chipping Teeth Can Be Avoided
Function during biting and chewing pressures is very much related to the orientation of the upper and lower teeth. If there is a balanced and even bite on both sides and on the top and bottom, your teeth will be much less likely to break or chip over time. If the bite is uneven then the pressure is higher where the teeth bang against each other. In other places, there might be an open bite which doesn’t contribute to the balance. Correcting bite-balance issues can save the teeth from excessive wear for many years.
Crowding and Gum Disease Go Hand in Hand
When the root orientation of the teeth doesn’t allow for proper spacing for the gums we get gum disease. The gums will become inflamed and bleed easily where there is crowding. Over time, that inflammation leads to bone loss. When we correct crowding, we also prevent problems for the gums. Decreasing teeth and root crowding is the best way to avoid gum surgeries and other unpleasant dental treatments.
My benefit to you as your Woodland Hills dentist is to safeguard the short-term and the long-term. I pride myself on projecting 10 to 20 years into the future offering you foresight and knowledge to help prevent problems from occurring. Straightening teeth and balancing the bite is the most beneficial dental treatment because they reduce wear and tear and make it easier to maintain a healthy mouth overall.
Remember, straighter teeth aren’t just about a nicer smile.
Home Dental Care for Cavity-Prone People
Why do some people go through life without cavities? Why do others have minimal cavities while not properly adhering to proper home care treatment, i.e., flossing? And why do others seem to have a cavity every time they visit the dentist?
Do some people have “soft teeth?”
The answer is not simple. The factors that influence being cavity prone are saliva content, tooth density, bacteria types, oral hygiene habits, and pH level.
We can’t really control the first two factors (tooth density or saliva content) because that is like trying to control your skin color. These are things you are born with so we have to accept them as they are. Of course when we do put a crown on a tooth we can make it more dense, but the point is to prevent treatment.
Therefore, we have to try to control the other three factors (bacteria types, oral hygiene habits, and pH level). If we consistently kill the bad bacteria (coconut oil pulling), have good oral hygiene (floss and pick as well as brush well) and raise pH (use baking soda toothpaste) we can combat the problem in a cavity-prone person and help them prevent dental treatment. More details and specific testing can reveal other strategies as well.
Do some people have “soft teeth?”
The answer is not simple. The factors that influence being cavity prone are saliva content, tooth density, bacteria types, oral hygiene habits, and pH level.
We can’t really control the first two factors (tooth density or saliva content) because that is like trying to control your skin color. These are things you are born with so we have to accept them as they are. Of course when we do put a crown on a tooth we can make it more dense, but the point is to prevent treatment.
Therefore, we have to try to control the other three factors (bacteria types, oral hygiene habits, and pH level). If we consistently kill the bad bacteria (coconut oil pulling), have good oral hygiene (floss and pick as well as brush well) and raise pH (use baking soda toothpaste) we can combat the problem in a cavity-prone person and help them prevent dental treatment. More details and specific testing can reveal other strategies as well.
How to Prevent the Return of Gum Infection
Tips to Get Your Kids to NOT Be Afraid of the Dentist
- As the parent, you are the protector of your child. In the dental office, we ask that you allow us to take the lead in preparing your child with our dental team’s terminology – which we present in ways that kids understand and take a liking to. This helps us develop a rapport and gain your child’s confidence which, in turn, supports your encouragement of us as dentists. Your encouragement in trusting us goes a long way. What is most important is that your child chooses to trust us on their own.
- Be supportive of our dental terminology for kids
- We ask that one parent may be present during treatment. That parent will be our silent helper. In our experience, it’s best if no other siblings or parents are in the treatment area. This is to reduce distractions and allow the child to focus on us.
- We will make sure that your child is very comfortable and safe at all times. If that changes, we will discontinue treatment and discuss other options with the child and you.
- Often parents choose to wait in the waiting room. This is a good idea especially if siblings or friends have come along. Another reason for parents to consider staying in the waiting room (but within earshot) is to maximize cooperation with your child. We find that, at times, children can act less cooperatively when a parent is nearby. You can be sure that we will do our utmost to make your child’s dental appointment easy and comfortable.
What is a Dental Crown? Crowns are for Kings…
…..and teeth. When a tooth has broken or can’t support a filling inside, it can receive a crown around it. That means you can keep using the tooth for many more years. A crown can also be used to make a tooth look better, or to match the other teeth nearby if it’s discolored. Golden crowns work well, unless you need one in the front where other people can see. Ceramic crowns (like E-max) are great because they are strong and beautiful (or handsome if you prefer). I prefer to use Ceramics where possible, because not only are they more natural looking, they allow us to bond using bio-compatible adhesive and resin cements. Bonded crowns are sealed and stay on much better. More info about crowns can be found here.