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Dental Trauma

June 23, 2017

Dental Trauma

Auto accidents, falls, and wounds from sports activities like baseball, basketball, hockey, football, soccer and volleyball can cause severe facial and dental injuries. Proper assessment and treatment should be given to patients distressed with major skull, neck or injuries on the face. These injuries may result in patients suffering from temporary memory loss, fainting, and severe aching of the head or ears, nose or ear bleeds, confusion and shock and could involve jaw or head fractures which would require treatment in an emergency rooms. Our doctors and staff from BrightSmile Avenue will be able to treat upper or lower jaw fractures. We can also carry out tooth extraction and the dental arch restoration in emergencies.

Breaking of the tooth may result either from wearing away of cavities or from mastication of  solid and tough things like candies, cubes of ice, hard nuts and even chewing unusual things like pencils. BrightSmile Avenue dental office can treat minor dental damages like a cracked tooth, or teeth completely dislodged from the mouth due to some sudden force which do not involve skull or neck injury. Inflammation of the gums and tissues of the mouth may result from such dental mishaps. On the way to your dentist, the ache and inflammation can be lessened by the application of ice or cold packs outside the injured area or inside the mouth just above the wounded tooth.

What treatment will be given to my injury?

Most dental injuries are chipping of teeth. Wounds involving complete removal or dislocation of teeth are not very common. The nature of injury, the place and gravity of injury are taken into account in order to give the treatment. To avoid an injury going unnoticed, especially a tooth next to the damaged tooth, a careful assessment of the mouth by a dentist or endodontic specialist is required even for a small injury. Such examinations can be carried out by your dentist

Dental injuries can be classified into two types. When a tooth is totally dislodged from the socket, it is called an avulsed tooth. In case of such an injury the tooth should be picked by the crown and never by the roots, instantly put into a plastic jar filled with saliva, saline solution or even whole milk. In case the injured person is alert and conscious and is old enough to follow instructions, the tooth can be kept under the tongue. The best chance of saving the tooth is up to two hours.

A tooth that has not been entirely dislodged but loosened from the socket and can move back and forth and even sideways is called a luxated tooth. The sportsperson with such an injury should get the tooth pushed back in place by your dentist.

An examination will be carried out once the tooth has been pushed back in place to rule out injuries to the neighboring teeth or even the face. A support will be placed for a couple of weeks. Within a week or two, judging by the development of the root, the dentist or endodontic specialist may perform a root canal treatment. The root canal is filled a few days after the tooth is treated with some medication.

Since the teeth of children in the age of 7-12 are still developing, they may not require a root canal treatment. The healing process is observed carefully by a dentist or endodontic specialist who will act immediately in case they notice adverse outcome. Root canal treatment requires several appointments for follow-ups. Infections or injuries can be completely healed in young people as research show the presence of stem cells.

The layers involved in root fractures, which are quite frequent, classifies the four types of root fracture.

A horizontal fracture of the root may be an outcome of a distressing injury. Success rate of healing depends on the proximity of the fracture to the gum line which if close by would have a lesser chance of success. The closer it is to the root tip, the better its chances of healing. A support may be provided for a short time period.

Dental injuries can be avoided by using protective gears in good condition. Sports practices should be with mouth guards. A sportsperson with dental problems should always wear a mouth guard. In cases of emergency and dental trauma please call BrightSmile Avenue Dental Clinic at 6212556.

Personalizing and Individualizing Your New Smile with Porcelain Veneers by Dr. Huefner

March 30, 2017

 

You want a “new smile?” Choosing the best smile for you can be challenging because there are virtually a thousand different combinations of shape, length, texture, opacity/translucency and color (shade) that porcelain veneers can be made. Cosmetic dentistry is a true art form, and rarely would two different cosmetic dentists create the same kind of smile design for the same patient. Let me discuss the amazing aspect of individualizing porcelain veneers and the creation of an individualized “personality” by varying their shapes.

It is interesting, as the shape of the upper front six teeth each play a different role in this regard. The front two teeth, called the central incisors, have the role of indicating age. The teeth next to the central incisors, the second tooth on each side from the front teeth are called the lateral incisors. They are the teeth that impart gender to the smile design. The next tooth back from the lateral incisors, the “eye teeth” or canine teeth, impart personality. I will explain how each of these teeth perform their respective roles.

First, the central incisors, which are the most obvious teeth to be seen (or sometimes “not seen”). In a young person they appear rectangular, with rounded corners, and are usually 11mm or 12mm in length. However, with age and wear these teeth shorten, sometimes as much as 1-5mm by the time one gets to middle or late age. Along with shortening, they become more square in shape and with that also comes square corners rather than the normal rounds corners of younger teeth. Thus, for someone who is concerned with their appearance and their age, changing the length and shape of the central incisors porcelain veneers can give one a much younger looking smile. Also, teeth in general usually darken with age, so to compliment this we almost always make the porcelain veneers lighter in color, depending on the wishes of the patient.

Next, varying the shape of the lateral incisors porcelain veneers can make a smile look more feminine or more masculine, imparting some gender characteristics. Thus for women, we shape the lateral incisors porcelain veneers to be more rounded at the end, and also slightly shorter than the central incisors. We call this a “gull wing” silhouette.

 Feminine Smile Design

 

For men, we lengthen the lateral incisors porcelain veneers to be almost the same length as the central incisors and make them more square in shape, which makes their teeth look more masculine.

Masculine Smile Design

But the most interesting is the choice in shape of the canine teeth, as these are the teeth that most imparts “personality” to the smile design. Cuspids that are pointy, more prominent, and longer than their adjacent teeth impart a more “aggressive” smile. This is used most often when a patient wants to appear “more powerful” with their new smile. The opposite can be created by flattening or rounding the tip of the cuspids and making them less prominent, giving the patient a more “passive” appearance. This design would be used most often with a large person or one with many dominant features who wants to soften their appearance with their porcelain veneers. But, most patients prefer that we create for them a more normal cuspid, not leaning to either the “aggressive” or “passive” smile design.

There is no “right” or “wrong” smile design, but what is most important that the cosmetic dentist discuss smile design options with the patient and that the patient have some input as to their preferences. Sometimes these are subtle differences with regard to shape, length and color of their new porcelain veneers and other times the differences can make a dramatic difference.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

 

Dental Anxiety

June 2, 2016

Anxiety is a state of uneasiness of mind that resembles fear, but usually has no identifiable source. Anxiety ha both physical and mental aspects. The anxious patient may be tachycardic, nauseated, diaphoretic or light headed. Although a patient may be diagnosed with a generalized anxiety disorder, at times clearly defined categories of anxiety apply. These categories include phobia, agrophobia, panic attacks, obsessive – compulsive disorder, posttraumatic stress disorder and performance anxiety,

Pain associated with dental treatment is managed effectively through the administration of local anesthetic drugs prior to the start of the treatment. The fear of pain is a major deterrent to the recipient of dental care in our time. Patients who are not in pain fear to visit the dental office because they feel at some time during the dental treatment they will be hurt. The fear of pain produces a heightened anxiety in these patients, a factor that occasionally leads to the avoidance of dental care until they are truly in pain.

To be able to manage these overly fearful patients is to induce a state of consciousness (or more precisely, altered consciousness) in which a person is more relaxed and carefree than previously. Names such as chemamnesiam, secdamnesia, twilight sleep, relative analgeisia and comedication have been used to describe the state of consciousness that is now called sedation.

Various techniques and levels of consciousness and awareness:

  • General anesthesia – the elimination of all sensation, accompanied by the loss of consciousness
  • Analgesia – the diminution or elimination of pain in the conscious patient
  • Local anesthesia – The elimination of sensations, especially pain, in  one part of the body by the topical application or regional injection of a drug
  • Conscious sedation – A minimally depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and respond appropriately to physical stimulation and verbal command and that is produced by a pharmacological or nonpharmacological method or combination thereof.
  • Deep sedation – another term given by the academy of pediatric dentistry; a controlled state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway independently, and/ or respond purposefully to verbal command, and is produced by a pharmacologic or nonpharmacologic method or a combination thereof.

ADA Guide to Therapeutics 3rd Edition; Sedation A Guide to Dental Management 

Cranio Sacral Therapy

January 7, 2016

Cranio Sacral Therapy might be new to other people but some people may have heard about this healing modality but aren't sure what it is.

"CranioSacral Therapy is an educated, specific, noninvasive touch that supports your body’s innate ability to heal."

This gentle healing technique can address a variety of health concerns.  

Tissue Release – it is a sense of softening and relaxation when the technique in use has come to a successful completion.

It doesn’t mean that the session is over, just that this phase is finished.

 

Factors for tissue release which are part of CST are:

  1. Relaxation of nervous reflexes which have produced increased tissue tone.

2.      Tissue morphological change from elastic resistance to viscous compliance. This indicates lengthening of tissue fibers without biomechanical memory for the return of their original dimensions.

3.      A sense of increased passage of fluids through the tissues under treatment.

4.      A sense of increased flow of energy through the tissues under treatment

5.      An emission for increased heat radiating form the appropriate body region.

6.      A sense of repelling force as perceived by the therapist’s hand when palpating the involved area.

7.      There may be a sense of crescendo and decrescendo of the Therapeutic Pulse related to the release.

 

Common Signs that you may during your therapy:

  1. Softening

2.      Lengthening

3.      Increased fluid flow

4.      Increased energy flow

5.      Heat

6.      Energetic repelling – feels like opposing magnets

7.      Therapeutic pulse (this will fade)

8.      Deep breaths

 

Excerpt from writer/ blogger K. Mackinnon

 

Here’s why CranioSacral Therapy may be the answer you seek for your health issue:

1.  You Can Discover the Healing Power of Your Inner Wisdom: 

CranioSacral Therapy is a simple, direct way of accessing your own inner wisdom and innate healing mechanism. The clients’ inner wisdom leads and directs the session, which is the central premise of this modality.  Once a therapist has completed an assessment, the next step is to pay close attention and note what’s going on in your body.  The therapists’ hands respond accordingly and are guided to what has been shown.  As a therapist myself, I like to describe it as listening and following with my hands.

 

2.  It Uses a Combined Mind, Body and Spirit Approach:

It works on the physical, emotional and spiritual aspects of oneself.  Each session is unique which means any one of these aspects, or combination of these aspects, can appear in a session. For example, sometimes we have a sense with a headache that it’s in response to an emotional trigger, but can’t quite identify it. With CranioSacral Therapy, clients’ are provided the opportunity to feel how and where the tissue is holding tension as the emotional trigger shows up. Many times it is one of those “ah ha” moments when a connection is made between a physical ailment and an emotional trigger!

 

3.  Receive It At Any Age: 

CranioSacral Therapy can be received from the time of conception and onwards, including support of the dying process. This is one of the beauties of CST.  Plus, it can be of great help during pregnancy, too.  I benefited from CranioSacral Therapy during my pregnancy with twins. I received regular sessions throughout, which meant that my body was able to easily adapt to the rapid changes taking place as my twins grew during pregnancy. When my children fall and hurt themselves I can effectively treat them wherever we are. Being grounded and present in my body and my hands are all that’s needed!

 

4.  Complements Western or Alternative Medicine Approaches: 

Any other form of treatment a client is receiving can be combined with CranioSacral Therapy. For example, I have successfully treated people who are undergoing chemotherapy, surgery or dental work. CranioSacral Therapy helps the body find its most efficient way of healing after surgery. It’s often when the acute phase of healing is over that the tissue needs a reminder that it no longer needs to hold on to the trauma and can let go of the work it has been doing to contain it.  

 

5.  It’s Flexible:

Clients can work as intensively as they like. Treatments can be received daily, weekly, monthly or as one personally decides. Another option is a CranioSacral Therapy Multi-Hands session.  When a client opts for a Multi-Hands session, it includes two or more therapists working with the client at one time.  This can be an extremely effective choice when working with a more complex health issue such as a head injury.  Or, when clients want to expedite the healing of a particular issue, they can choose a Multi-Hands session.  CranioSacral Therapy is routinely carried out on a massage table or on a dental chair.  Surprisingly short treatments can be very effective while standing in line, too!

 

Overall CranioSacral Therapy is a highly effective light-touch therapy that works with the source of pain and dysfunction and the whole body simultaneously.  Now that you have more information about this noninvasive healing technique, you can decide if it’s the answer for your health issue.   I encourage you to give it a try and let me now the results!

 

 

Root Canal Therapy

November 26, 2015

 

A root canal problem can be a very serious issue if not treated as it may cause  further implications so to treat it as soon as possible is a must. An endodontic treatment is needed when there is pulp inflammation which is usually caused by a number of factors, such as:

  • Serious tooth decay
  • Cracked or chipped tooth
  • Tooth injury

If left untreated, the inflammation or infection can cause a great deal of pain and can possibly lead to an abscess.

Root Canal treatment is a process that involves the removal of the inner layer of pulp from within the tooth, which has become infected by the bacteria and disease, present within the mouth. The pulp provides the tooth from your blood vessels. This is also where the nerves are located and also the sensitive tissue.

To help with the efficient extraction of the root canal, a small hole is drilled into your tooth so that extraction and cleaning can take place. When this has taken place, the tooth is then re-shaped and the void inside the tooth is then filled to leave a full tooth.

 

Oral Surgery

November 14, 2015

Photo: by Mark Peck

Wisdom Teeth

Wisdom teeth are the last teeth to erupt within the mouth. They usually  come out at between the age of 17 up to 21 years old. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. Them may grow sideways, partially emerge from the gum,and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such fure problems and to decrease the surgical risk involved with the procedure. 

Pain Management in the Dental Field

October 5, 2015

Mention the word dental surgery and many people would start to get nervous. This kind of anxiety is brought on by fear of pain and the invasiveness of the procedure, among other things. This fear is unwarranted. In our practice, we provide a safe, pain free experience that can even be unbelievably relaxing during any dental treatment. 

Different Types of Medications at the Dentist's Office - taken from WebMD

  • Topical anesthetics. Topical anesthetics, applied with a cotton swab and are routinely used to numb the area in the mouth where the dental work will be done.  Topical anesthesia is given prior to injection with a local anesthetic, such as  Lidocaine 
  • Laser drills. Some dentists are now using lasers to remove decay within a tooth and prepare the surrounding enamel for placement of the filling. Lasers may cause less pain in some instances and result in a reduced need for anesthesia.
  • Electronically delivered anesthesia (also called transcutaneous electrical nerve stimulation -- or TENS). This is an alternative to the injection of a local anesthetic. Adhesive pads are placed on the face and a battery-powered device sends electrical impulses to the treatment area to numb it. The patient controls the level of stimulation through a hand-held unit. Another form of electronically delivered anesthesia is called cranial electrotherapy stimulation. Under this technique, electricity is passed into the brain, which causes relaxation. Again, the patient controls the intensity of the current, increasing or decreasing it to control the pain as needed. Advantages of these approaches are that as soon as the device is switched off, the effect is instantly reversed. The patient is able to drive and resume normal activities immediately following the dental visit.
  • Nitrous oxide (also called laughing gas). This gas, which is inhaled by the patient through a rubber face mask, helps people feel relaxed and is one of the most common forms of sedation used in the dental office. Effects wear off quickly after the gas is turned off. This is the only form of sedation under which patients can drive after the procedure and can eat food within a 12-hour period of the procedure. With IV, oral and general anesthesia, the patient cannot drive following the procedure or eat after midnight the night before the procedure.
  • Intravenous sedation. This form of pain and anxiety control involves injecting a sedative into a vein of a patient's arm or hand. This approach is usually reserved for patients undergoing extensive dental procedures or for the extremely anxious patient. Dentists need to monitor the oxygen level of patients receiving IV sedation and may need to give such patients additional oxygen during the procedure. With IV sedation, the patient is awake but very relaxed. If you think you may be interested in IV sedation, ask your dentist if he or she is licensed to administer intravenous sedatives. Oral sedation. An oral medication, such as  Halcion, works on the central nervous system to help patients relax. Oral sedatives are often not prescribed because they take about 30 minutes before their effects are felt and can cause drowsiness that may last for hours. 
  • General anesthesia. With this technique, the patient is "put to sleep" for the duration of the procedure. Patients requiring general anesthesia can be treated in the dentist's office, but more likely are treated in a hospital setting. This is because this type of anesthesia has risks, which include a sudden drop in  blood pressure and irregular heartbeats, so the patient needs to be closely monitored. For these reasons, general anesthesia is typically only used if extensive dental work is needed and when other forms of sedation or pain control are not sufficient to conquer fear. 

Myobrace System

September 18, 2015

Myobrace is a preformed functional orthodontic device, especially used in interceptive orthodontic cases. Its mechanism of action is a combination of a functional device , a positioner and a myofunctional therapy device.

It works promoting the balance of facial and masticatory muscles, and re-educating the posture of the tongue. It has a threefold purpose: to get a myofunctional effect, together with a dental alignment and a mandibular development.

Myobrace is a removable appliance that combines the rehabilitation of the oral musculature to the properties of a dental positioner, acting on the mouth breathing, atypical swallowing and on the thumb-sucking.

Myobrace (MB) is a preformed orthodontic device, designed for the treatment of malocclusions in patients in late mixed dentition (8-12 years). However, it can be used also in adult patients and, in any case, only for non-extractive cases and for mild or moderate malocclusions.

* Myobrace System: A no-braces approach to malocclusion and a myofunctional therapy device Author(s): Anastasi G, Dinnella A

 

Obstructive Sleep Apnea (OSA)

September 17, 2015

Symptoms of Obstructive Sleep Apnea (OSA)


Night-time symptoms

  • Snoring, usually loud, habitual, and bothersome to others, is found in almost all patients with obstructive sleep apnea. However, not all snorers suffer from OSA.
  • Apneas (pauses in breathing) that often interrupt the snoring and end with a snort
  • Gasping and choking sensations that intermittently arouse the patient from sleep
  • Restless sleep (insomnia), with patients often complaining of frequent arousal and tossing/turning during the night

Daytime symptoms

  • Excessive tiredness, for example inability to stay awake while reading or watching television
  • Waking without feeling refreshed
  • Morning headache

If untreated, obstructive sleep apnea may have serious consequences. Obstructive sleep apnea affects the cardiovascular system due to the periods of poor oxygenation during sleep and the stress on the body during attempts to re-initiate breathing. This may result in heart failurearrhythmias (abnormal heart rhythms), or hypertension (high blood pressure).

Poor sleep due to recurrent arousals may result in excessive daytime sleepiness, personality changes, memory loss and intellectual impairment.

 

 

Brace Watchers Diet

February 27, 2014

“BRACE WATCHERS DIET”

Your dentist's goal is to provide you with a beautiful smile.  This can only be accomplished if the braces stay attached to your teeth.  Some types of foods are capable of breaking your bands or brackets, bending your wire, and breaking the cement under your bands or brackets so that these leak and possibly cause decay.  All of these PROLONG TREATMENT TIME.

A careful patient can eat a nutritionally balanced diet and do no harm to their braces.  The foods listed below are the ones that we have found to be the most common causes of loose bands, brackets and broken appliances.

 

HARD FOODS

These HARD FOODS are especially bad when you have braces on your front teeth:  carrots and apples (may be eaten if cut into small pieces), corn-on-the-cob (may be eaten if sliced off the cob), ribs, peaches or anything which a hard center (may be eaten if taken off the bone or pit).

 

 

  • Ice
  • Hard edges of pizza
  • Popcorn (hard kernels)   
  •  Hard corn chips or tortilla chips
  • Hard candies 
  • Nuts

STICKY AND CHEWY FOODS

Foods of which you should be careful include:  gum, candies like Now and Later, caramels, Gummy Bears, Sugar Daddy, taffy or toffee or anything else sticky.

SWEET FOODS

Care should be taken to limit the intake of sugary goods and drinks.  Although they may not cause damage to your braces, they promote cavities.  If you cannot avoid these items, limit them to once a day or less, and brush immediately after you eat.  it you cannot brush, at least rinse your mouth out with clear water. 

Foods of which you should be careful include:

Cake      Ice Cream

Pie            Cookies

Candy      Sweet Drinks like Cokes and lemonade 

 

 

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Brightsmile Avenue is located at Unit 305, McKinley Park Residences, 31st Street corner 3rd Avenue, Bonifacio Global City, Taguig, Metro Manila, Philippines.

+632 621 2556
+63 915 443 8879

info[at]brightsmileavenue.com 

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Saturdays 
10:00 a.m. - 5:00 p.m.
 
We accommodate special appointments outside working hours and on Sundays. Please inform us 2 days in advance so we can prepare for your visit.