Dr Hardeep Bhatta & Dr Allen Friesen
Suite 205 - 1465 Salisbury Ave
Port Coquitlam, BC V3B 6J3
(604) 239-5954

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Posts for: May, 2014

WhatyoucandotoReduceComplicationsAfterGumSurgery

Today's periodontal (gum) surgical procedures are less painful and have fewer complications than ever before. Nevertheless, the best outcome still depends on how well you care for yourself as you recuperate. Here are some things you can do after surgery to lessen its effect.

In the first twenty-four hours after surgery, your primary objective is to prevent swelling, the major source of post-operative discomfort. You can accomplish this by applying an ice or cold pack to the outside of your face in the area of the surgery. It's best to alternate five minutes on and off with the pack for the outside, and ice chips, cold water or ice cream inside your mouth as often as possible. Your aim is to surround the surgical site with cold as much as you can with the five-minute on and off strategy.

You should eat only foods that are cold and soft (Jell-O™, applesauce, yogurt, ice cream, etc.), to help ease any swelling. The next day switch to hotter foods like soup, mashed potatoes or buttered pasta, as well as hot, salt water rinses as often as convenient. Avoid crumbly foods like chips, cookies or popcorn for a few days to help keep the incision site particle-free.

We typically prescribe a number of medications during recuperation: analgesics (usually of the aspirin or ibuprofen family) for swelling and pain, and antibiotics and antibacterial rinses to inhibit bacterial growth. Be sure to follow directions with each prescribed medication, taking the correct dosage and for the specified duration.

There is a possibility of post-operative bleeding — but don't panic. You should first attempt to locate the bleeding area, clean it, and then apply gentle pressure with moist, sterile gauze for ten to fifteen minutes. If the bleeding doesn't stop, give us a call.

You should keep the wound site as clean as possible to help avoid infection. However, don't brush, floss or rinse during the first twenty-four hours to avoid bleeding, and limit hygiene activities to antibacterial mouthrinses like chlorhexidine near the wound site for several days to weeks. During the first few days to a week after surgery avoid activities like strenuous exercise, drinking alcohol, sucking through a straw, or blowing up a balloon, as these can also increase your risk for bleeding. You should also avoid tobacco products during this time as these can inhibit the healing process. Each surgery is different and you should make sure you follow the specific instructions your surgeon will provide for you.

Taking these precautions will help keep discomfort and complications to a minimum. They will also help you recover quickly so that you can get back to your normal life.

If you would like more information on periodontal surgery and what to expect, 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 “Instructions Following Periodontal Surgery.”


By Smiling Creek Dental
May 22, 2014
Category: Oral Health
TheImportanceofSavingImpactedCanineTeeth

Your upper canine teeth are pretty easy to identify — they’re usually longer and more pointed than other front teeth, and are normally positioned just under the eyes (hence their other name, eyeteeth). Besides helping us chew and bite our food, upper canines are part of a normal smile — when they don’t appear in the mouth (erupt) properly, the person’s smile may appear unnatural or “off.”

Unfortunately, upper canines can become impacted, meaning the teeth have grown and developed in positions that prevent them from erupting. Because impacted teeth can develop abscesses and cysts, or damage the roots of neighboring teeth, it’s necessary to treat them.

The first step is a thorough orthodontic evaluation to assess not only the teeth in question, but also how they could affect the position of other teeth in the future. Next, we must locate the exact position of the impacted canines through some form of radiographic examination, either x-rays or 3-D imaging using a cone beam CT scanner (CBCT). This evaluation will determine our treatment options for these teeth.

If the teeth are in a reasonable position, the best option is to expose the impacted tooth and prepare it for movement into proper position. To expose the tooth, a surgeon creates a small, surgical opening or flap in the gum tissue closest to the crown of the tooth. Once gaining access, the surgeon then bonds a small bracket to the crown and attaches a small gold chain to it. The chain can then be looped over orthodontic hardware attached to adjacent teeth, which will pull the impacted tooth over time into the proper position. Although this may sound complicated, coaxing the impacted canine in this manner into a proper eruption is actually quite routine and predictable.

If at all possible, saving impacted upper canine teeth should be the primary treatment goal — extracting them could have an adverse effect on biting and chewing, as well as disrupting your appearance. If they must be removed, however, tooth replacement such as dental implants can help restore any lost form or function.

If you would like more information on impacted teeth, 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 “Exposing Impacted Canines.”


By Smiling Creek Dental
May 14, 2014
Category: Oral Health
Tags: jaw pain  
JawPainCouldbeLinkedtoOtherPainCausingConditions

Chronic pain and reduced function of the jaw joints, muscles and other surrounding tissues is generally known as a temporo-mandibular joint disorder (TMJD or TMD). It’s also possible that sufferers of TMD may also experience chronic pain in other parts of the body.

TMD affects from 10 million to 36 million American adults, mostly women of childbearing age. Although the exact causes are still elusive, most researchers believe this family of conditions arises from a combination of gender, genetic, environmental and behavioral factors. This may also hold the key to its connection with other painful conditions in the body.

About two-thirds of patients with some form of chronic jaw pain or disability also suffer from three or more similar medical conditions, including fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, headaches or sleep disturbances. Investigating the connections between these conditions is a fertile area for developing treatment strategies that would benefit all of these associated conditions.

In the meantime, there are both thermal and surgical treatments for alleviating and managing pain associated with TMD. About 90% of TMD patients respond well to thermal treatments, including hot and cold compresses applied to the jaw area and hot baths. Surgical treatment, however, has a mixed result: some studies show only a third of those undergoing surgical procedures experience noticeable pain relief and restored function and nearly half indicate worse symptoms after the surgery.

The best approach is to begin with an examination by your primary physician or specialist to be sure you are not suffering from a medical condition mimicking the symptoms of TMD. If this should eventually lead to a diagnosis of TMD, you should first try thermal techniques with over-the-counter pain relievers to ease the symptoms. A diet with softer foods that don’t require strenuous chewing may also prove helpful.

If you receive a recommendation for extensive bite treatment or surgery, you should discuss this thoroughly with your dentist, or even seek a second opinion. Surgical treatments in particular are not reversible and the results may not be favorable.

For more information on TMD and networking opportunities with other patients, be sure to visit the TMJ Association (www.tmj.org) on the Web.

If you would like more information on chronic jaw pain, 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 “Chronic Jaw Pain and Associated Conditions.”


By Smiling Creek Dental
May 06, 2014
Category: Dental Procedures
Tags: gum surgery  
FrequentlyAskedQuestionsAboutCosmeticGumSurgery

Q: Why should I consider cosmetic gum surgery to improve my smile?
A: If you’re looking to enhance the natural beauty of your smile, you may have heard about various cosmetic procedures that can improve the appearance of your teeth. But don’t forget about the other, equally important element of a bright, appealing smile: the healthy-looking and well-proportioned gums that surround and support those pearly whites. Many times, cosmetic flaws are caused by gum tissue that’s covering too much or too little of the tooth’s surface; in other situations, the gum line is uneven, and covers some teeth more than others. Cosmetic gum surgery can successfully remedy these imperfections.

Q: How exactly does cosmetic gum surgery resolve smile defects?
A: There are several minor surgical procedures that may be recommended, depending on what’s best for your individual situation. For example, some people have a “gummy smile,” where teeth seem excessively “short” because they’re covered with too much gum tissue. In this case, a “crown lengthening” procedure can be performed, where gum tissue (and perhaps a small amount of bone tissue) is removed; this makes the teeth appear in better proportion to the smile. In the opposite case — where the teeth appear too “long” due to receding (shrinking) gums, tissue can be grafted (added on) to the gums. Gum recontouring procedures are used to re-shape the gum line for a more even, pleasing effect.

Q: Are there non-cosmetic reasons for having gum surgery?
A: Yes. A tooth with too much of its root area exposed is often more prone to decay, and may become extremely sensitive to hot or cold. Covering an exposed root with gum tissue is just one non-cosmetic reason why gum surgery may be necessary.

Q: What’s involved in gum surgery — do I have to go to the hospital?
A: Cosmetic gum surgery is normally performed in the dental office, and usually involves only a local anesthetic. However, if you need a deeper level of relaxation, other forms of sedation may be available. In some cases, lasers can be used instead of conventional surgical tools to remove excess gum tissue. If you need a tissue graft, the grafting material can be taken from your own mouth, or may come from donor tissue that is processed to ensure your safety. Gum surgery is minimally invasive, and most people experience only minor discomfort.

If you’d like to know whether cosmetic gum surgery could help you get the smile you’ve always wanted, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Gummy Smiles” and “Periodontal Plastic Surgery.”