REVIEW
In the last post I reviewed some of the Dental challenges of a longer life. These were addressing the 10-20 year life span of dental work before a problem arises. Then how it may not seem like a problem to most people until it is an obvious problem and often if more difficult and expensive to address. This may have been okay when the average life span meant that the dental disasters happened with few years left but now it means things fall apart with a decade or more still to live. Lastly, to help avoid tooth loss it is helpful to treat the mouth when initial problems develop instead of waiting until the problem is obvious.
CHALLENGES
It is not uncommon to hear about dental fears. I have heard many people call themselves "Big babies", "Cowards", or even "Bad patients" because of how fearful they are of going to the Dentist. So a big challenge we face as Dentists is make a comfortable experience out of something which is not a fun as say Disneyland.
Getting fillings to look like teeth and last a long time is difficulty were huge developments have been made. This challenge is actually filled with multiple other challenges including making it so there is little discomfort the day after fillings are placed, getting material to work in a wet environment and having the numb feeling for hours after appointments.
Affordability is the last challenge faced by most patients. This one is a little complicated. Nationally people spend much less on dentistry than many other things they would consider less important. So why do most people consider it so expensive? Probably because most people usually face the expenses all at once. A second reason is a continuing change with dental insurance most people have been unaware of.
SOLUTIONS
Lucky for us, we live in a time of great progression and this holds true for the world on dentistry. I don't have enough time write out all of the advancements that have been made but I will try to at least review some solutions for the challenges we commonly face.
-Improved
Dental appointments
Very few people think about one of the first advances that has been made. There have been advances in the management of an office. There are actually companies that focus all there time and efforts into what to do to for offices to make their patient experiences positive. We work hard to stay up to date with ways to make sure our office is comfortable to be in from the sights to the sounds, and the smells. We also spend time learning how to arrange our schedule to keep our patients wait time to a minimum.
Minimizing the pain from dental work is a constant area of research. Even with new developments nitrous oxide (laughing gas) is still commonly used to help relax patients. It also has it's a numbing effect on the body, in fact many years ago they pulled teeth with only the use of laughing gas. Today still I am able to avoid injections while treating many small cavities by using nitrous oxide.
Better needles have been made, yes better needles which are sharper, beveled and smoother which make injections less of a pain.
Different anesthetics work faster and can last longer. Novocaine is no longer in use but many of its cousins are. Articaine, prilocaine, buffered lidocaine and marcaine are all different local anesthetics that have been developed to either last longer, penetrate the bone better and or sting less as they are administered. Needless to say it is easier to give a "painless" injection today than it was years ago.
-Better crowns and fillings
I work with a metal drill in a small space only millimeters away from a nerve confined in a hard case (the tooth) which offers no relief to any swelling from the trauma of both a bacterial infection (cavity) and physical removal the hardest substance in the body often at the same time as removing an old metal filling. I am amazed that complications don't happen much more often. I am even more amazed that we have been able to almost completely eliminate them.
There are several improvements that have made it possible to reduce post operative sensitivity as low as we have achieved. Water has been used with drills now for years to reduce the heat generated during a procedure. They have recently developed something we can apply to the teeth that is antibacterial in addition to sensitivity reducing. After I started to use this almost all my patients have little to no tooth sensitivity the day after dental surgery. Amazing! That's all I can say.
Dental fillings don't set well when exposed to water, and the mouth is normally filled with saliva. Years ago to keep the working area dry a rubber dam was used. The mouth was covered in latex and a metal clamp was used to keep it in place. They were time consuming and patients did care for them so they were rarely used.
Now there is a much more comfortable simple to use plastic piece the removed the water used during the procedure and well as keeping the tongue and check out of the way to prevent tissue damage. Using this has provided a convenient way speed up dental procedures (less time in the chair) and provide a longer lasting filling.
I know very few people who are excited about the appearance of silver fillings or gold crowns. Esthitic dental work was had to develop and was not very strong at first. In the last few decades huge strides have been taken to improve the strength, appearance and fit of dental fillings and crowns. Bonding agents no longer require a separate acid etch which would often leave teeth sensitive. Fillings strengths have increased to were they have favorable out comes for the hard chewing back teeth. New porcelains have been developed that are strong enough with out the old metal cores previously required. Stronger fillings and
crowns also mean I can keep more of the tooth when do fillings and crowns were as years ago more needed to be removed to make space for the material to be strong enough.
-Expenses
Unfortunately I have some bad news first. Dental insurances plans have had a history of changing to cover less and have a lower yearly pay out. Originally they pain about $1,000 per year, which is still about what they pay only adjusted for inflation that amount should be around $6,000 per year. Need less to say patients have needed to reach into their pocket books more to cover beneficial dental procedures.
I should also add in here that most people are lucky to have dental insurance because most plans pay benefits to you regardless of were you go. Also those benefits tend to be higher than what is pain into the insurance because only 50% people go to the dentist often even when they have insurance. This means if your one of the people who uses there insurance that is paid by their work, you are basically getting free money for your dental care even if it's not as much as it use to be. So
come in to see me and use it.
The good news is that relative to other medical cost dentistry is actually fairly reasonable. The difficulty is people often come in to the dentist once problems have come to a point of requiring an investment all at once. Luckily there are
financial options available to be able to pay for treatment that could greatly improve peoples lives.
Other advances
I will just briefly mention a few other advances that have been made in dentistry.
Quicker root canals with less files, with new rotary file systems
Less bleeding in some gum surgeries with lasers
Numb reversal agents, oraverse
Digital impressions
Online patient portals for better access to patient account balances and other patient information
Summary
The mouth is a very personal and sensitive part of the body. It is easy to have a bad experience in the dental chair. The challenge to make the experience a better one has been met by the hard work of many before me. There is now better understanding of how to create a comforting office. Improving techniques and materials have made for better looking, working and feeling dentistry. Even if a longer life means more dental work to keep you teeth, the options available have greatly improved.
Next post I will finish with the new and improved solution to replace teeth.
#comfortable#dentistry
#dental#advances
#dentalcrowns
