“I don’t want braces, but can you fix this one tooth?”

The Demand

This is a common request in my office. Often, patients just don’t want to go through the hassle of straightening their teeth via conventional orthodontics. In addition, the time to get teeth straightened can take years. Not to mention, such an endeavor can cost a small fortune.

The Thought Process Prior To Treatment

First, I evaluate every situation unique to that patient. Before any treatment begins, there needs to be a discussion of the pros and cons. Equally important, esthetic expectations are shared. When patient and dentist are in alignment, we can then begin.

Treatment Flow

To begin with, I inject usually one shot of lidocaine locally. Next, there’s about seven minutes of preparation with the drill. Finally, there is a quick digital impression of the area with the CEREC capturing wand. The virtual design of the restoration takes me about 4 minutes. Soon after, milling of the unit may take another 8 minutes. Without delay, the unit is carefully placed by my assistant into the ceramic furnace for a 15 min cure. In due time, the restoration gets bonded into place, which takes me about 4 minutes flat.

Final analysis

In conclusion, many times there can be a simple solution. From time to time, a simple change can be delivered in a seamless manner with minimal cost, time in the chair and no complications. In this case, a single Emax ceramic veneer was bonded to place. LOOK CAREFULLY. IT IS THE LATERAL UPPER INCISOR. The key is that it should fit in and be not so “perfect”. Intentionally so. It’s important to realize, the entire visit took less than an hour. With this in mind, the patient left with a smile.

BEFORE___”Tucked behind” front lateral incisor
AFTER___Smile Line. The Veneer “fits in” with the other teeth
AFTER___Retracted lip

Credits:

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

You Tube : Robert Emilio DDS & Associates 

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com

Do I Still Need To Take My Antibiotics?

I recently had a wonderful elderly female patient who was complaining of jaw pain status/post Third Molar (wisdom tooth) extraction in my office.

The previous day, I had extracted the fractured vital tooth. Beautifully removed with minimal effort and stitched up to perfection by me. Her Past Medical History was unremarkable. She was taking no medications of concern that should have alerted me to potentially a risky post operative recovery.  I had no reason to believe there could be an issue with the post operative care of the area.

Dry socket is always a concern. Dry socket ( alveolar osteomyelitis) is a condition where the extraction site clot is dislodged and the underlying bone of the socket gets exposed to the harsh oral environment. This is a very painful situation such that the pain is unique and radiates thru your entire jaw, face and neck on the side of the tooth extraction. Although a rare occurence for my patients, clinical experience demonstrates a higher predisposition to dry socket in the lower third molar area than any other area in the mouth.

She was in pain. She was feeling drawn out and called me directly on my emergency contact. Timing was essential and aided in my diagnosis of the origin of post operative pain.

The patient stated that she was sore and feeling slightly febrile the very next day; I estimated, twenty-four hours since the surgical event.

“I need antibiotics to Knock Out the infection” , she stated with confidence. She continued on stating that she was ,”….. a bit febrile,,,,I’m running a bit higher than usual”.

I conceded and with a very slight reluctance, but obeyed to the wisdom of this implacable women. I prescribed the antibiotics because I respected the patient’s desires. I do believe that some patients can be their best and worst doctors. It’s definitely was possible she was in the early cascade of infection,,, most likely, not. She presented initially non infected. It was too early for in infection to be present so soon after the extraction. Typically, infection would start on the THIRD DAY after a surgical event.

I called her one day after the initiation of the antibiotic therapy and she stated, “I am feeling so much better now. Thank you.  Do I need to finish the antibiotics?”

MY ANSWER WAS…EMPHATICALLY…….. YES!

My feeling was such that she was not truly infected, but instead feeling beat up from the extraction  event (the message not the messenger). Post operative edema peaks 24-36 hours a surgical event; that’s when the post extraction pain was the worst.

Dental extractions are always traumatic. It involves, local anesthesia which initiates an Adrenaline rush through your system. In response to the needle shot in anticipation of the surgical event, corticosteroids get surged out from your adrenal glands to help cope and compensate for the traumatic event you are about to endure; this is the Flight or Fright response. This is a totally natural occurring biological response to an average dental visit (comparable to getting charged by a saber tooth tiger—-that’s a joke….). It’s Normal to feel zonked after seeing me for a denatl procedure.  You will be tired the next day, especially after an extraction.

The patient’s febrile component was most likely associated with a slight dehydration effect that impacts body temperature in the slightest fashion. That’s why it’s important to drink your fluids. It’s on the post op instruction sheet..

Upon follow-up phone call, on the Second day after extraction, and one single dose of antibiotic, she reported to be just fine…Her next question was,  “Do I need to finish my antibiotic?”

Yes, was my response the current theory states that :” Treating bacterial infections with an antibiotic kills those bacteria, but this may take a week or more to accomplish. If you stop treatment early, you have only killed the weaker of the bacteria, those bugs most readily wiped out by the antibiotic. The ones leftover are the tougher bacteria, which would have been killed if the treatment continued but now, in the absence of antibiotics, have room to multiply and pass their genetic-based resilience to their progeny. Next time around, the infection is that much tougher.” Finishing your antibiotic

However, the same article states the mindset of this theory is changing. Each situation of infection type needs to be addressed individually. The debate is duration time period of antibiotic consumption. An Excellent read. I suggest you read the details.

Dedicated To Regina.

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com

“Does Candy and Drinking Hot Tea Give You Cavities?” …. Leslie asks

Yes, and most definitely yes.

Go to the interview Leslie and her Candy.

Candy and sugar are synonymous.

Black licorice a particular favorite of mine, I’ll admit is a triple threat. Consisting of sugar, it’s notorious for plucking away perfectly good dental work, such as crowns, off of unsuspecting teeth. The black coloring adds the extra drama of the unbrushed teeth look. Next Halloween, if want to give your hygienist a nightmare recall visit, make a quick snack of it on the way over to the office for your appointed time. Drinking hot tea just melts things away creating a more hydrodynamically  homogeneous sugary environment that will actually create the worst kind of cavities; root decay. The hot liquid sugar just sits on the soft vulnerable part of the tooth with the bacteria laying down acid  gnawing away creating big dental problems.

Dental decay involves plaque formation. When candy is consumed and if the sugars aren’t cleaned off your teeth, the naturally present bacteria in your mouth feed on the candy and produce destructive acids. The acids dissolve away the enamel of the tooth, hence a cavity.

There is some good news. If you want that candy, go for it!

Studies show that if you brush your teeth properly within 12 minutes of consuming the candy, no changes will occur in the enamel.

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com