Use of Laughing Gas for Ooltewah Pediatric Dental Procedures

To ease anxiety during dental procedures, a mild form of sedation called Nitrous Oxide can be used. We are happy to explain the procedure, why it relaxes patients, and how it makes them feel.

Among the benefits of its use are the reduction or elimination of anxiety in patients, enhancing patient communication and cooperation, raising the pain reaction threshold, making longer appointments more tolerable, aiding in the treatment of mentally or physically disabled patients, reduction of gagging, and general sedation.

Who Discovered ‘Laughing Gas’?

Nitrous Oxide, commonly known as “laughing gas,” is a colorless, almost odorless gas, first discovered in 1772 by the English scientist and clergyman Joseph Priestley (who was also famous for being the first to isolate other important gases such as oxygen, carbon monoxide, carbon dioxide, ammonia, and sulfur dioxide). He hoped it would serve as a preserving agent, but with no success. Humphry Davy of the Pneumatic Institute in Bristol, England, experimented with the physiological properties of the gas, such as its effects upon respiration. He noted that it appeared “capable of destroying physical pain” and might serve as an anesthetic agent in minor surgical procedures.

Before widespread use for that purpose was adopted, “laughing gas” was primarily used recreationally, sometimes at carnivals where the public would pay to inhale the gas, laughing and acting silly until the euphoric effect wore off.

During one of these public nitrous oxide exhibitions, a local dentist named Dr. Horace Wells watched with interest as a man injured his leg while staggering into some nearby benches, then went back to his seat, unaware of his injury until the effects wore off. The next day, Dr. Wells inhaled the nitrous while another local dentist extracted one of his molars. Experiencing no pain during the procedure, he declared that a dental and medical painkiller was born, replacing the far more dangerous (and explosive) ether as an anesthetic. Ironically, Dr. Wells would later be given the accolade of discovering anesthesia, but he was shunned while demonstrating with a tooth extraction at Harvard Medical School in Boston after the patient expressed some discomfort. Never mind that the patient would have experienced excruciating pain without the use of the nitrous!

More than a century later, dentists now use Nitrous Oxide as a mild sedative and analgesic. It offers some degree of painkilling ability while reducing anxiety that patients may have toward dental treatment.

Use of laughing gas is not always effective because it requires the patient to breathe through the nose while his or her mouth is open to allow access to the teeth and gums.

Risks of and Guidelines for Nitrous Oxide Use for Pediatric Dental Patients

Dentists today use laughing gas because it is safe and effective. Its use is mostly limited to professionals because it is a compressed liquefied gas and asphyxiation risk. The euphoria felt during use causes short-term decreases in mental performances and manual dexterity, as well as spatial and temporal disorientation. In other words, you’re fine inhaling it while comfortably seated during a dental procedure, but you don’t want to run a marathon or try to drive a racecar while huffing the stuff.

Nitrous oxide also depletes vitamin B12 levels, but this is generally not an issue when administered during a dental procedure. Nitrous oxide does have a negative environmental impact on the greenhouse effect, but this is primarily from natural emission from bacteria in soils and oceans, as well as the burning of fossil fuels. We also have to prevent room air contamination due to the occupational risks associated with prolonged exposure to the gas.

Like any substance producing euphoric states, laughing gas is susceptible to abuse. Many states have laws regulating the possession, sale, and distribution of nitrous oxide. Such laws usually ban distribution to minors or limit the amount of nitrous oxide that may be sold without a special license. Nitrous oxide/oxygen must be administered only by appropriately licensed individuals, or under the direct supervision thereof, according to state law. The practitioner responsible for the treatment of the patient and/or the administration of analgesic/anxiolytic agents must be trained in the use of such agents and techniques and appropriate emergency response.

According to the American Academy of Pediatric Dentistry, nitrous oxide exhibits a superior safety profile with no recorded fatalities or cases of serious morbidity when used within recommended concentrations. Nausea and vomiting are the most common adverse effects, seen in 0.5 percent of patients.

What to Know about Laughing Gas During Your Child’s Dental Procedure

When reviewing whether your child is a suitable candidate for nitrous use, medical history is assessed. It’s important to tell us about:

• Allergies and previous allergic or adverse drug reactions.
• Current medications including dose, time, route, and site of administration.
• Diseases, disorders, or physical abnormalities.
• Previous hospitalization to include the date and purpose.
• Recent illnesses (eg, cold or congestion) that may compromise the airway.

Nitrous Oxide use has an excellent safety record precisely because it is used by trained personnel on carefully selected patients with appropriate equipment. The reason we ask questions during a procedure is to monitor a patient’s level of consciousness and to make sure the respiratory rate is suitable for normal breathing.

It's called "laughing gas" for a good reason. Reactions to dental anesthesia have been the stuff of memes. “David After Dentist” is the name of a YouTube video uploaded in January 2009 featuring a young boy’s reaction after a May 2008 dentist appointment. The clip is known for receiving more than 3 million views in three days, becoming YouTube's second most watched video of that year. After his surgery was completed, the youngster asked deep questions including "is this real life?" and "Is this going to be forever?" It was even spoofed in a Star Wars parody. A heavier form of sedation than nitrous oxide was likely used in this instance. 

At the end of most procedures, we administer 100 percent oxygen once the nitrous oxide has been discontinued. This usually results in patients feeling like their normal selves again before leaving our office. We encourage patients to communicate about any residual disorientation and to wait additional time in the waiting room before attempting to drive if there are residual effects felt from the laughing gas. Also, maybe make sure the person taking you home promises not to record you on video and share it with the world unless you are a really good sport about that sort of thing. 

Answering your questions about Nitrous Oxide and Pediatric Dentistry Services Ooltewah

Let us know if you or your child may benefit from laughing gas during a dental procedure. We are happy to discuss specifics at our office by calling (423) 238-8887 or scheduling an appointment to visit our family dentistry office located in Ooltewah, TN. We also serve Collegedale TN, Chattanooga TN and Cleveland TN communities.

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Photo: © One Blink / 123RF Stock Photo

Blog © 2018 Tedford Family Dentistry: Tedford Keith DDS Ooltewah TN 37363

Chattanooga Preventive Dentistry

Part of our mission for Chattanooga Preventive Dentistry is encouraging and educating patients to achieve a more balanced, healthy life in general. Poor nutrition affects oral health in ways that may not seem as obvious as usual culprits of gum disease or cavities. 

Eating for Healthy Gums and Teeth

Foods that can Damage Teeth and Gums

You’ve probably already guessed what we are going to say. The American Dental Association (ADA) has promoted the message for years: Junk Food is bad for you and your teeth. Sugars are easily the arch-nemesis of many a dentist. Cake, cookies, candies, milk, and other sugary foods may taste delicious but these can cause tooth decay. Starchy foods like pretzels and potato chips aren’t good for teeth either. The longer these carbohydrates stay on the teeth, the more damage is done.

Non-Food Consumables that can Damage Teeth and Gums

This time of year, a lot of people get a cough. Cough drops may contribute to tooth decay. The next time you have one in your mouth, run your tongue over the front of your teeth and you can feel it leaving a coating. The same concept applies to lollipops, hard candies, and mints. 

More Fruits and Vegetables = Nutritious Diets

More nutritious choices can include raw vegetables, fruits, plain yogurt, and non-microwave popcorn. Other nutrient-dense foods include salmon, seaweed, garlic, shellfish, potatoes, liver, sardines, blueberries, and egg yolks. Studies show these foods contain powerful antioxidants, can help us lose weight, lower blood pressure, and help to fight cancer. Potatoes can be very filling while also high in potassium, magnesium, iron, copper, and manganese, plus vitamin C and most B vitamins. Make lean protein choices, such as lean beef, skinless poultry, and fish. Try and vary your protein choices to include eggs, beans, peas, and legumes, too. Fortified soy drinks and tofu, canned salmon, almonds and dark green leafy vegetables all help to promote strong teeth and bones. Phosphorus, found in eggs, fish, lean meat, dairy, nuts, and beans is good for strong teeth. Vitamin C promotes gum health, so eat plenty of citrus fruits, tomatoes, peppers, broccoli, potatoes, and spinach. 

Strategies for Better Nutrition for Improved Oral Health

It’s easy enough to grasp what’s good or bad for us, but how are we to actually put better eating habits to work? There are a few suggestions you may want to try if you’ve always wanted to eat better but weren’t sure how to make it happen…

• Limit sugar to part of a complete meal rather than as snacks throughout the day. A sweet dessert immediately following the entrée is the best time. Why? Because mealtime usually means increased saliva in the mouth, which always makes it easier to wash food particles away from the teeth. Swallowing a beverage at mealtime amplifies this process.
• Substitute cheese for snacks instead of sugary, sticky and chewy foods. Snacks like raisins, dried figs, granola bars, oatmeal or peanut butter cookies, jelly beans, caramel, honey, molasses, and syrup all tend to stick to teeth, whereas cheddar, Monterey Jack, Swiss, and other aged cheeses at least trigger the production of saliva to help wash food particles away.
• Substitute water instead of milk, formula, juice, or soda. Even milk contains sugar; water doesn’t. Adding more water aids in washing away food clinging to teeth. Some sports and energy drinks contain a lot of sugar, as you’d expect.
• Reduce the frequency of snacking to two or three times per day. That’s more important than how much is eaten per snacking session, so remember it is frequency rather than quantity. Frequent bouts of snacking, without brushing teeth after, create more opportunities for bacteria to grow, increasing the likelihood of plaque developing on teeth and around gums.
• Sometimes the best way to make sure you eat better is to make better decisions at the grocery store. Look for foods that come unsweetened or sugar-free. Foods with the sugar substitute xylitol can potentially help to prevent cavities.
• Check the sugar content in everything you eat or drink before buying -- spaghetti sauce, cereal, and canned fruit may be loaded with a lot of sugar.
• While reducing unhealthy foods from your diet, add more of the ones that are better for you. Good sources of calcium like broccoli and yogurt add calcium to your diet. Calcium, as we know, is good for strengthening bones, including the teeth.
  
• When all else fails and you backslide on your old dietary habits, continue to use fluoride and brush and floss teeth every day to reverse tooth decay. A fluoride mouthwash also helps.
• Get kids in the habit of brushing between meals and flossing at least once a day. If no toothbrush is available during the day, rinse the mouth with water several times to at least remove those pesky particles between teeth and below the gum line.
• Beware of kids’ foods loaded with sugar like many breakfast cereals, trying a whole-grain cereal instead. 

How to Transition to a Healthy Eating Lifestyle

How do you get the family to skip candy, cookies, and cake to instead munch on kale? Follow a process to gradually wean yourself of these unhealthy foods and replace them with healthier alternatives. It is important to always replace bad food with healthy food that you enjoy. For example, eat fruits as snacks, drink water instead of soda, eat whole grain bread instead of white bread, add steamed greens to dinner, focus on poultry and seafood while limiting intake of red meats, make homemade pizza instead of ordering, and snack on nuts like unsalted peanuts or raw almonds instead of potato chips. Berries can offer a sweet substitute to satisfy sweet cravings instead of sugar-loaded chocolate candy.

Regardless of how it is achieved, fruits and vegetables need to make up half of what is eaten daily, according to the U.S. Department of Agriculture. You don’t have to become a vegetarian to eat better, but you’ll end up healthier the more you transition away from sugary foods and starches to dishes that grow out of the ground instead of coming in a can. With these healthy eating guidelines, you can reduce your risk of enamel erosion and cavities to keep your smile looking healthier, plus you may just live longer too. 

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Photo: © Evgenya Amanenko / 123RF Stock Photo

Blog © 2018 Tedford Family Dentistry: Tedford Keith DDS Ooltewah TN 37363

Did you know there is more than one type of mouthwash? Cosmetic mouthwashes will address short term bad breath, while therapeutic mouthwashes are designed to address numerous dental concerns that can improve your oral health. Whichever type you pick, you’ll find there are plenty of reasons to reach for some type of mouthwash next time you’re are the store. Perhaps you’re on your way to a job interview or a date and are worried about your breath smelling fresh. Or you’re worried that flossing isn’t going far enough in your quest to get rid of plaque. Maybe your dentist told you to take an extra step to prevent gingivitis and tooth decay. Or maybe you’ve had a toothache, and you’re looking for a little extra relief.

Whatever your reason for wanting to swish, you don’t need to feel limited to a minty concoction with a harsh burn. Not only are there two main categories of mouthwash, there are many brands and flavors now on the market. Which one you choose depends on your dental health needs, price point, and what tastes you like. But here are few ingredients to look out for that might help you narrow down the playing field:

Therapeutic mouthwashes tend to contain ingredients including:

• cetylpyridinium chloride
• Chlorhexidine
• essential oils
• Fluoride
• Peroxide

Cetylpyridinium chloride sounds like something out of chemistry class, but it’s not so complicated. It’s simply an antiseptic that kills bacteria in your mouth, including those that cause odor. Instead of simply covering up odors on your breath, this ingredient tackles the cause, and can help kill bacteria in hard to reach places after you brush or floss.

Chlorhexidine and essential oils can both be used to combat plaque and gingivitis. The main difference is that chlorhexidine can only be obtained by prescription. That’s because it’s so good at killing bacteria it’s also an ingredient in surgical hand scrub! Certain essential oils can also have antimicrobial properties, without killing good bacteria and while providing a tasty flavor.

Fluoride is a familiar ingredient you might recognize from your toothpaste package. It helps protect your tooth enamel by helping to repel acids, sugars, and bacteria in the mouth before they can cause trouble. You should wait for at least 30 minutes after using a fluoride product to give the ingredient a chance to reach maximum protective effectiveness.

Peroxide is also a way to disinfect your mouth, but it doesn’t have the harsh burn that many associate with alcohol-based mouthwashes. Not only can it help kill bacteria around your teeth and gums, it can also sooth mouth ulcers.

Keep in mind that children under 7 should brush their teeth and learn good flossing habits, but they shouldn’t use mouthwash because their swallow skills might not be developed enough to keep them from ingesting some of the product. Mouthwash is great in your mouth, but it’s not so great in your stomach!

If you still feel overwhelmed by the options, talk to your dentists and dental hygienists at Tedford Dentistry! We’d be happy to help you find a product that keeps your teeth clean and your mouth healthy that is just right for your smile. Whether you’re tackling a specific periodontal condition or just want to keep your whites bright and your breath smelling great, we’ll point you in the right direction.

Below are some simple, general tips from our Ooltewah dentist to keep your dentures, either complete or partial dentures, in good shape.

When you visit with Dr. Tedford, he will make recommendations on the best denture solutions for you.

1. Take Your Dentures Out Daily.
If possible, take your dentures out while you sleep. If this is not a good option for you, take them out for 6 to 8 hours a day during another time period. This will give your mouth tissues time to recover.

2. Help Retain Your Dentures Shape

Place your dentures in warm water (or a denture cleanser solution), when they are not being worn, to help retain the denture's shape, remain pliable and keeps it from drying out. Dentures should never be placed in hot water, which could cause them to warp.

3. Clean Your Dentures Daily

Like natural teeth, dentures must be cleaned daily to remove food particles, tartar and bacteria, and to help prevent dentures from becoming permanently stained.

Commercial denture cleansers for removable dentures come as tablets, creams, pastes, gels and solutions. The first step in cleaning dentures is to rinse away loose food particles and remove any denture adhesive.

Denture cleanser tablets are dropped into warm water to create an effervescent solution. Dentures are removed from the mouth and placed in the solution. Soaking dentures in the cleaning solution helps kill germs that can cause odor. The amount of time dentures should be soaked—from a few minutes to overnight—depends on the manufacturer’s instructions.

Denture cleansing creams, pastes or gels are brushed on the denture after it is removed from the mouth and then rinsed off, according to the manufacturer’s instructions. Denture cleansers should not be used while dentures are still in the mouth.

Dentures can also be cleaned with toothpaste or soap—mild hand soap or dishwashing liquid—warm water and a soft-bristle toothbrush. However, denture wearers should never use bleach or powdered household cleansers, which can be abrasive, for cleaning their appliance as this may damage the denture.

4. Find Out if You Need Denture Adhesives

A film of saliva typically helps hold dentures in place. Denture adhesives may be used if the salivary glands do not produce a sufficient amount of saliva. Denture adhesives are not, however, a remedy for ill-fitting dentures. A denture that fits poorly (i.e., feels loose or causes discomfort) may need to be relined or replaced as it can contribute to the development of mouth sores.

Denture adhesives, also called denture adherents, are creams, powders, wafers or strips that are used to hold dentures firmly in place. The adhesive also helps form a seal that keeps food particles from sticking between the dentures and gums. Adhesive is applied to clean dentures, which are then positioned in the mouth and held in place for a few seconds, according to the manufacturer’s instructions.

During denture cleaning, adhesive should be removed with gentle scrubbing to prevent contamination.

5. Look After Your Whole Mouth

You still need to care for your gums, even with complete dentures. When you take out your dentures, give your mouth a good rinse and then massage your gums with a washcloth or a soft toothbrush. If you have partial dentures, you still need to properly brush and floss your regular teeth every day.

6. See Your Dentist
You still need to see your dentist at least once a year. Dr, Tedford will examine your oral tissues for changes and for sores that might become cancerous and he will also provide advice as to oral hygiene and denture care.

7. Watch for Changes in Fit
If your dentures aren’t fitting properly or don’t feel right, please check in with Dr. Tedford, your Ooltewah Dentist. He may be able to adjust your dentures
or recommend a solution. The gums and bones in our mouths change over time, which can lead to an improper denture fit. Poorly fitting dentures can cause problems like sores, pain and burning and may be a sign of periodontal disease.

8. Nourish Your Body
Be sure to be eating a balanced diet. Research suggests that proper nutrition slows the progress of gum disease, so a healthier diet could even mean a healthier mouth.

9. Use ADA Approved Products

A company earns the ADA Seal of Acceptance by producing scientific evidence that demonstrates the safety and efficacy of its product, which the ADA Council on Scientific Affairs carefully evaluates according to objective requirements.

Look for the ADA Seal—your assurance that the product has been objectively evaluated for safety and efficacy by an independent body of scientific experts, the ADA Council on Scientific Affairs.

For more information, please contact our dental office in Ooltewah TN at (423) 238-8887.