Conscious Sedation Dentistry, Brentwood TN

As long as there have been dentists, there have been those that delay and neglect their oral health due to fear; enduring unnecessary discomfort and pain rather than visit the dentist office. If this sounds familiar, Conscious Sedation Dentistry may be right for you.

Sedation dentistry has been around in one form or another since the mid-1800s when William T.G. Morton administered ether compound to a patient. Sedation dentistry has, luckily, evolved into a relaxing and comfortable option for those that fear dental visits.

Through the use of medication, we pride ourselves on offering our patients state of the art care, in a comfortable and relaxed environment. We tailor the level of Conscious Sedation Dentistry based on each patient’s need and level of anxiety. Best of all, we can perform a wide range of dental procedures in a single visit!

It’s important to discuss your dental fears with Dr. Kussman as we have many options to ensure you get the care you need in as comfortable a manner as possible.

flouride_treatment_kussmanConscious Sedation Dentistry Options

Light Sedation – Relaxing while allowing you to remain awake and alert.

Moderate Sedation – Relaxed and feeling sleepy and less alert, but awake.

Deep Sedation – Relaxed to the point of  ‘sleep’, or barely awake.

After the Procedure

Patients report little to no memory of their procedure after the fact allowing many to address issues they might previously have ignored.

We are dedicated to providing you with best possible care available and Conscious Sedation allows us to complete many procedures in the shortest amount of time. We encourage you to contact our office with any questions and get started on the road to optimum oral health today.

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Wisdom Teeth

Wisdom teeth get their name because they usually appear around age 18. They can erupt straight, crooked or not at all. Even if they come in straight, wisdom teeth might need to be extracted due to a lack of space and the ability to be cleaned and maintained. Please read and view the images below for the various types of erupting patterns and impactions.

Vertical Impactions

vertical-impactions

The lower tooth, in the image to the left, is partially vertically impacted. This means that part of the tooth is above the bone and visible in the mouth, and part of it is submerged in the bone. This tooth could still erupt properly as the tooth next to it is not in its way.

The upper tooth is fully vertically impacted. This means that the entire tooth is submerged in the bone.

If no tooth movement is shown after a few years, then we know that the teeth are impacted and should be considered for removal. This tooth could still erupt properly as the tooth next to it is not in its way.

 

 

Mesial Impactions

mesial-impactionsThe lower tooth, in the image to the left, is partially mesially erupted. This means that part of the tooth is above the bone and visible in the mouth and part of it is submerged in the bone and that is it tilted mesially, which means it is tipped toward the front of the mouth. This tooth will not likely erupt properly as the tooth next to it is in its way. These teeth typically need to be extracted because the bacteria that get under the gum tissue are almost impossible to clean, which causes an infection. The tooth next to the wisdom tooth can also decay due to the wisdom tooth.

The upper tooth is fully mesially impacted. This means that the entire tooth is submerged in the bone and is tipped toward the front of the mouth. These teeth can be observed for a few years but it is best if they get removed especially if other teeth need to be removed.

 

 

Distal Impactions

distal-impactionsThe lower tooth, in the image to the left, is partially distally erupted. This means that part of the tooth is above the bone and visible in the mouth, and part of it is submerged in the bone and that is it tilted distally, which means it is tipped toward the back of the mouth. This tooth will not likely erupt properly due to a lack of space toward the back of the jaw. These teeth typically need to be removed because the bacteria that gets under the gum tissue is almost impossible to clean, which then causes an infection.

The upper tooth is fully distally impacted. This means that the entire tooth is submerged in bone and is tipped toward the back of the mouth. These teeth can be observed for a few years but it is best if they get removed especially if other teeth need to be removed.

 

 

Horizontal Impactions

horizontal-impactionsBoth of the teeth, in the image to the left, are horizontally impacted. This means that the tooth is perpendicular where they should be. This tooth will not erupt properly since there is no place for them to go and there is almost no chance that they will be guided into proper position in the mouth.

These teeth typically need to be extracted but they can be observed for a few years but it is best if they get removed especially if other teeth need to be removed.

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Tooth Fractures

cracked-tooth-split-rootFractured Cusp

This is the most common type of fracture and it has the best long term prognosis. In this type of fracture, a part of the tooth can completely break off and, occasionally, no pain is felt after the tooth fractures.

Treatment for this type of fracture is to place a crown on the tooth. If the fracture extends into the middle part of the tooth, root canal therapy would be required in addition to a crown.

Vertical Furcation Fracture

cracked-tooth-vertical-furcationThis tooth has a vertical crack that extends vertically into or toward the furcation. The furcation, which is where the arrow is pointing, is the place where the tooth splits into two or more separate roots. The nerve is almost always involved in a vertical furcation crack. The tooth rarely separates into two pieces because the tooth is held in position by the surrounding bone.

The prognosis for this type of crack is fair but it depends on how deep the crack extends into the internal aspect of the tooth. The options are to treat the tooth with a root canal followed by a build up, post and crown or to extract the tooth.

Split Root Fracture

cracked-tooth-split-rootA split root fracture, known as a subgingival oblique fracture can be restorable but it depends on where the fracture ends. Subgingival means below the gumline. If the fracture is not to far below the gumline, the tooth can be restored with a procedure called crown lengthening followed by a crown. The tooth might also require root canal treatment. If the fracture is too far below the gumline, it is unrestorable and requires extraction.

These types of fractures occur for various reasons such as biting down on very hard foods or foreign objects, the presence of a previous filling in the tooth, and a tooth that had root canal therapy that was not treated with a crown.

Vertical Root Fracture

cracked-tooth-vertical-rootVertical root fractures are not a very common type of fracture and it usually occurs with teeth that have had root canal therapy. If the fracture is very short in length, the tooth can possibly be saved by performing an apicoectomy. This involves gaining access to the root tip within the bone and removing the part of the root that is fractured. The only other option is an extraction.

Oblique Root Fractures

Oblique Root Fractures are fractures that are limited to the roots of teeth and the crown portion is intact. The fractured root is generally entirely below the gumline and usually entirely in bone.

cracked-tooth-obliqueIf the fracture is close to the crown as shown by number 1 the tooth is usually unrestorable. The tooth might be able to be treated with endodontic therapy and root amputation if the remaining roots are strong and healthy but the overall prognosis is poor.

If the fracture is close to the tip of the root as shown by number 2, the tooth can try to be restored with root canal therapy. The root canal cannot be performed on the fractured root tip and the body tends to resorb the untreated piece. The prognosis for this procedure is fair to good, and regular exams are recommended to check how the body responds to the treatment.

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Pericoronitis

pericoronitisPericoronitis is a common problem that occurs around an erupting wisdom tooth that typically does not have enough room and it most commonly occurs on lower wisdom teeth. It literally means inflammation around the crown. A piece of gum tissue appears over the biting surface of the tooth, which is very difficult to clean. Debris collects under the flap and, when the debris is not removed, the gum becomes inflamed. The gum can also become inflamed if the top tooth catches the flap of tissue during chewing. In most cases pericornitis is treated with an antibiotic for a few days and when the infection has decreased, the wisdom tooth is removed.

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