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Our Dental Treatment Process

July 15, 2019
Posted By: Russell Schafer, DDS
Dentist in New Orleans LA

Creating a Plan for Dental Treatment

When I meet a patient for the first time, my first question is often “any problems with your teeth?” and I get responses that range from “all is good” to “I have the worst teeth in the world.” Thankfully, most of the time when someone says “all is good” usually thing are in pretty good shape. Maybe I will see a small cavity forming or crack line around an old filling happening, and we can do treatment when it is small and less expensive. On the flip side of the coin, most people who believe that they have the worst in the world generally do not, and even if the teeth and mouth are in very rough shape, everything is fixable. However, no matter what treatment is needed, my patient and I must put together an plan for in what order the treatment should be done. The most important part of the plan is that everything must build as I do not want to go back and redo work which increases cost and time. I break treatment needs into emergency treatment, infection control, and elective.

Emergency Treatments

Emergency treatment is where I get started for many of my patients. The most obvious emergency treatment is a tooth that is hurting and needs to either be removed or needs a root canal to remove the nerve. Some patients are used to dentists giving them antibiotics to help the infection clear up before treating a painful tooth, and while I do it occasionally, I am not a fan of giving antibiotics which will not actually fix the problem. The times when I do it are if I cannot get a tooth numb due to infection. The reason I am opposed to doing it on a regular basis is that every time a patient takes an antibiotic, the chance of having either a bad reaction or causing antibiotic resistance infections increases. Also I find that often the antibiotic makes the problem go away temporarily, but then it comes back with a vengeance and must be dealt with then. The second type of emergency that I see is when a tooth in the smile line breaks. While it isn’t necessarily painful, it is still not good and embarrassing. For these situations, I will either do esthetic bonding to fix the tooth even if it is only temporary or I will make a 3d printed partial denture which I can do within 24 hours.

Treating Dental Infections

After any emergencies are treated, I generally move onto infection control. The purpose of infection control is much like the name suggests: remove as much infection as possible. Generally the infection that I’m treating is either periodontal/gum disease or cavities. For cases where there is both gum infection and cavities and some teeth that need to be removed, I will generally remove teeth after I have fixed the cavities or done the first part of the periodontal treatment. Unless a tooth is causing pain, I do not like to remove these teeth first as I would rather spend time, money, and energy fixing the teeth that are savable. I do not want to let the infection sit on the tooth for any time longer than necessary as there is a chance that the infection can cause the tooth to be lost and then we are removing another tooth. The final part of infection control is then putting practices in place that help lower the risk of the infection returning. For many of my patients, this is a combination of seeing me for cleanings once every 4 months for 2 or 3 years as well as prescription-grade toothpastes and mouthwashes to use for daily home care. Last but not least, I am a big fan of night time whitening as it helps lower the amount of bacteria in the mouth which can help prevent new infections from starting.

Elective Dental Treatment

The third and final part is elective treatment. Elective treatment is a catch-all term for anything that is not an infection, but I recommend be fixed to fix the smile, to fix the bite, or to fix both. It is important to do the elective treatment after doing infection control because if elective treatment is done first, the infection present in the mouth can attack the electively treated teeth. Generally, I define elective treatment as fixing problems that are not expected to arise within the next two years. One common example of elective treatment is a person who does not like how their smile looks due to old fillings and mismatched crowns. For these patients, the best treatment to fix the smile would be a combination of crowns and veneers so that everything looks the same. Another example would be a patient with a crack forming on a back filling on a tooth. The crack would need to be removed and treated with a crown to help strengthen the tooth. However, because cracks are unpredictable it is hard to know exactly when the crack will go further and cause problems with the tooth. The last example is making a new set of dentures to replace a worn set. The worn set will cause issues in the future as the bone becomes weaker and breaks down and chewing and speech are affected. However, there is no medically urgent reason to create a new denture the same day.

Dental Treatments in New Orleans

Phasing treatment is important because it helps create a good path to get back to a smile. As every person’s needs and desires are different, people who have similar teeth can have vastly different plans. By creating a dental treatment order, my patients and I can prioritize needs while trying to look at the future to decide on what makes the best sense long term. If you have a lot of issues with your mouth and need an opinion for what makes the most sense, call me and my team at 504-392-5104 and we will help you out.

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