Many just from the thought of how to drill their teeth feel uneasy. The article will explain why pain and modern dentistry are incompatible. You will learn how to make sure that even a child goes to the reception calmly and with a smile.
Why drill teeth?
Drilling teeth in the language of dentists means dissecting. The doctor removes the tooth tissue damaged by caries before filling. However, teeth are drilled not only during treatment.
The tooth can be dissected to cover with a crown. Prosthetics are necessary if the doctor sees that restoring a tooth with a filling is unreliable. For example, when it is a front tooth and there is a risk of spalling due to increased load. Another reason is the small amount of healthy tissue. If the patient has deep caries, and especially pulpitis, restoration of the tooth with a crown is indicated. In this case, the dentist drills the tooth in several stages. The doctor prepares it to remove the tissues affected by caries in order to open the pulp chamber, gain access to the canals and expand them. At the last stage, after the removal of the nerve, treatment, the dentist drills the tooth, turning it under the crown.
The doctor is sometimes forced to dissect even healthy (without caries) and live (with nerve) teeth. This happens when staging veneers. They are ceramic overlays for teeth. It happens that the front teeth are too small or there are large distances between them. It happens that a spot appears on the tooth due to fluorosis, enamel hypoplasia or injury. Sometimes a small part breaks off the front tooth or the cutting edge is erased. There are simply very demanding patients with aesthetics. They want frontal teeth of the same shape, size and perfect appearance. In all these cases, the installation of veneers is possible. Their advantage is that the tooth remains alive. They do not depulp it and remove (grind) a small layer of enamel.
Drilling teeth without pain
Some, especially the older generation, tell how they treated not only caries, but also pulpitis without anesthesia. The doctor, by the way the patient jerked sharply, determined that he had reached the nerve with the instrument. Now everything is completely different. Anesthesia has become the standard in dentistry, with anesthesia both drill teeth and remove them.
This is primarily necessary so that the patient in the chair at the dentist does not experience stress. Anesthesia also makes the doctor’s work more convenient. When the dentist is just starting to dissect, the patient is not hurt because there are no nerve endings in the enamel. But when the doctor comes to the enamel-dentin border, a person can jerk sharply from pain, and a dentist can damage the mucous membrane with an instrument.
Do not be afraid that the injection will not work. All modern anesthetics anesthetize equally well, and it does not matter how old a person is, what ailments he has and what kind of drugs he takes. The remedy can not work, only if the doctor enters it in the wrong place. This happens either due to the inexperience of the dentist, or due to the fact that the nerve bundle passes a little bit in the wrong place. In such cases, they simply do it again at the right place.
Drilling teeth with an injection is not painful. However, the patient feels the way they drill their teeth, that is, the vibration of a rotating tool. Anesthetic blocks the type of nerve fiber that is responsible for pain. For touch of pressure, vibration, completely different (proprioceptive) receptors are responsible. Fortunately, these feelings do not cause discomfort.
Anesthesia
Consider what else people are afraid of when they hear about pain relief.
- Pain from an injection. There are patients, especially children, who are intimidated by the very injection of anesthetic with a syringe. Doctors know this, so they pre-lubricate the injection site with an anesthetic gel. It minimizes discomfort. But I must say that a good doctor makes an injection almost imperceptibly.
- Allergy to anesthetic. The probability of its occurrence is negligible, much lower than the probability of poisoning by food.
- Short duration of anesthetic. Some are afraid that the “freeze” will come to naught before the dentist finishes work, pain will appear. Indeed, the duration of anesthetic injection in different people may vary slightly. Anesthetic will “work” faster for those who have better blood circulation in the area of ​​pain relief. These same patients are more likely to "move away" from the injection. The doctor cannot predict this, but a good specialist is always interested in the patient's sensation. If the analgesic effect is reduced, the dentist transfers the following stages of work to another technique.
- Side effects of anesthesia. Sometimes patients complain that immediately after the injection their hands and feet begin to tremble, their heartbeat increases, etc. Adrenaline in some anesthetics causes this reaction. In this case, the doctor selects another drug, without adrenaline or with a reduced content. There are plenty of such options; they are also used for children. Occasionally, because of a “freeze” a person does not close his eyes. Do not be scared: this will go away as soon as the anesthetic ceases to act. The thing is in the proximity of the anesthetized nerve with the optic nerve.
How long do they drill teeth?
I must say that tooth treatment is not always possible in one visit. And the reason for this is not the slowness of the dentist, but the careless attitude or fear of the patient, because of which he postpones the visit to the doctor.
Caries, when it is not necessary to depulpate a tooth (remove a nerve), is treated in one visit. Pulpitis is treated in two visits. After removing the nerve and cleaning the canals, the dentist puts a temporary filling, and under it - a medical gasket. The patient is released for about a week. The next time the doctor asks if the tooth is sick. If not, then the channels are cleaned well. They can be filled and the tooth is restored with a permanent filling.
It happens that the patient brought the tooth to periodontitis, i.e., when the inflammation has already spread to the tissues around it. Then the dentist injects medicine into the canals. After a few days, he repeats the procedure, and so several times, until the inflammation disappears. Further treatment is the same as treatment for pulpitis.
Restoring a tooth with a filling even without depulpation can be lengthy. How long a tooth is drilled depends on the size of the cavity. It often happens that the tooth is affected from several sides, for example, on the chewing surface and in the interdental space. In this case, the dentist forms several cavities under the fillings. It takes a lot of time to make a tooth indistinguishable from natural, healthy teeth. That is why doctors prefer to call treatment an aesthetic restoration. Of course, you can drill a tooth and seal it in 5 minutes, but quality work, when you pay attention to details, takes 30 and 60 minutes.
Instruments
What does a dentist treat with teeth? The working tool is a turbine tip. Thanks to the motor, it rotates at a speed of 200-500 thousand revolutions per minute. More powerful tips have a larger head. Boron is installed in it (diamond, steel or alloy). Burs are of various abrasiveness, shape, size. This is determined by purpose. The turbine tip has a cooling system, and modern samples have a backlight.
How is a tooth treated?
Consider the stages of caries treatment, i.e. the situation when the tooth remains alive (with the nerve), and the filling of the channels is not performed.
When the anesthetic has acted, a rubber dam is put on the tooth. This is a thin elastic film that protects the tooth from saliva or gingival fluid.
The dentist drills all tissue damaged by caries and forms a cavity for filling. He then etches the tooth for 10–40 seconds. This substance (acid), which removes sawdust after drilling and makes the surface of the tooth rough for better adhesion.
After washing off the etch, the doctor applies fluoride, which strengthens the dentin and reduces the sensitivity of the tooth. The next step is bonding. This substance is for the ligament of the tooth with the filling, which penetrates the dentinal tubules. In order for bonding to harden, it is illuminated with a heliolamp. Its rays are harmless, it's just a blue LED lamp.
For filling, the dentist needs several types of filling material, because different parts of the tooth have different color and transparency. The doctor applies an opaque material of dentin color, illuminates it. A transparent layer (enamel) is applied to the incisal edge and illuminates. Further, the doctor, so that the tooth looks natural, forms a longitudinal ribbing of the tooth (mamelons). If the tooth is chewing, it creates grooves (fissures) between the tubercles. It illuminates, removes rubber dam and polishes. Grinding is needed not only for the beauty and brilliance of the tooth, but also so that plaque sticks to it less.
Then the dentist checks the height of the filling. He puts on the tooth a special paper, similar to carbon paper. The patient makes several chewing movements, and imprints remain on the teeth at the points of contact. According to them, the doctor determines whether the seal is not overstated or underestimated. Modifies if necessary. If this is not done, the filling will interfere with chewing, the bite will be broken.
Features of children's treatment
If the parent himself is afraid of the dentist, scares the child, then visiting a doctor will be problematic. Show that you regard visiting a doctor as something ordinary. Say that all relatives and friends go to the dentist. If possible, take your child with you to your appointment. Play at home in treatment, do not tell how teeth are drilled, but count them, look in the mirror.
On the day of the visit to the doctor, do not be too affectionate, do not give gifts. This will alert the child. Do not threaten punishment. Do not come too early, do not sit in the corridor, because the baby can get excited due to crying children.
A good pediatric dentist never drills a child’s tooth from the doorway. He will talk with the baby using the definitions available to him. For example, do not drill, but buzz, do not inject, and smear with cold ice cream, do not treat, but take out a worm from a tooth, do not put a seal, but fill it with chewing gum. In expensive private clinics there is even an adaptation service, when the doctor plays with the child, teaches you to brush your teeth, etc.
Local anesthesia is required, the baby should not feel pain. But pay attention to the fact that the clinic must have a license for children's treatment. Different dentists treat different anesthesia differently. It can be avoided in 99% of cases. Sedation is justified if the child with a strong gag reflex has to treat the posterior teeth, if the child is uncontrollable, if the previous dose caused him severe psychological trauma.
Is it often harmful to drill teeth?
Teeth damaged by caries, drilling is not harmful, but necessary. Even a person who is attentive to oral hygiene may need treatment, and here's why. In the cervical areas, in the fissures of the posterior teeth, plaque accumulates faster due to limited access. In addition, the enamel layer in these areas is thinner than, for example, on chewing tubercles. The resulting caries may not be visible to the patient, but it develops quite quickly.
It happens that a person sees a tiny dark speck on his tooth, and the doctor has to drill a huge cavity and cover it with a large seal. How is that? The fact is that enamel is the hardest tissue in the body. Caries affects her more slowly than the dentin located on it. A small inlet in the enamel leads into a large carious cavity in the dentin.
If a person turned to the dentist because the tooth began to hurt, then inflammation began, i.e. pulpitis. In this case, it will be necessary to drill more. We can conclude that more often they drill teeth for those who do not go to the doctor on time, ignore preventive examinations.
Drill teeth in a dream
If you dreamed that you were drilling teeth, this is wonderful. Firstly, this is an occasion to remember how long you visited the dentist. Secondly, according to the dream books, this is a sign that your affairs will go smoothly, problems will be resolved. If you were a patient in a dream, your financial situation will improve, and relationships with others will come into balance. If you drilled your teeth to another, then you have a reliable friend who is ready to lend a helping hand at a difficult moment.
Expert Advice
Before starting treatment, a good doctor always explains what he will do and why. Feel free to ask the dentist for anything you don’t understand. A professional doctor is interested in indifferent patients. In addition, you should clearly state what result you expect from treatment.
Describe your fears to the dentist. People are often afraid of the unknown, so the doctor should dispel doubts with his explanations, and also do everything to make you feel comfortable. If you have trusted a specialist, agreed to treatment, then in the process follow the doctor’s requests.
Sometimes after filling, a reaction to hot and cold appears. This is due to the fact that the filling material has a higher thermal conductivity than the tooth. In this case, the doctor uses sealant. Another option is to wait, with time the sensitivity will decrease by itself. In six months, everything will be as before. If after filling the tooth began to respond to acidic, go to the dentist. Such a reaction indicates a leak in the seal.
Caries prevention
A child whose teeth are being cut must be shown to the pediatric dentist once. The doctor will check whether everything is going as it should. Until the age of three, it is enough to come for an examination once a year. After three years, the child, like an adult, should visit the dentist twice a year.
Brush your teeth twice a day with a soft or ultra-soft toothbrush and low abrasive paste. Thanks to such a brush, you will never have a wedge-shaped defect when the enamel in the cervical part of the tooth is erased due to excessive pressure. Brushes "with bells and whistles" do not make sense. The most important thing is the size of the head. The smaller, the more convenient and better cleaning. For patient perfectionists there are mono-beam brushes. They clean out best, but for a long time.
It is necessary to brush children's teeth from the moment they appear. When the baby is too small, the adult does it with a fingertip. Children 3-4 years old can be taught quality cleaning using plaque indicators. These are chewable tablets, lozenges that stain plaque in blue or red.
Thin dental floss will help to remove plaque between the teeth and under the gum. Some complain that she injures the interdental papilla. In this case, you can use interdental brushes. Irrigator allows you to brush your teeth even better. Especially needed for people with braces. All this, coupled with regular (twice a year) professional cleaning at the dentist gives excellent results.
Do not think that drilling a tooth hurts, because they do it under local anesthesia. If the doctor refuses to give anesthetic injection, disagree and go to another specialist. A good doctor will never stress a patient.