Do you have Nitrous Oxide?

We do have Nitrous Oxide(laughing gas) and find it useful for anxious patients. Some patients are so anxious that it is difficult to work on them. Most of these patients seem to do quite well when Nitrous Oxide is used. It does not eliminate the need for local anaesthesia, but it eliminates most of their anxiety and helps them relax.

Also, Nitrous Oxide is said to be and amnesiac. This means that the patients do not seem as aware of how long a procedure takes and often, when told the procedure is done, respond with "So soon?".

Nitrous Oxide seems to wear off quickly and has minimal side effects.

What do you think of online health records?

On line health records are probably a good idea and offer a number of advantages over off line decentralized health records. In the event that there is an emergency and it ia needed,having health records in on easily located place makes it easier for health care workers to access a permanent version of your health history. No longer will you records be placed in a hospitals archives where they are not easily gotten.

When I recently went to NYU emergency room and I was passing a kidney stone, I still had to give the doctors and the triage nurse, my medical history, even though I have been using that facility exclusively for over 30 years. With online records, my history would be instantly found by anyone I gave permission to access them.

Although these online records are a good idea, to my knowledge, congress has not passed adequate laws concerning third party protection of these records from abuse, such as data mining and other invasions of privacy. This month Google has launched Google Health, their attempt at the development of centralized Internet accessible health records. I am both excited and concerned about what Google does with this new project.

How do you get your patients?

I have maintained a dental practice in N.Y.C. at 30 east 40th st. since 1984. There are a lot of dentists practicing in my building (over 40) and my office is on the sixth floor, without any street level announcements, so My office is not noticable to passers by on the street. We usually do not get 'walk in patients' and most of our patients come from 'word of mouth referrals'. Recently, we have been noticed an increase in number of new patients who are 'self referred' from the Internet and we welcome them as well.

To best answer this question, It should be pointed out that satisfied patients refer their friends, collegues and family members, so we try our best to take really good care of our patients, work to keep them happy and hope that they continue to find value in remaining patients in our dental practice!

I tripped last night and chipped my front teeth. One of them has moved. What can be done?

I was asked this question this morning from a patient who tripped the night before. After a some questioning on the phone it was determined that her lip wasn't badly cut and didn't require stitches, but was swollen. Her two front teeth were badly chipped and she wanted them repaired, even temporarily. At least one of her teeth was subluxated(moved in the socket)but she was in no real pain.

What made me concerned other than hearing about her distress over chipping her two front teeth, was the fact the her tooth had shifted in the socket, since this is a situation that I thought should be addressed right away. When teeth move forcibly due to an accident, they can remain in the new position unless they are pushed back into place.

This patient was seen the same day and after giving her local anesthesia, I moved her tooth back into position and then splinted and repaired the teeth using bonding composite. This will allow the teeth to remain in the correct position while the bone heals itself and will provide a reasonably esthetic result. It was entirely possible that part of the socket housing the tooth is cracked , so it is best that the teeth are splinted to allow healing.

The patient was informed that the two teeth might require endodontic therapy (root canals) and that she would be followed closely over the next six weeks to see if an endodontic infection develops.

If a patient has sustained a true jaw fracture, then a visit to an oral surgeon is suggested and the surgeon will most likely use an arch bar to splint the jaw(s) together by ligating the teeth to the bar.