For many, just the thought of having their teeth drilled makes them uncomfortable. The article will explain why pain and modern dentistry are incompatible. You will learn how to make even a child go to the appointment calmly and with a smile.
Why are teeth drilled?
To drill teeth in the language of dentists means to dissect. The doctor removes caries-damaged tooth tissue before placing a filling. However, teeth are drilled not only during treatment.
The tooth can be prepared to be covered with a crown. Prosthetics is necessary if the doctor sees that it is unreliable to restore a tooth with a filling. For example, when it is a front tooth and there is a risk of chipping due to increased load. Another reason is the small amount of he althy tissue. If the patient has deep caries, and even more so pulpitis, restoration of the tooth with a crown is indicated. In this case, the dentist drills the tooth in several stages. The doctor dissects it to remove caries-affected tissues 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 dentistdrills a tooth, turning it under the crown.
The doctor is sometimes forced to dissect even he althy (without caries) and live (with a nerve) teeth. This happens when veneers are placed. 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 speck appears on the tooth due to fluorosis, enamel hypoplasia or trauma. Sometimes a small part breaks off from the front tooth or the cutting edge is erased. There are simply very demanding aesthetic patients. They want anterior teeth that are the same shape, size, and perfect fit. In all these cases, it is possible to install veneers. Their advantage is that the tooth remains alive. It is not depulped and a small layer of enamel is removed (grind off).
Drill your teeth without pain
Some, especially the older generation, tell how they were treated without anesthesia, not only caries, but also pulpitis. The doctor, by the way the patient twitched sharply, determined that the instrument had reached the nerve. Now everything is completely different. Anesthesia has become the standard of dentistry, with anesthesia both drilled and extracted.
This is necessary first of all so that the patient in the dentist's chair does not experience stress. Anesthesia also makes the doctor’s work more convenient. When the dentist is just starting to prepare, the patient does not hurt because there are no nerve endings in the enamel. But when the doctor approaches the enamel-dentin border, the person can twitch sharply in pain, and the dentist can damage the mucosa with the tool.
Do not be afraid that the injection is notwill 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. A remedy can “not work” only if the doctor injects 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 slightly in the wrong place. In such cases, just do it again in the right place.
Drill teeth with an injection does not hurt. However, the way the teeth are drilled, i.e., the vibration of the rotating instrument, is felt by the patient. The anesthetic blocks the type of nerve fibers that are responsible for the pain. For the touch of pressure, vibrations, completely different (proprioceptive) receptors are responsible. Fortunately, these sensations do not cause discomfort.
Anesthesia
Let's look at what else people are afraid of when they hear about pain relief.
- The pain of the injection. There are patients, especially children, who are afraid of the very injection of anesthetic with a syringe. Doctors know about this, so they pre-lubricate the injection site with anesthetic gel. It reduces discomfort to a minimum. 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 food poisoning.
- Short duration of anesthetic. Some are afraid that the "freeze" will come to naught before the dentist finishes the work, pain will appear. Indeed, the time of action of an anesthetic injection in different people can be a littlediffer. The anesthetic will “work” faster for those who have better blood circulation in the area of anesthesia. 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 feeling. If the analgesic effect decreases, the dentist transfers the next stages of work to another appointment.
- Side effects of anesthesia. Sometimes patients complain that immediately after the injection, their arms and legs begin to tremble, their heart rate increases, etc. This reaction is caused by adrenaline in some anesthetics. In this case, the doctor selects another drug, without adrenaline or with a reduced content of it. There are plenty of such options, they are used, including for children. Occasionally it happens that because of the "freeze" a person does not close his eyes. Do not be afraid: it will pass immediately as soon as the anesthetic stops working. It's all about the proximity of the anesthetized nerve to the ophthalmic nerve.
How long does it take to drill teeth?
It must be said that tooth treatment is not always possible in one visit. And the reason for this is not the slowness of the dentist, but the negligent attitude or fear of the patient, because of which he postpones the visit to the doctor.
Caries, when it is not necessary to depulp 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 pad. The patient is released for about a week. The next time the doctor asks if the tooth hurt. If not, then the channels are cleaned well. They can be filled andrestore the tooth with a permanent filling.
It happens that the patient has brought the tooth to periodontitis, that is, when the inflammation has already spread to the tissues around it. Then the dentist injects medicine into the canals. After a few days, repeat the procedure, and so on several times, until the inflammation disappears. Further treatment is the same as the treatment of pulpitis.
Restoration of a tooth with a filling, even without depulpation, can be lengthy. How long a tooth is drilled depends on the size of the carious 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 for fillings. It takes a lot of time to make the tooth indistinguishable from natural, he althy teeth. That is why doctors prefer to call the treatment aesthetic restoration. Of course, you can drill a tooth and close it with a filling in 5 minutes, but high-quality work, when you pay attention to details, takes 30 or 60 minutes.
Tools
What does a dentist-therapist drill with? 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. A bur (diamond, steel or alloy) is installed in it. Burs come in different abrasiveness, shape, size. It 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 treatmentcaries, i.e. the situation when the tooth remains alive (with a nerve), and the root canals are not filled.
When the anesthetic has worked, a rubber dam is put on the tooth. It is a thin elastic film that protects the tooth from saliva or gum fluid.
The dentist drills out all the tissue damaged by caries and forms a cavity for the filling. He then applies an etchant to the tooth for 10-40 seconds. This is a substance (acid) that removes sawdust after drilling and makes the surface of the tooth rough for better adhesion.
After washing off the etchant, the doctor applies fluorine varnish, which strengthens the dentin and reduces tooth sensitivity. The next step is to apply the bonding. This is a substance for bonding a tooth with a filling, which penetrates into the dentinal tubules. In order for the bonding to harden, it is illuminated with a solar lamp. Its rays are harmless, it is just a blue LED lamp.
To place a filling, the dentist needs several types of filling material, because different parts of the tooth have different colors and transparency. The doctor applies an opaque dentin-colored material, illuminates it. A transparent layer (enamel) is applied to the incisal edge and illuminated. Next, the doctor, in order for the tooth to look natural, forms a longitudinal ribbing of the tooth (mamelons). If the tooth is chewing, it creates grooves (fissures) between the tubercles. Illuminates, removes rubber dam and polishes. Grinding is needed not only for the beauty and shine of the tooth, but also so that plaque does not stick to it.
Next dentistchecks the height of the seal. He puts a special paper similar to carbon copy on the tooth. The patient makes several chewing movements, and prints remain on the teeth at the points of contact. According to them, the doctor determines whether the filling is overestimated or underestimated. Makes changes 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 with it, then visiting the doctor will be problematic. Show that you treat visiting the doctor as something ordinary. Say that all relatives and friends go to the dentist. If possible, take your child with you to the appointment. Play treatment at home, do not tell how teeth are drilled, but count them, look in the mirror.
On the day of your visit to the doctor, do not be too affectionate, do not give gifts. This will alert the child. Don't threaten punishment. Do not come too early, do not sit in the hallway, because the baby may get excited because of the crying children.
A good pediatric dentist never drills a child's tooth right off the bat. He will talk to the baby using the definitions available to him. For example, not to drill, but to buzz, not to inject, but to smear with cold ice cream, not to treat, but to get a worm out of a tooth, not to put a seal, but to cover it with chewing gum. Expensive private clinics even have an adaptation service, when the doctor plays with the child, teaches them how to brush their teeth, etc.
Local anesthesia is required, the baby should not feel pain. But pay attentionthat the clinic must be licensed for pediatric treatment. Different dentists treat general anesthesia in different ways. It can be avoided in 99% of cases. Sedation is justified if a child with a strong gag reflex is to be treated for lateral teeth, if the child is uncontrollable, if the previous appointment caused him severe psychological trauma.
Is it harmful to drill your teeth often?
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 lateral teeth, plaque accumulates faster due to limited access. In addition, the layer of enamel in these areas is thinner than, for example, on masticatory tubercles. Appearing caries may not be noticeable to the patient, but develops quite quickly.
Sometimes, a person sees a tiny dark spot on a tooth, and the doctor has to drill a huge cavity and close it with a large filling. How does it work? The fact is that enamel is the hardest tissue in the body. Caries affects it more slowly than the dentin that is along it. A small opening in the enamel leads to a large cavity in the dentin.
If a person went to the dentist because the tooth began to hurt, then inflammation began, that is, pulpitis. Drilling in this case will need more. It can be concluded that teeth are drilled more often for those who do not go to the doctor on time, ignore preventive examinations.
Drill teeth in their sleep
If you dreamed that your teeth were being drilled, that's wonderful. First, it is a reasonremember how long ago you visited the dentist. Secondly, according to 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 relations with others will come into balance. If you drilled someone else's teeth, then you have a reliable friend who is ready to lend a helping hand at a difficult moment.
Expert Tips
Before starting treatment, a good doctor always explains what he will do and why. Feel free to ask your dentist anything you don't understand. A professional doctor is interested in caring patients. In addition, you must clearly articulate what result you expect from the treatment.
Describe your fears to the dentist. People are often afraid of the unknown, so the doctor must dispel doubts with his explanations, as well as do everything to make you feel comfortable. If you trusted a specialist, agreed to treatment, then in the process follow the doctor's requests.
Sometimes, after filling, there is a reaction to hot and cold. This is due to the fact that the thermal conductivity of the filling material is higher than that of the tooth. In this case, the doctor uses a sealant. Another option is to wait, over time the sensitivity will decrease on its own. In six months everything will be the same as before. If after filling the tooth began to react to sour, go to the dentist. Such a reaction indicates a leak in the seal.
Caries Prevention
A child who is teething should be seen by a pediatric dentist once. The doctor will check if everything isgoes as it should. Until the age of three, it is enough to come for an examination once a year. After three years, a 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 a low-abrasive toothpaste. 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 monopuff brushes. They clean best but take a long time.
Children's teeth should be brushed from the moment they appear. When a child is too small, an adult does it with the help of a fingertip. Children 3-4 years old can be taught to clean properly with the help of plaque detection indicators. These are chewable tablets, lozenges that stain plaque blue or red.
Thin dental floss will help to remove plaque between the teeth and under the gum. Some complain that it injures the interdental papillae. In this case, you can use interdental brushes. The irrigator allows you to brush your teeth even better. Especially it is 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 it is done under local anesthesia. If the doctor refuses to give an anesthetic injection, do not agree and go to anotherspecialist. A good doctor will never stress a patient.
