Making the “impossible” possible through Sedation Dentistry
BIO: Being both a dentist and board-certified anesthesiologist, Dr. Lichtenstein created and developed his sedation dentistry office in Holmdel, NJ to incorporate the facilities of a hospital operating room in a friendly, pleasant, private office setting. He and his highly trained staff offer general dentistry services as well as dental treatments that can be performed using sedation dentistry and general anesthesia techniques to make their patients’ experiences more pleasant and comfortable.
What sets your dental practice apart from others?
In addition to over 20 years experience, THE most important thing that sets me apart from all other dentists doing “sedation” is – I did a full hospital based residency program in anesthesiology. I am an anesthesiologist.
(I spent 80 – 90 hours per week in hospital, mainly OR, as as well as critical care areas (ICU, CCU, PICU, ER) and outpatient treatment sites.) Patients choose my practice because I have a full training background in anesthesiology, with state-of-the-art monitoring equipment that other dental offices may not have.
Are there different options available for sedation dentistry?
Sedation for dental procedures in our office provides several options and depends on what works best for each individual. It can be as simple as talking to a patient to reduce anxiety, and the use of nitrous oxide (“laughing gas”). The next level is the administration of Valium-like drugs orally. The next level is intravenous medication for moderate conscious sedation. General anesthesia is the deepest level on the continuum, its administration reserved for practitioners with the highest level of license. The use of general anesthesia is reserved for patients with the more difficult issues. The higher the level of sedation needed, the more training the dental professional needs to have.
What kind of patient benefits from sedation dentistry?
Really, any patient who wants to have a more relaxed and comfortable experience when they have dental work done can opt for some level of sedation. There are people who are afraid to have the needle for the Novocain local anesthetic, and those for whom the usual doses do not numb the mouth sufficiently to block the pain. Any patient who has anxiety, fears, or phobias that render them reluctant or unable to seek out the dental care they need can be helped by sedation dentistry. Little children often can’t understand what is happening at the dentist, so it’s hard for them to sit still and cooperate. There are also a whole range of people with other special needs who are able for the first time to access regular dental treatment at our office.
Are there other types of special needs do you accommodate?
We feel that no one should be forced to suffer poor dental health because of a disability or disorder. There are a wide range of conditions that we accommodate, including neurological disorders like Parkinson’s or epilepsy that can cause tremors or seizures. Individuals on the autism spectrum or those with Down’s Syndrome may not understand that the dentist is here to take care of them, so sedation helps to calm their fears and give them an easier and more comfortable experience. Similarly, with Alzheimer’s and dementia, decreased reasoning capacity can keep the patient from cooperating. When the patient is asleep, the dentist can do the work that the patient needs.
Can you talk about your practice philosophy?
The mainstay of my practice is restorative dentistry. I want to fix and save the natural teeth whenever possible. We do root canal therapy, whether conventional or surgical, oral and periodontal surgery, and place and restore implants with the least discomfort to the patient. Sedation allows for work to be done on multiple teeth at the same appointment, even for the patient who can’t sit in a dental chair or keep their mouth open for extended periods. Our objective is to maintain a healthy mouth and teeth, so that every patient is able to speak properly, eat without discomfort, and flash a winning smile.
From performing regular exams to full-mouth reconstruction, your dentist plays a key role in maintaining your overall health. Good oral and dental hygiene can help prevent bad breath, tooth decay and gum disease, and can help you maintain or replace your teeth as you get older. Researchers have discovered that good oral health can help ward off serious medical disorders such as heart disease, stroke, diabetes and even preterm labor.
Establish an Oral Health Baseline
“Adults should have a dental exam and cleaning twice yearly,” says Dr. Joseph P. Prasad D.M.D., M.A.G.D. “It is very important to establish your oral health baseline,” he explains. “Your dentist should perform a complete oral examination, including an oral cancer screening, a periodontal evaluation, an analysis of
your bite, and a thorough examination of your teeth, their supporting structures, and of the oral anatomy.”
“Regular cleanings by a dental hygienist will help prevent new cavities, preserve teeth that have been restored, and manage periodontal disease,” says Dr. Prasad. “If you haven’t visited the dentist in a while,” he adds, “schedule an appointment soon.”
Technology-Driven Patient Care
Technology is contributing to more beautiful smiles for patients of all ages. “Orthodontic practice is embracing the future of technology in dentistry,” says orthodontist Dr. Patrick Cuozzo. “One great advance is using 3-D printing to create in minutes customized orthodontic models for clear aligners, precise surgical guides and more, which can be done right in the orthodontist’s office.”
After a digital impression has been made, the data is fed into a computer program and a 3-D printer produces a model on the spot. “State-of-the-art 3-D printing is just one of the technologies available to streamline patient care without sacrificing accuracy and precision,” says Dr. Cuozzo.
Accelerated Orthodontics: Faster Orthodontic Treatment with Less Discomfort
“For anyone considering orthodontic treatment, the first question is always ‘How long will treatment take?’” says Dr. Tara Gostovich.
“The goal of an emerging school of treatment called “Accelerated Orthodontics” is to shorten the time in orthodontic appliances and treat the patient with less discomfort,” says Dr. Gostovich. “Almost anyone is a candidate for accelerated treatment, but it is perfect for those who have a special event in mind, such as a wedding or the start of a new job.”
“Today’s surgical and non-surgical accelerated orthodontic treatment options painlessly stimulate the movement of teeth into proper alignment in less time,” says Dr. Gostovich. “These accelerated treatment options can be used in combination with current orthodontic treatments such as braces or clear aligners to reduce treatment time by as much as 50 percent.”
Prosthodontists: Architects of the Smile
Not all dental care is preventative. Some conditions require the advanced care of a prosthodontic specialist. Sometimes called the “architects of the smile,” prosthodontists are primarily concerned with the restoration and replacement of lost or damaged teeth with implants, dentures, bridges, crowns and other restorations.
After graduating from college and completing four years of dental school, prosthodontists receive an additional four years of advanced graduate training recognized by the American Dental Academy. These specialists are highly familiar with all the elements that go into a beautiful, functional and naturallooking smile—not just the teeth, but also the gums, lips, and facial features.
“Dental reconstruction because of trauma, disease and congenital disorders can sometimes require several steps, including bone grafts, implants and orthodontic therapy,” says prosthodontist Dr. James Courey. “The prosthodontist puts the plan together and sequences other dental specialists. By collaborating with dental professionals in other specialty areas, we can ensure the best possible outcomes for the patients we serve.”