All Posts tagged dentistry

Dental Anesthesia: Its Not Just Shots Anymore!

 dentist with dental anesthesia needle

I Hate Shots. I Wish That You Would Have Something Else!

Many years ago, just the opposite was stated. Dental anesthesia simply didn’t exist! There was really nothing to numb or deaden a tooth so it could be treated. The first local anesthetic used was actually cocaine. It worked but of course, it was addictive and toxic. It wasn’t until the beginning of the last century that our famous Novocaine came on the scene. In fact, it was so popular that many people today use the word to mean a local anesthetic.

Pain-free dentistry is now a reality!

We really don’t use Novocaine anymore in dentistry as it has been replaced by better anesthetics with fewer side issues. These newer products give better numbing, which we call “anesthesia” and work quicker. It would be an understatement to say that local anesthetic has revolutionized dental care. We can now perform a variety of procedures, whether simple or sophisticated with the patient being totally pain-free.

Before local anesthetic, the only treatment available was the removal of a troublesome tooth and of course was not a pleasant experience for any one. The ability to numb a tooth has led to more people keeping teeth for their entire lives, rather than being toothless in their twenties. So that’s great! We can do a dental procedure in a pain-free environment using a local anesthetic. The problem with this from the patient perspective is how we have to administer it. Of course, I am referring to the dreaded shot.

What is dental anesthetics?

Let’s talk a little about this. The method of action of a local anesthetic is to bathe the nerves that transmit sensation from the tooth to the brain in this numbing liquid. When the nerves come in contact with the solution they shut down and no longer do their job of sending a pain signal. This closed for lunch sign is effective until the anesthetic leaves the area of the nerve and sensation comes back to the tooth.

Different locations of the mouth have different requirements for giving the anesthetic. For the upper teeth, it is given one way. For the lower teeth, it is given another way. The upper jaw is much more porous than the lower jaw. Therefore, simply placing the anesthetic under the gum next to an upper tooth will cause the tooth to numb. The lower jaw is much denser and if you put anesthetic next to a tooth it will not penetrate the jaw and reach the nerves of the tooth. To numb a lower tooth, you have to find the nerve that supplies the entire side of the mouth and numb that. That is why we numb the back of the mouth when we work on lower teeth even though we may be working more towards the front of the mouth.

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Did you know? There is now a nasal spray dental anesthetic!

The human body is a marvel of complication, sophistication, and crossovers when it comes to its various parts. Because of this, we now can actually numb many upper teeth without a shot. Yes, that is not a typo! We DO NOT need a shot for a number of upper teeth. Just last year the FDA approved a product called Kovanaze for use in dentistry for upper teeth. The product is a nasal spray that is given prior to performing dental work. It can numb the upper front teeth without the side effect of numbing the lips and cheeks. It is not for all teeth, but one of the most sensitive injections is in the front of the mouth. With this nasal spray anesthetic, those days are history.

Topical dental anesthetic for pain-free cleanings

Many people are sensitive to having their teeth cleaned. Because of this, they skip their very important dental cleanings and checkups and only come when it is too late. I use another product which can be squirted around a tooth without the use of a needle to numb the area. This can make your cleaning totally pain free.

Unlike the nasal spray, I can use this any place in the mouth. It doesn’t make a difference if it is an upper tooth with its porous jaw or a lower tooth with a dense jaw. This product simply works without having to use a shot. This product is called Oraqix (pronounced Ora-Kicks) and I have used it for a number of years to make routine procedures more comfortable and easier. When you are at ease, our work goes faster and is done much better. It is a win-win for all involved.

Today, Dental Anesthesia does not have to mean shots

So although needles have not left medicine, and dentistry, in particular, there are a number of innovations that work towards my goal in interacting with my patients. That goal is providing the best care with the most comfort. Needle free anesthesia is an example of that approach and desire. If these or other dental topics are intriguing and you want to learn more about new techniques and products, please call me. I can be reached at 440.951.7856 and look forward to hearing from you.

One of the best ways to learn about the latest in dental care is to register and attend my next educational seminar which is open to the public. It will take place on Thursday, August 24, 2017. It will be at my office on Lakeshore Boulevard at 6:00 PM. Call our office to register.


Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.


There’s no Such Thing as a ‘Dental Implant Specialist’

Smiling dentist looking and pointing up to the side

Should I see a specialist for my dental implants?

Do I need a separate dental implant specialist to have my implants done?  This is a question that is asked to me periodically. The most recent occurrence of this question happened 2 weeks ago. Let me add, parenthetically, that the question is usually asked to me by a new patient. Once a patient becomes part of the practice, he or she is usually comfortable with the wide array of services that our office can provide.

Let me get back to our question and relate to you what happened. I was outlining a treatment for a new patient. The treatment included dental implants, removal of teeth, crowns, a full denture and a partial denture. We had discussed various options for a number of appointments. As always, I make the patient a partner with me in the ultimate plan. I inform and educate. Together we create a plan that works for that patient in that circumstance. After a number of discussions, he asks me the specialist question.

How specialties operate in dentistry

Before I answered him, I needed to explain how specialties operate in dentistry.
To be called a specialist, you must practice one of the dentistry’s recognized specialties. Periodontics which involves treating the gums, endodontics which treats root canals, oral surgery which involves tooth extractions and more. Lastly, orthodontics, the discipline that helps to straighten teeth is another specialty. These are all recognized specialties by the governing bodies of dentistry. Governing bodies are state boards and national societies. You can’t just take any procedure and call yourself a specialist. You will be taken to task by state dental boards. Most dental specialists limit their practice to their specialty. This is why if you see a root canal specialist for a root canal procedure, you will need to go back to the general dentist to place a filling or crown over the hole that was made to do the root canal.

Technically, there is no such thing as a ‘dental implant specialist’

So now let’s go back to our question from my patient. The answer is simply that implant dentistry is not a recognized specialty in the United States.
The American Dental Association (ADA) has not established implant dentistry as a specialty. Some professional dental organizations offer “credentials” in implant dentistry for their members, who often promote their expertise using these credentials. However, none of these credentials are recognized by the ADA.
As such, no dentist is a “dental implant specialist” per se.

Now there are specialists such as oral surgeons or periodontists that place implants, but they are not “dental implant specialists”. In fact, if either of these types of doctors places an implant you have to go to another office to finish and put a crown on the implant. This is what I hear from so many patients who don’t like bouncing from office to office. Dentists who do the entire implant case for a patient from start to finish have been referred to as an ‘Implantologist’. Going by that unofficial and casual definition, my credentials and work fit into that category.

Planning and executing your implant procedure from start to finish

As a patient would you like to go from office to office to get your implant procedure completed? Starting it by one specialist and following up at another? Of course not! I find it very stimulating for me to plan and execute a case from start to finish. When I place an implant, I know what it will be used for and can control the placement to accommodate the final result. In cases where issues may arise, I can apprise the patient when it happens and then deal accordingly so the final result is not changed or if need be, altered in the least way possible. My patients always appreciate me staying on top of their treatment. You also benefit from getting the entire procedure done by one doctor – me.

Having years of experience is a huge advantage

When it comes to dental implants, having years of experience is a huge advantage, especially for my patients.
I have been placing and restoring dental implants since the early 1990’s. Besides teaching graduate students, I am now proud to say that I am associated with Northeast Ohio’s first implant company – Zuga Medical located in nearby Beachwood, Ohio. As their head trainer and instructor, I instruct licensed dentists in the discipline of placing and restoring dental implants using the Zuga Implant System. I present theory and science to these doctors. I follow this with live patient treatment while they watch the procedure.

If a picture is worth a thousand words, then these demonstrations must be worth over a million words for these doctors. This is so rewarding for me as I can share my many decades of knowledge with many of my colleagues. This allows more patients in our local area to benefit from one of the most exciting advancements in dentistry in many years.

In Conclusion

If you are contemplating dental implants and would like to find out more about this exciting aspect of dentistry, please feel free to call me at 440-951-7856 and allow me to share in creating a healthy mouth for you to enjoy for years to come. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.