Our Blog

Gettysburg Emergency Dentist discusses treatments

Posted by Peter Samuels on Tue, Feb 26, 2013 @ 19:02 PM

 

 

Gettysburg Emergency Dentist

 

What is a dental emergency?

Well that could be different things for different people!  When we watch glamerous TV emergency medicine shows we think of life threatening , every second  is critical, heroic action.  Nurses and physicians rush to gather data and make a diagnosis.  Specialists are consulted.  Bleeding is stopped.  Hearts are restarted.  Patients are stabilized. 

“I have a cosmetic dentistry emergency!”

A broken tooth, right in the front, would constitute an emergency for most of us.  A fractured veneer or porcelain crown would keep most of us from facing the public or going to work.  Quick work with composite bonding usually provides, at least a temporary emergency fix.  The tooth is etched with a mild acidic solution, a bonding agent is applied, and plastic resin can artfully be sculpted to replace the broken parts.

“I’ve been up all night with a toothache.”

Pain, unfortunately, is the motivator for many people to visit an emergency dentist.  Now we are dealing with a medical problem as well as a dental one.  As a matter of fact, many toothache problems are treated in the emergency room.  Pain from an infected, abscessed tooth can land you in the hospital and can even be life threatening.  Just as with any other medical problem a diagnosis must be made.  Sometimes it’s simple. “This is the tooth, doc.  It hurts when I bite on it and I’m swollen.”  An x-ray often shows a dark area under the root where the infection has spread to the bone.  Pain comes from a buildup of pressure.  Treatment involves draining and treating the infection, then  root canal treatment or extraction of the tooth to keep the infection from returning.

But not all toothaches are so straight forward.  “It hurts on the left side, Doc.  I can’t tell which one.”  This can be a challenge to figure out.  First of all the emergency dentist needs to put on his medical cap.  Is the pain from a tooth are something completely different?  Did you know that jaw pain can be the first sign of a heart attack?  More commonly, sinus problems can mimic tooth pain. TMD (jaw Joint pain) can also cause jaw and facial pain. If it is from a tooth, which one and why?  Sometimes the offending tooth can be identified by tapping (percussion)  A tooth with an inflamed pulp will often be inflamed in the ligament surrounding the tooth.  Tapping pressure pushes on the inflammation and causes pain.  “That’s’ the one, Doc!” Now we have to have a diagnosis.  Is the pain reversible with a sedative filling?  Is the tooth cracked?  Is it so deeply decayed that root canal treatment is necessary to relieve the pain?

“I bit on a pretzel and broke my tooth.”

Hard pretzels do bring be a lot of business!  Often a cusp will break off on a tooth already weakened by a large filling.  If the filling is old and leaky and bacteria has found a way to get underneath, the tooth structure becomes soft and it doesn’t take much to snap off a cusp.  If the tooth isn’t cracked down the root or broken into the pulp the fix is usually straightforward; a temporary filling for now and a return trip for a porcelain crown to protect the tooth.

“My little girl fell off her bike and knocked out a tooth.”

This one requires quick action.  If it’s a permanent tooth that came out (was avulsed) try to get to the dentist within thirty minutes to have it replaced.  There is a good possibility the tooth will reattach.

Whether it’s a “cosmetic” emergency or a life threatening dental infection, your local emergency dentist is here to help!

Topics: Cosmetic Dentistry, Dentist in Gettysburg, Gettysburg sedation dentist, Gettysburg dentist

Gettysburg dentist reflects on teaching

Posted by Peter Samuels on Mon, Feb 18, 2013 @ 10:02 AM

Gettysburg Dentist Peter J. Samuels, DDS

 

Friday is my favorite day.  Not that the other days of the week are bad.  I really do still enjoy my family dental practice, but, for the last few years now, I’ve looked especially forward to Fridays.  There is something neat about handing down almost three decades of experience as a dentist in Gettysburg, PA to a new generation of eager minds.  For three years now I have forced myself, against my groggy will, to rise at the crack of dawn and suffer the unpredictable two hours of traffic to the University of Maryland Dental School in Downtown Baltimore. 

The dental school is a huge, modern complex rising eight floors from its inner city block and standing proudly across from the medical school across the street.  While I never went to the University of Maryland, (I’m a Georgetown graduate), I am proud to call this dental school my adopted alma mater.

As I enter the third floor of the building my charges await me.  The huge, ultramodern clinic floor is broken into sections by specialty: one area endodontics, or root canal treatment;  one area periodontics; treatment of gum disease.  One area is devoted to children’s dentistry. My section is for general dental practice; dental fillings, dental crowns, dental implants, cosmetic dentistry,  etc.;   the bread and butter of my Gettysburg dental practice.  Six to eight third and fourth year dental students line up to present their cases.  These are very bright, but totally inexperienced, dental students eager to sap my mind for the experience and dental wisdom they crave.  For the tens of thousands of dental procedures I have performed and could now do in my sleep , they have done, at most, ten!  For the thousands of patients, each with their own unique personalities, medical histories, and nerve anatomies, that I have come across in daily practice as a Gettysburg dentist, they have seen but a handful. 

One by one the students present their cases.  Medical histories can be involved and complicated.  Is it safe for this patient to undergo routine dental treatment?  Has a medical consult been ordered? Which local anesthetic is indicated and why?  What do the x-rays tell us?  What are the indications and contraindications for the proposed treatment plan? What are the choices of materials to be used? 

Once the pre-op discussions are complete it's time to begin.  Sometimes shaky, novice, student hands need my guidance and a little encouragement.  How well I remember the first time I ever injected a patient with local anesthetic!  Over the years I’ve learned how to give a virtually painless injection and I mentor the students in the technique.  I teach them all I can about conservative, modern dental treatment.  I stress the importance of treating the whole patient, not just the tooth.

Three hours later the morning clinic session is over.  With prodding, encouragement, and often a little hands on help the procedures are completed and signed off.  The appreciation of my students for my help more that makes up for the two hour city traffic retreat back to Gettysburg.   I thoroughly enjoy my “day job” as a family and cosmetic dentist in Gettysburg, Pennsylvania,  but I have to say teaching family dentistry one day a week refreshes the spirit and is good for the soul!

Topics: Dentist in Gettysburg, Gettysburg sedation dentist, Gettysburg dentist

A day in the life of a Gettysburg Dentist

Posted by Peter Samuels on Mon, Feb 4, 2013 @ 16:02 PM

Gettysburg family and sedation dentist, Peter J. Samuels, DDS 

 

 

What is it like to be a dentist in Gettysburg?  What is the typical day of a Gettysburg dentist?  Well, here's what this family dentist did today.

The day began with Maia.  Maia’s blue eyes welled with tears.  The dental chair dwarfed her tiny, seven year old body.  She clung to my assistant’s hand as she looked over all the strange “tooth ticklers” and squirmed nervously.  “My big brother said it’s gonna hurt real bad, but my mommy said it wouldn’t be worse that a bee sting.” 

“Oh my”, I thought.  The family had already set the stage for a bad experience. This was going to take all my children’s dentist chairside skills!  Well, we turned it all around and Maia had a great experience.  Her first cavity was bonded with white, composite filling and she bragged to her mom that she never felt anything at all!  We sealed the permanent molars and spent some time showing Maia how to brush and even floss so she will, hopefully, never have another cavity in her life.

Mrs. Wolfe was already in the next room.  A new patient, she had called first thing this morning in pain, hoping we could work her in.  Her jaw was swollen to the size of a golf ball on the lower right and she looked exhausted from lack of sleep.  A quick, digital x-ray showed the culprit.  An abscessed, lower right molar.  I hate to blog gross, but a quick, small opening in the top of her dead tooth allowed a back pressure of pus to drain and almost instant pain relief followed.  Mrs. Wolfe was a happy camper and so was I.  The ability to immediately relieve pain is one of the most rewarding aspects of life as a Gettysburg dentist.  Time for a course of antibiotics and a trip back in a week or so to go over some long term options.

Beep…beep..beep… the heart monitor called out its rhythm as our anesthesiologist provided his expertise in our dental sedation room.  Sandra was meticulous about her health, but when it came to her teeth,  her bad, childhood, dental  experiences had left their mark.  She hadn’t been to a dentist for 20 years before seeking us out for sedation dentistry.  I remember when she first came in.  A grown woman of 45, she had cried before we even examined her mouth.  She tried to rationalize her fear, but she simply could not.  Sandra lay quietly sedated in la la land as my team and I worked for three hours repairing  years of dental neglect.  She smiled at the end with pretty, new front teeth and whispered, “That felt like I was in the chair for five minutes!”

Lunch, for me, is more of a power nap time that an eat time.  A time to recharge.  I looked over the afternoon’s schedule.  At two I would make a porcelain cap for Carmen’s upper lateral incisor.  Carmen was 62.  She’d broken her tooth in a bicycle accident when she was 11 and it had been down hill since.  After years of patching it had finally given up the ghost and broken off at the gum-line.  Luckily, dental technology had improved since Carmen’s accident.  We had replaced her tooth with a titanium dental implant anchored in the jaw several months ago and today we would make the final, beautiful, all porcelain crown that goes on top.  From three feet away,  no one would be able to tell it wasn’t her real tooth.

Three o’clock , a Cerec , in office, computer  cad cam created porcelain crown and bonded, composite fillings.  Four o’clock, two orthodontic patient checks.  One had Fast Braces on, and it was always fun to see how much her teeth had moved since the last visit.  The other, preferring no visible wires,  was wearling Invisalign aligners.

There is more.  In between  procedures I’ll be checking  the progress of our periodontal therapy patients as they work with the hygiene department.  Periodontal disease is one of the most widespread infectious diseases and the most common reason for tooth loss.  It has been implicated in heart disease, diabetes, and even dementia.  Treating and controlling gum disease is one of the most important jobs of the modern, family dentist and it is important healthcare.

The day in the life of a Gettysburg dentist is sometimes hectic, sometimes stressful, often rewarding, but never boring!  I honestly look forward to tomorrow.

Topics: gettysburg sleep dentist, Gettysburg sedation dentist, Gum Disease, Gettysburg dentist

Follow Me