Does the idea of going to the dentist make your heart skip a beat? It used to be the case that dentists worried about how routine visits could do more than that to your lub-dubbing ticker, but that was twenty-five years ago. Back then, patients with heart conditions such as murmurs or irregular heartbeats going in for a routine dental visit were asked to take an antibiotic a day before, and then again two days after those visits. Have times changed? Any scratch on your skin or gums, even a very small one, can lead to viral or biotic germs entering the blood stream, and that can be critically serious, especially for those of advancing years or compromised immune systems. Under normal conditions the body will take care of germs without any trouble, but it’s entirely possible for germs to get into the blood stream and infect the endocardium of the heart causing a condition called infective endocarditis, which is fatal in about 25% of cases, by some estimates.And it isn’t just limited to “going to the dentist”, but the very infection that may already have taken up residence in your gums, cavities or beneath an ill-placed filling may already be sending out sentries looking for a buck so grand to fell as your heart.  So can antibiotics help or hurt? Most of the retrospective studies published to date have shown the cons of taking antibiotics outweigh the advantages, with the onset of diarrhea, allergies and other side effects. Basically this means that it’s so incredibly unlikely that a healthy person would require them, that the only notable outcome from taking them is the side-effects.If you have artificial heart valves, a history of heart infections or problems with blood flow in the heart, you should still talk very seriously with your dentist about the possibility of using antibiotics pre and/or post-op.

If you want to get technical, fluoride is the reduced form of fluorine. Both organic and inorganic compounds containing the element fluorine are considered fluorides, for what it’s worth. As a halogen, fluorine forms a monovalent ion (−1 charge). The range of fluorides is considerable as fluorine forms compounds with all elements except He, Ne, and Ar[citation needed]. Fluorides range from severe toxins such as sarin to life-saving pharmaceuticals such as efavirenz and from refractory materials such as calcium fluoride to highly reactive sulfur tetrafluoride.

Alright, now that we’ve got all that out of the way, let’s take a quick stroll through the history of it.

1909 - Colorado Springs dentist Frederic K. McKay asks the US dental community to help him find an explanation for the “Colorado brown stain,” or “Texas Teeth,” a discoloring of teeth common to the Pikes Peak area. Though residents’ teeth are mottled and discolored, they have far fewer cavities than typical, which is cause for question.

1927 - A dentist in Bauxite, AR, reports extensive staining of residents’ teeth. The town gets its water from a deep well near the site of an aluminum mine; fluoride is a waste by-product of aluminum mining, but the answer isn’t quite clear just yet.

1931 – Using a new analysis on the Bauxite well water, a chemist finds high concentrations of the naturally occurring substance fluoride. McKay hears about the test and sends water samples from other cities. McKay and others eventually determine that fluoride causes the staining but none speak out yet about the prevention of tooth decay.

1939 - Researcher Gerald J. Cox at the Mellon Institute in Pittsburgh releases results from a rat study (showing healthier teeth) to support his recommendation that water be fluoridated.

1942 - The National Institutes of Health publishes a study of 7,000 children which shows that fluoride at 1 part per million in water is enough to minimize tooth decay without causing discoloration (or dental fluorosis, as it’s now called.)

1945 - Federal scientists choose four pairs of cities for a 13- to 15-year study of fluoridation: Grand Rapids and Muskegon, MI; Newburgh and Kingston, NY; Evanston and Oak Park, IL; and Brantford and Sarnia, Ontario. Grand Rapids becomes the first city in the world to have fluoridated water.

1951 - Muskegon, the comparison city for Grand Rapids, begins fluoridating its own water supply. Communities across the country join in, well in advance of any published results of the four-cities studies.

1955 - Procter & Gamble introduces Crest, the first fluoride toothpaste endorsed by the American Dental Association.

1990 - As part of its “Healthy People 2000″ plan, the CDC sets a goal of getting fluoridated water to 75% of Americans. Then, as now, roughly two-thirds have treated water.

Whether you live in a fluoridated water area or not, the evidence is pretty, well, evident. Fluoride will harden enamel and prevent tooth decay in modest doses. If the dosage becomes too high, the worst possibility is that a patient may need to consider a switch to a tooth-whitening formula of toothpaste.

Regardless of your age, you should ask your dentist about the benefits of a fluoride treatment. Who knows, the tooth you save my just be your own.

Sedation dentistry promises an experience most memorable because of how perfectly forgettable it is, but some experts have concerns about safety. If you hate having dental work done, this may be just the thing you’ve been waiting for to get your crowns done, your fillings filled or your otherwise miserable experience (by your estimation, not ours) over with before you even know it’s begun. For many, the very experience of going to the dentist is the sort of thing of nightmares. Many don’t feel this way, but for those who do, it’s a very real emotional experience, and one that simple words can not mitigate.  You might put it off and put it off, and once it’s time to go the ramifications have crept up on you with a vengeance. Where you might have had an uncomfortable cleaning and a filling or two might now be a deep cleaning, four fillings and a crown. Can you deal with sitting in the chair for a solid hour or two with the drill whirring away as it breaks through your enamel, or worse still, an existing filling, just to get to the decay that lies beneath?As a teenager, I discovered a mediocre coping mechanism. I brought my Sony Walkman in with me and blasted School of Fish at top volume in vain attempts to drown out the drill. It wasn’t a perfect system, but it was what I had, and it almost did the trick. Still, the experience is palpable in my memory even today. But what if there was a way to experience less than that. Sure, the rock and roll is gone, but what if also could be gone the sound and the emotional experience of sitting in the chair? I drove a few friends home after having their wisdom teeth extracted, and all they suffered was a bit of groggy head from it. Why did they fare better from surgery than I did from a filling?

Turns out my question wasn’t as singular as I had suspected, and the answer was that much easier still… It’s called Sedation Dentistry, and not every dentist is in a position (in terms of safety, legality or qualification) to do it, but many are. At Dental Care Design, we are DOCS Certified, which means we are fully trained, certified and entirely ready to perform sedation dentistry. Sit back, relax, and wake up a few minutes later with the whole procedure behind you, regardless of what the procedure might have been.It’s also sometimes called oral conscious sedation, but it’s more commonly referred to as sedation dentistry. It’s easier than you can imagine. All you do is take a sedative pill like a Halcion an hour before your dental appointment, you know, to help you relax. When you get to the office, you may get more pills, depending on how well the first one worked on you and your metabolism. Imagine being oblivious to whatever it is that goes on while you’re sitting in the dental chair. That is the beauty of the approach. The next thing you know, you’re back home.

The American Dental Association (ADA) doesn’t have a problem with dentists administering a single dose of Halcion or similar drugs like Valium, but they do caution against multiple doses that could potentially give patients too much of a drug, causing them to be overly sedated — possibly even unconscious. The safety and success rates are as high or higher than that of any elective surgery, and it comes as no surprise. The event that’s being blanked out is not major surgery or honestly anything that couldn’t be weathered by bearing down, grinning and bearing it (if only grinning was possible). In most cases, it is not a general anesthesia (requiring an anesthesiologist or certified nurse anesthetist) but rather just a simple sedation to take the patient to another place for the duration of the procedure.In many cases sedation dentistry is covered by existing dental insurance plans, and when it isn’t, it’s very common that the extra cost can either be absorbed by the dental provider or paid out of pocket without any negative impact to the insurance payment policy. And let’s be honest, when it comes to the unprecedented comfort afforded by the luxury of opting to sit out your next dental visit, is there any price you wouldn’t pay?