Opioids in Dentistry: What You Should Know

2020-07-16T16:59:31+00:00August 28th, 2018|Dental Insurance, Dental Trends, General|

Have you ever been afraid of going to the dentist? Whether your fear is based on prior bad experiences or the potential for pain, you’re not alone.

However, many dental patients express a different fear regarding dental pain: potential addiction to prescribed pain treatments. Opioids are a type of narcotic pain medication often prescribed after major dental procedures. Opioids work by reducing pain signals to the brain. They are very effective in treating pain; however, they also carry a risk of addiction.

Opioid abuse and overdose has been an increasing epidemic across all ages, genders, and classes in the United States. A stunning national statistic reveals that although the U.S. represents 5 percent of the world’s population, it consumes 80 percent of the global opioid supply. According to the NC Department of Health and Human Services (NCDHHS), from 1999 to 2016, more than 12,000 North Carolinians died from opioid-related overdose.

Fear of opioids or opioid addiction creates a tricky situation for patients who might be wondering, “How is my dentist going to make sure I am not experiencing pain or suffering, while also avoiding addiction to the pain medications prescribed after dental procedures?’ At Carolinas Dental Choice we make sure to work with you to safely manage your pain.

What are opioids?

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others, according to the National Institute on Drug Abuse. At first, opioids produce feelings of pleasure or euphoria. After repeated and prolonged use, the brain develops a tolerance towards its effects and begins to crave the pleasure-inducing effects, despite becoming less susceptible to the actual pain relief of the drugs. 

How addiction to opioids starts

Opioids are very effective in treating pain, especially when someone is in high pain and needs immediate relief. Often, and unfortunately, addiction may be an unforeseen result of a legitimate need for pain treatment. Opioids like morphine, codeine, oxycodone, and hydrocodone are highly addictive and lead to physical dependencies.

Opioids are prescribed for short-term pain management and aid in treating severe pain. Opioids used over a longer period become less effective, which may drive the urge to take higher doses in order to achieve the same effect as when the medication was first started.

What does addiction to opiates look like?

• Using drugs past the prescription or initial pain treatment
• Becoming tolerant and needing the drug more often
• Having withdrawals from the drug
• Strong desire or urge to use the drug
• Continuing use despite financial, legal, or social problems

Once the opioid is stopped, withdrawal symptoms can include muscle and bone pain, insomnia, diarrhea, vomiting, cold-flashes, and more. To lessen the chances of withdrawal take any prescription as directed and plan to taper down doses. Your doctor can help you create a plan to safely reduce your medication use while managing your pain.

Opiates at the Dentist: What’s the problem?

Dentists are the second highest prescribers of opioids in the U.S. Over the past few years however, opioid prescriptions from dentists have been in decline. On average, dentists prescribe three days worth of opioids to their patients, aiming to only administer the lowest-potency opioids for short periods of time for conditions associated with severe pain.

Procedures and conditions that call for opioid prescriptions can range depending on the patient’s pain tolerance and preference, but most commonly include:

• Wisdom teeth surgery
• Tooth/Molar extraction
• Dental infections
• Surgical trauma

The American Dental Association announced new policies to combat the opioid epidemic in March 2018, which include continued education in prescribing opioids and other controlled substances, and statutory limitations on opioid dosage and duration of no more than 7 days for acute pain.

Manage pain responsibly

There is a no one-size-fits-all for treatment, so talking to your dentist to determine what course of action is best for you is a great place to start. At Carolinas Dental Choice we encourage you to update your dentist on your health history, share what medications you might be taking, and disclose if you or someone in your close family are in recovery or have struggled with addiction in the past.

We want to have a conversation with you to answer these questions:

• What is the goal of this prescription?
• At what time and when should I take these?
• How long should I take these drugs?
• Are there risks from this medication?
• What do I do with any extra medication?

Dentists and patients alike need to be on the same page about the perception of pain for these dental procedures, as well as what realistic expectations are for their pain treatment. The goal of pain management is exactly that — management not magic. Often patients may expect to feel absolutely no pain after procedure and anxiety about pain can actually contribute to feeling it. Experiencing a little bit of pain is okay. It will help you keep track of whether something actually hurts and needs treatment or you are continuing to take a medication out of habit. Only treat your pain to the point that it is manageable and does not interfere with your quality of life.

How to treat dental pain without opioids

Opioids are not usually dentists’ first choice to send home with patients. The alternatives to opiates include familiar medications. Over-the-counter pills can be just as effective for controlling pain, and safer, as they are nonsteroidal anti-inflammatory drugs (NSAID).

In a recent study by The Journal of the American Dental Association, the most effective pain relief with the fewest side effects is 400 milligrams of ibuprofen with 1,000 milligrams of acetaminophen. They also found that this combination is more effective than any other opioid or opioid-containing drugs. Most patients can find pain relief with a combination of Tylenol and ibuprofen, or even aspirin, which are easily accessible and inexpensive.

Patients should keep in mind that unlike opiates, the over-the-counter drug combinations may not work as instantly to relieve pain—but, when used correctly and consistently, these NSAIDs will relieve pain as effectively. At Carolina’s Dental Choice we recommend other pain relief measures such as hot or cold compresses, topical numbing gel, and comforting things such as taking a shower or bath, meditating, or distracting oneself with a favorite activity.

Most people associate major dental procedures with some lingering pain, sensitivity, and discomfort. But if you’re experiencing excessive pain post-dental procedure, don’t hesitate to contact us. Your dentist may recommend an additional evaluation, or develop an alternative pain management plan suited for you.

Struggling with an addiction? Get help. 

Various treatment options and resources are available to help people with addiction. Your primary care doctor, dentist, or any other health professional can help assess the situation and recommend treatment options.

Other useful resources centralized in NC include:

The Alcohol/Drug Council of North Carolina

Carolina Healthcare System #ThisisSober Campaign

North Carolina Council of Community Programs – Treatment Services Guide

Recovery Communities of North Carolina

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Where Did The Tooth Fairy Come From?

2020-07-16T17:01:03+00:00March 31st, 2018|Carolina's Dental Choice, Dental Trends, General|

Do you remember the excitement of losing your baby teeth as a kid? Maybe even sticking your tooth under your pillow for the Tooth Fairy and waking up to a fun surprise. The Tooth Fairy makes losing teeth so much more exciting and helps children overcome any fears they have when teeth start falling out of their mouth. But where did this tradition come from? Carolina’s Dental Choice wants to share the story of the Tooth Fairy with you.

Each magical figure, like Santa Clause, the Sandman, and the Easter Bunny, has a story and reason that we love them. These stories are all interesting and are so different in many widespread cultures. Everyone’s traditions are all unique and the way people celebrate them make it fun and create charitable moments.

Where does the tradition of the Tooth Fairy come from?

The Tooth Fairy is an old, ancient, mythical figure from western folklore. The tradition began in Northern Europe by the Old Norse. They would reward children for the first tooth they lost. The tradition formed to help children escape the fear of losing teeth and replace the feelings with excitement. The myth goes as follows: children would lose their tooth and tuck it under their pillow at night. Once the child was fast asleep, the Tooth Fairy would fly in, collect the tooth, and in exchange leave the child a small gift or money. This tradition goes back to as early as the beginning of the 20th century.

Before the Tooth Fairy tradition, people did not celebrate teeth in quite the same way. Some actually feared teeth or thought that teeth could bring hardships or even cures. In the Middle Ages, people thought that teeth would bring bad experiences in the afterlife and that they would be searched for after death. To save children from future hardships, they would burn the teeth. Others burned their teeth out of fear that witches would find them and with the tooth, they could control them.

The Tooth Fairy myth came about to distract the fear of losing teeth. Children can be scared when it comes to teeth falling out. They may think that it will hurt or have fears that they won’t be able to eat or speak normally. Many are afraid that their tooth will never come back and that all of their teeth will just fall out. The Tooth Fairy tradition helps alleviate the fear of losing teeth and replaces it with a fun and exciting tradition that leaves children waiting for the fairy.


What does the Tooth Fairy leave in place of the tooth?

Twenty years ago, the tooth fairy may have left a quarter under the pillow but as with everything, teeth are subject to inflation. On average children receive between one and five dollars per tooth. Sometimes children receive different amounts based on which tooth is lost. Generally, the first tooth children lose is valued far more by the tooth fairy and children may receive a higher amount as a reward. Many warn against giving too much for a tooth, as it could cause problem amongst the child and their friends. Children love to share their encounters with magical figures. Who wouldn’t? But when the stories don’t add up, some might get angry or feel left out. This fun and exciting myth should stay fun instead of having children compare whose tooth was worth more.


When does the Tooth Fairy stop coming?

The Tooth Fairy stops visiting a child when they have lost all of their baby teeth or when they stop believing in the magic. Children begin loosing baby teeth between the age of four and eight. This process continues until a child is around nine to twelve years old. Many children will place every tooth under their pillow: some still believing and others just enjoying the fun in the magic. Others will outgrow the tradition before they have lost all their teeth. If this happens, don’t be discouraged: it is just a part of growing up but they will cherish the memories of the tradition when they are older. Children often stop believing in the magical figures around the same time. So if they have out grown the magic of the Tooth Fairy, be prepared for them to lose interest in the Easter Bunny and Santa Clause soon after as well. When children are around age seven to nine, they are psychologically expanding their mind to begin distinguishing fantasy from reality. They is usually when they begin questioning magical figures. 

Even if the child has figured out the myth, it can still continue in the spirit of fun and tradition. Many children admit that even once they no longer believe, they still enjoy the tradition and find it fun to do with their parents. As long as it’s still enjoyable and you don’t have to lie to keep the children believing, Carolina’s Dental Choice says continue with the fun. Who doesn’t love tracking progress with small rewards along the way? The Tooth Fairy is a great way to keep track of a permanent smile in growth.


Why Carolina’s Dental Choice loves the Tooth Fairy

Here at Carolina’s Dental Choice, we love the Tooth Fairy because it helps promote oral health early on. Children can’t learn about their teeth and the importance of the oral health early enough. Starting good habits and educating children on their teeth early in life will help children carry oral health skills with them as they grow. The Tooth Fairy lightens the introduction to dentistry. For children, visiting the dentist, losing teeth, and keeping up with oral hygiene can be scary, but the Tooth Fairy helps take away from the fear and makes the process of dental growth more exciting, less scary, and fun for children.

To get the most out of the Tooth Fairy while teaching children about oral health, we recommend telling your children that the Tooth Fairy likes healthy and clean teeth. This is a great way to encourage your child to brush their teeth and start building healthy habits. At Carolina’s Dental Choice, we love working with children to help them learn the value of their smile early. Our goal is to help you keep your child’s teeth healthy and will make sure your child leaves our office with a smiling face. Also children are able to earn small prizes for every appointment where they make the No Cavity Club! To make your appointment, call (704) 289-9519.


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Dry Mouth in the Elderly

2020-07-16T17:03:08+00:00September 14th, 2017|Carolina's Dental Choice, General|

Dry mouth syndrome, otherwise known as Xerostomia, is much more than simply feeling parched every now and again. As we age the composition of our saliva changes, and we produce less of it. There seems to be no real cause for this reduction in saliva produced, but it can become a serious problem, one that tends to gradually become worse the older we get. This is why we, at Carolina’s Dental Choice, encourage all our patients who experience dry mouth to come in for a quick check-up. Whether you are young or old, and experience mild or severe xerostomia, it is worth a visit to one of our professionals who can help find a way for you to feel better again.


An Increasing Elderly Population

Thanks to an ever-increasing mortality rate and decreasing fertility rate, America’s elderly population is growing. With a better quality of life comes a richer, longer one. However, there are always two sides to the coin. As our mortality rate continues to grow, we find the need to deal with certain pesky health complications that target the elderly. One in particular, being oral care. Sure, we have found ways to deal with rotting teeth and gum disease. Veneers, dentures, and bridges have come a long way. The practice of restorative dentistry is beyond impressive, just ask any Carolina’s Dental Choice patient and he or she will attest to the wonders of modern dentistry. We can and have done wonderful things for elderly people who find their oral health deteriorating, but one condition that seems to often get missed is dry mouth syndrome. This tends not to be dealt with because most people feel it is one that must be endured. What a lot of elderly people do not know is that dry mouth syndrome can lead to some pretty serious health problems if it is not dealt with. The truth is this is not a condition that needs to be suffered through. For the sake of one’s health and quality of life, dry mouth is something to be taken seriously.


What Xerostomia Can Lead To

Chronic dry mouth can cause difficulty in speech, kill the appetite, and can even lead to cavities and bad breath. In older patients who find their gums beginning to recede, this can be even more detrimental. Dry mouth can affect the exposed area of the teeth, causing them to rot. To add to this problem, taking medication regularly can induce dry mouth. Since the elderly generally take more medication than younger individuals, this directly targets them.

Constant sore throat, dry nasal passages, dental decay, difficulty swallowing and speaking, these all can be a direct results due to poorly produced saliva. Our saliva does so much more than simply lubricate the mouth. One of its most important jobs is to neutralize and rinse away bacteria and acids that are harmful to the teeth and gums. Sadly, as we grow older our mouth produces less saliva, thus leading to xerostomia. This is why Carolina’s Dental Choice takes dry mouth seriously. We know how uncomfortable it can be to have a constantly dry pallet. No one, especially the elderly, should have to suffer through this, which is why we have come up with a few helpful hints for those who are ready to get passed their bouts of dry mouth.

Home Remedies for Dry Mouth Syndrome

If you are tired of constantly having dry mouth there are some pretty successful home remedies you can try. Here are the ones we recommend:

  • This seems a bit obvious, but it’s rather surprising how many people do not drink enough water. According to the Mayo Clinic, older men should drink at least three liters of water a day. Older women should have two to three liters. It’s also important to drink water throughout the day, rather than trying to get it all down in one sitting. By continually drinking water during the day you can help keep your mouth moist and fresh.


  • Sugar-Free Candies. Sucking on sugar-free candy is a great way to temporarily stimulate the production of saliva. Any time your mouth feels dry, pop in a candy. Just be sure your candy is sugar-free, as sucking on sugar can cause tooth decay and continue to dry out the mouth.


  • Sugar-Free Gum. Just as with candy, chewing gum does a wonderful job at stimulating saliva production. Though it is only a temporary fix, chewing gum can last longer than sucking on a piece of candy. Nowadays there are plenty of sugar-free options to choose from, but it’s best to make sure you choose gum with an ADA Seal of Acceptance.


  • Stay Away From Caffeine. This might be the most difficult one to do, but it makes a huge difference. Caffeine naturally dries out the mouth, which will only make things much worse. Choose decaffeinated coffees and teas so you can still enjoy the taste of your favorites, and if you rely on these drinks to wake you up in the morning there are plenty of other options to get you up and moving. A full breakfast, fresh fruit, oats, almonds, these are great ways to wake up. Try eating an apple first thing in the morning. You will be amazed at how well it stimulates. Some even say an apple is more powerful than a cup of coffee!


  • Keep a Humidifier Running. Having a little extra moisture in the air can do wonders to relieve dry mouth. For $50 to $100 you can purchase a nice little humidifier that will keep your room, or even your entire house, free of dry, stale air.


  • Breathe Through Your Nose. As much as you can, try and breath only through your nose, as mouth breathing quickly dries the mouth out. Obviously there are times when you need to breathe through the mouth, like when you are running short of breathe, but when you are resting utilize the nose.


  • Stay Away From Smoke. Smoke, especially from cigarettes or cigars, drastically dries out the mouth. Even just being around those who smoke can cause a reaction. Try your best to stay smoke free, and if you have friends or family members who smoke, kindly ask them to put it out.


  • Use the Right Mouthwash. Rinsing the mouth a few times a day with alcohol-free mouthwash is another great way to keep the mouth moist. Just make sure it truly is alcohol-free! Alcohol is another one that tends to dry the mouth.


  • Floss Daily. Those of us who suffer from dry mouth can end up with periodontal disease due to bits of food and decay stuck between teeth. These bits of food can become dangerous when there is not enough saliva in the mouth to break them down. You can counteract this problem by flossing at least once a day. Morning and night are the ideal times, but if you can only do one, try and floss right before bed. This way you are not sleeping, and possibly mouth breathing, with dirty teeth.


Our last bit of advice is possibly the most important: come see us for a teeth cleaning. Not only will we make sure your teeth are shiny and clean, we can also find additional ways to help your specific case of dry mouth. This way, if you suffer from extremely dry mouth we can advise on some more serious methods to make you happy again. Call us at 704-289-9104, or visit our website: https://adambrown.wpengine.com. See you soon!


By: Andrae Bergeron

Content Writer

CCP Web Design





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Cosmetic Dentistry That Works With Your Lifestyle

2020-07-16T17:23:49+00:00February 6th, 2017|Carolina's Dental Choice, General|


 Cosmetic Dentistry

Looking to improve your smile? Cosmetic dentistry can help bring you confidence through an impeccable smile. Whether you are looking for a simple whitening treatment or complex implants, cosmetic dentistry can work with your lifestyle.

Whitening is a fun and simple treatment that can brighten your teeth by remove stains and discoloration.  This is an easy treatment that can fit all lifestyle. If you are looking for a totally brighter smile making an appointment with Carolina’s Dental Choice is a must. But if you are looking for a simple and affordable method to brighten your smile, using a whitening toothpaste or whitening stripes could be useful.

Another great way to build confidence in your smile, is with veneers. Veneers allow a dentist to enhance the structure of your teeth. This can be with correcting the color, length, or size of a tooth. Veneers are made in porcelain and are permanently bonded to the natural tooth. This procedure can be lengthy or can require little to no preparation. The shorter experiences are done with minimally prepped veneers. This is a great cosmetic option for a variety of lifestyles.

A great cosmetic dentistry option to enhance your smile, is crowns. Crowns are much like veneers, by enhancing the appearance of misshaped or discolored teeth. The cosmetic dental crown covers the teeth by cupping over and encasing the entire surface of the tooth.  This procedure is commonly used to enhance the smile of those in a professional lifestyles.

Overall, cosmetic dentistry is a great option for anyone looking to build confidence in their smile. Whether you have plenty of time or are on a schedule cosmetic dentistry has a procedure that works with all lifestyle. Those looking for a quick process should consider whitening options or minimally prepped veneers. Whichever procedure is right for your lifestyle Carolina’s Dental Choice can help.  

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