Sleep Dentistry FAQ

Why do people choose Sleep Dentistry?

The most common reasons are fear or anxiety, a bad previous experience, concern about discomfort or pain (especially if complex treatment is required), or a gag reflex that makes treatment whilst awake difficult. Other patients are not necessarily afraid, but they have extensive needs. Under an average dental setting, numerous lengthy appointments (5 to 10) may be needed to complete their treatment. This could take months or even years to complete everything in a busy lifestyle. With sedation, treatment can usually be completed in one visit. Sedation makes dental treatment a breeze. It is also great for more complex or invasive procedures such as dental implant surgeries and wisdom teeth removal. Patients are pleasantly surprised when they have advanced, complex or lengthy treatments without realising it ever happened!

Will I remember?

A wonderful effect of our medications is amnesia. Patients remember little or nothing of their dental appointments. This is very appealing for those who are highly fearful and anxious.

Does it hurt? Are there any needles?

In order to start the sedation, we place a small cannula into a vein in your forearm or back of the hand. This is actually easy and all you might feel is a tiny scratch, because it is done very gently. But if you are concerned about this part, you can have an anaesthetic cream/patch placed on your arm an hour before the appointment so you don’t even feel the scratch at all!

How long will I be out of work?

Most sedation patients return to work the day following their appointment. We ask that you not return to work the day of your sedation appointment, but may sometimes advise an extra day’s rest.

Are there any side effects?

Drowsiness the day of your appointment is to be expected. Most patients feel refreshed and very relaxed. Some feel slight nausea, but that is due to the fact that they have not eaten. Normally, patients feel fine after eating and taking in some fluids afterwards.

Will I be able to drive?

You should not drive until 24 hours after your appointment. We require that someone bring you to our office in the morning and take you home after your appointment.

Will I be asleep during Sleep Dentistry?

Yes, you will enjoy a deep relaxing sleep. You will be in a relaxed, tranquil state of snoozing through the procedure. The great thing about our Sleep Dentistry technique is that whilst you snooze, your body is actually conscious and maintains control of its own breathing.

What is the difference between General Anaesthesia and Sleep Dentistry?

In sleep dentistry, even though you close your eyes and your mind enjoys a relaxing sleep, your body stays in control of its own breathing. General anaesthesia is different in that your body is rendered completely unconscious and your breathing is aided by a machine. This must be done at a hospital, whilst Sleep Dentistry is easily carried out at our specialty practice.

If I need a lot of work, how many appointments will I need?

Depending upon your particular situation and procedures required, with our special expertise and approach to Sleep Dentistry, your treatment requirements can often be met in as little as one visit. In any case, you will save many appointments and hours of treatment by using our advanced approach to Sleep Dentistry.

What is the cost of treatment?

There is a fee for the sedation depending upon the number of hours of treatment in addition to the fees for the dental or surgical procedures needed. It is costly for us to have all the required facilities and equipment, but generally is much less than it would be for hospital visits to accomplish the same results, even if hospital time was available for the required treatments.

Who will do the sedation? Are they qualified?

Dr Misagh Habibi administers and monitors the sedation. He holds special postgraduate qualifications in the field of Conscious Sedation and Pain Control, registered with the Dental Board of Western Australia. Most General dentists do not have this training. It is a recommendation of the Australia and New Zealand College of Anaesthetists that only dentists and medical practitioners with special qualifications or experience in anaesthesia/sedation should administer IV sedation. Dr Misagh Habibi is one of only few dentists in WA that falls in this category.

In addition to his expertise, we also make use of anaesthetists who provide sedations for particular procedures in our offices.

Does anyone else besides your group do this kind of treatment on a regular basis?

In Western Australia, only a handful of dentists are qualified to provide intravenous sedation services, and a few anaesthetists provide this service as well. We are unique in the nature and level of service we provide and are the only full time sedation practice in WA, carrying out sedation procedures daily.

How safe is Sedation Dentistry?

Conscious Sedation is very safe in trained hands. Dr. Misagh Habibi has special qualifications and training in this field and uses state of the art monitoring equipment to monitor you very closely during your conscious sedation appointment. To ensure your optimal safety, Misagh uses monitoring techniques and equipment more comprehensive than even what is recommended by the Australian and New Zealand College of Anaesthetists. His is probably the most advanced in–office dental sedation monitoring system being used in WA. Unlike a hospital general anaesthetic, you will not need the assistance of a breathing machine with this type of sedation. Your reflexes are still intact and you are able to breath spontaneously on your own. The medications we use are commonly used for sedation procedures all over the world, and are extremely safe. Please contact us direct if you have any other questions!

Wisdom Teeth Removal FAQ

What are "wisdom teeth"?

Wisdom teeth are the third molars–the chewing teeth located furthest back in the mouth. Most people have first, second and third molars. Wisdom teeth typically “erupt” (or emerge from the gums) behind the second molars during a person’s late teens or early twenties. Often, they’re “impacted,”or trapped in the jawbone and gums, usually due to lack of space in the mouth.

What problems can wisdom teeth cause?

If wisdom teeth do erupt, they may be hard to clean, increasing the chance of decay or infection of surrounding gum tissue. If they are impacted (unable to erupt, or partially erupt due to misalignment or lack of space), they can still cause disease including decay or resorption of other teeth, crowding, cysts and most commonly gum and facial infections. These infections can often be contained but recur continually. In some cases they can spread acutely and become very dangerous.

When do wisdom teeth need to be removed?

Sometimes disease associated with wisdom teeth makes it clear that they need to be removed. Other times we (or your referring dentist) may recommend surgery to remove them to protect you from problems that could develop in the future.

Do I need a referral for a consultation?

You can make a wisdom tooth consultation directly with Dr Misagh Habibi, or if you are under the care of a dentist you can be referred to our practice for management of your wisdom teeth. If you are being referred we request that you have an OPG x–ray of your jaw sent with your referral, or made available at your consultation.

What does the treatment involve?

When a wisdom tooth has not fully grown into the mouth, it is often necessary to make an incision in the gum over the tooth. It is often also necessary to remove some bone surrounding the tooth and/or cut the tooth into pieces to allow it to be removed. Once the tooth has been removed the gum and soft tissue are closed back with stiches.

Will I need to go to the hospital?

Our practice specialises in Sleep Dentistry by means of IV Sedation in the comfort and convenience of our own rooms, so you can avoid hospital time and fees.

What type of anaesthetic do you use?

At Perth Sedation Dentistry, Dr Misagh Habibi removes problematic wisdom teeth with one or more of the following methods of pain control: local anesthetic, nitrous oxide-oxygen or intravenous sedation (Sleep Dentistry). Most commonly our patients who need 4 wisdom teeth removed do so comfortably utilising our Sleep Dentistry technique. At your consultation your best options will be discussed with you.

Do you remove many wisdom teeth? Are you a specialist?

The most common procedure at our practice is the removal of wisdom teeth under IV Sedation (Sleep Dentistry), and our practice is specially equipped and limited to Oral surgery, implant and sedation procedures. Dr Misagh Habibi is a dentist with an interest, experience and training in surgical procedures and postgraduate qualifications in sedation. He is not a specialist Oral & Maxillofacial Surgeon, who you can also choose to consult regarding impacted wisdom teeth.

Is there much pain or swelling after the removal of wisdom teeth?

Generally, some discomfort and swelling is common during the two or three days following surgery. It is normal for your cheek to swell, and you may use an ice pack during the first 48 to 72 hours to limit the swelling. You may also feel that your jaw is stiff, and may need to eat only soft foods for a week or so. If it is likely to be sore, we will prescribe painkillers for you. In some cases you could experience some discoloration of the skin of your face that should disappear in a few days.

Is there anything else I need to do after the extractions?

Plan to rest for the remainder of the day following your surgery. Over the next few days, you may still be drowsy from the pain medication, other drugs, or anaesthetic, so don’t plan on driving, drinking alcohol, or operating any kind of machinery. To control excessive bleeding at the surgery site, we may instruct you to bite down on a piece of gauze, applying constant, direct pressure. For the first two days following surgery, you should eat only soft foods, and drink fluids (but avoid drinking fluids with a straw). It is also recommended that you avoid smoking and over-exertion. You will be given written post op directions which you can also download here.

What are the possible problems?

There may be a little bleeding at the time of the removal; however, this usually stops quickly and is unlikely to cause a problem after the wound is stitched. If the extraction site begins to bleed again after you get home, you can usually stop it by applying pressure on the area for at least 10 minutes with a rolled-up handkerchief or cotton swab. If the bleeding does not stop, please contact us. If the mouth is kept clean following surgery, infection is uncommon. Be on the lookout for such symptoms as fever, abnormal swelling and pain, salty or prolonged bad taste, and formation of pus. If any of these occur, contact us immediately, and we will prescribe appropriate antibiotics to treat the problem. There is also a remote risk of bruising to one of the nerves in your jaw, which can lead to altered sensation, tingling or numbness in the lip, chin or tongue which in extremely rare cases has been reported to be permanent.

Dental Implants FAQ

What is a dental implant?

A dental implant is a metal fixture or component that is placed into the jaw bone. It acts as a support for a false tooth or a set of false teeth. Implants fuse with your own jaw bone in a process called osseointegration and a naturally appearing tooth crown is placed over them.

What are implants made of?

Implants are made of commercially and medically pure Titanium. This is the same metal that has been successfully used in hip replacements for many years. It is inert and is not known to cause any type of rejection phenomenon. Different types of implants have different surface properties and designs which can make them suitable for different applications in the mouth.

What are the advantages of implants?

Dental implants provide a number of benefits if you want a solution to the problems created by tooth loss such as loss of bone and dental/facial aesthetics and function. These benefits include: Renewed ability to chew and speak properly Restoration of facial aesthetics Preservation of remaining jaw bone structure Reduction of possible gum problems and infections Increased confidence and self esteem

How long after a dental implant is placed can it be used to anchor my new teeth?

Conventionally, we waited three to four months in the lower jaw and four to six months in the upper jaw before constructing the new dental prosthesis that will be supported by the implants. In recent years, however, there has been a lot of research indicating that this period can be shortened in certain circumstances, even to the point of loading the implants as soon as they are placed. Each case has to be assessed on its merits, and the dentists placing your implants will advise you what’s best in your particular situation

Who is a candidate for dental implants?

Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. But in cases where teeth have been left missing and bone has been lost as a result, we can perform augmentation or grafting procedures to create the necessary bone to replace dental implants.

How many teeth can dental implants replace?

Some people are missing all their teeth and most of those are excellent candidates for dental implants. We also use implants to replace small bridges, removable partial dentures and even missing single teeth.

Who is not a candidate for implants?

Not every one can have implants. Certain factors, such as diabetes, smoking, bleeding disorders, certain medications as well as compromised physical and mental integrity, may influence the procedure and outcome of the treatment.

How do you know if I have adequate bone?

We will need to assess your jaws by clinical and radiographic (X-Ray) examination to determine the amount, shape and quality of the bone in the intended implant site. At Perth Sedation Dentistry we utilise more detailed 3-D technology (such as Cone Beam Imaging technology or Dental CT Scan) to gain a great deal of information not available in normal radiographs.

Why do you use 3–D imaging to plan dental implants?

Using Cone Beam or CT technology allows us to visualise exactly your jaw anatomy where implants need to be placed –such as bone thickness and height, location of nerves, blood vessels, sinuses and other teeth, etc. Because we utilise a lot of 3–D imaging for dental implant planning, our patients receive special rates arranged by the specialist radiologists of Perth Radiology Clinic (PRC) just for our patients! In complex cases we also use world–leading SimPlant technology to virtually plan your surgery and its results before it is accurately replicated in your mouth. We have the technology and expertise, so why expect less?

What if I don't have enough bone?

By utilising various bone augmentation procedures, or in some cases, by grafting bone from other sites, we are usually able to provide adequate bone to support the implants. Dr Misagh Habibi can assess your individual situation and advise you of the best treatment options available to you.

What is the success rate of dental implants?

Success depends very much on where in the jaws the implants are placed and what they are used to support. The best position for implants is in the front portion of the lower jaw, where success rates can be very close to 100%. In other areas of the mouth, success rates can drop significantly. According to figures that we have today, the success of implants in the front part of the upper jaw are anywhere from 90–95%. Success rates of implants in the back part of the upper and lower jaw were traditionally quoted as 85–90% but with our advanced scientific principles for implant selection and the types of implants we use, the figure is much higher.

I have loose and annoying dentures. Can dental implants help?

Absolutely! We can either replace your dentures altogether with a fixed set of teeth supported by implants, or as a simpler and less expensive measure, stabilise your dentures with a lesser number of implants so they are stable, much more comfortable and functional.

Do all dentists provide implants?

Not all dentists are trained in implant dentistry. Dentists lacking sufficient training refer their patients to other dentists who are trained, or to specialist periodontists or oral and maxillofacial surgeons. Perth Sedation Dentistry is a practice restricted to Oral surgery, implants and sleep dentistry. Dr Misagh Habibi is trained and experienced in all aspects of implant dentistry, including diagnosis, planning, implant surgery, bone augmentation and sinus elevation procedures, and prosthetic restoration and rehabilitation.

Do I need a referral for a consultation?

You can make a dental implant consultation directly with Dr Misagh Habibi, or if you are under the care of a dentist who can restore the crown (non–surgical) part of implants, you can be referred to our practice for the dental implant surgery. If you are being referred we request that you have an OPG x–ray of your jaw sent with your referral, or made available at your consultation.

Why do dentists recommend implants?

People are becoming increasingly aware of the importance of a healthy dentition in their overall well–being and ability to enjoy life. Dentures and removable bridges have some problems, because they are relatively loose and unstable. Implants can provide people with replacements for missing teeth, that are both functional and aesthetic. Most importantly, they prevent the shrinkage of the jaw bones and face which can have dramatic results on function and the appearance of the face.

Does it hurt?

Almost without exception, our patients report that there was no discomfort during or after their implant placement. The actual procedure to surgically place a dental implant is usually done under local anesthesia or Sleep Dentistry (IV Sedation) and is not at all painful. We usually prescribe pain killers to go home with, just in case there is any mild discomfort when the anaesthetic wears off some hours later. Where bone grafting procedures are performed, some post operative discomfort and minor swelling can be experienced in the short–term depending on your own body’s response and the size and location of the graft. However even our patients who have sinus elevations or bone grafts have often told us that they never required pain killers once they got home!

What happens if I have dental implants and they are rejected?

Occasionally dental implants fail to integrate with the bone or, as some people say, they are rejected. In most instances, they are replaced with another implant, usually of a slightly larger size.

Do I have to go without my "teeth" while the implants are bonding to my jaw bone?

This varies greatly with the individual circumstances of each patient. In most situations, patients leave the office with some form of prosthesis in place, especially if the smile is involved. Every patient and procedure is evaluated separately and there might occasionally be a recommendation that a patient go without their prosthesis for a short period of time.

How much do they cost?

Because of the great variance in patient needs, implant brands, additional component needs and laboratory fees, it is not be possible to mention actual dollar amounts here. Where implants are used instead of conventional bridgework, the costs tend to be quite similar. In some cases, two or more implants are placed to provide a means of stabilizing an otherwise conventional denture. In this situation, the implants are usually charged for on a per–unit basis, with a small additional charge for the components that fit in the denture itself. This form of treatment is extremely cost effective, giving the patients a dramatic change in comfort for a relatively low cost

What 'brands' of implants and materials do you use?

Traditionally a couple of major implant companies have dominated the ‘market’ of implant dentistry, especially in Australia, namely Nobel Biocare and Straumann. However in the last 15 years new science and research has led to development of many advances in the field of implantology, and out of this new implant designs by other companies have been developed. Dr Misagh Habibi’s implant selections and use of other biologic materials are based on solid scientific research for the applications they are used for. For instance, he has introduced both BioHorizons and Bicon implants to Perth and assisted in educating referring dentists and patients on their merits on bone and tissue health, implant survival and the ease and practicality of restoration. On a case by case basis, Dr Habibi selects implants that are best suited for the function and aesthetic they are are to create and on their ability to preserve the health of the surrounding bone and gum. Biologic materials used by Dr Habibi in implant surgeries include MinerOss, Grafton DBM, BioOss, Alloderm, BioGide and Laddec.

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