We Now Offer Exparel for Oral Surgery

We are pleased to announce that we are offering Exparel for non-opioid pain relief after oral surgical procedures such as wisdom teeth extractions. We are one of only a handful of dental offices across Connecticut publicly offering this solution. Dr. Nick Calcaterra personally administers Exparel himself in our Orange, CT office.

What is Exparel?

Exparel is a medication used to provide long lasting pain relief after invasive surgical procedures such as wisdom teeth removal with IV sedation. It is a liquid medication that comes in vials. Dr. Calcaterra administers the medication directly into the surgical sites immediately upon completion of the procedure. Once administered, Exparel acts as a long lasting numbing agent, providing pain relief for up to 4 days.

Exparel non-opioid pain reliever seen in Orange, Connecticut

A box of Exparel medication that Dr. Nick Calcaterra administers after wisdom teeth surgery in our office in Orange, CT

When used along with traditional pain medications such as high dose Motrin (a.k.a. ibuprofen), our patients need reduced amounts of opioids, or in many cases do not need opioids at all.

Why Exparel?

Vicodin prescribed after oral surgery in Orange, CT

Vicodin – called hydrocodone – is typically prescribed after oral surgery

As you are likely aware, the use of opioids (a.k.a. narcotics such as Vicodin and Percocet) in the United States has created a crisis. There are many factors behind the crisis, but the end result for certain users of opioids is addiction, disability, and sometimes even death.

There is a wealth of research which shows that for many patients – typically older teenagers and young adults – their first exposure to opioids is after third molar extractions. Generally speaking, research has shown that those individuals who received narcotic prescriptions for wisdom teeth were more likely to develop addiction problems later on in life.

Given the risks associated with opioids and the crisis, Exparel was developed. Exparel has been proven in clinical studies to reduce the need for opioids following wisdom teeth removal.

Are Opioids Still Necessary for Wisdom Teeth Extractions?

Sometimes (in our opinion and experience).

Pain affects people differently. Wisdom teeth cases vary significantly in their surgical complexity and invasiveness. Our patients’ medical histories, age, and other factors also impact how much pain they will experience and what type of medications they will require afterwards.

Dr. Nick Calcaterra with Exparel for wisdom teeth extractions in Orange, Connecticut

Dr. Nick Calcaterra with Exparel he is about to administer after a wisdom teeth removal case in Orange, CT

Given the dynamic and unpredictable nature of post-surgical pain, we will re-phrase the question:

Do we still prescribe opioids after tough surgical cases? Sometimes

But we feel comfortable stating the following:

Based on our own use of Exparel on patients requiring wisdom teeth extractions, we’ve witnessed firsthand a reduction and sometimes elimination of the need for opioids.

Can Exparel Help?

The short answer is: probably.

Talk to your dentist or oral surgeon. See if they offer Exparel. See what their experiences have been. Use the internet. Learn more on our Exparel page. Read about Exparel on Reddit.

Appointment request for wisdom teeth surgery with exparel

Do you need your wisdom teeth out and want Exparel to reduce the pain afterwards? Are you looking to avoid opioids after oral surgery? Do you need IV sedation? Then you’ve come to the right place. Call us at (203) 799 – 2929 or visit this page to request an appointment.

Dr. Nick Calcaterra awarded Master Status from American Dental Society of Anesthesiology

Dr. Nick Calcaterra recently sat for and passed the rigorous exam to become a Master in the College of Sedation in Dentistry. This makes Dr. Calcaterra the only general dentist in the entire State of Connecticut who has achieved this prestigious certification who is actively providing IV sedation.

This accomplishment, along with being one of only a select few general dentists in all of Connecticut with a license to provide sedation, has made him the most accomplished sedation dentist in the entire state.

Dr. Nick Calcaterra Master College of Sedation in Dentistry

What is the College of Sedation in Dentistry?

American Dental Society of Anesthesiology

American Dental Society of Anesthesiology

The College of Sedation in Dentistry was created and is maintained by the American Dental Society of Anesthesiology. ADSA, as it is called, is the professional organization representing dental professionals who employ advanced forms of sedation and anesthesia to patients.

The College of Sedation is designed primarily for general dentists and periodontists who wish to further their anesthesia skills. Achieving Master Status – which is the highest level a general dentist or periodontist can achieve – indicates that the provider has complete mastery of all the skills needed to perform IV sedation in his or her office. The rigorous prerequisites – along with a three hour board exam – make it extremely difficult for providers to achieve this status.

Why Sedation Dentistry with Dr. Nick Calcaterra?

Dr. Nick Calcaterra’s vast experience and expertise in sedation for dental patients is what sets him apart. And becoming the only general dentist in Connecticut to be admitted as a Master is testament to his commitment and knowledge.

Dr. Nick Calcaterra Master College of Sedation

Dr. Nick Calcaterra with his two Anesthesia assistants Cyndi and Amanda.

Dr. Nick averages over 100 sedation cases per year, performing procedures such as extractions, root canals, and even simple fillings. For Dr. Calcaterra, sedations are an almost daily procedure. Most other sedation providers – assuming they even have a sedation license – average only one or two cases per month.

Our vast experience in providing twilight anesthesia to patients – along with our caring staff – and Dr. Calcaterra’s deep expertise – are why Connecticut patients choose our office.

Sedation Dentistry requestAre you interested in learning more about sedation dentistry? Then you’ve come to the right place! Go to this page to request a consultation or call us at (203) 799 – 2929. Dr. Nick and two assistants Cyndi and Amanda will be happy to help you.

 

Liz’s IV Sedation Video – Over 110,000 YouTube Views!

(Note: this post was updated to reflect the total number of views)

That’s right. Our video – Liz’s IV Sedation Wisdom Teeth Journey – has been viewed over one hundred thousand times on YouTube! And even more impressive, it racked up this number of views in only 18 months. In the video, you see Liz during her third molar extraction procedure – being sedated and having her teeth removed – and then hear her talk about it when we interview her several weeks later.

Is the viral YouTube popularity due to our brilliant videography? Our excellent surgical techniques? Our expertise in IV sedation? Our awesome staff? All of the above? Check it out and see for yourself:

What do you think? Did you watch all 6 minutes of it? We bet you did – along with over 110,000 other YouTube viewers!

We believe the explosive YouTube popularity has to do with several factors:

  1. Great videography and editing by our multifunctional Dental Assistant Cyndi.
  2. Compassionate surgical and anesthesia skills exhibited by Dr. Nick in the video.
  3. A great patient – Liz – who remembers almost nothing of the procedure – but who was kind enough to allow us to document her surgical journey.

It could also be due to her virtually painless healing period afterwards. Or the mango sherbet (go to the 3:55 point to see Liz as for it during the sedation).

Want to be featured in one of our YouTube videos and become an overnight viral sensation? OK – we can’t guarantee that – but we can guarantee a great experience with one of Connecticut’s most experienced sedation dentists.

appointment request with Dr. Nick Calcaterra Sedation DentistInterested in learning more about IV sedation with Dr. Nick? Need your wisdom teeth removed and want twilight anesthesia? Call us at (203) 799 – 2929 or visit this page to request an appointment.

Can a Chipped or Fractured Porcelain Crown be Repaired?

As a busy dental office, we see some variation of this quite often:

“Doc, the porcelain on my front tooth veneer chipped. Can you fix it?”

The answer is yes, but there are some limitations. But let’s first look at a successful porcelain repair case we completed in our office.

Before and After Photos of Porcelain Bridge Repair

The photo below shows a patient of ours. He had a 7 unit dental bridge that he loved – and that had been in his mouth for over twenty years. An unfortunate slip in the bathroom led to him banging his tooth on a porcelain sink (notice the irony?) which led him to fracture off a huge chunk of the ceramic on his front tooth.

The porcelain chip was large, unsightly, and very noticeable. His greatest fear was that we would have to do a brand new bridge.

Before and After photo showing porcelain repair of a chipped dental bridge

In Round 1, in Dental Bridge vs. Sink, the Sink won. In Round 2, Dr. Nick emerges victoriously over the Sink and saves his patient’s bridge! Photos and dentistry by Dr. Nicholas Calcaterra.

We utilized the highest rated porcelain repair kit on the market. Leveraging this product, along with our expertise, we produced a phenomenal result. It took us approximately 1 hour. And the best part is that our patient did not need a new bridge.

The Details on Repairing Porcelain

If you noticed from the beginning of this post, we said that we could repair porcelain, but there were exceptions.

Cosmetic porcelain crowns, bridges, and veneers are made in a variety of ways. But nearly every method requires the porcelain to go to extremely high temperatures – like over 1,000 degrees Fahrenheit! So to add porcelain to a crown in a predictable manner, you would need to put the crown into the firing oven. But that’s not possible given that there’s a person connected to the tooth!

So, the next best thing is to bond composite material to the fractured porcelain. Composites are the white material used in fillings and bonding. The challenge is that the bond from composite to porcelain is not that strong. Nevertheless, when done correctly, we can still get a good result, as you can see below:

Before and after photo porcelain fracture repair of front dental bridge

Another chipped dental bridge. You can see the underlying gold of the bridge. 45 minutes later, he walked out like the bridge was brand new! Photos and dentistry by Dr. Nicholas Calcaterra

His bridge was cemented in placed. So we bonded composite on there. Two years later, he still looks great!

How to Get a Porcelain Chip Repaired

If you have a chipped front crown, veneer, or bridge, you might just think you can call any dentist and have it taken care of. That is not always accurate for the following reasons:

  • Repairing porcelain is not an every day procedure for most dentists. So, many dentists simply do not know how to do it.
  • A dentist has to keep in stock a very specific (and expensive) porcelain repair kit. Most dentists don’t have this in stock.
  • Some larger fractures can be impossible to repair in a manner that lasts a while. In those cases, you may need to invest in a new crown, bridge, or veneer.

If you believe this is what you need, it never hurts to call and ask the dental office if they are able to do this type of procedure.

Request a consult to repair porcelain on a crown or bridge

Do you have a crown or veneer that is chipped? Interested in seeing if it can be repaired? Call us at (203) 799 – 2929 or visit this page to request an appointment.