Sedation dentistry is pretty common these days. There are different levels of sedation. Ranging from lightest to deepest, they are: Nitrous oxide (laughing gas), conscious oral sedation, and intravenous (IV) sedation. None of these options will make you fall asleep, although you will feel very relaxed.
If you’ve been delaying seeing a dentist because of any of the following reasons, then sedation dentistry could be a great choice for you.
It’s no secret that the dental chair and the whining of the drill make lots of folks a little anxious. Some people could even consider their anxiety to be at phobia proportions. Modern dentistry practices understand this, and many have taken steps to make patients as comfortable as possible with amenities like music or TVs in the exam rooms. But for people with dental anxieties, these amenities may not be enough.
Dentists become dentists because they genuinely care about oral health; they know that a healthy mouth is the foundation for good quality of life. It’s the goal of every dentist to help nervous patients feel comfortable scheduling regular check-ups and cleanings, and get the interventional treatments they need. Sedation dentistry is the answer. Don’t let your anxieties ruin your oral health; ask a dentist about your sedation options.
Ever have one of those days where your to-do list is so ridiculously long that you aren’t even sure where to begin? Similarly, it can be tough to get started on extensive dental work, especially if spending a few hours in a dentist’s chair is just not your cup of tea. Sedation dentistry may be right for you if you need extensive work done. While you’re under the influence of oral conscious sedation or IV sedation, time will seem to pass more quickly. And because you’ll be completely relaxed, it’ll be easier for you to hold your mouth open for such a long time without feeling discomfort.
One patient getting a filling may only need a little local anesthetic, while another patient having the exact same thing done needs multiple doses of it. Everyone has a different pain threshold, and you should never feel like you have to “tough it out.” If you have trouble getting numb or you’re just very sensitive to pain, then sedation dentistry can give you the extra help you need to stay comfortable during your treatment.
Before you receive sedation, you need to make sure the dentist you’ve chosen has undergone appropriate training in this area. That’s why so many nervous dental patients choose Long Island Implant and Cosmetic Dentistry. Dr. Nick and Dr. Elliot have NYS certification in IV and PO sedation. Our practice is dedicated to ensuring the complete health, safety, and comfort of our valued patients! Give us a call today at (631) 850-3145 to discuss whether sedation dentistry in Suffolk County is the right choice for you.
For those who tremble at the thought of going to the dentist, but who require a dental procedure, one option for easing their worry is sedation. Dr. Nick and Dr. Elliot at LI Implant and Cosmetic Dentistry would like to share some common concerns that patients have expressed about sedation dentistry:
Are these concerns warranted, or only myth? Let’s find out!
Sedation dentistry is not the same as general anesthesiology. Instead, when a patient is sedated at the dentist they remain awake and conscious throughout the procedure. Patients lose feeling in the area the dentist is working on, which allows them to relax and experience minimal to no discomfort.
Prior to undergoing any type of sedation, it is important that you speak with both your dentist and doctor to see if you are a suitable candidate. There are multiple types of sedation, so chances are at least one of them will be safe for you. For instance, sedation via nitrous oxide is safe for most patients, whereas IV sedation may be an issue if you are pregnant. To avoid any types of complications and make sure you find which type of sedation is appropriate for you, be sure to be transparent about your medical history prior to any dental work.
Sedation dentistry is not only a good fit for those wary of the pain a dental procedure might bring, but also for individuals with strong gag reflexes, patients undergoing a long and uncomfortable procedure, and even those who are just feeling overly anxious.
One other big misconception around sedation dentistry is the belief that there is only one type of sedation patients can get. There are actually three different types: nitrous oxide, oral sedation, and IV sedation.
Nitrous oxide is also known as “laughing gas”. While undergoing nitrous oxide, patients wear a small mask that administers a nitrous oxide gas, alternating with 100% oxygen. This form of sedation is most popular amongst patients; it reduces gag reflexes and saliva flow.
Oral Sedation is a pill taken by mouth that causes patients to be completely relaxed and comfortable yet awake. Patients often feel that the procedure they are undergoing finishes in the blink of an eye because of how comfortable and at ease they feel.
IV Sedation is administered by a thin needle that is inserted into a vein by an anesthesiologist. The needle is connected to an IV drip containing anti-anxiety medication that puts patients into a deep state of relaxation. It is common for patients to feel a bit confused after coming out of this type of sedation, however they do remain conscious and awake throughout.
For more information about what type of dental sedation is right for you, be sure to give us a call today. We will assist you with making the right choice for feeling the utmost comfort during all your visits to Long Island Implant and Cosmetic Dentistry.
Visiting a dentist regularly is essential for your oral health, but not everyone feels relaxed in the dentist’s chair. For some, it may be the noise of the drill or the bright overhead lights that trigger dental anxieties. Unfortunately, dental anxieties may stop certain patients from scheduling dentist visits.
If you’re feeling uncomfortable in the dentist’s chair, it’s important to discuss your concerns with your dentist. You might be surprised to learn that sedation dentistry may be appropriate for you.
Sedation is often a good choice for patients who are undergoing gum grafting, dental implant placement, and other oral surgeries. Sedation can help patients stay relaxed and calm during these procedures, particularly when dental anxieties are an issue. But there are many other good reasons to consider dental sedation. Even if you feel comfortable having dental work done, you might prefer to be lightly sedated during long procedures. In some cases, sedation can help you get extensive work done in one treatment session, without having to go back for multiple appointments.
A cosmetic dentist will use sedatives in addition to a local anesthetic. Although sedatives aren’t technically pain relievers and are not intended to take the place of anesthetics, sedatives can indeed help make dental treatments pain-free. Sedatives are particularly helpful for those who have extremely sensitive teeth and those who have trouble getting the tissues completely numb. Some people also choose sedatives because they have a strong gag reflex.
Dental sedation is appropriate in many cases, but it’s important to fully disclose your medical history to your dentist. Your dentist may make sedation recommendations based on whether you have heart disease, diabetes, epilepsy, sleep apnea, respiratory illnesses, or other chronic medical conditions. Be sure to discuss your medications, and disclose whether you’re pregnant, could be pregnant, or breastfeeding.
Another benefit of choosing dental sedation is that it’s customizable to suit your needs, preferences, and underlying medical conditions. Aside from general anesthesia, which is rarely used for dentistry, there are three primary levels of dental sedation.
Here at Long Island Implant and Cosmetic Dentistry, your comfort is one of our top priorities. We’re pleased to offer nitrous oxide, conscious oral sedation, and intravenous sedation to suit the needs of our patients. In addition to our general dentistry services, Dr. Nick and Dr. Elliot are leading providers of cosmetic dentistry services, including dental implants and gum grafting. If you’re looking for exceptional dentistry care within a stress-free setting, call our Suffolk County office today.
If you’ve ever breathed in nitrous oxide at a dentist’s office, then you’ve already experienced the benefits of sedation dentistry. Sedatives in the dentist’s office are much more commonplace than they used to be, but it’s important to do a little research before becoming a sedation dentistry patient. There are some surprising things you might learn. And remember to make sure you receive sedation dentistry from providers who are specially trained to administer it safely and effectively.
“Not all dentists are certified to administer sedatives and this can sometimes pose serious threats to the health of the patient,” says Dr. Elliot Koschitzki of Long Island Implant and Cosmetic Dentistry. He and his colleague, Dr. Nick Augenbaum, both hold New York State certification in IV and PO sedation.
The top surprising thing you probably didn’t know about sedation dentistry is that it doesn’t work like a painkiller. A sedative is administered to help a patient relax during a stressful procedure. Oral sedatives, for example, are primarily in the class of benzodiazepines, which are anti-anxiety drugs. But there’s no need to fret; in addition to administering a sedative, your dentist can still use topical and injected anesthetic to eliminate pain during the dental treatment.
Many people are surprised to learn that there are different types of sedation dentistry. More specifically, there are different levels of sedation. The lightest level is nitrous oxide, commonly referred to as laughing gas. This is the only level of sedation that allows you to drive yourself home after the appointment. The next level is conscious oral sedation, which involves taking an anti-anxiety drug by mouth. Aside from general anesthesia, which is not commonly used in dentist’s offices, the deepest level is intravenous (IV) sedation. This involves administering the drug via an IV line into a vein.
Sedation dentistry is an excellent way to convince people with dental anxieties to receive the routine oral care they need, but fear of the dentist’s office isn’t the only reason why you might consider sedation dentistry. Sitting still in the dentist’s chair for a long time can be difficult. If you need a particularly lengthy procedure done or multiple procedures done, the use of sedatives can be a lifesaver. Sedation dentistry can allow you to complete multiple treatments in the same visit. With a deeper level of sedation, the appointment will seem to pass by much faster than it ordinarily would. Plus, you’ll remain comfortable throughout the procedure.
Sedation dentistry may also be appropriate for some children and adults with special needs. Individuals with autism spectrum disorders (ASDs), for example, often have significant trouble lying on a dentist’s chair and coping with the loud noises and bright lights. Sedation dentistry can eliminate these challenges.
If you have dental anxieties or simply desire a relaxing oral care experience, you can put your trust in the cosmetic dentists of Long Island Implant and Cosmetic Dentistry. Dr. Nick and Dr. Elliot are pleased to offer free consultations to patients who are interested in receiving conscious oral sedation, nitrous oxide sedation, or intravenous sedation during their dental procedures. Give us a call today at (631) 850-3145 with any questions you may have.
Dentistry has an unpopular reputation for causing discomfort, but this is largely a myth. One of your dentist’s top priorities is making sure you have a positive and comfortable experience in the dentist chair. This is the best way to ensure that you’ll stick to your recommended exam and cleaning schedule. To eliminate the possibility of any discomfort, your dentist can use a variety of pain prevention methods.
“Here at Long Island Implant and Cosmetic Dentistry, we’re proud to offer sedation dentistry for a wide range of procedures-everything from deep cleaning to root canals to oral surgery can be performed with the help of carefully planned sedation,” says Dr. Nick Augenbaum. “It’s our goal to put our patients’ minds at ease when they’re with us. We want them to have a positive experience,” adds Dr. Elliot Koschitzki.
Sedation dentistry might not be a good option for every dental patient, but that doesn’t mean that dental fillings or other treatments will be painful. First, your dentist will use a sterile swab to apply a numbing gel to the area. Once the soft tissues are numb, your dentist will inject a local anesthesia. Because of the numbing gel, you shouldn’t even feel the injection.
If the type of dental treatment you’re receiving is expected to result in lingering discomfort, your dentist might recommend an over-the-counter pain reliever or provide a prescription for a non-narcotic drug such as a prescription-strength anti-inflammatory medicine.
You might have already had a form of sedation dentistry without realizing it if you’ve ever breathed in nitrous oxide from a face mask. There are different levels of sedation and nitrous oxide provides the lowest level. It won’t make you sleepy, but it will help you to relax. Nitrous oxide, also known as laughing gas, can even reduce the gag reflex. This is a very safe level of sedation and after your appointment is over, you’ll be able to drive yourself home.
A deeper level of sedation can be induced with a prescription drug that you’ll take before your dental appointment. It won’t necessarily induce sleep, but you may feel drowsy and time will seem to pass more quickly. You’ll need someone to drive you to and from your appointment, and you can expect to rest at home afterward instead of returning to work.
If you have severe dental phobias or you need a lot of work done, you might consider intravenous (IV) sedation. This is administered through an IV drip in your arm by a highly trained anesthesiologist. IV sedation won’t put you to sleep the way that general anesthesia does, but you will be deeply relaxed and you might not remember much about your appointment afterward.
Dr. Nick and Dr. Elliot at Long Island Implant and Cosmetic Dentistry invite new and current patients to come in for a consultation. We’ll discuss your treatment goals and explain your pain management options, which may include safe and effective sedation dentistry.
For your own safety, please do share your full medical history with us before receiving sedation dentistry. We’re dedicated to maintaining the highest standards of patient care and safety. Give us a call today at 631.296.0549.
Colgate, Local Anesthesia, http://www.colgate.com/en/us/oc/oral-health/procedures/anesthesia/article/local-anesthesia
American Dental Association, Anesthesia and Sedation, http://www.mouthhealthy.org/en/az-topics/a/anesthesia-and-sedation
Are dental anxieties keeping you from seeking routine preventive dental care? Do you want to schedule a smile makeover, but are reluctant to spend a long time in the dentist’s chair? Consider asking your cosmetic dentist about the various types of sedation dentistry.
Sedation dentistry usually doesn’t involve putting a person completely to sleep, which is known as general anesthesia. Rather, it involves administering FDA-approved medications to induce different levels of relaxation. The implications are tremendous for people who have been putting off treatment because of dental anxieties.
Sedation dentistry is also ideal for people who need to have extensive work done, such as multiple procedures to extract damaged teeth, replace missing teeth, treat gum disease, or reconstruct gum tissue. Sometimes, dental work needs to be broken up into multiple office visits. With sedation dentistry, the dentist may be able to perform all of the work in one visit, which is certainly more convenient for the patient.
Sedation dentistry can even make dental work far more comfortable for patients with temporomandibular joint (TMJ) disorder. This is a condition that can involve considerable jaw pain, which is made worse by holding one’s mouth open for lengthy periods of time such as during a dentist visit. Sedation dentistry can make it possible for these patients to have a comfortable dental experience.
There are different levels of relaxation that are achievable through sedation dentistry. Nitrous oxide induces the lightest level of relaxation. It’s commonly referred to as laughing gas. Conscious oral sedation involves taking a sedative by mouth. This pill doesn’t force you to fall asleep, but induces a relaxed, drowsy state. IV sedation is administered by an anesthesiologist. An intravenous drip delivers anti-anxiety medication directly into a vein to induce a very deep state of relaxation. With IV sedation, your dental appointment will be over before you know it.
Only your cosmetic dentist can definitively determine if sedation dentistry is right for you. To get started, you’ll be asked to provide your full health history. Be sure to inform your dentist if you’re allergic to any medications or might be pregnant.
If sedation dentistry is a good option for you, you may need to have a responsible adult drive you home from your dental appointment and stay with you until the effects of the medication fully wear off.
Dr. Nick and Dr. Elliot at Long Island Implant and Cosmetic Dentistry are committed to helping each patient have a comfortable, positive experience in the dentist’s chair. Both Dr. Nick and Dr. Elliot have extensive credentials, including certification in IV and PO sedation, and are dedicated to upholding the highest standards of patient safety.
To schedule your consult for cosmetic dentistry in Suffolk County, please call 631.296.0570.
The first things that come to mind when it comes to dentistry in general are “What’s it going to cost?” and “How much is it going to hurt?” Not a surprising reaction given that before current advances in the field, dental work, in particular cosmetic dentistry, has been expensive and – depending on the treatment – painful.
These misconceptions have long since been laid to rest with advances in technology, less invasive techniques, and better, longer lasting materials. But old myths die hard. For those who want to improve their confidence but are still shying away from a better smile due to misconceived notions, our Long Island cosmetic dentists want to bust some common myths surrounding cosmetic dentistry.
This is probably the number one anxiety provoking myth about cosmetic dentistry. It’s as if people still believe the old cartoons where dentists use giant pliers or tie a string to your tooth, tie it to a doorknob, and give it a good yank. Dr. Elliot and Dr. Nick, widely considered among the best cosmetic dentists in Long Island, make it their top priority to ensure a comfortable, pain-free experience for their patients. It’s the new world of cosmetic dentistry—serene treatment areas, sedation dentistry for a stress-free experience and state-of-the-art equipment and facilities.
Cosmetic dentistry provides more than a dazzling smile. Ignoring dental problems like misaligned, broken or missing teeth can cause more serious problems including infection, gum disease, even bone loss. Cosmetic dentists provide beauty but also functional restoration of your teeth. Dental implants help maintain the structural integrity of the mouth which in turn helps maintain facial integrity.
The materials and techniques used in today’s cosmetic dentistry for implants, fillings, bonding, and other cosmetic procedures are far more sophisticated than even those of a few years ago. Precise measurements, computer technology for fabricating the replacement materials, and custom shading are formulated to create a natural looking set of teeth virtually undetectable from the original, and in most cases, better looking.
Dr. Nick and Dr. Elliot take painstaking care to fabricate every detail of your new smile so that the colors and shapes are as natural looking as possible.
There is a broad range of attractive and affordable options for creating a new and beautiful smile. The use of new materials and technologies have made cosmetic dentistry affordable for virtually any budget.
Long Island Implant and Cosmetic Dentistry offers financing and customized payment plans for our patients who want to improve their oral health but have normal financial constraints. A decent dental plan may provide partial reimbursement for dental implants and crowns. This type of work is also extremely important to be done when a problem is first detected to avoid the inevitable and more serious problems and procedures that will have to follow.
While cosmetic enhancements like teeth whitening may not be covered by insurance, the results are well worth it! Call Long Island Implant & Cosmetic Dentistry at 631. 319. 7891 to schedule a free consultation with Dr. Nick and Elliot to learn how we can help you achieve the smile of your dreams.
For some people, a trip to the dentist is the stuff of nightmares. NBC News told the story of Barbara Scott, a 50-year-old woman who had responded poorly to Novocain as a child and had to endure drilling and filling without any anesthetic at all. “I can remember sitting there with tears running down my face,” she recalled, saying that she often put off needing work done, which only made problems worse. When she heard about sedation dentistry, she said she felt it “was totally an answer to a prayer.”
Dr. Nick and Dr. Elliot’s sedation dentistry on Long Island aims to make you as comfortable and relaxed as possible during your dental procedure. Here are five points to consider before your next appointment.
We can do four different methods of sedation:
The general rule of thumb is to use as little anesthesia as possible to reach the desired state of relaxation.
The Chicago Tribune details how dental patient Valerie Carlson used sedation for regular teeth cleaning. “There is no other option for me,” she said. “I can’t even hear the instruments. It just makes my skin crawl.” Here at Long Island Implant and Cosmetic Dentistry, we have some extremely anxious patients who prefer to be sedated for routine procedures.
Sedation dentistry is appropriate for patients with:
While sedation dentistry is considered safe, patients with the following conditions should speak with a general practitioner for clearance before their procedures:
The Commission on Dental Accreditation is recognized by the U.S. Department of Education as the national accrediting body for advanced dental education in the United States. In New York State, dentists must have at least two years of accredited post-doctoral education in anesthesia or have completed a graduate level program in oral and maxillofacial surgery to administer general anesthesia. For IV sedation, dentists must clock at least 60 hours of coursework and clinical experience on at least 20 patients with an accrediting body before certification. They must be trained in Advanced Cardiac Life Support and emergency management as well.
A good sedation dentist will:
For more information about sedation dentistry with Suffolk County cosmetic dentists Dr. Elliot and Dr. Nick, please call us to arrange a free consultation by dialing 631-296-0602.
Every year millions of Americans postpone dental visits out of anxiety and fear. Traumatic incidents from childhood and a fear of needles and grinding drills are just some of the reasons given by patients. This so called “dental phobia” prevents many from getting routine preventative care, which can lead to much bigger problems – and costly treatments– later on.
Sedation dentistry, sometimes called sleep dentistry, is now widely used to help quell patient fears when having routine procedures like teeth cleanings, fillings (whether new or replacing amalgam) and crowns. Sedation dentistry is gaining popularity across a number of fronts, not only because of its safety, but for its practicality when used in more invasive, multi-step procedures like dental implants.
Conscious oral sedation, nitrous oxide ( a.k.a. laughing gas) and IV sedation are the three methods used today. Unlike general anesthesia which completely puts you out, nitrous and oral sedation keep you awake but in an extremely relaxed, almost dream-like state. Passing minutes feel more like seconds and patients float through the entire visit without any pain or sensation. A deeper sedation through IV medication puts patients into a twilight sleep, erasing all memories of the procedure.
Dr. Bob Lalor, a certified NY State dentist in Parenteral Conscious Sedation, has been helping conquer dental fears in his practice for over a decade. “Patients who benefit from sedation dentistry may have but are certainly not limited to: an extreme fear or anxiety of visiting the dentist, problems with a gag reflex, overly sensitive teeth, and or a need for complex dental treatment.” He says that sedation is “a simple, relaxing way to experience dentistry” for many of his patients, whether they’re getting a deep cavity filled, or need other restorative dental work.
A highly respected dental blog launched in 2009, Dental Geek has been covering all of the hottest topics in the industry including why patients are so afraid of their dentist. “Memories of childhood visits, or painful treatment bring on the nerves and cause many to either avoid seeing a dentist altogether until an emergency crops up, or to dread the visit so much that they arrive at the surgery in a state of panic,” says contributing author Emma Ward. “There are relaxation exercises that people can learn and practice before coming to their appointment. Chemical intervention, such as nitrous oxide, sedation or anti-anxiety medication can be discussed.”
Beyond routine cleanings, fillings, and the occasional tooth extraction, sedation dentistry is immensely useful for complex procedures that would normally take several visits. For instance, patients getting periodontal surgery along with a complete “smile makeover” with implants can typically get the work done in fewer appointments.
But does nitrous oxide or oral sedation pose serious health risks? When administered by a trained dentist, “sedation carries very little risk and is suitable for a large number of patients who have been carefully pre-screened,” says Long Island cosmetic dentist, Dr. Elliott.
“Nevertheless,” he continues, we still obtain medical clearance from the patient’s physician prior to that visit. We have an in depth consultation for each patient as to why they feel the need to be under any type of sedation. For example, a candidate needing dental implants or a root canal would be recommended IV sedation. It is the most intense level of sedation dentistry performed in our practice.”
Whether you just want an anxiety-free dental cleaning or desire the amnesia effect of IV sedation for a more intricate procedure, a dentist certified in IV and PO Sedation can discuss the benefits and types of sedation dentistry for suitable your needs.
Dr. Nick and Dr. Elliot at Long Island Implant and Cosmetic Dentistry understand the trepidation many people feel when coming in to have work done on their teeth. The fear of pain, unpleasant sounds, needles, and complications can be overwhelming, and unique to the individual.
We take a compassionate approach to dentistry with gentle hands and offer our patients multiple options for sedation during cosmetic dental procedures. Here are some of the frequently asked questions about sedation dentistry, which will hopefully help assuage some of your concerns.
Sedation is routinely used for:
Ideally, you would go to sleep, leave your pain behind, and wake up feeling great — with a brand new, beautiful smile. Total sedation is possible for some patients and some procedures, especially if you are extremely sensitive, anxious, or fearful of the dentist and have an easily triggered gag reflex. We most commonly use IV sedation when multiple procedures are required or when we’re dealing with a patient who is extremely distressed by what needs to be done.
However, the American Dental Society of Anesthesiology cautions against using total sedation with patients who have:
For these patients, we may consider a form of conscious sedation, which will safely relieve anxiety.
Conscious sedation via oral pill or laughing gas puts patients into an altered state of consciousness that minimizes pain and discomfort. The patient can speak and respond to basic verbal cues, but will find it easy to rest and relax while the work is being done. A brief period of amnesia makes patients feel as though they are in a pleasant dream-like state. Just as with IV sedation, a dentist or qualified Registered Nurse will monitor your heart rate, blood pressure, breathing, oxygen levels, and alertness throughout the procedure. Occasional side effects may include fatigue, nausea, headache, or limited memory.
We will give you detailed instructions regarding preoperative protocol, but generally speaking you should:
Patients who were sedated with laughing gas can drive as little as 15 minutes following their procedure. With IV sedation and oral sedation, you will need someone to accompany you to your appointment to drive you back home. For most patients, the effects of oral sedation last two to four hours. With IV sedation, some mental fog may persist for up to 24 hours, so you should not drive or operate machinery for the rest of the day.
We recommend that you go home and take it easy, avoiding any strenuous activity. Eat a light diet such as toast, soup, Jello, and smoothies. Avoid heavy, greasy, fatty foods. You may feel a little dizzy or nauseous following sedation, so have carbonated beverages on hand to alleviate these symptoms. Avoid alcohol or un-prescribed medications for the next 24 hours. Watching television or a movie and sleeping will help take your mind off any residual discomfort you may feel.
In some cases – such as periodontal scaling or root planing of all four quadrants – your insurance may cover IV sedation. Most often, the patient picks up the bill, which is why it’s so important to visit a place like our Long Island Sedation Dentistry office, where we do everything in-house and do not call in an outside anesthesiologist, which adds the cost. We are happy to discuss all possible payment methods and help you find the most affordable sedation option.
Patients choose our Suffolk County cosmetic dentistry practice for the following reasons:
Call (631) 850-3145 to schedule a free consultation and learn more about sedation dentistry in Long Island.
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“Have never had things explained as clearly and he has such a warm, personable manner. It was very refreshing.”
- Susan S.
"I needed work and had anxiety. The entire office made me feel welcome and as calm as I could get. I am almost finished and so happy with the people and the work done."
"As a resident of both New York City and Long Island I am so pleased to have discovered this practice. Up on all the latest dental procedures and techniques makes necessary treatment easy and well done!"
"I would recommend using Long Island Implant and Cosmetic Dentistry. They helped me change the way I look dramatically. Thanks so much!"