Posts for: April, 2012
The third molars, called “wisdom teeth” because they usually become visible when a person is 17 to 25 — supposedly the time we achieve wisdom, may have adverse effects on adjacent teeth. Most adults have four wisdom teeth, although some people have more; and some, none at all. The wisest thing to do about wisdom teeth may be to have them removed if they are poorly positioned.
What is an impacted wisdom tooth?
If a wisdom tooth is pushing against gums, other soft tissues, or adjacent teeth at an awkward angle, it is referred to as “impacted.” Usually this occurs when there is not have enough room in the jaws for these last molars to fit next to their adjacent teeth. They can disrupt the gum tissue attachment of their neighboring teeth and the surrounding bone leading to periodontal disease and, ultimately, their loss.
In many cases, impacted teeth are painless, and those who have them have no warning of the problem. Thus it is important to have routine dental exams during the time when the third molars are coming in.
When should wisdom teeth be removed?
It is better to remove wisdom teeth early rather than waiting until periodontal (gum) disease has set in. As individuals age, keeping their wisdom teeth may lead to more serious problems. Periodontal defects tend to get worse in the presence of retained third molars. Furthermore, there is a higher incidence of postoperative symptoms in people over 25.
What are the pros and cons?
Removing impacted third molars can have a negative influence on the periodontal tissues of adjacent second molars. A number of techniques, such as scaling, root planing, and bacterial plaque control, can be used to minimize periodontal problems and promote healthy healing.
Surgical removal of wisdom teeth will involve some mild to moderate post-operative discomfort. Use of aspirin or ibuprofen for a few days after surgery will provide pain relief and control most swelling and symptoms. Antibiotics may be prescribed to ensure infection-free healing. It is important to keep the socket area clean by washing and rinsing with saline or antibacterial rinses. Careful surgery will promote good healing with minimal periodontal consequences to adjacent second molar teeth.
To decide whether your wisdom teeth should be removed, you will need an evaluation to assess the clinical health of the wisdom teeth, the neighboring teeth, and other vital structures. X-ray and digital imaging techniques play an important role in determining the exact position of the wisdom teeth in the jaw. A full assessment and consultation will include all the risks, benefits, likely consequences, and alternative treatment options. This will provide you with the wisdom you need to determine what is best for your wisdom teeth.
To learn more about wisdom teeth, read “To Be or Not to Be: What are the consequences of an impacted wisdom tooth?” Or contact us today to discuss your questions or to schedule an appointment.
While the long-term success rate for a dental implant is well over 95%, there are factors that can compromise their success. For this reason, our office has put together this list so that you can be prepared should you ever need a dental implant. We feel that by providing our patients with this type of easy-to-understand information, we can educate, address any concerns and help produce the best results.
The three most common categories for classifying factors that influence dental implant success are: general health concerns, local factors and maintenance issues. As you may suspect, general health concerns include factors such as:
- Whether or not you smoke or use tobacco products.
- Certain prescription and over-the-counter medications you are currently taking or have recently taken.
- If you have or have a family history of osteoporosis (“osteo” – bone; “porosis” – sponge-like).
- If your medical history includes any cancer or radiation treatment to the jaws.
- Or if you have a compromised immune (resistance) system.
The second category is “local factors” and includes bone quantity and quality — there must be sufficient bone to anchor implants. Other considerations that fall into this category include whether or not you clench or grind your teeth or have additional bite concerns, as all of these can have negative impacts on both the short and long-term success of an implant.
The last category concerns maintenance. While dental implants are superior works of technology that can last a lifetime and produce results that are nearly identical to natural teeth in looks and durability, they do require routine maintenance. This includes daily cleaning (brushing and flossing) and routine visits to our office for evaluation and professional care to make sure they are functioning properly.
To learn more on this subject, continue reading the Dear Doctor magazine article “Factors which can influence implant success.” You can also contact us today to schedule an appointment to discuss your questions about dental implants.
It is always good to be prepared before you have any dental or medical procedure. Make sure that you are informed and know what to expect to make you as comfortable as possible. We recommend that you have a list of questions with you to ask us during your consultation. If we inform you that you need a crown, consider asking any or all of the following questions:
- Am I a good candidate for a crown?
- Can you do a computer-generated mock-up of my new smile with crowns? (This question is only applicable if the crown is for a front or visible tooth.)
- Is there a way that I can “test-drive” my new smile and crown(s) before making them permanent?
- How long will the entire process take from my first appointment through completion?
- What are the risks, benefits and alternatives associated with the type of crown(s) you are recommending?
- Is there any discomfort associated with crown procedures?
- Will I need or receive any type of sedation when you prepare (drill) the tooth or teeth for a crown?
- Is what you are recommending commonly done?
- Can you show me some before and after photos of cases that you have done?
- How much will my crown(s) cost?
- Will my insurance cover all or a portion of the cost?
- How long can I expect my crown(s) to last?
- Will there be any maintenance required with my crown(s)?
If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.
When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.
If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.
If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.
When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.
Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.
Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”