Posts for: November, 2013
Many people view a tooth extraction (removal) as a major ordeal; but from a dentist’s standpoint it’s a routine procedure. That’s not to say, though, that all extractions are alike — there are varying levels of complexity depending on the type, size and location of the tooth.
Teeth are held in place to the jawbone by a tissue known as the periodontal ligament, whose collagen fibers attach the tooth to the bone of the jaws. By gently manipulating the tooth, we can release the hold that these fibers have on the tooth. This takes not only skill but also a kind of “feel” that comes with experience.
From that point, removing the tooth will depend on its root structure and how it’s positioned in the jaw. Upper front teeth have a single, straight root usually shaped like a cone; their path of removal is relatively straight and uncomplicated. Many teeth in the back, however, have more than one root, and not as straight in shape as an upper front tooth, that complicates the path of removal. Depending on the level of complication, the extraction may require an oral surgeon, a dental specialist.
After the tooth is extracted, it may be necessary to fill the socket (the area of the bone once occupied by the tooth) with some form of grafting material that will encourage bone growth. This new growth will aid with any future plans for dental implants.
After the procedure, we will give you instructions for cleaning and caring for the extraction site as you recover over the next few days. We may also prescribe medications to help you cope with discomfort and swelling, as well as antibiotics and antibacterial mouth rinses.
Before undertaking any extraction, we would first conduct a thorough examination and provide you with your options and our recommendations for treatment. We would also discuss your options for replacing the teeth after theyâ??ve been extracted.
The thought of having an extraction may fill you with anxiety. But in the hands of an experienced professional, removing a tooth is a routine and safe procedure.
If you would like more information on tooth extractions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?”
Whether you think they're the height of fashion or the depth of “ice,” oral piercings like tongue bolts are a sign of our times. But along with these bodily adornments come a host of questions about risks to the wearer's health, both immediate and long-term. To help sort out these concerns, here are five facts everyone ought to know about oral piercings.
Oral piercings can cause acute health problems.
Rarely, nerve problems may result from an oral piercing. In at least one case, a teenager who had just gotten a tongue bolt developed severe facial pain and the feeling of electrical shocks. A neurologist traced these symptoms to an irritated nerve in the tongue, and the bolt's removal made the pain go away. More commonly, however, the immediate problems are soreness in the area of the piercing, bleeding in the mouth, and the risk of infection.
Oral piercings can lead to gum disease.
Periodontal problems associated with oral piercings include gum recession, inflammation, and even infection. Long-term bone loss may also be an issue. Over time, all of these conditions may affect a person's general health.
Oral piercings can lead to tooth problems.
Tooth pain and sensitivity are sometimes reported after the installation of an oral piercing. Chipping of the teeth is also a possibility, due to repeated contact with the metal of the ornament. People who decide to wear oral piercings should consult with us about increasing the frequency of their dental checkups.
Closing the hole left by a tongue piercing may require minor surgery.
As is the case with an ear piercing, the hole made for a tongue bolt often closes on its own. If it doesn't, a little surgery may be required to help it. In some cases, the tissue around the piercing may need to be removed before the hole itself can be sewn closed. Carried out under local anesthesia (a numbing shot), however, the procedure is usually simple and quick to heal.
Removing an oral piercing improves your oral health.
Losing the piercing reduces your risk factors, and thus improves your oral health. It's as simple as that. But any decision about oral piercings is ultimately yours to make. You should have a frank conversation about its risks and benefits with a knowledgeable health professional.
If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”
Not only can orthodontic treatment transform your smile, it can also restore function to your teeth and mouth that will improve both your oral and general health. But any treatment to straighten misaligned teeth requires careful planning. Depending on the exact nature of your misalignment, there may be some additional steps we would need to perform before undertaking orthodontic treatment.
One common need is space to help relieve overcrowding. To make room for tooth movement, often a tooth may need to be removed if the crowding is excessive. The most likely candidates are the first bicuspids, teeth located between the cuspids (or eyeteeth, located in line under the eyes) and the second premolar located in front of the molar teeth. The removal of these first premolars won't have a great effect on future form or function. Under the gentle pressure exerted by the braces, neighboring teeth will move and fill in the open space. Today's orthodontist goes to great lengths to avoid removing any teeth; in severe overcrowding, though, this is an acceptable way to create needed space.
Damaged teeth in need of replacement may also be removed before orthodontics and certainly more desirable — if any tooth needed to be removed, you would always choose a damaged tooth first. The object is to first preserve the underlying bone and close the space to avoid replacing that tooth or, if not possible, maintain the correct amount of space for any future restoration.
As living tissue, bone constantly reshapes in response to its environment. If it no longer senses a tooth (or the forces exerted by a tooth when biting or chewing), the bone will slowly disappear through a process known as bone resorption. To counteract this process, we may graft material (like processed donor bone) into the socket to encourage and maintain bone growth. This creates a platform for future tooth replacements like implants or bridgework after orthodontic treatment.
After orthodontics, it may also be necessary to install some type of “placeholder” (temporary bridgework or partial denture) in the area of missing teeth. Keeping the teeth from migrating into the space will improve the chances that any permanent restoration like an implant or fixed bridgework will look natural — as if it belonged there the entire time.
A complete dental examination will indicate whether any teeth need to be removed before undergoing orthodontic treatment. If necessary, taking this strategic step will help ensure we achieve the best result — a winning smile.
If you would like more information on tooth removal and other options to enhance orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”
If you were to look closely at many of your teeth, you would notice deep, natural grooves in the enamel surface. Often referred to as “pits and fissures,” these are some of the most difficult places in the mouth to keep clean. Toothbrush bristles simply can't reach deep enough into them to be effective; what's more, their warm, moist environment is the perfect breeding ground for bacterial growth. Consequently, pits and fissures are the most common location for tooth decay.
Children are especially susceptible — pits and fissures account for 43% of tooth decay in patients between the ages of six and seven. This is because when children's teeth erupt (first become visible in the mouth) the new enamel is more permeable and less resistant to decay than older teeth. Until the enamel matures, the risk for decay remains high.
Fortunately, in recent years there has been a decrease in the occurrence of tooth decay among children. Better hygiene practices, fluoride products and fluoridated drinking water, better nutrition, and regular dental visits are all factors in this improvement. One development in particular provides children an extra layer of protection — the use of sealants on the tooth surfaces.
Sealants are protective coatings applied to tooth surfaces, especially in pits and fissures that act as a barrier between bacteria and the immature enamel. Although the degree and extent of sealant use varies across the profession, many dentists recommend sealant application in children for all permanent molars and many primary molars soon after eruption.
The accessibility of regular dental care also plays a factor — those who have no or limited access (and thus are at high risk for tooth decay) may benefit from sealants on all of their back teeth, while children with regular care access (low risk) may need only a few. In fact, some dentists only recommend sealants in low-risk children when tooth decay is already present and after first removing as much decay as possible.
The goal, of course, is to prevent decay, or reduce its effects, in children. Sealants can help, but only when coupled with other measures — and a good habit of oral hygiene.
If you would like more information on sealants for children's teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sealants for Children.”