Posts for: December, 2018
As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, 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 “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, 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 “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
If there’s one essential tool for protecting your dental health, it’s the humble toothbrush. The basic manual brush with a long, slender handle and short-bristled head is still effective when used skillfully. The market, though, is full of choices, all of them touting their brand as the best.
So how do you choose? You can cut through any marketing hype with a few simple guidelines.
First, understand what you’re trying to accomplish with brushing: removing dental plaque, that thin film of bacteria and food particles on tooth surfaces that’s the main cause of dental disease. Brushing also stimulates gum tissue and helps reduce inflammation.
With that in mind, you’ll first want to consider the texture of a toothbrush’s bristles, whether they’re stiff (hard) or more pliable (soft). You might think the firmer the better for removing plaque, but actually a soft-bristled brush is just as effective in this regard. Stiffer bristles could also damage the gums over the long term.
Speaking of bristles, look for those that have rounded tips. In a 2016 study, less rounded tips increased gum recession in the study’s participants by 30%. You should also look for toothbrushes with different bristle heights: longer bristles at the end can be more effective cleaning back teeth.
As far as size and shape, choose a brush that seems right and comfortable for you when you hold it. For children or people with dexterity problems, a handle with a large grip area can make the toothbrush easier to hold and use.
And look for the American Dental Association (ADA) Seal of Acceptance, something you may have seen on some toothpaste brands. It means the toothbrush in question has undergone independent testing and meets the ADA’s standards for effectiveness. That doesn’t mean a particular brush without the seal is sub-standard—when in doubt ask your dentist on their recommendation.
Even a quality toothbrush is only as effective as your skill in using it. Your dental provider can help, giving you tips and training for getting the most out of your brush. With practice, you and your toothbrush can effectively remove disease-causing plaque and help keep your smile beautiful and healthy.
If you would like more information on what to look for in a toothbrush, 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 “Sizing up Toothbrushes.”