Posts for category: Dental Procedures
When a tooth is beyond repair due to disease or injury, it may be necessary to remove it. A “simple” tooth extraction is among the most common in dentistry and certainly not the agonizing procedure depicted in common lore.
They’re referred to as simple extractions because the shape of the tooth and root allows for a fairly straightforward and uncomplicated removal. An example would be the normally cone-shaped upper front tooth that doesn’t offer a lot of resistance during the extraction process.
The process itself is fairly straightforward. Teeth are held in place by the periodontal ligament, an elastic tissue made of tiny fibers that attaches the tooth to the supporting bone. These fibers can be dislodged from the tooth with some careful manipulation — in the hands of an experienced dentist there’s a deft “feel” to the fibers loosening. Once they’ve detached, it requires little effort to remove the tooth; with the aid of local anesthesia, you won’t feel anything but a little pressure.
Immediately after the tooth is removed, we commonly insert bone grafting material in the socket to minimize bone loss until a permanent replacement like a dental implant can be installed after tissue healing. We then place sterile gauze over the site for a few minutes to control bleeding and, depending on the size of the wound opening, we may also place a few stitches to close it. We then give you instructions for caring and cleaning the site over the next few days, and prescribe antibiotics to reduce the chance of infection and anti-inflammatory drugs for any discomfort.
Although a simple extraction is a routine procedure, it’s important to perform a proper assessment of the tooth and the surrounding bone beforehand, including x-rays to determine the tooth’s exact shape and position. If we discover a complication that makes a simple extraction impractical (like multiple roots at acute angles), we may then refer you to an oral surgeon for a more complicated surgical extraction.
It’s our hope you’ll have your natural teeth for as long as you live. But if you must have one removed, you can rest assured it’s a common — and uneventful — experience.
If you would like more information on tooth extraction, 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.”
As Spring turns to Summer, millions of students will depart high school in the time-honored rite of passage called graduation. At the same time, quite a few of these graduates will be experiencing another maturity milestone: the eruption (coming in) of their last permanent teeth.
Typically, these are the back third molars, better known as “wisdom teeth,” emerging on either end of both the top and bottom jaws sometime between the ages of 18 and 24. Their arrival heralds the end of a long development process that began in infancy.
But this auspicious event can give rise to dental problems. Because they’re the last to come in, wisdom teeth often erupt in an environment crowded by earlier teeth. Depending on jaw size and other factors, there may not be enough room for a normal eruption.
Wisdom teeth can thus erupt out of position, creating a poor bite (malocclusion). Or they might not erupt at all—becoming stuck fully or partially within the gums and bone, a condition known as impaction. Impacted teeth can also cause problems for the adjacent teeth, damaging the roots of the second molars or disrupting the surrounding gum tissue, making them more susceptible to periodontal (gum) disease.
Because of these and other issues, impacted wisdom teeth are among the most common type of teeth removed: an estimated 10 million each year. And many of these are removed before they show signs of disease or complications as a preemptive strike against developing dental problems.
Although unnecessary surgery should always be avoided, according to some research, there’s a one in three chance that erupting wisdom teeth that are not showing signs of trouble will eventually become problematic. And the earlier they’re removed, the lower the risk of post-extraction complications.
Wisdom teeth should always be evaluated on a case by case basis. Those with obvious signs of disease or complications do require prompt treatment, including possible extraction. Others that are asymptomatic can be monitored over time: If they’re tending to become problematic, we can adjust the treatment plan accordingly. Our goal is to ensure these particular teeth signaling the end of childhood won’t detract from dental health in adulthood, so a measured approach seems to be the best and safest one.
If you would like more information on treatment options for wisdom teeth, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Wisdom Teeth: Coming of Age May Come With a Dilemma” and “Wisdom Teeth: To Be or Not to Be?”
If you’re considering a dental implant as a replacement for a lost tooth, you’re looking at a restoration method with an amazing 95% success rate after ten years. But that being said there’s still a risk, albeit quite low, the implant might fail.
And if you smoke, the risk is slightly higher. In a recent study of implant patients, twice as many of the failures occurred in smokers compared to non-smokers. If you’re a smoker, you can increase your chances of a successful outcome if you quit the habit.
Nicotine, a chemical within tobacco, is the primary cause for this higher risk. Besides its effect on the pleasure centers of the brain, nicotine also restricts smaller blood vessels that are abundant in the mouth and skin, causing less blood flow. As a result, the mouth doesn’t have as many antibodies and other substances available to fight infection and help traumatized tissues heal.
Because of this, as well as reduced saliva flow due to the habit, smokers have an increased risk of dental disease and are slower to respond to treatment. This can be especially problematic if the gum tissues around an implant become infected, which could lead to a catastrophic failure. Slower healing also impacts the post-surgery period when bone cells in the jaw are growing and adhering to the implant surface, forming a stronger bond.
To avoid these potential risks you should stop smoking before you undergo implant surgery. If you can’t completely kick the habit, you should at least stop a week before surgery and for two weeks after. It’s also critical that you practice good oral hygiene — both brushing and flossing — to minimize the occurrence of dental disease and see us for regular checkups and maintenance appointments.
Taking these steps will greatly increase your chances of being in the vast majority of people who continue to enjoy success with their implants for many years.
If you would like more information on the impact of smoking 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 “Dental Implants & Smoking.”
Biting the inside of your cheek is high on the list of minor but painfully irritating occurrences like paper cuts or tongue scalding from hot coffee. A mouth bite, though, has an additional tormenting feature — there's a good chance you'll bite the same spot again.
This kind of repeated mouth injury results in an enlargement of the soft tissue that has been traumatized. They're often diagnosed and referred to as a traumatic fibroma. When you bite your cheek, lips or tongue, you create a small wound that usually heals quickly. This healing process, though, can be interrupted if you bite the area again, which can then cause excess scar tissue to form.
The fibrous scar tissue, made up of a protein called collagen, is similar to a callous. You can often feel it with your tongue — a knot of tough skin that protrudes from the otherwise flat cheek wall. Because of this prominence, it tends to get in the “line of fire” during eating or biting, so you'll bite it again — and again. If this cycle continues, then even a more prominent scar tissue forms that you're more likely to bite again.
The wound will heal most of the time, unless you continually bite it. If it becomes a nagging problem, we can surgically remove the lump. After numbing the area with local anesthesia, we'll either use a laser or scalpel to remove it. The area is easy to fix and will flatten out the cheek surface. The entire procedure takes fifteen minutes or less and in a few days to a week you won't even notice it had been there.
While the vast majority of these lesions are harmless, it's still standard protocol to biopsy the removed tissue: a pathologist examines it under a microscope for cancer cells. This is a routine part of any medical practice and not a cause for alarm.
If you've had a lump for awhile that you always seem to be biting, see us for an examination. With a simple procedure, we may be able to remove that irritation once and for all.
If you would like more information on treating mouth lumps and other sores, 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 “Common Lumps and Bumps in the Mouth.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”