Posts for: August, 2019
Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.
Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.
It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.
But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?
That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.
For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.
More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
Although periodontal (gum) disease starts with the gums, the teeth may ultimately suffer. An infection can damage the gum attachment and supporting bone to the point that an affected tooth could be lost.
The main cause for gum disease is dental plaque, a bacterial biofilm that accumulates on teeth due to ineffective oral hygiene. But there can be other contributing factors that make you more susceptible to an infection. Smoking tobacco is one of the most harmful as more than half of smokers develop gum disease at some point in their life. If you’re a heavy smoker, you have double the risk of gum disease than a non-smoker.
There are several reasons why smoking increases the risk of gum disease. For one, smoking reduces the body’s production of antibodies. This diminishes the body’s ability to fight oral infections and aid healing. As a smoker, your body can’t respond adequately enough to the rapid spread of a gum infection.
Another reason for the increased risk with smoking are the chemicals in tobacco that damage the connectivity of gum tissues to teeth that keep them anchored in place. The heavier the smoking habit, the worse this particular damage is to the gums. This can accelerate the disease and make it more likely you’ll lose affected teeth.
Smoking can also interfere with getting a prompt diagnosis of gum disease because the nicotine in tobacco reduces the blood supply to the gums. Usually a person with an infection may first notice their gums are reddened or swollen, and bleed easily. Smoking, however, can give a false impression of health because it prevents the infected gum tissues from becoming swollen and are less likely to bleed. As a result, you may learn you have the disease much later rather than sooner, allowing the infection to inflict more damage.
There are ways to reduce your disease risk if you smoke. The top way: Kick the smoking habit. With time, the effects of smoking on your mouth and body will diminish, and you’ll be better able to fight infection.
You should also practice daily brushing and flossing to keep plaque at bay, followed by regular dental cleanings to remove hard to reach plaque and calculus (tartar) deposits. You should also see your dentist at the first sign of trouble with your gums.
If you would like more information on the prevention and treatment of gum disease, 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 “Smoking and Gum Disease.”