Posts for: November, 2013
The old saying, “If it ain't broke, don't fix it,” doesn't really apply when discussing your wisdom teeth. It's great if they are not bothering you, but don't wait for problems to develop before you take action. This may seem counter-intuitive, but you should know that the best time to have your wisdom teeth removed is when they are not causing problems.
Why do wisdom teeth cause problems?
Wisdom teeth are so-called because they appear at ages 17 to 25, the age of supposedly attaining wisdom. They are also known as third molars and are farthest back in your jaws. For some people they come through the gum-line only partially, or they may not erupt into the mouth at all. Unerupted they have the potential to cause problems associated with the neighboring teeth and surrounding gums.
You may have heard of “impacted” wisdom teeth. This means that they are impacted or forced against neighboring structures, teeth or bone that prevent them from coming into the mouth in correct biting position. Since they are your last teeth to come in, space for them may be severely limited. They may push into the teeth that are already in place, becoming stuck as they try to erupt. When wisdom teeth are trapped like this below the gum line and are pushing against neighboring teeth, these molars can cause problems such as infections, cysts, or gum disease.
My wisdom teeth seem OK, so why remove them?
The dilemma is that if you wait until you feel pain connected with your wisdom teeth, their neighboring teeth may already be in trouble.
Another reason to remove these back teeth before they cause problems is that it's a good idea to have your surgery while you are young. Younger, healthy patients with no infections at the site have the best chance of having their wisdom teeth extracted without complications, with an easier recovery and uneventful healing.
Of course, each situation is different. Make an appointment with us for an examination and a consultation to discuss the risks and benefits of removing your wisdom teeth. For more information read the article “Removing Wisdom Teeth” in Dear Doctor magazine.
Our smiles are our “calling cards” for first impressions. When our front teeth are missing, chipped or otherwise damaged, it will certainly make an impression — and not a positive one.
The good news is many aesthetic problems with front teeth can be remedied with the use of composite resins. This cost-effective treatment choice not only minimizes a negative appearance, but can actually create a positive smile transformation.
Composite resins are tooth-colored materials made up of two or more polymer substances. We call materials like these biomimetic, meaning something non-living that’s fashioned to appear or “mimic” something living. Composite resins are made of substances that aren’t teeth, but fashioned to look and function like teeth.
Composite resin restorations are bonded to the outside of the tooth with dental adhesive, with little to no preparation of the enamel surface of the tooth. They’re best suited for teeth with minor to moderate damage from decay or trauma, but where the majority of the structure is still viable and intact.
These restorations require skill and an artistic eye to achieve the most life-like result. One of the most important considerations is tooth color. The natural color of your teeth is actually a combination of color from the inner core of the tooth, the dentin, and the outer enamel layer. Much of the color comes from the dentin as it shows through the translucence of the enamel. The intensity and hue also changes along the length of the tooth — there are subtle zones of color that run vertically along the length of the crown (the visible portion of the tooth). Our aim is to replicate this variety of color in the restoration and affix it in such a way that it blends with the natural color of surrounding teeth.
Composite resins aren’t the best option for all situations; depending on the tooth’s condition and location, a porcelain veneer may be the better choice. After a thorough dental examination, we can make the best recommendation for your situation. If conditions are right, a composite resin restoration could transform your smile and your life.
If you would like more information on front teeth repair options, 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 “Artistic Repair of Front Teeth With Composite Resin.”
Do you clench your jaw or grind your teeth? Bite your nails? Chew on pencils or toothpicks? Or, heaven forbid, unscrew hard-to-open bottle caps using your precious pearly whites?
Over time, habits such as these — referred to in dentistry as “parafunctional” (para – outside; functional – normal) or beyond the range of what nature intended — can inflict excessive wear and tear on your teeth. Besides the impact damaged teeth can have on your smile, so called “tooth to tooth” and “tooth to foreign object” behaviors can cause physical problems, such as jaw joint and muscle pain, headaches, earaches, and even neck and back pain.
Use of Excessive Force
Parafunctional behaviors exert an abnormal amount of force on your teeth — up to 10 times the amount used for biting and chewing. Tooth grinding or “bruxism” (from the Greek word brykein – “gnash the teeth”) is particularly detrimental and is commonly seen in individuals who are experiencing a stressful time in their life. Some medications can also trigger it. Since bruxism often occurs while people sleep, it's possible to be unaware of it unless a partner comments (it can be noisy!) or a dental professional points out the tell-tale signs of wear.
To counter the adverse effects of nocturnal tooth grinding our office can create a customized night or occlusal (bite) guard. Typically fashioned from a hard, clear “processed acrylic” (wear-resistant plastic), this type of guard is amazingly inconspicuous. It is made to fit over the biting surfaces of the upper teeth only and is thinner than a dime. When it is worn, the lower teeth easily glide over the upper teeth rather than chomping into and gnashing with them, which minimizes the likelihood of erosion, chipping and uneven or excessive wear of the biting surface of the teeth. The guard is so unobtrusive, that some people even wear it as they go about their daily activities.
Remember: In addition to proper dental hygiene, you can help keep your teeth healthy by using them wisely!
If you would like more information about parafunctional habits like bruxism and ways to protect your 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 articles “Stress & Tooth Habits” and “How And Why Teeth Wear.”
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.”