Posts for: December, 2018
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
There’s one sure thing about tooth decay: you can’t ignore it. In fact, the best outcomes result from finding it early and treating it before it enters the pulp in the center of the tooth, often a filling or similar treatment.
If it does advance to the pulp, you may need a root canal treatment to save the tooth. This is a moderately invasive procedure where we access the pulp and root canals, tiny passageways leading to the root and supporting bone. We then remove all the diseased tissue and fill the empty pulp chamber and root canals with a special filling. Later we’ll crown the tooth for added protection against future infection or fracture of the tooth.
But there’s also another less-invasive method than a root canal called pulp capping. It’s only appropriate to use, however, if the pulp has become exposed or almost exposed by decay, but hasn’t yet shown signs of disease.
Pulp capping can be either direct or indirect. We use direct pulp capping if the healthy pulp has been exposed by the disease process. We first isolate the tooth from the rest of the mouth to prevent contamination and then proceed to remove all of the tooth’s decayed dentin structure. We then apply a biocompatible material directly over the pulp to protect it from further decay and to facilitate healing. We then restore the tooth, usually with a filling, to its proper function and life-like appearance.
When the pulp is threatened by decay but not yet exposed, we may then use the indirect method. In this approach we first remove most of the decayed dentin, but leave a small amount next to the pulp to keep it covered. We then treat this remaining dentin with a material to help it heal and re-mineralize, followed by a temporary filling of the tooth. A few months later we’ll remove this filling and inspect the treated dentin. If it has regenerated sufficiently, we remove any remaining decay and permanently restore the tooth.
As we said, pulp capping is only used with patients with deep decay whose pulp tissue is healthy. But when we can use it we can avoid some of the permanent alterations that often come with a root canal treatment and still save the tooth.
If you would like more information on treatments for tooth decay, 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 “Pulp Capping: A Procedure that May Save a Decayed Tooth.”
If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.
Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.
Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush. Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.
Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.
In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.
If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.
Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.