Q:
When should wisdom teeth be removed?
A:
The ideal age for wisdom tooth removal, also called third molars, is between the mid-teens and early twenties. During these ages, the teeth are frequently not fully formed, and the bone tends to be somewhat less mineralized than in older age groups. This makes third molar removal less complicated, minimizes your recovery, and reduces the risk of permanent complications.
Q:
What is the normal recovery from most oral surgery procedures?
A:
Typically, the use of prescription medications for pain might be required for 24-72 hours, depending upon the complexities of the procedure. Complete wound healing usually requires about 6 weeks, but as a rule, by the end of one week, patients have resumed their normal diet and oral hygiene routines.
Q:
What are dry sockets?
A:
A dry socket, actually know as alveolar osteitis, is a pain syndrome, most commonly associated with the removal of impacted lower wisdom teeth. In this scenario, the pain typically intensifies on the third or fourth postoperative day, and represents a loss of the blood clot at the base of the surgical site. These are typically treated with the placement of a gauze dressing saturated with clove oil. Pain relief is typically experienced within 24 hours.
Q:
How much bleeding should I expect?
A:
Generally, bleeding should only last approximately 30 minutes postoperatively. However, some "oozing" may last for up to 24 hours subsequent to surgery. Rinsing of the mouth, use of a straw, and smoking should be avoided on the first postoperative day so as to minimize this complication.
Q:
Should I continue my medications when I come for surgery?
A:
While most medications can be continued, medications which may cause bleeding, i.e. Coumadin (Warfarin), Plavix (Clopidogrel) may require adjustment prior to surgery. It is important to notify our office receptionist and schedule a consultation if your are on these types of medications.
Q:
What type of anesthesia will I have?
A:
Anesthetic choices may range from the use of local anesthesia only (i.e." novocaine"), nitrous oxide ("Laughing Gas") administered in conjunction with local anesthetics, oral sedation or intravenous sedation (i.e. "General Anesthesia"). Anesthetic choices are determined by the complexity of the procedures in question, the patient's age and overall health, as well as the types of medication, if any, being taken. A presurgical consultation is generally helpful in making this determination.
Q:
What if I take medicatons for osteoporosis?
A:
The most common group of medication taken for osteoporosis orally are the Bisphosphonates, which include Fosamax, Actonel and Boniva. These medications may impair wound healing specifically following oral surgery procedures. There is some controversy regarding these findings, but in certain circumstances these drugs should be discontinued for as long as three months prior to having oral surgery. This should be discussed during your pre- surgical consultation as well as with the dispensing physician.
Q:
What are my options if I have missing teeth?
A:
With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.
Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.
When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.
Options for replacement of missing teeth:
Implants - Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.
Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.
Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural tooth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.
Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.
If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.
Q:
What should I do if a tooth is knocked out?
A:
We’re all at risk for having a tooth knocked out. More than 5 million teeth are knocked out every year! If we know how to handle this emergency situation, we may be able to actually save the tooth. Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:
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Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
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DO NOT scrub or use soap or chemicals to clean the tooth. If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.
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Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful reimplantation.
Ways to transport the tooth
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Try to replace the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place. Apply a cold compress to the mouth for pain and swelling as needed.
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If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.
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Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.
The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years. So be prepared, and remember these simple steps for saving a knocked-out tooth.
You can prevent broken or knocked-out teeth by:
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Wearing a mouthguard when playing sports
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Always wearing your seatbelt
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Avoiding fights
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Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.
Q:
What do heart disease and other medical conditions have to do with periodontal (gum) disease?
A:
Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections; often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!
Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!
There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections. Research suggests that periodontal bacteria in the blood stream may:
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Contribute to the development of heart disease
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Increase the risk of stroke
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Compromise the health of those that have diabetes or respiratory diseases
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Increase a woman’s risk of having a preterm, low-birth weight baby
Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.
To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.
Remember….the mouth body connection! Taking care of your oral health may contribute to your overall medical health!