Posts for: August, 2011
Wisdom teeth are the third set of molars that erupt in the late teens or early twenties — so-called because they come in around the age of maturity or “wisdom.” While teeth are designed to last a lifetime, wisdom teeth are often problematic requiring early removal because they frequently become impacted, meaning they are not able to erupt fully through the gums to become healthy functioning teeth. However, not all wisdom teeth need to be removed if they are fully erupted and functional.
Prevention: Having a tooth submerged below the gum, pressing on the roots of neighboring teeth can cause damage and decay even though you may not be feeling any discomfort. By the time the tooth becomes painful, significant damage may already have occurred. In addition, the ability of the body to heal following oral surgery tends to decrease with age. A recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation strongly recommends that wisdom teeth be removed in young adulthood in order to prevent future problems and to ensure optimal healing.
Reasons for Removal: If your wisdom teeth are impacted against (pressing on) the roots of other teeth, damage can occur. To prevent infections, gum disease, decay, or damage to other permanent teeth, our office may recommend removal of your wisdom teeth.
What to Expect: If wisdom teeth removal is recommended, it can generally be done in the dental office as a surgical procedure with local anesthesia and conscious sedation (twilight sleep). After the surgery, you may experience some moderate discomfort and swelling depending on the degree of impaction and difficulty. Taking non-steroidal anti-inflammatory medication like ibuprofen, or prescription medication for several days after surgery will provide pain relief and control swelling.
Contact us today to schedule an appointment to discuss any questions you may have regarding removal of your wisdom teeth. Read more about this topic in the Dear Doctor magazine article “Wisdom Teeth: To Be Or Not to Be?”
It used to be that when it came to treating tooth decay (cavities), your primary option was to have the tooth decay removed and filled with a metal amalgam (silver-colored filling). This treatment sometimes requires a special shape cut called an “undercut” to be drilled into the tooth to hold it in. Unfortunately, it can also involve removal of some healthy tooth structure. Silver amalgam fillings still have limited applications and are still used in back teeth where they don't show in the smile. This is because they are strong and resist biting well; however, over time they can fatigue and fracture.
Older restorative concepts were based upon the development of strong and stiff materials such as gold, which tends to be unyielding and therefore contributed to failures of the remaining tooth substance around restorations (e.g., decay or cracking). Newer concepts tend to get away from the “stronger and stiffer is better” concept and have moved towards safety principles using materials that involve mimicking the properties of natural tooth structure. In fact, it is now clearly established that a new “biomimetic approach” (“bio” – life; “mimetic” – mimicking) to dentistry is possible through the use of tooth-like materials such as composite resins and porcelains. And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, which both stabilize and strengthen teeth.
These techniques are also suitable for children's teeth and can incorporate fluoride to reduce further decay. But perhaps best of all, using these materials and more modern technologies can restore proper tooth function and normal wear while producing results that appear indistinguishable from natural teeth.
To learn more, continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” You can also contact us today to schedule an appointment to discuss your specific questions about replacing your metal fillings with tooth-colored ones.
One question we are most often asked by parents of athletes or those who participate in physical sports is, “Do mouthguards really work?” And when we respond, “yes,” a common follow-up question is, “Is there any scientific evidence to support this claim?” Based on this scenario, we feel it is important to provide you with some interesting and evidence-based facts on this topic.
The first reported use of mouthguards was in the sport of boxing. And because participants and bystanders in the 1920s quickly witnessed their effectiveness even back then, the trend's popularity grew to the point that boxing became the first professional sport to require them. However, other sports soon started following this lead — especially those high-contact sports. The American Dental Association (ADA) started mandating the use of mouthguards for football in 1962 and the US National Collegiate Athletic Association (NCAA) currently requires mouthguards for football, ice hockey, lacrosse and field hockey. The ADA has since expanded their recommendations to now include 29 different sports and exercise activities. So now that you know more about the professional organizations pushing the use of mouthguards, let's get back to the second question, “What's the evidence?”
There have been numerous studies over the years regarding the properties of mouthguards, and more specifically their shock absorbing capabilities. Other studies have been based upon their protective abilities due to their stiffness, hardness and strength. This research has enabled us to vastly improve upon the effectiveness of mouthguards. For example, years ago latex rubber was a popular material used to create mouthguards. However, today we use products such as ethylene vinyl acetate or polyurethane because they are far superior in durability and flexibility. And impact studies have shown that the chances of fracturing teeth is dramatically reduced when wearing one of these mouthguards...especially when compared to individuals wearing no mouthguard at all. In fact, research has revealed that by not wearing a mouthguard during physical sports or exercise, individuals are 60 times more likely to experience an injury to the mouth and/or teeth.
To learn more about the importance of protective mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment to discuss your questions about mouthguards.
Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.
If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.
Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.
What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.
At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.
Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.
Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.
Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”