As Spring turns to Summer, millions of students will depart high school in the time-honored rite of passage called graduation. At the same time, quite a few of these graduates will be experiencing another maturity milestone: the eruption (coming in) of their last permanent teeth.
Typically, these are the back third molars, better known as “wisdom teeth,” emerging on either end of both the top and bottom jaws sometime between the ages of 18 and 24. Their arrival heralds the end of a long development process that began in infancy.
But this auspicious event can give rise to dental problems. Because they’re the last to come in, wisdom teeth often erupt in an environment crowded by earlier teeth. Depending on jaw size and other factors, there may not be enough room for a normal eruption.
Wisdom teeth can thus erupt out of position, creating a poor bite (malocclusion). Or they might not erupt at all—becoming stuck fully or partially within the gums and bone, a condition known as impaction. Impacted teeth can also cause problems for the adjacent teeth, damaging the roots of the second molars or disrupting the surrounding gum tissue, making them more susceptible to periodontal (gum) disease.
Because of these and other issues, impacted wisdom teeth are among the most common type of teeth removed: an estimated 10 million each year. And many of these are removed before they show signs of disease or complications as a preemptive strike against developing dental problems.
Although unnecessary surgery should always be avoided, according to some research, there’s a one in three chance that erupting wisdom teeth that are not showing signs of trouble will eventually become problematic. And the earlier they’re removed, the lower the risk of post-extraction complications.
Wisdom teeth should always be evaluated on a case by case basis. Those with obvious signs of disease or complications do require prompt treatment, including possible extraction. Others that are asymptomatic can be monitored over time: If they’re tending to become problematic, we can adjust the treatment plan accordingly. Our goal is to ensure these particular teeth signaling the end of childhood won’t detract from dental health in adulthood, so a measured approach seems to be the best and safest one.
If you would like more information on treatment options for wisdom teeth, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Wisdom Teeth: Coming of Age May Come With a Dilemma” and “Wisdom Teeth: To Be or Not to Be?”
Occurrences of obesity and Type 2 diabetes have soared in the last few decades. While there are a number of influencing factors, health officials place most of the blame on one of our favorite foods: sugar. Only a generation ago we were consuming an annual average of 4 pounds per person. Now, it's nearly 90 pounds.
We've long known that sugar, a favorite food not only for humans but also oral bacteria, contributes to dental disease. But we now have even more to concern us—the effect of increased sugar consumption on health in general.
It's time we took steps to rein in our favorite carbohydrate. Easier said than done, of course—not only is it hard to resist, it's also hard to avoid. With its steady addition over the years to more and more processed foods, nearly 77% of the products on grocery store shelves contain some form of sugar.
Here's what you can do, though, to reduce sugar in your diet and take better care of your dental and general health.
Be alert to added sugar in processed foods. To make wiser food choices, become familiar with the U.S.-mandated ingredient listing on food product packaging—it tells if any sugar has been added and how much. You should also become acquainted with sugar's many names like "sucrose" or "high fructose corn syrup," and marketing claims like "low fat" that may mean the producer has added sugar to improve taste.
Avoid sodas and other prepared beverages. Some of the highest sources for added sugar are sodas, sports drinks, teas or juice. You may be surprised to learn you could consume your recommended daily amount of sugar in one can of soda. Substitute sugary beverages with unsweetened drinks or water.
Exercise your body—and your voice. Physical activity, even the slightest amount, helps your body metabolize the sugar you consume. And speaking of activity, exercise your right to have your voice heard by your elected officials in support of policy changes toward less sugar additives in food products.
Becoming an informed buyer, disciplined consumer and proactive citizen are the most important ingredients for stopping this destructive health epidemic. Your teeth—and the rest of your body—will thank you.
If you would like more information on the effects of sugar on dental and general health, 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 “The Bitter Truth About Sugar.”
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
There's no doubt treating dental problems can improve your health. But because the mouth is among the most sensitive areas of the body, many dental procedures can be potentially uncomfortable after treatment.
We rely on pain medication to alleviate any dental work discomfort, especially during recuperation. Our arsenal of pain-relieving drugs includes strong opioid narcotics like morphine or oxycodone which have effectively relieved dental pain for decades. But although they work wonders, they're also highly addictive.
We've all been confronted in the last few years with startling headlines about the opioid addiction epidemic sweeping across the country. Annual deaths resulting from opioid addiction number in the tens of thousands, ahead of motor vehicle accident fatalities. Although illegal drugs like heroin account for some, the source for most addiction cases—an estimated 2 million in 2015 alone—is opioid prescriptions.
Dentists and other healthcare providers are seeking ways to address this problem. One way is to re-examine the use of opioids for pain management and to find alternative means that might reduce the number of narcotic prescriptions.
This has led to new approaches in dentistry regarding pain relief. In a trend that's been underway for several years, we've found managing post-discomfort for many procedures can be done effectively with non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen or ibuprofen. They don't share the addictive quality of narcotics and are regarded as safer when taken as directed.
There's also been a recent modification with using NSAIDs. Dentists have found that alternating the use of ibuprofen and acetaminophen often amplifies the pain relief found using only one at a time. By doing so, we may further reduce the need for narcotics for more procedures.
The trend now in dentistry is to look first to NSAIDs to manage pain and discomfort after dental work. Narcotics may still be used, but only in a secondary role when absolutely needed. With less narcotic prescriptions thanks to these new pain management protocols, we can reduce the risk of a dangerous addiction.
A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.
Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.
While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.
Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.
There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).
If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.
Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.
If you would like more information on treating loose 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 article “Treatment for Loose Teeth.”
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