Understanding your wisdom teeth

Many patients ask whether wisdom teeth are really necessary since so many people have them removed.

The fact is that wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned.

However, problems can occur that sometimes make it better to have them removed.

For example, when the jaw isn’t large enough, the wisdom teeth can become impacted – misaligned or unable to grow in properly. They may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.

The reasons wisdom teeth may have to be extracted include:
– The teeth have only partially erupted. This leaves an opening for bacteria which cause infection.
– There is a chance the wisdom teeth will damage adjacent teeth.
– A cyst forms which may destroy surrounding structures such as bone or tooth roots.

Ask your dentist about the health and positioning of your wisdom teeth.

Your dentist will tell you if there are any issues and will recommend any steps needed.

How sedation and general anesthesia can make your visit to the dentist easier

While local anesthetics are often used in dental treatment, there is sometimes a need for anti-anxiety agents – such as nitrous oxide – or sedatives to help people relax during dental visits.

Dentists may use these agents to induce “minimal or moderate sedation”.

In this case, the patient reaches a relaxed state during treatment but can respond to speech or touch.

Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.

More complex treatments may require drugs that can induce “deep sedation”.

This reduces consciousness and causes a loss of feeling which helps to reduce both pain and anxiety.

Sometimes patients undergo “general anesthesia” where the drugs lead to a temporary loss of consciousness.

A dentist may recommend deep sedation or general anesthesia for certain procedures with children or with adults who have severe anxiety or for people who have difficulty controlling their movements.

While these techniques to control pain and anxiety are used to treat tens of millions of patients safely every year, it’s important that you let your dentist know anything that might affect your ability to benefit from them for example, tell them about any illnesses or health conditions, whether you are taking any medications and if you’ve had any problems with allergic reactions to medications.

Choosing the right toothbrush for your needs

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.

Taking steps to stop oral cancer before it’s too late

Oral cancer hits more than 30,000 Americans every year but you can minimize the risk by taking steps to ensure it’s caught early enough.

The first indications of oral cancer may be a very small, but dangerous, oral spot or sore that you are not even aware of.

In a routine examination, your dentist will carefully examine the inside of your mouth and tongue.

If they notice a flat, painless, white or red spot or a small sore, this may be completely harmless. But harmful spots or sores often look the same as harmless ones.

To ensure that a spot or sore is not dangerous, your dentist may choose to perform a simple test, such as a brush test. This collects cells from the lesion which can them be analyzed.

Any positive results from a brush test must usually be confirmed by a biopsy before deciding the next step.

If precancerous cells are found, the lesion can be surgically removed if necessary during a separate procedure.

When caught early enough, the chances of preventing the cancer developing are high but only half of those diagnosed survive more than five years.

That’s why regular dental examinations are so important for your overall health and not just to have good teeth.

Different types of dentist and how they help your oral care

While many people see dentists as the single group of people who look after the health of your teeth and mouth, there are various specialist categories that help you in different ways.

The categorization of a dentist will depend on their education, training and experience.

Here are some of the main specialist areas of dentistry:

Endodontics: Concerned with the dental pulp – the part in the center of a tooth made up of living soft tissue and cells and root canal therapy

Oral and Maxillofacial Pathology: This deals with the identification, and management of diseases affecting the oral and maxillofacial regions

Oral and Maxillofacial Radiology: Deals with the production and interpretation of images and data produced by radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region

Oral and Maxillofacial Surgery: Diagnosis and surgical treatment of diseases, injuries and defects of the tissues including extractions, facial surgery and implants

Orthodontics and Dentofacial Orthopaedics: Mainly deals with diagnosis, prevention and treatment of misaligned teeth and modification of midface and mandibular growth

Pediatric Dentistry: Provides preventive and therapeutic oral health care for infants and children through adolescence.

Periodontics: Prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth and the maintenance of the health, function and esthetics of these structures and tissues. Most periodontist place implants

Prosthodontics: Diagnosis, treatment planning, rehabilitation and maintenance associated with missing or deficient teeth and/or oral and maxillofacial tissues. Includes dentures, bridges and the restoration of implants.

Plus, of course, general dentists provide everyday care and many specialist services to maintain your oral health.

Is it safe to have an X-ray while pregnant?

Some women worry about whether it’s safe to have an X-ray exam while they are pregnant.

This can cause them to put off treatment they need.

However, untreated dental infections can pose a risk to the fetus, and dental treatment may be necessary to maintain the health of the mother and child. Sometimes this will mean an X-ray is necessary.

Radiation from dental X-rays is extremely low but every precaution is taken to minimize radiation exposure.

For example, a leaded apron reduces exposure to the abdomen and should be used when a dental radiograph is taken.

In addition, a leaded thyroid collar can protect the thyroid from radiation, and should be used whenever possible. The use of a leaded thyroid collar is strongly recommended for women of childbearing age, pregnant women and children.

Overall there is no reason to avoid dental radiographs (X-rays) while pregnant, breastfeeding or trying to become pregnant.

Follow your dentist’s advice and ask questions if you have any concerns.

Why cavities aren’t just for kids

Tooth decay or cavities result from destruction of the tooth enamel and can lead to a range of problems from toothache to bad breath.

Cavities occur when foods containing carbohydrates (sugars and starches) such as milk, sugared drinks, cakes or candy are frequently left on the teeth.

Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Many people associate cavities with children but the changes that occur with aging make cavities an adult problem, too.

Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque.

Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges of fillings is also common to older adults. As many of them did not benefit from fluoride and modern preventive dental care when they were younger, they often have a number of dental fillings.

Over the years, these fillings may weaken, fracture and leak around the edges.

Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

– Brush twice a day with fluoride toothpaste
– Clean between your teeth daily with floss or interdental cleaner
– Eat nutritious and balanced meals and limit snacking

It’s also worth asking your dentist about supplemental fluoride, which strengthens your teeth, and about dental sealants, a plastic protective coating which is applied to the chewing surfaces of the back teeth to protect them from decay.

In addition, it’s important to visit your dentist regularly for professional cleanings and oral examination.