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?”

We say that we are going to have our teeth cleaned — but a lot more than simple cleaning takes place during a visit to a dental hygienist.

1. Health History
   Your hygienist will ask you about your general health and your dental health and any recent changes in either. By doing so she will pinpoint any issues that require special precautions during your cleaning.
2. Cancer Screening
   Next, the hygienist carefully examines the skin in and around your mouth looking for lumps, bumps, sores, tenderness or swellings and refers areas of concern to the dentist for further evaluation. The hygienist is one of the few people who get to closely assess your whole mouth, so she is trained to spot cancer and other diseases.
3. Evaluating Your Periodontal Health
   Your hygienist will look closely at the state of your periodontal health (from peri meaning around and dont meaning tooth). This includes checking your gums and the other tissues surrounding your teeth for inflammation (gingivitis) or bleeding.
4. Checking for Decay
   The hygienist will examine your teeth for decay and will note the location and condition of stains or hard mineral deposits (calculus or tartar). These deposits result from a buildup of plaque (a film of bacteria) that has not been removed by daily brushing.
5. Scaling
   The hygienist uses hand tools or a sonic scaler to remove the calculus from your teeth.
6. Polishing
   A mechanical polisher and an abrasive polishing compound are used to polish the surface of your teeth so that they are smooth, making them more resistant to plaque, removing stains and leaving your teeth feeling squeaky clean.
7. Measuring
   The hygienist uses a tiny probe to measure the space between your teeth and gums. Periodontal disease begins by forming pockets between the teeth and gums, so this measuring is key to your periodontal health. Generally a space of 3mm or less indicates healthy gums, pockets of 4 to 5mm indicate periodontal disease that may be reversed with good oral care at home, and pockets that are 6mm deep or more require specialized treatment by a dentist or periodontist (a dentist who specializes in care of gums).
8. Education
   Based on the observed conditions of your gums and teeth, the hygienist will provide information aimed at improving your home oral cleansing routines and about your risk for tooth decay and gum disease.
9. Making Your Next Appointment
   The hygienist will make an appointment for your next cleaning — in three, four, or six months depending on the health of your gums and teeth. Keeping these appointments not only keeps your teeth looking their best, but it also assures good management of your dental health.

Contact us today to schedule an appointment to discuss your questions about dental hygiene. You can also learn more by reading the Dear Doctor magazine article “Dental Hygiene Visit.”

We tend to think of aspirin as a harmless medication. It is dispensed over the counter and is the most widely used OTC medication in the U.S. We take it without thinking we may be exposing ourselves to risks. But in certain situations aspirin can cause dangerous side effects.

What is aspirin, and how does it work?
The chemical name for aspirin is acetylsalicylic acid. It is used to reduce mild pain, inflammation and fever. When you take an aspirin, it blocks the formation of prostaglandins, substances your body creates that are associated with inflammation. Prostaglandins cause inflamed tissues to become red and swollen, but they also serve protective purposes, such as forming a barrier that protects the stomach from the acid it produces to digest your food. That's why long-term aspirin use can sometimes cause stomach bleeding and ulceration or other health problems.

Why do cardiac patients take aspirin?
Another effect of aspirin is to prevent blood platelets from clumping together. Blood platelets are structures in the blood, smaller than white or red blood cells, that aid clotting by sticking together at the site of an injury. This effect of aspirin can cause prolonged bleeding, but it may be beneficial to people who have cardiovascular (from cardio, meaning heart; and vascular, meaning vessel) disease with narrowed blood vessels.

Aspirin can keep blood flowing in the obstructed vessels and thus prevent heart attacks and strokes; but it can also increase the risk for strokes that are caused by bleeding in the brain. Most physicians attempt to lower such risks by asking their patients to keep their daily aspirin consumption to a low dose 81 mg “baby” aspirin.

How does aspirin affect your teeth and gums?
Be sure to let your medical and dental professionals know you are taking aspirin, and how much you take. Also tell us about other OTC medications you take, including herbal medications and supplements, because they may interact with aspirin to cause side effects.

If you have been told to take aspirin because of a cardiac condition or procedure, be sure to follow your recommended treatment. Do not suddenly discontinue aspirin therapy; doing so can increase your risk for heart attack and stroke. Ask us if you should stop taking aspirin before a major dental or oral surgery, but do not stop taking it on your own. We will consult with your physician about your medical condition and let you know our recommendation. In most cases you can continue your aspirin therapy without causing excessive bleeding during the dental procedure.

Contact us today to schedule an appointment. You can also learn more by reading the Dear Doctor magazine article “Aspirin: Friend or Foe?”

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:

• Tooth preparation or reduction is not needed, leaving the original tooth whole.
• They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
• They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
• They can be used to “lengthen” teeth that have been worn down by grinding.
• Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:

• There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
• Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
• Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
• They do not usually work for lower teeth because of space restrictions.
• They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”

Most people think of bone as rock-solid, but it's actually a living tissue that's constantly changing. This has significant implications for your oral health, general health, and appearance — if you are one of the 70% of Americans missing at least one tooth.

Throughout the day, your top and bottom teeth make hundreds of fleeting contacts with each other. These small stresses are transmitted though the periodontal ligament (“peri” – around; “odont” – tooth) that supports each tooth in its socket like a hammock. Think of it as a gentle push on the hammock, which causes the tooth to gently bump the underlying bone. The bone then builds up in the spot that's receiving stress to counteract it. This constant remodeling of bone is what allows bone to stay healthy and strong.

When a tooth is lost, the bone does not receive that gentle stress. It reacts by literally melting away. Sometimes this happens fairly quickly — in a matter of months. After the tooth-supporting bone is lost, the jawbone itself begins the same process of deterioration. This could eventually change the shape of the face, as the distance from nose to chin can decrease — even if only a few back teeth are missing. The results aren't pretty. But the good news is, there's a way to prevent all this.

Dental implants, which function as substitute tooth roots, actually save underlying bone when teeth are lost. They do this because they are made of titanium, which fuses to the bone in which it's set, stabilizing it. The implant is topped by a realistic-looking crown, which replaces the part of the missing tooth that was visible in the mouth. Together, they look and function just as your natural tooth did.

If you are missing a lot of teeth, implants can also be used to anchor bridges or even removable dentures while providing that same bone-saving benefit. And when you consider that they are so durable they should never need replacement, implants are a great investment.

If you have any questions about dental implants, please contact us, or schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”