Dental Procedures

7 FAQs About Impacted Wisdom Teeth

June 7, 2012 by DentalCMO

“Impacted wisdom teeth.” The term alone sounds ominous. What are wisdom teeth, why do they become impacted, what is the best way to treat them? These are questions people often ask.

What are “wisdom teeth” anyway?
Your third molars, located in the very back of your jaws, are your wisdom teeth. Most people have four of them.

Why is their name associated with wisdom?
They usually begin to come in when a person is 17 to 25 years old, a time when he or she can be said to begin to reach an age of wisdom.

Doesn’t everyone get wisdom teeth?
While some people have more than four, others have fewer, and some have no wisdom teeth at all. Some people have wisdom teeth that can be seen in x-rays but do not erupt (grow up through their gums) and become visible.

What does “impacted” mean?
In normal usage, the term “impact” means “influence or effect.” In dental vocabulary, it means that a tooth is affecting another tooth or a nearby structure such as gums, nerves or blood vessels. Often an impacted wisdom tooth grows sideways into an adjacent tooth instead of growing upwards to come through the gums normally. This may be caused by a lack of room in your jaw for your third molars.

What kinds of problems can impacted wisdom teeth cause?
A wisdom tooth can impact the gum tissues surrounding nearby molars, leading to infection called “periodontal disease” (from the root words for “around” and “tooth.”) They can also cause root resorption in adjacent teeth, a process by which the tooth’s roots are slowly dissolved and eaten away.

What are the symptoms of impacted wisdom teeth?
Sometimes impacted teeth are asymptomatic — you feel nothing, even though damage is being done to gums and teeth surrounding the wisdom teeth. That’s why it’s a good idea to have regular checkups even if you are feeling no pain. Other times, impacted teeth can lead to acute inflammation and infection in surrounding gum tissues that is very painful.

Should I proactively have my wisdom teeth removed if they are not giving me any trouble?
Not necessarily but your wisdom teeth need to be evaluated. Generally speaking, however, it’s better to remove wisdom teeth early, before they begin to cause dental problems. By the time a wisdom tooth starts to hurt, its neighboring teeth may already be in big trouble. In addition, younger people’s wisdom teeth have undeveloped roots that make them easier to remove with fewer complications.

Contact our office for a full assessment and consultation about your wisdom teeth. You can also learn more by reading the Dear Doctor magazine article “Wisdom Teeth: To Be Or Not To Be?”

How Modern Dental Fillings Mimic Real Teeth

May 30, 2012 by DentalCMO

Until recently anyone who needed to repair cavities in his or her teeth ended up with a mouth full of “silver” fillings. Dental amalgam, which has a silver appearance, was the tooth restoration material of choice. Amalgam, a combination of metals including silver, mercury, and other metals, is still used — but today there are other options that mimic the original teeth they are restoring.

You may have read about some people’s concerns about the mercury used in dental amalgam. According to the American Dental Association (ADA), scientific studies have found no ill effects arising from using dental amalgam in fillings for adults or children: “While questions have arisen about the safety of dental amalgam relating to its mercury content, the major US and international scientific and health bodies, including the National Institutes of Health, the US Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.” Dental amalgam is still used for molars (back teeth) that must withstand heavy pressure from chewing.

For teeth that are more visible, materials that look and perform more like the original teeth — and are thus more pleasing in appearance — are now available. Dentistry is now taking a “biomimetic approach” (from words meaning “life mimicking”). The new materials — composite resins and porcelains — look like teeth because in many ways their structure imitates the biologic structure of teeth.

Composite resins are made of a plastic material (methacrylate) combined with fillers made of silica, a form of glass. They are able to bond to natural tooth structure and resemble the dentin, the inner layer of the tooth, which has a porous structure similar to bone.

Dental porcelains are a form of ceramic. They are non-metallic materials formed by the action of heat, like the ceramics used in porcelain cups and bowls. They come in a powder form that is mixed with water, shaped, and then placed in an oven until they reach the proper hardness. The end product is translucent and very hard, resembling the densely packed crystals of calcium that make up a tooth’s normal outer layer, the enamel.

The old amalgam fillings required removal of tooth material to prepare a site in which they could be placed. Composite resins and porcelains can be used to treat teeth that have small or large amounts of damage to their natural substance because the materials bond directly to the remaining dentin and enamel. Thus they end up stabilizing and strengthening the restored tooth, as well as providing a natural-looking appearance.

Contact us today to schedule an appointment to discuss your questions about tooth colored fillings. You can also learn more by reading the Dear ‘Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

Whitening a Discolored Tooth from the Inside Out

May 22, 2012 by DentalCMO

If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth’s body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth’s internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”

Veneers: Not Just for Woodworking

May 6, 2012 by DentalCMO

You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

The third molars, called “wisdom teeth” because they usually become visible when a person is 17 to 25 — supposedly the time we achieve wisdom, may have adverse effects on adjacent teeth. Most adults have four wisdom teeth, although some people have more; and some, none at all. The wisest thing to do about wisdom teeth may be to have them removed if they are poorly positioned.

What is an impacted wisdom tooth?

If a wisdom tooth is pushing against gums, other soft tissues, or adjacent teeth at an awkward angle, it is referred to as “impacted.” Usually this occurs when there is not have enough room in the jaws for these last molars to fit next to their adjacent teeth. They can disrupt the gum tissue attachment of their neighboring teeth and the surrounding bone leading to periodontal disease and, ultimately, their loss.

In many cases, impacted teeth are painless, and those who have them have no warning of the problem. Thus it is important to have routine dental exams during the time when the third molars are coming in.

When should wisdom teeth be removed?

It is better to remove wisdom teeth early rather than waiting until periodontal (gum) disease has set in. As individuals age, keeping their wisdom teeth may lead to more serious problems. Periodontal defects tend to get worse in the presence of retained third molars. Furthermore, there is a higher incidence of postoperative symptoms in people over 25.

What are the pros and cons?

Removing impacted third molars can have a negative influence on the periodontal tissues of adjacent second molars. A number of techniques, such as scaling, root planing, and bacterial plaque control, can be used to minimize periodontal problems and promote healthy healing.

Surgical removal of wisdom teeth will involve some mild to moderate post-operative discomfort. Use of aspirin or ibuprofen for a few days after surgery will provide pain relief and control most swelling and symptoms. Antibiotics may be prescribed to ensure infection-free healing. It is important to keep the socket area clean by washing and rinsing with saline or antibacterial rinses. Careful surgery will promote good healing with minimal periodontal consequences to adjacent second molar teeth.

To decide whether your wisdom teeth should be removed, you will need an evaluation to assess the clinical health of the wisdom teeth, the neighboring teeth, and other vital structures. X-ray and digital imaging techniques play an important role in determining the exact position of the wisdom teeth in the jaw. A full assessment and consultation will include all the risks, benefits, likely consequences, and alternative treatment options. This will provide you with the wisdom you need to determine what is best for your wisdom teeth.

To learn more about wisdom teeth, read “To Be or Not to Be: What are the consequences of an impacted wisdom tooth?” Or contact us today to discuss your questions or to schedule an appointment.

Dental Procedures

What is an impacted wisdom tooth?

When should wisdom teeth be removed?

What are the pros and cons?

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