By: Dental Pointe
💉 From wisdom tooth removal to a reconstructive operation, each oral surgery type has different functions. Determine which of them is suitable for your needs. The Woodview Oral Surgery Team
By: Dental Pointe
💉 From wisdom tooth removal to a reconstructive operation, each oral surgery type has different functions. Determine which of them is suitable for your needs. The Woodview Oral Surgery Team
By: by Hans Ulrich Brauer, DDS, Dr. Med Dent, MA; Robert A. Green, DDS, MD, Msc, FRCD(C); Bruce R. Pynn, Ms, Oral Health Group
💉 There are recent studies which identify risk factors during and after removal of third molars. Complications may arise, therefore, thorough planning and surgical skills are very important. The Woodview Oral Surgery Team
Third molar surgery is one of the most common procedures performed in oral and maxillofacial surgery offices.1-6 Nevertheless, this procedure requires accurate planning and surgical skills. With surgical procedures in general, complications can always arise. The reported frequencies of complications after third molar removal are reported between 2.6 percent and 30.9 percent.1 The spectrum of complications range from minor expected sequelae of post-operative pain and swelling, to permanent nerve damage, mandibular fractures, and life-threatening infections. Minor complications are generally defined as complications that can recover without any further treatment. Major complications can be defined as complications that need further treatment and may result in irreversible consequences.5,6 Although impacted third molars may remain symptom-free indefinitely, they may be responsible for significant pathology.7 Pain, pericoronitis, development of periodontal disease on the second molar, crown and/or root resorption of the second molar, caries in third or second molars and TMJ-symptoms are associated with retained third molars.2 More significant pathology such as fascial space infections, spontaneous fracture of the mandible, and odontogenic cysts or tumors may also occur.2
There are numerous recent studies, which identify risk factors for intraoperative and/or postoperative complications.1,5,6,8-15 Common intra- and postoperative complications and side effects associated with third molar removal are summarized in Table 1. For the general dental practitioner, as well as the oral and maxillofacial surgeon, it is important to be familiar with all the possible complications. This improves patient education and leads to early recognition and management. In this review, complications are considered rare or unusual if the incidence is commonly quoted below 1 percent. The aim of this systematic review is to remind us of the unusual complications associated with third molar surgery.
METHOD AND MATERIALS
Studies were found using systematic searches in Medline and the Cochrane Library electronic databases between 1990 and the present. Additionally, hand searching of key texts, references, and reviews relevant to the field was performed. Key words included the terms “third-molar,” “wisdom tooth,” “complications,” “unusual,” and “rare.”
Data was included if the following criteria were met:
1. The study had to deal with intra- or postoperative complications associated with the removal of third molars.
2. The date of publishing had to be between 1990 and 2013.
3. The text had to be published in English or German language.
In order to gather all the important studies, the references from the found studies were double-checked.
There are many studies reviewing permanent inferior alveolar and lingual nerve injuries and mandibular fractures during and after lower third molar removal. Several other studies/reports include inflammatory processes, unusual abscess formations and displacement of teeth in different spaces. An overview is shown in Table 2. All of these complications are considered major.
Furthermore, there are single case reports that describe extreme events, such as asphyxial death caused by postextraction hematoma, life-threatening hemorrhage, benign paroxysmal positional vertigo, subcutaneous and tissue space emphysema, subdural empyema, and herpes zoster syndrome. The reviewed case reports are presented in Table 3.
The main patient age among the cases was 28 (SD 12.7) years. In the majority of the cases, the complication occurred after third molar removal of the lower jaw. A second surgical intervention was needed in nearly all cases. In order to find the cause of the complication, computer tomography (CT) or magnetic resonance imaging (MRI) was need all of the cases. In the majority of the cases, the first surgical procedure was described as complicated and the intervention was reported as extensive or lengthy.
Permanent nerve damage
Permanent inferior alveolar or lingual nerve damages is extremely rare, but in general, well-known risks associated with third molar surgery. Injury of the lingual or the inferior alveolar nerves during removal of lower third molars is among the most common causes of litigation in dentistry.16 A close anatomic relationship between these nerves and the third molar places them at risk for injury. The incidence of these extremely rare complications vary among the studies and are difficult to be determined exactly due to the small study populations. The incidence of permanent inferior alveolar nerve lesions ranges from 0 percent17,18 to 0.9 percent;19 the usual accepted rate is about 0.3 percent.20,21 The complication rate for temporary lingual nerve damage is around 0.4 percent22 and for permanent lingual nerve damage, it is even lower.2,20
Immediate or late fracture of the mandible is a rare event, but a major complication.23 The reduction of bone strength may be caused by physiologic atrophy, osteoporosis, pathologic processes, or can be secondary to surgical intervention.24 There is no valid data on the incidence of mandibular fractures and the risk factors are not clearly understood.24 Libersa et al., found an incidence of 0.0049 percent.25 In a study by Arrigoni & Lambrecht, 3980 third molar removals were analyzed.8 This group detected a complication rate of about 0.29 percent. The peak incidence occurs in patients over 25 years, with a mean age of 40 years.24-26 Due to a greater masticatory force, men may be more likely to have late fractures.25 Intraoperative fractures may occur with improper instrumentation and excessive force to the bone during tooth removal. Most late fractures occur between two to four weeks after surgery during masticating.51,62
Unusual inflammatory processes and abscess formation
In the reviewed case reports, extensions of the inflammatory processes to atypical regions of the brain and cervical region are discussed. In one case, a subperiosteal abscess of the orbit appeared in a 57-year-old man following the uneventful extraction of the left maxillary third molar27 which might have been caused by extension of infection via the pterygopalatine and infratemporal regions to the inferior orbital fissure. Another group presents a subdural empyema and herpes zoster syndrome (Hunt syndrome).28 In this case, a 21-year-old man had all four third molars removed. An abscess involving the right pterygomandibular and submasseteric spaces and extending to the infratemporal fossa was found. Although antibiotic therapy and drainage was initiated, he developed severe frontal headache and vomiting with a Glasgow coma score of 13. Magnetic resonance imaging (MRI) showed a subdural collection in the right temporoparietal region. He had emergency craniotomy and subdural drainage.28 Burgess reported a case of epidural abscess of a 20-year-old woman after extraction of a wisdom tooth.29 First, she was diagnosed with a musculoskeletal neck sprain resulting from posture during the operation. Three days later, the patient presented with an increased right-sided neck pain and sensational numbness to the right arm. Nine days after surgery, an epidural abscess to the right side of C4/C5 vertebrae was seen in the MRI29. In another case, a brain abscess developed after removal of the right lower third molar of a 26-year-old man. He needed emergency neurosurgery and antibiotic treatment for eight weeks.30
Displacement of third molars and instruments
Accidental displacement of impacted third molars, either a root fragment, the crown, or the entire tooth, is not common during extraction, but is nevertheless a well-recognized complication that is frequently mentioned in the literature.31-33,58 However, there is only limited information about its incidence and management. Displacement of mandibular teeth/roots usually occurs when it is located lingually, or when the lingual cortical plate is fenestrated and if surgical technique is poor.32 When a root fragment “disappears” during extraction, its retrieval should not be attempted. Immediate referral to a specialist should be arranged.34,35 Upper third molars can be displaced into the infratemporal fossa.38,39,52,56 Further reports describe third molar displacement into the submandibular space,33,38 the sublingual space,39,40,60 the pterygomandibular space,35,41 the lateral pharyngeal space42,43 or into the lateral cervical area. In one case, the symptoms started after two months. The patient experienced recurrent inflammatory swelling in the right submandibular space. Over a period of 14 months, the same dentist supervised treatment with antibiotics. After extensive imaging procedures and surgery the tooth was located beneath the platysma muscle.44 Parts of dental equipment or burs can also be lost in the adjacent tissues. A 35-year-old woman had severe trismus, swelling, and pain three weeks after removal of tooth 48. A 20 mm long diamond bur was found in the submandibular space.33
Further unusual complications
Airway compromise was described by Moghadam & Caminiti.45 A 32-year-old man experienced swelling of the soft palate due to post extraction hemorrhage after he had undergone extraction of teeth 18, 38, and 48 at his dentist’s office. Computed tomography revealed a hematoma in the submandibular and lateral pharyngeal spaces which resulted in deviation of the oropharynx and constriction of the airway at the level of the oropharynx. The patient was intubated for two days and was treated with antibiotics and high-dose steroids.45 Funayama et. al.,46 report a case of asphyxiation caused by a postextraction hematoma in a 71-year-old man. Respiratory arrest occurred 12 hours after treatment. The hematoma involved the submandibular, lingual and buccal spaces leading to severe narrowing of the oropharynx. Wasson et. al., reported a case of severe hemorrhage during the removal of an impacted third molar in a 60-year-old male patient. Over 2L of blood loss occurred prior to obtaining control, using embolization of the facial and inferior alveolar arteries.57 A single case report by Goshlasby et al., discussed the development of a right sided retrobulbar hemorrhage after the removal of an impacted maxillary right third molar. The resulting hematoma caused right periorbital swelling and ecchymosis with evidence of proptosis. The maxillary incision was extended and the hematoma was drained and bleeding was controlled. It was believed that a branch of the posterior superior alveolar artery was injured during the extraction and bleeding tracked into the orbit via the infra-orbital fissure.53 Severe intraoperative or postoperative hemorrhage is one of the few life threatening complications in which a dentist may have to initiate management.45
Thoracic complications are very rare, but have been reported in the literature.47,48,49,55,61 Sekine et. al.,47 reports on a case of extensive subcutaneous emphysema with a bilateral pneumothorax during removal of the left lower third molar in a 45-year-old man. As with many cases of emphysema, an air turbine dental handpiece was used.47-49 Recognition of mediastinal emphysema following surgical extraction is difficult because there are no absolute clinical symptoms and signs.48,49
Benign positional paroxysmal vertigo was described in one case after the removal of all third molar teeth.50
Third molar surgery is a very common procedure, but is associated with many attendant risks and complications. Fortunately, significant complications are rare, but need to be diagnosed and managed early in order to reduce morbidity, and perhaps, mortality. For the general dental practitioner, as well as the oral and maxillofacial surgeon, it is critical to be familiar with all potential complications associated with this procedure. OH
By: Amy Freeman, Colgate
🍰 It is very important to plan the right kinds of food after your tooth extraction. They can ease your recovery and aid in faster healing. The Woodview Oral Surgery Team
If you need a tooth removed, summer might just be the best time. The kids are off from school, so they won’t have to miss a few days after having their wisdom teeth out. If you need to have a tooth extracted yourself, it’s often easier to get time off during this season because business slows down and you’re already more relaxed.
Once you’ve scheduled the surgery, you might wonder what to eat after tooth extraction. And as you might expect, soft foods are ideal during the first few days of recovery.
Eat: Ice Cream
Unless you have particularly sensitive teeth, ice cream tops of the list of what to eat after tooth extraction, especially in the summer. It’s cool and soft, so you can eat it comfortably even when your mouth is tender. Because ice cream is cold, it can help minimize any natural swelling that occurs in the mouth.
Choose your ice cream with care, though. Soft serve is ideal right after surgery since it doesn’t require as much jaw muscle to eat. You’ll also want to avoid any mix-ins or solid sprinkles along the top of the ice cream. Remember to pick a cup over a cone, too.
Eat: Cool Soup
Pureed, lukewarm or cool soups are also great to eat after a tooth’s removal. It is summer time, however, so you might prefer a smooth gazpacho over a bowl of lukewarm broth. Soup is not only easy to eat after your surgery, but it also contains plenty of nutrients and, in some cases, protein, to help the muscles in your face feel better. To avoid any discomfort, make sure the soup is as smooth as possible before you eat it. A few small pieces of cooked vegetables or pasta in the soup should be manageable, but you want to avoid anything that will require a lot of chewing.
Fresh fruits tend to be at their peak in the summer. One of the best ways to enjoy them after you’ve had a tooth pulled is in smoothie form. Blend the fruits with some yogurt or kefir to add protein, calcium, and probiotics to the drink. Adding yogurt or a similar type of dairy to the smoothie also helps it become less acidic, and less likely to irritate tender gums as a result.
Eat: Scrambled Eggs
As long as they aren’t too hot, scrambled eggs are another good pick following a tooth extraction. They’re gentle, high in protein and don’t require much effort in the way of chewing when eating them.
Avoid: Spicy and Acidic Foods
You may love adding a dab of hot sauce to the things you eat during the day, but after you have a tooth removed, the best thing to do is put the bottle down and play it “cool.” If you’ve ever felt the burn of a hot pepper, you know that spicy foods can irritate your gums and mouth. And because outside irritation is the last thing you want while your mouth is healing, it’s best to wait until your dentist gives you the all-clear before enjoying your favorite spices. Like spicy foods, acidic foods can irritate your mouth after a tooth extraction and should be avoided just the same.
Avoid: Crunchy Snacks
During the first week after your tooth is pulled, steer clear of crunchy snacks, even those that may be cold or otherwise forgiving. Not only are they difficult to eat when your mouth is sore, but there’s also the chance they’ll break off and bits of them will get stuck in the socket. Stick to soft foods until your dentist tells you otherwise.
Straws and Other Concerns
As the U.S. National Library of Medicine notes, using a straw right after you have a tooth pulled causes a sucking motion that can increase your risk of developing dry socket. To minimize your risk for these complications, it’s best to take small sips of cool beverages after surgery, without a straw.
To keep your mouth in good shape, it’s usually OK to start brushing again the night after your extraction. But be as gentle as possible, sticking with a soft-bristled toothbrush such as Colgate® 360®, and avoid brushing near the area of the extraction.
By: Main Street
👩👧 Even children are not free from dental surgery if their oral hygiene is neglected. Guide them to a healthy oral routine and this will be avoided. The Woodview Oral Surgery Team
Your child’s dental health is determined by their dental habits. It’s important for kids to learn good oral hygiene when they’re young so they can grow up with a healthy smile. If your child’s smile is neglected or isn’t well protected, they may require dental surgery to treat their pain and problems. In order to avoid that scary scenario, you must help your child develop a healthy dental hygiene routine with regular visits to a pediatric dentist.
Did you know that the leading cause of kids dental surgery is tooth decay? Commonly known as cavities, tooth decay can develop for a variety of reasons, but it is typically the result of improper dental hygiene or a diet deficient in nutrients. That’s why experts in family dentistry advise parents to practice these dental health guidelines at home:
When tooth decay is left untreated, it can spread inside the tooth and cause an infection. This can be extremely dangerous for children and may require an emergency root canal. Even worse, if the infection has spread to the point that a root canal couldn’t control it, an expert in family dentistry may need to extract the tooth to prevent the infection from affecting other teeth.
Since so many kids play sports or are active in physical activities, it’s rather common for a pediatric dentist to treat children for tooth trauma. When the trauma is severe, it can do so much damage to the tooth that it needs to be extracted. Such extractions require kids dental surgery, which is frightening for children and parents. To prevent these scary accidents, children should wear a mouth guard when they’re playing sports or engaging in physical activity.
Imagine you’re in the market for a new camera, but you’re not interested in paying top dollar. In an effort to save money, you decide to browse through one of countless stores offering “deep discount” pricing on name brand, top-of-the-line cameras. Chances are, those cameras made their way to the retailers via the “Gray Market” or, worse yet, are counterfeit or even “Black Market” products. In other words, they might not be the real deal, the warranties — if any — are questionable, and as a buyer, you’d better beware.
Unfortunately, Gray and Black Market products aren’t limited to high-priced consumer electronics. Dental materials — everything from the composites used to create minimally invasive composite bonding veneers, to the impression materials used to create molds of your teeth for precision crowns and porcelain veneers — also are being sold in unauthorized ways to unsuspecting dentists.
Gray Market dental products are those sold legitimately by a manufacturer intended for export or sale elsewhere, or those that are counterfeit to look like the real deal, which makes their way back to the United States and are ultimately sold to dentists through unauthorized channels.
Black Market dental products are either stolen or otherwise transported and distributed in ways that avoid regular taxes and fees, making their way to the end user through risky and unknown supply chains.
More often than not, both types of products are outdated and expired, repackaged and relabeled. Usually, the cost for these dental products and materials is significantly less than manufacturers originally intended. However, the ultimate cost in terms of treatment longevity and patient safety could be high, according to dental material science experts.
When Gray Market, Black Market or counterfeit dental materials are used, dentists cannot be sure how those materials will perform, or how long the restorations they’re placing will last. That’s because most Gray and Black Market products travel back and forth between multiple countries via long shipping and handling processes that subject them to harsh stress and strain that negatively impact their effectiveness.
This is particularly true for the adhesives used to secure dental restorations in place, and for the impression materials used to create molds of your teeth. Inaccurate and faulty impressions ultimately result in improper and poorly fitting restorations that could chip, fracture or result in tooth decay. However, other dental materials — such as sealants, ceramics and composites — and products sold on the Gray or Black Market also could perform poorly or below acceptable standards.
Legitimate products that are sold to dentists through the proper channels are manufactured nearby to control the materials, prevent expiration and prevent exposure to extreme temperatures that could negatively affect performance when used in dental treatments.
Many businesses these days are trying to compete in the “global marketplace.” Unfortunately, not all countries can afford to pay the same prices for products that we pay here in the United States. As a result, many companies have different prices for their products throughout the world, and sometimes there’s quite a big difference between what consumers in one country pay for a product and what that product is sold for in another country. It’s no different with dental products and materials.
Because dental product pricing fluctuates between countries, it becomes more profitable for distribution chains to find unauthorized ways to sell the products back in the United States. The price will be lower than what U.S. dentists usually pay, but more than what overseas dentists are paying, so those unauthorized sellers make a bigger profit.
The dental products, equipment, and materials sold and used in the United States are regulated by the Food and Drug Administration (FDA) to ensure they meet appropriate standards, as well as confirm their safety and efficacy. For this reason, the FDA inspects dental manufacturing facilities to ensure compliance with federal guidelines. The FDA also must approve products, materials, and equipment before they are marketed and sold in the United States. Those approved by the FDA carry specific serial numbers on their packaging.
Gray and Black Market products making their way back into the United States typically were intended for sale in other countries and may not be approved by the FDA for use. As such, their packaging is usually altered or changed to appear consistent with other “for sale in the U.S.” products. Therefore, there’s no way to guarantee that Gray or Black Market products meet FDA standards or are FDA approved.
Experts have pointed out that while Black Market products are illegal according to the laws of most countries, the sale and purchase of products on the Gray Market approved by the FDA typically are not illegal. Again, however, because these products usually have been tampered with, it’s hard to determine if they’re the real thing.
Sometime in 2011, the FDA is expected to announce stronger rules for material and product labeling that will affect anything considered a medical device, including dental products, materials, and equipment. Such packaging will enable manufacturers and their authorized dealers to better track and identify discrepancies in the distribution chain.
Additionally, dental product manufacturers are working harder to label and package products intended for foreign countries as a completely different product or material brand. This will make it harder for unauthorized channels to reintroduce the product into the United States on the Gray Market.
That’s comforting to know. It’s also good to know that dentists are concerned with the oral health of their patients and strive to deliver the best possible care using scientifically proven materials. Reputable dentists purchase legitimate and tested products from well-known and respected manufacturers and product dealers and likely will be willing to answer your questions about the materials they use and the manufacturers from whom they’ve purchased them.
Therefore, do not be afraid to ask about the type and brand of dental products your dentist will be using for your treatment. Understanding what’s involved with your treatment will enable you to have confidence in your dentist and participate actively in the process.
By: Sally Solo, Real Simple
😄 Keep this guide to common dental problems handy so you’ll achieve the perfect smile everybody would want to see! The Woodview Oral Surgery Team
How to prevent or treat the (sometimes painful) troubles that can lurk in your mouth.
Also known as dental caries or cavities, tooth decay occurs when plaque, a sticky film of bacteria that forms when you eat sugars or starches, is allowed to linger on teeth for too long.
Who’s at risk: Anyone can get a cavity, but children and older people are the most prone. The incidence among children has been declining, thanks to community water fluoridation and the increased use of fluoride toothpastes, but “more than half of all children have cavities by the second grade,” according to the U.S. Department of Health and Human Services report Healthy People 2010. Older adults are prone to cavities at the root because protective gum tissue often pulls away.
What to do: Don’t give plaque a chance: Brush with a fluoride toothpaste and floss every day. Children can also benefit from sealants (plastic coatings applied to the chewing surfaces of their back teeth) as soon as their adult molars come in. Older people should be particularly vigilant: “Those who have a tendency toward dry mouth should receive regular fluoride treatments from a dentist and use a fluoride-containing mouth rinse,” says Bruce Pihlstrom, D.D.S., acting director of the Center for Clinical Research at the National Institute of Dental and Craniofacial Research (NIDCR).
A bacterial infection caused by plaque that attacks the gums, bone, and ligaments that keep your teeth in place. The early stage is known as gingivitis, the advanced stage as periodontitis.
Who’s at risk: Everyone. The National Institute of Dental and Craniofacial Research (NIDCR) estimates that half of all adults have some signs of gingivitis. Most at risk are people with poor oral hygiene; those with a systemic disease, such as diabetes, that lowers resistance to infection; and smokers. Women also have a tendency to develop gingivitis during pregnancy. Other risk factors are stress, which weakens the immune system, and genes. “Some people can have gingivitis all their lives and never progress to periodontitis,” says Bruce Pihlstrom, D.D.S., acting director of the Center for Clinical Research at the NIDCR. “It depends on a person’s susceptibility to the disease.”
What to do: See a dentist regularly, and tell her if your gums feel tender or bleed. Gingivitis can be reversed with regular brushing and flossing. To combat periodontitis, a dentist or periodontist may perform a deep cleaning around the teeth and below the gum lines and prescribe medication to combat the infection. If the disease has progressed to affect your gums and bone, your dentist might suggest surgery, such as a gum graft.
The pulp inside the tooth (which contains nerves) is damaged or becomes infected because of decay or injury. The root canal, which connects the top pulp chamber to the tip of the root, may become infected, too.
Who’s at risk: Anyone with a deep cavity or a cracked tooth, which can let in bacteria. An injured tooth can have a problem even if it’s not visibly cracked or chipped.
What to do: If you feel pain in or around a tooth, see your dentist. He may refer you to an endodontist, who specializes in root-canal procedures. In one to three visits, the dentist will perform the notorious root canal (which is much less painful than it used to be). He will remove the pulp, clean the pulp chamber and root canal, then fill the tooth. Finally, he may seal the tooth with a porcelain or gold crown.
Exposure to acid, primarily from soda or citrus drinks, can wear down the surface of the teeth, making them rounded and discolored. Overbrushing can have a similar effect on enamel near the gum lines.
Who’s at risk: Anyone who sips lemonade, soda (even diet soda), or sports drinks all day. This is also an occupational hazard of wine professionals. “I see people with good home care who are getting cavities,” says Cindi Sherwood, a dentist in Independence, Kansas, and a spokesperson for the Academy of General Dentistry. “A lot of times the only risk factor we can come up with is diet soda.” Aggressive brushers may also be wearing away the enamel along with the plaque.
What to do: If necessary, teeth can be restored with bonding materials. But to prevent further damage, you have to change your habits. If soft drinks are the culprit, for example, switch to water. Second, best is to drink sodas (or sports drinks) with a full meal or sip them through a straw, then follow with a tooth brushing, sugarless gum, or a good swish of water in the mouth. If the problem is overbrushing, a soft-bristled brush or an electric toothbrush is a start. A dentist or a hygienist can demonstrate proper, gentle brushing technique.
Also known as xerostomia, dry mouth results from a decrease in the flow of saliva in the mouth. It is extremely uncomfortable and increases the chance of tooth decay since saliva helps wash away harmful bacteria.
Who’s at risk: Those who take any of 400-plus medications, including diuretics and antidepressants. “Dry mouth becomes more prominent as women get older, in their 50s and 60s,” says Sally Cram, an American Dental Association consumer adviser and a periodontist in Washington, D.C. Hormonal and metabolic changes that come with age can also change your salivary flow. Another cause is Sjogren’s syndrome, a rare disorder most common among women in their late 40s that causes a person’s immune system to attack her salivary and tear glands.
What to do: Keep sugarless gum on hand; avoid caffeine, tobacco, and alcohol; and drink plenty of water. Artificial rinses or moisturizing mouth gels can help the salivary glands function. If you suspect that you have dry mouth, see your dentist or doctor. “Anyone needing additional fluids to speak or to swallow dry foods for three months or longer should be evaluated for Sjogren’s,” says Jane Atkinson, D.D.S., deputy clinical director of the National Institute of Dental and Craniofacial Research (NIDCR). While there’s no cure, she says, “as with lupus or rheumatoid arthritis, you can manage it.”
Problem: Temporomandibular Joint Disorder (TMJ)
TMJ is a group of conditions that affect the temporomandibular joint, just below the ears and above the jaw. Sufferers may clench or grind their teeth subconsciously, often at night.
Who’s at risk: About twice as many women as men are believed to have TMJ, most commonly during their childbearing years. People who are under a great deal of stress are also more prone to it, or a severe injury to the jaw may cause the condition. It’s usually not chronic, though it can become so. TMJ can lead to worn-down and sensitive teeth, as well as other painful symptoms, such as a sore jaw, headaches, neck aches, and earaches.
What to do: See your dentist if you feel pain when you chew, find that your jaw has limited movement, or have radiating pain in your face, neck, or shoulders. Treatment may be as simple as relaxation exercises, cold compresses, ibuprofen, and avoiding foods that require serious chewing. To train yourself to stop clenching and grinding your teeth, the Mayo Clinic recommends “resting your tongue upward with your teeth apart and your lips closed.” To stop nighttime grinding, your dentist can fit you with a mouth guard.
Oral cancer may start with a small, pale, red, painless lump on some area of the mouth. A dentist can easily screen for the disease by examining and feeling around a patient’s mouth, head, and neck.
Who’s at risk: Of the estimated 30,000 cases of oral cancer diagnosed each year in this country, about three-quarters are associated with tobacco use or tobacco in combination with heavy alcohol use. Most cases occur after age 40. Many people aren’t screened, and detection usually occurs when the cancer is at an advanced stage. That’s why the five-year survival rate is one of the lowest for all cancers.
What to do: Stop smoking, and make sure your dentist screens you every time you visit. Even people missing many or all of their teeth should see a dentist regularly to make sure their dentures fit, as chronic irritation can be a risk factor.
😞 Kids are not safe from cavities. This condition should receive immediate treatment before it causes pain to your child. The Woodview Oral Surgery Team
Though children are using a set of teeth they will eventually lose, that set of teeth needs to survive until the adult teeth guide them out of the gums, which helps ensure the adult teeth grow in correctly and with enough room. That’s why oral hygiene is important as soon as a baby’s teeth begin to come in, and teaching oral hygiene should begin at a young age. Despite your best efforts to ensure good dental hygiene, sometimes kids end up with cavities. Cavity care for children is very similar to cavity care for adults, because preserving tooth health is the most important aspect.
Though baby teeth aren’t permanent, they are the only teeth your child will have for several years, until the adult teeth come in. To preserve your child’s oral health, your dentist will opt to drill out the cavities in baby teeth and fill or crown them accordingly. The primary teeth help the adult teeth to come in properly, so losing primary teeth before they’re ready to come out isn’t good for your child’s permanent teeth.
As with adult teeth, baby teeth fillings are made out of either white composite or metal. The other filling and crown materials, like gold and ceramic, are rarely as fillings for children. Metal fillings are a popular choice because they take less time to put in, and because they’re less expensive than composite fillings. Though your kid might not like the look of a metal filling, choosing a cost-effective option for a tooth that will eventually fall out is usually the smart move. Your dental insurance may also dictate what kind of fillings your child can get.
Your dentist will drill the tooth decay from your child’s baby teeth as necessary. Depending on how much damage the cavity has caused, the dentist will then fill the tooth or create a crown. Kids should continue using good oral hygiene when caring for fillings or crowns, whether those repairs have been done on baby teeth or on permanent teeth.
Though your dentist works very hard to remove all the tooth decay, sometimes it is a recurring issue. Teeth with cavities between them, even with decay removal and fillings, have a better chance of cavity recurrence than teeth with cavities on exposed surfaces. When decay comes back, the dentist will need to replace the filling to take care of the new decay and re-fill the tooth.
Tooth decay is just one reason kids need fillings. If trauma has happened to the tooth to cause a crack, a filling is necessary as well. Other issues include incorrectly shaped teeth, underdeveloped teeth, and teeth which have chipped. Dentists often opt for crowns on both front and back teeth instead of fillings in these instances, as the crown can provide more complete correction to the damaged or misshapen tooth than a filling could.
Preserving baby teeth is an important part of dental care for children. The reason revolves around maintaining the right amount of space for the adult teeth to come in. However, sometimes your dentist will have no choice but to pull the baby tooth early. If the decay is so advanced it’s causing gum issues or pain for your child, extraction becomes the best option. Many dentists fill the gap where the extracted baby tooth was removed with a prosthetic to maintain the correct space for the adult tooth to come in.
When children are having cavities filled, dentists sometimes opt to use nitrous oxide, commonly called laughing gas. If you’ve ever experienced this gas at the dentist before, you may remember the sensation that it provides. For some children, nitrous oxide reduces anxiety and distracts them from the pain associated with both getting that Novocaine shot in the gums and getting a tooth drilled. Nitrous oxide doesn’t work for all kids, and your dentist may opt to go with an orally administered sedative, instead. And of course, as with many things, not all dentists offer nitrous oxide, so it’s best to check beforehand.
When dentists fix cavities for kids, sometimes they do all the cavities at once and sometimes they do only one at a time. The reason for this has to do with the kids, not the cavities. Some children are fine sitting in the chair for long periods of time, while others are not. Dentists want the best outcome for the kid, and if that means making multiple appointments to fill cavities, then that is what will happen. Providing quality oral care to a crying child is very difficult for both the kids and the parents.
If you’re anxious about your child’s first filling, our dentists will put you at ease. We develop a treatment plan that is right for you and your child, with an aim to preserve the baby teeth until the adult teeth come in. The most important thing you can do as a parent is to keep teaching your kids about proper oral hygiene and continue scheduling regular professional teeth cleanings to minimize fillings and more invasive care.
By: Jenny Green, Colgate
👩👧 Parents also play an important role during the dental sedation procedure. Prepare your child and follow the guidelines to gain positive results. The Woodview Oral Surgery Team
Safety is parents’ top consideration when it comes to their child receiving dental sedation. Dentists may recommend sedation for long, complex procedures and for patients who are especially young or nervous. Sedating a patient is normally a very safe procedure, and parents can help reduce the risks and stress level for their child before, during and after the treatment.
Types of Sedation
Oral sedation, nitrous oxide and intravenous sedation are the major types of sedation dentists provide. According to the Children’s Hospital of Pittsburgh of UPMC, oral sedation is taken by mouth or through the nose as soon as the patient arrives at the appointment, as the medicine usually takes up to 20 minutes to work. Oral sedation doesn’t put patients to sleep, but it helps them stay calm and relaxed.
Nitrous oxide, or laughing gas, also helps children remain calm. A mask delivers a mixture of nitrous oxide and oxygen, and within five minutes, the patient relaxes and experiences euphoric feelings. At the end of the procedure, pure oxygen is given to the patient to clear out any remaining nitrous oxide.
Intravenous sedation is delivered through a needle inserted into the patient’s vein. The American Society of Dentist Anesthesiologists explains that nitrous oxide is used to send the child to sleep before a needle is inserted, usually into a vein on the back of the child’s hand. A tube is also inserted into the patient’s throat to aid breathing.
The American Academy of Pediatric Dentistry advises parents that children tolerate sedation and other dental procedures best if the parents understand what is happening and help prepare the child. Parents must restrict food and drink before sedation, and it’s especially important that parents follow these guidelines closely for key safety reasons, as sedation poses the risk of stomach contents being vomited and inhaled into the lungs. Dressing the child in loose-fitting clothing also helps because it allows dental assistants to attach monitors quickly and without fuss. Parents must provide a full medical history and tell the dentist if the child is receiving any prescriptions, over-the-counter medication or herbal supplements.
At the Dentist’s Office
Parents can help their children stay relaxed by being calm and encouraging, according to the Children’s Hospital of Pittsburgh. Try bringing along a comfort item for the kid to hold, such as a favorite toy or stuffed animal. Holding the child’s hand and talking or singing gently are other good comfort tactics. Parents should also avoid bringing other children to the appointment so that they can focus their full attention on the child receiving care.
For dentists, ensuring the patient’s safety is paramount during dental sedation. While sedated, the patient’s blood oxygen level, blood pressure, temperature and heart rate are closely monitored. A patient who requires general anesthesia may be referred to the dental hospital, such as that at the University of Maryland School of Dentistry.
At the Children’s Hospital of Pittsburgh, parents are usually asked to be present while their child wakes up after sedation. The child may be confused or fussy and may feel nauseous. Two adults should accompany the child or teen on the way home — one to drive and one to check the child’s breathing. Longer-lasting aftereffects of sedation include loss of physical coordination, dizziness, sleepiness and nausea, so going back to school or daycare is definitely not an option on the day of the procedure.
For the first few hours after the procedure, parents should give the child only soft foods. If the child experiences vomiting, severe pain, severe bleeding or fever, parents should contact the dentist immediately. When the mouth has healed, the child may continue caring for his teeth as normal, brushing twice a day with a fluoride toothpaste, such as Colgate® Kids 2in1.
Dental sedation is a safe and fuss-free procedure with the right preparation and proper care after it’s over. By communicating clearly with your child’s dentist, you’ll provide the best possible experience for your child.
By: Prestige Oral Surgery
😄 If a dental implant is your best tooth replacement option, the length of this procedure depends on your oral health. But one thing is for sure, results can last a lifetime! The Woodview Oral Surgery Team
Dental implants are, bar none, the best tooth replacement option available. Dental implants are natural looking, allow you to eat your favorite foods, require no special care and can last a lifetime. But they do have one limitation. The dental implant process can take time. How long it takes depends on your oral health.
If you are having a tooth extracted, it is often possible to place the dental implant immediately after the extraction if you have good oral health and bone density.
Osseointergration: Three To Six Months
Dental implants work just like natural teeth because they are integrated into your jawbone, just like natural teeth. To ensure the survival of your dental implants and their proper function, you normally have to wait for this integration to occur before we can place the final restoration on top of the implant. For some people, this may take as little as three months, but it usually takes about six months.
Bone Graft: Three To Four Months
Sometimes periodontal disease destroys so much bone around your teeth that it is impossible to place a dental implant without first restoring the bone. In a bone graft procedure, bone or bone-like material is placed at the site where you are going to have your dental implants, and then has to integrate with your own bone. The length of time necessary for this step depends on how much bone was lost and how quickly your bone heals, but it typically takes at three to four months.
If you do not have good oral health at the time you are looking to get your dental implants, the procedure may take longer. Periodontal disease can cause your dental implants to fail, so it is important to get it treated before we place your dental implants. How long periodontal disease treatment takes depends on how serious your periodontal disease is, how well you follow home care instructions, and other factors that can be hard to predict.
Results Can Last A Lifetime
The dental implant procedure may be completed in a day, or it may take a year or more to complete. The good news is that, no matter how long your procedure takes, dental implants have been proven to last several decades.
😁 Knowing the things you should expect from your tooth extraction procedure is one effective way to get prepared. Each step matters to achieve a better dental experience! Read more about what to expect! The Woodview Oral Surgery Team
Wisdom teeth are a third set of molars in the back of your mouth. They usually come in between the ages of 17 and 25, and they’re spotted on X-rays. Most people have them removed for one of these reasons:
You’ll meet with the oral surgeon to talk about the process. At this appointment, make sure you:
Your surgery should take 45 minutes or less.
You’ll get one of these types of anesthesia so you don’t feel pain during the removal:
Your doctor may have to cut your gums or bone to get the teeth out. If so, he’ll stitch the wounds shut so they heal quickly. These stitches usually dissolve after a few days. He may also stuff gauze pads in your mouth to soak up some of the blood.