Wisdom Teeth Surgery - Part II

How is a wisdom tooth extraction performed?

When a wisdom tooth has emerged into its expected position it can be removed in a routinary process. This is generally perfomed by a maxilofacial dentist.

The dentist injects local anesthesia just in the area where the wisdom tooth is, until that part of your mouth has got totally numb to prevent any discomfort during the extraction.

Then the doctor proceeds to pull out the wisdom tooth, which usually lasts around 15 to 20 minutes at most. After the wisdom tooth extraction, the dentist will put a piece of lint in the place where the molar was. You have to keep the lint for 30 to 45 minutes to stop the bleeding.

Generally dentists prescribe some analgesics to ease the pain after. Spill the saliva and blood, but do not rinse your mouth or do any gargles during the first hours.

The effects of anesthesia disappear after one hour. Afterwards, you will feel certain pain and discomfort that will fade away in a couple of days.

Please note: When the wisdom tooth has not totally emerged, it is called an impacted widom tooth, to extract it, it si necessary to perform a wisdom tooth surgery.

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Wisdom teeth surgery – Part I

How to prevent a wisdom tooth surgery

It is obvious that the ideal thing is avoiding reaching the maximum limit, which is a wisdom teeth surgery. And for this aim, the only way to make this possible is by visiting your dentist every six months.

This way your doctor can prevent the incidence of any impacted wisdom tooth. If this turns out to be the case, it will require wisdom teeth surgery that will have to be perfomed by a maxilofacial surgeon.

A maxilofacial surgeon is the dental specialist who is trained to perform surgeries in mouth and maxillaries. A maxilofacial specialist can extract the four wisdom teeth in just one single intervention of 30 to 60 min with minimal effects (pain and swelling).

Beware: When a wisdom teeth surgery is not performed correctly it can cause permanent problems as infections, sinusitis, and low nerve damage (the enrve that gives sensibility to the lower lip and chin).

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When is necessary to remove wisdom teeth?

Wisdom tooth removal is performed when there is no enough space for them to come out and fix in the dental cavity.

Here we mention the symptoms that tell us when exactly a wisdom tooth has to be removed, even though it has not come out completely onto the surface, before they get impacted and start giving you trouble.

Wisdom tooth symptoms

- Pain
- Dental cavity infection
- Face swelling
- Gum inflammation in the back side of the mouth

Once, you present any of these symptoms your dentist will naturally recommend you to proceed to get an extraction done in order to prevent wisdom tooth problems, as an impacted wisdom tooth may destroy a second molar.

According to the American Academy of General Dentistry, the retention of wisdom teeth is the most common disorder during development stage.

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Did you know that not everyone has wisdom teeth?

That's right, there are super lucky individuals who will never undergo the dread pain and discomfort of wisdom teeth. And why is that? Genetic reasons determine whether any or the four-set of wisdom teeth come put or not. But before you jump on your feet...these cases are not the most.

The second option is that any wisdom tooth or the four erupt and join your other teeth to perfom the chewing process.

The third option –and the most troublesome- si they get partially or totally trapped in the maxilar bone or the jaw that rproduce much more pain and discomfort than the second option, and that will require an immediate visit to your dentist.

Note: If you didn’t know, wisdom teeth are called this way becasue they appear between the ages of 18 and 25 years old, when the person has arrived to the age of “wisdom”.

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Wisdom Tooth Extraction - Part II

Advantages of not having a wisdom tooth pulled

Keeping wisdom teeth allows reaching the plentycapacity of growth and development of teeth and jaw. A wisdom tooth also can, under appropriate conditions, be transplanted to the position of a premature loss of another tooth elsewhere in the jaw.

You don't exposed yourself to the risk of a wisdom tooth surgery.

The risks and the advantages of a wisdom tooth removal must be examined.

Risks of a wisdom tooth removal

Complications of smaller importance as dental nerve damage, infection, alveolitis, trismus (difficulty to open the mouth), hemorrhage, fractures, periodontal injury, and damage ofthe adjacent tooth.

Alveolitis is the commonest complication that particularly happens to women and in the range of 25 years. Also it is seen more often in the patients who had dental indication for wisdom tooth extraction that in those who they did it by own election.

This happens in a 5% of te patients without concerning the ability or the surgical method of the chosen dentist. The damage of the nerves is rare, but it can imply paresthesia (persistent numbness) of the lip or the tongue.

Greater complications include dysesthesia (a sensation of a needle prick or something that crawls in the skin) and infections. Most of the injuries of the nerve they are cured after certain period, but some permanent injuries happen. Any damage that lasts beyond six months is probable to be permanent.

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Wisdom Tooth Extraction - Part I

A widom tooth extraction is the most common procedure dentists do. Since there is no exact way to predict what wisdom tooth will cause problems and which not, dentists are subjective when it comes to make a decision and say that, even though they do not cause to pain, they must be removed.

Since dentists are divided on this question, here we set some standards to youon the risks that exist in each one of the two options: extracting it or to leaving it if there is not wisdom tooth symptom.

Which are the risks of not removing wisdom teeth?

• One of the most common reasons is when the affected wisdom tooth pushes other teeth. Some dentists say that this can happen, but that that does not justify to clear them if they do not bother.
  

• An impacted wisdom tooth can cause to damage to the tooth or molar that is opposed to it. This is a fact, but it only occurs to a 2% of the world's population.

• Periodontal disease around the wisdom tooth. This is possible, but in young adults less of 1% have these problems. The problem must to the deficiency of good dental hygiene.
  

• Pericornitis: A wisdom tooth infection that produces the formation of abscesses, is seen more commonly in wisdom teeth. This is a reason for wisdom tooth removal.
  

• The development of mouth cysts and tumors is often mentioned, but this is very rare. The cysts often are confused with other normal characteristics in the x-rays. The tumors are in less of a percent of wisdom teeth.

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How to fix those separated teeth

One of the teeth abnormalities that calls attention the most, in people of all ages is diastema, or the gap between the upper central incisors. This empty space is normal before the permanent canine come up.

It is usual when canine erupt, this space closes in, but there is the chance this does not happen due to:

- The absence of the lateral incisors.- There is a supernumerary tooth (one extra tooth) located between the two upper central teeth. On an X-ray it is shown how this tooth impairs the two central teeth get close. - Lip frenum(frenillo) with low insertion. This can be solved with a frenum surgery or fraenum removal after the eruption of the permanent canine and the placement of a device that helps keep the incisors together until the formation of dental bone around them until the final closing.

Laughingstock smile

It is important to consider the treatment for teeth gap, not only for an esthetic reason, but also to bolster self-esteem, particularly in children and teenagers, who can be easily picked on by their classmates, which of course, has a deep psychological that can alter their academic performance.

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Mouth ulcers or aphtae: How to get rid of them. Part II

Symptoms

Before the mouth ulcer

- Tingling or burning
- Red knobs

When the ulcer appears

- Appearance of one or more small ulcers inside the lips, or cheeks, or palate (soft palate) or underneath the tongue
- White, yellow or gray cover
- Pain when eating, talking, or sleep difficulty.

Diagnosis

The doctor will ask you about your medial history and will examine your aphtous ulcers. If these ulcers repeat frequently, the doctor will look for an underlying cause as vitamin or mineral deficiency or an immune system disorder.

If the mouth ulcer can not get healed, it can be taken a small sample or biopsy to analyze the tissues under the microscope to detect cancerous cells.

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Mouth ulcers or aphtae: How to get rid of them. Part I

Part I

What are they?

Aphtaes are small, painful and superficial mouth ulcers. They usually come and do, after a brief or long period between two outbreaks. They are not contagious.
What causes them?

They cause is unknown, but some of their triggers are:

- The abnormal response of the immune system against the superficial mouth tissue.
- Genetic predisposition
- Food allergies or sensitivity to certain foods as chocolate, nuts or citric fruits.
- Mouth tissues injury (rough tooth brushing)
- Nutritional deficiencies

Risk factors

A risk factor is a something that increases the chances of contracting a disease or disorders

- Family history of aphta sufferers
- Bad absorption of nutriebnts- Ptrolognued temperature
- HIV or Aids
- Stress
- Hormonal changes in women.

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Designing perfect smiles for each sex

Once we have understood that all the phases of the restorative process are important we can focus on the design of an esthetic smile for you. We can check many fashion magazines with models with perfect smiles, but we do not have to stick to duplicating what is considered “perfect”.

The smile definitely has sexual connotations: It depends on the sex of the patient, so we have to analyze it according to that. Just by looking at the teeth (the entire mouth, actually), we can tell if it belong to a man or a woman.
For instance, a smile with dominant dental and lateral teeth, small incisors and straight angles, belong to a man.

In women, the predominant teeth are the central ones, leaving the laterals a bit relegated, and the incisors are accentuated because the angles are rounded. This is what makes women’s smile softer.

These features, proper of each sex, can not be exchanged, because the result would be a smile that does not go at all with the patient’s face.

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What we can call a perfect smile. Part I

Within esthetic dental parameters, the most important thing to understand is that teeth are not alone. They share the space with gums, lips and face. This entire environment has to be considered when deciding the size, shape and color of teeth.

For instance, when checking a dental mould we can not guess if they are teeth of a man or a woman just by looking at the teeth.

Gingival architecture

We can classify gingival architecture in:

• Esthetic patrons
• Non-esthetic patrons

The esthetic patron is the one that determine an imaginary line that connects the gingival margins of central and canine teeth, leaving the lateral teeth slightly under the line.

Small modifications (asymmetries) of this patron are sometimes acceptable, as long as the gingival margins of any tooth do not overpass this line.

When we visit the dentist because we don’t like our teeth, we sometimes can not say exactly why. For this, the dentist will make an analysis of the gingival architecture to get better result for your smile makeover.

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Fix bridges

Porcelain fix dental bridges constitute a complex treatment since not only esthetics is taken into account, but also the functionality of the bridge (bite). The neighboring teeth around the empty space are trimmed around 1.5 mm in all their sides to place a crown.
f you have a missing dental piece it means you will a bridge of three units or crowns, two for support and one that is missing. Once these pieces are collocated, the dentist applies dental cement on the pillar teeth. The most important thing is that the patient keeps a good dental cleaning.

For dental bridge placing, there have to be considered physical aspects and acknowledge of the restoring materials. Not all cases require a fix bridge. For instance, for cases when there are many dental pieces missing, this is not recommendable. They can not be placed on molars or teeth that are not in good conditions. It may be that one piece is strong to hold on to the mouth, but it is not strong enough to hold on to the others.

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Tooth extraction. Part II

Will it hurt?

Anesthesia prevents pain during the procedure, but you may feel some pain in your jaw once the effect of the anesthesia has passed.

Possible complications

- Infection
- Excessive bleeding of dental fossa.

Postoperative care

- Bite firmly but softly the dressing placed by the dentist on the fossa. This will help you reduce bleeding and will allow the formation of a blood clot in the tooth fossa.
- If the bleeding continues, replace the dressing wit a new and folded one in 20 to 30 minutes intervals. On the contrary, leave the dressing in its place from 3 to 4 hours.
- It is important not moving the blood clot off the injury. Do not spill or rinse your mouth strongly in the first 24 hours.
- Do not smoke
- Do not let food particles cover the injury.
- Do not use straws during the first 24 hours
- To ease swelling, apply an ice bag immediately after the procedure in the affected area.
- Rinse your mouth 24 hours after the surgery using a solution of ½ teaspoon (8 ounces) of warm water.
- Keep on brushing and using dental floss between your teeth, this will help preventing infection in the tooth extraction place.
- Have a soft or liquid diet during the first 24 hours.
- Avoid hassle during the first 24 hours after surgery. In the first and second day after the surgery just perform limited activities.

Result
During the first 24 hours after the dental extraction it is normal having some bleeding and swelling. The initial healing period normally takes from 1 to 2 weeks. New dental tissues will grow inwards the gums, bone and fossa.

Having a slack tooth can lead to push aside the other teeth, biting inadequately or biting difficulty. Your dentist may try restoring the area with a dental implant, fix bridge or fake denture.

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Tooth extraction. Part I

Body parts envolved
 Teeth
 Gums
 Jaw bones

Reasons for a dental extraction
Although many teeth can be saved with modern dental techniques, some still have to be extracted. Teeth extractions can de necessary in these situations:

- Teeth is too damaged or with cavities to be saved by endodontia.
- The tooth’s nerve is infected.
- The tooth is preventing the normal dental growth.
- The tooth is loose because of a periodontal disease.
- Loss of support bone, gums or tissues

Risk factors due to complications during the procedure
- Smoking
- Blood or heart disease.
- High blood pressure
- Alcoholism
- Bad nutrition
- Use of medication without medical prescription (tell your dentist of any medication or supplement you have been taking in the last month).

What to expect

Before the procedure
- Mouth radiography
- Blood and urine test

During the procedure
General or local anestesia

The procedure
If the tooth is damaged, the dentist will remove the gum and the bone tissues to unveil the tooth. Using forceps, the dentist will hold the tooth and will make it twist smoothly forwards and backwards. This action releases the tooth of the alveolar bone and breaks the ligaments that attach the tooth on its place. The tooth is pulled off, and a blood clot is formed in the empty space. The dentist will put a dressing on it, and occasionally he/she will make some stitches on the gum borders.

After the procedure
It is analyzed the extirpated tissues, bone and blood.

How much it lasts?
Around 20 minutes. More time for damaged teeth.

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Fake teeth or dentures

What dentures are?

Dentures replace missing teeth and surrounding tissues in the forms of a removable dental device of acrylic resin or of a metal combination.

What are the types of fake dentures?

There are four types of fake teeth:

Complete: Replaces all teeth and surrounding dental tissues.

Partial: This type of dentures acts like a dental bridge, since it fills the empty space between the teeth and the missing teeth.

Conventional: Conventional dentures allows a recovering time (generally from 4 to 8 weeks) after the extraction of all teeth before placing fake teeth.

Immediate: This does not allow a healing time after teeth extraction. Dentures are immediately placed in the mouth. Additional adjustments may be needed as long as the healing advances.

Fake teeth care

- Take out your dentures everyday and brush it gently with a special toothbrush and toothpaste for dentures.

- If the prosthesis has holding clips, clean them in and out carefully.

- Avoid the use of abrasive cleaners and hot water because this can seriously harm it.

- If partial dentures are in their place, take them out before brushing the natural teeth.

- Once fake teeth are clean, dip it into cleaning solution or water and keep them in safe place.

- Visit your dentist every 6 months for a dental cleaning.

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101 on mouth guards: Part II

What are the different types of mouth guards?

Stock mouth guard: The cheapest option for mouth protector; though it offers minimum protection, since the fitting regulation is limited. It can disturb when talking and breathing because with this protector your mouth has to be closed to keep it in its place. The stock mouthguard is not considered an acceptable device of face protection.

Formed-in-mouth mouth guards: These dental guards come with a covering people as a “boil and bite” product. The peel is covered with acrylic or gum. When it is placed in the mouth, the protector moulds to the teeth and fixes in.

Custom-made mouth guards: The best option is a dental protector custom made by your dentist. It offers protection, fitting and comfort at a superior level since they are made form a plaster mould that feet your teeth.

How should I take care of a mouth guard?
- Wash your dental device with soap and warm water, not hot.
- Rinse it in mouth wash- When not being used, keep the mouth protector in a ventilated plastic box. Make sure the box has some holes or opening that let the air come in.
- Heat is damaging for mouth protector, so do not expose it to sunlight or keep it in your car.- Do not fold your mouthguard when storing it.
- Do not use somebody else’s mouth guard. - Call the dentist who made your mouth guard if you present any problem.

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101 on mouth guards: Part I

What is a mouth guard?
A mouth guard or dental protector is a flexible device made of plastic that is used for athletic and any other physical activities to protect teeth from any possible traumatism.

Why should I wear a mouth guard?
You should wear them to protect your teeth from injuries. Dentists unanimously support the use of dental protectors, especially when practicing sports. Every year there are over 200 000 mouth and jaw injuries.

Do mouth guards avoid injuries?
The teeth protector, as it is also known, can prevent serious injuries like commotions, brain hemorrhages, conscious loss, maxillary fractures and neck injuries, since it avoids that the lower jaw gets incrusted into the upper jaw. Mouth protectors separate well teeth from the soft tissues of the mouth; avoiding in this way injuries and wounds in lips and cheeks, especially in people who use braces or any orthodontic device.

For which sport should I use a mouth guard?
Whenever there is the possibility of contact with other players or hard surfaces, mouth guards are recommended. If you practice a sport such as basketball, baseball, football, wrestling, soccer, lacrosse, rugby, skating, martial arts, and even riding a bike or doing skateboard, demand wearing a mouthguard.

Why should children wear mouth devices?
Sometimes, parents are unaware of the level and potential dental injury risks there are in the sport their children practice. Some schools make emphasis on the advantage it represents for health wearing a dental protector when practicing contact sports.

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Crooked teeth: Part IX

Periapical radiographs: They are a series of small individual radiographies of teeth taken to observe detailed characteristics of some particular area or small details of some tooth that can not be observed on a panoramic radiography.

Photographic studies: They help evaluating physiognomic characteristics, shape, length and width of the face and facilitate detecting facial asymmetries of patients, as well as details that can not be perceived by first sight, being a valuable instrument to compare results of the treatment.

Yeast models: They are an exact duplicate of your teeth that is realized introducing a soft dough that will quickly get hard in your mouth, being removed smoothly, pouring on it a special yeast to make a model that will allow the orthodontist study your teeth when you are not at his/her office.

Once these exams are realized, the orthodontist will indicate you the most adequate type of treatment for your particular case, when to start it, the type of devices you will use, who much time it will last, the cost and the way of payment.

Eventually, the orthodontist may demand complementary exams if he/she considers them necessary as respiratory airways exams, blood test and others the doctor consider necessary.

So, without radiographies I can not get an orthodontics treatment?
Definitely NO, since the doctor could not be able to know how the roots of your teeth are or where the missing teeth are or if there are supernumerary teeth (more teeth than normal) or if there are congenital absences of teeth or bone problems, or any other problem.

How often should I go to the dentist?

The first appointments will be weekly until finishing placing all the devices (3 to 4 visits), then your visits to the dentist will be once a month. When the devices will be removed, you visits tot he dentist will be more spare.

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Crooked teeth: Part VIII

Do I have to take radiographies? Aren’t them health hazardous?
The only way the orthodontist has to find out the type of malocclusion you mat have is by the means of radiographies analysis. Fortunately, with technological advances, radiographies are less harmful due too the fact that modern devices emit low doses of radiation and they are better directed to the zone to be analyzed. However, it is better to ask the radiologist to wear an apron of plum for more protection, especially if you are pregnant, suffer from anemia or any other condition.

Among the radiographies you will be taken are:

Panoramic radiographies: It allows observing the degree of eruption of the teeth, the formation of roots, the teeth that will grow up; and it allows observing the nasal bones, the jaw and evident bone injuries, rests of fractured teeth and other things that can not be seen by the naked eye; that is why this type of radiography is used for any dental exam.

Complete cephalometry: this is a lateral radiography of the crane that is analyzed in a special way to measure the angles of teeth, their position respect to the maxillary and the type of bone structure you have to determine your type of malocclusion.

Nowadays, with the use of computers, there can be realized millimetrical measurements and angulations in the most exact way to facilitate the diagnosis of the orthodontist.

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Crooked teeth: Part VII

Once the treatment is finished, the position of teeth is permanent?

If the orthodontic treatment was adequately finished, the permanent improvement is in 95% of cases. However, our teeth, as any other part of our body tend to move and readapt with age. Likewise, winkles tart appearing on our skin, hair falls or change its color, teeth also suffer changes. Most of facial and dental changes are permanent, except for some growing pattern. A suitable following of the case, once the treatment is finished and the use of diverse types of fix or removable holders are important factors to avoid possible changes with age.

How much is an orthodontic treatment?

Each person has a different dental treatment plan, since the type of bite, the dental clustering and the times it takes to correct them differs in each person. These factors considerably alter the approximate cost of the treatment; however, the payments are divided into shares during the total time of the treatment, facilitating its payment considerably.

Remember that nice teeth bring many aesthetic and functional benefits during a life time, and what could be best than investing in your own health.

What are the components of an orthodontic treatment?

– Wire arch
– Bands
– Braces or brackets
– Elastics
– Extra oral arch tube

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