Removing Wisdom Teeth
Removing wisdom becomes necessary when the health of your mouth is threatened. Other teeth in your mouth can be pushed out of alignment when wisdom teeth come in. Pain and discomfort almost always accompany the emergence of wisdom teeth.
Thanks to modern technology and advanced dental techniques, removing wisdom teeth can now be done with complete effectiveness and total comfort. Gone are the days when going to the dentist for this procedure was one of the most dreaded events of one’s early adult life.
Before the actual extraction procedure begins, however, certain preparatory steps have to be taken. The first thing we have to do is making certain you are relaxed and comfortable. If nitrous oxide works well for you, we will administer that before giving you an appropriate local anesthetic to numb the area around the tooth. We wait several minutes and thoroughly check the area for complete numbness before removing your wisdom teeth.
Please understand that it is normal for you to feel pressure from the procedure while we are working in the back of your mouth. However, if at any point you feel pain, you need to let us know so we can administer more anesthetic. Pain should not be a part of this procedure at any point in time.
Removing wisdom teeth is done several ways, depending on where the teeth are position in relation to other teeth. If they have not completely come in yet, we have to cut them out of your gums. These days, we do not have to do very much cutting at all. Only a small incision is needed to give us enough room to work with.
Next, we will place an instrument next to the tooth called an elevator. It is used to gently loosen the tooth before we actually pull it out using forceps.
If the roots of the tooth have curved around the jawbone, we have to remove the wisdom tooth by cutting it into sections. Again, we do this with minimum invasiveness to your gums. As cosmetic dentists, we are very conscious of the need to preserve as much existing tooth matter as possible in your adjacent teeth, and of the need to keep your gums in as good a shape as possible.
All incisions made during these procedures are immediately sutured and sanitized to minimize the risk of infection.
In addition to these measures, we also send you home with a very detailed list of instructions on post-operative care. These instructions emphasize how important it is to take care of yourself, particularly during the first 24 hours, and include strategies for controlling bleeding, swelling, and also dietary guidelines.
Removing wisdom teeth is never fun, but it is necessary in most adults because impacted wisdom teeth can affect your entire bite and cause future problems with tooth decay, gum disease, and jawbone cysts.
Extracting a Single Tooth
As cosmetic dentists we recommend treatments that save teeth. There are times, though, when a tooth is so badly damaged that it cannot be saved and a single tooth extraction is the only choice.
Examples of these times include:
· Teeth fractured below the gumline
· Severe tooth decay
· Advanced gum disease
· Impacted wisdom tooth
Before the procedure, we might give you nitrous oxide as a relaxant. We also numb the area around the tooth with anesthetic so as to make the procedure painless. We want you to be as comfortable as possible. We will make sure that the area is completely numb before we begin extracting the tooth.
During the tooth extraction, you will feel pressure, but you should not feel any pain. If you do feel pain, we stop and give you more anesthetic.
The procedure varies per location and condition of the tooth. For instance, if the tooth has not emerged through the gums, we begin by making a small incision in the gum. We then use an instrument called an elevator, which is placed next to your tooth, to gently loosen it.
After the tooth is loose, we then use forceps to grip the tooth and carefully pull out the tooth with as little bleeding as possible.
Single tooth extractions procedures are more complicated if tooth roots are curved. If we find this, we often have to cut the tooth into sections to remove it.
In any event, any time we make an incision during a procedure, we always close it up with a few stitches after completing the extraction.
It is mandatory that you take care of yourself after a tooth extraction. We want you to minimize all potential problems after your tooth has been removed. The most critical time to be on guard is during the first 24 hours after the procedure, when bleeding and infection are most likely to occur
To help you do this, we give you detailed post-operative instructions which we advise you to follow implicitly. These post-operative instructions include information on how to control bleeding, how to minimize pain, and how to reduce swelling.
We also give you instructions on the prevention of dry sockets, and we give you a list of recommended foods you should eat, and foods you should avoid.
As cosmetic dentists, we are not here to promote the benefits of extracting teeth as the first option for any of our patients. However, we do admit that there are those times when it becomes necessary as a last resort. Single tooth extraction is sometimes the only way to reduce the risk of infection, the spread of periodontal disease, jawbone cysts, or severely crowded and misaligned teeth.
Labels: extracting a single tooth, single tooth extraction
Ridge preservation is one of many bone grafting techniques. At times, bone grafting techniques are needed to preserve the ridge of the jawbone after one or more teeth have been extracted. This is because the jawbone shrinks after a tooth has been lost. Unless restorative measures are taken, permanent disfigurement will result.
The procedure will vary to some degree on a case by case basis. In some instances, a ridge preservation procedure can be done at the same time the tooth is extracted. The dentist begins by numbing the entire area to prevent the patient from feeling any pain. If at any point the patient begins to feel uncomfortable, or experiences noticeable pain, the dentist will give him or her additional anesthetic. Sensitive patients may also qualify for sedation dentistry at the dentist’s discretion.
The bone grafting material will then be prepared. Bone could be taken from another part of the patient’s body, or it can be taken from another source. The tooth socket is then rinsed and cleaned to remove all debris and any resident bacteria that could cause infection. At this point, the socket is filled with the grafting material.
In some cases, dentists will place a special membrane over the graft to ensure that the bone and gum tissues heal properly. The socket is closed, usually with only a few stitches.
Ridge preservation offers a number of benefits to patients who have lost teeth. First and foremost, it preserves the shape and strength of the jawbone. This is important for more than one reason. Not only does the integrity of the bone itself need to be preserved, but the contour of the cheeks and lips, which are directly impacted by the shape of the jawbone, must also be preserved.
Secondly, this procedure fills the empty socket left by the missing tooth. Bone tends to grow better when it is in contact with other bone, so this actually helps the existing jaw grow a portion of its original mass back, eventually fusing with the bone graft material.
As a result, the shrinkage that will otherwise result from missing teeth is slowed down significantly. Without tooth roots, the jaw will begin to recede because it will not have the normal vibrations that are normally transmitted through tooth roots during biting and chewing.
Keep in mind, however, that this is not going to stop jawbone recession completely. Bone graft material will provide sufficient surface area for the recession to occur at a slower rate, but the only thing that stops bone recession altogether is a cosmetic dental implant.
Nevertheless, is still a procedure that is worth investing in for the sake of maintaining a healthy appearance and making future tooth replacement options less complicated and more comfortable.
Labels: bone graftin, perio ridge augmentation, ridge preservation
What Would Four Dental Implants Cost
What is the cost for 4 implants in the front of my mouth?
I have a removable bridge at the present time, which I hate.
Wow --- what a loaded question. There are many variables on this question. Anterior esthetics are important and are a prime consideration in how to handle this situation. When there is ample bone present, it is much easier to place implants and restore them esthetically. Oftentimes the cause of anterior tooth loss is traumatic – a blow or fall – or periodontal - and this often compromises the amount of bone present. With inadequate bone, there are options of adding bone by grafting, placing smaller implants, or not placing implants at all…it just varies.
The only way that we can give you any kind of answer as to what we advise is to see you personally and get proper photos, x-rays and visual exam. Even with adequate bone present, there are times that we place 4 implants, as you envision, and there are times that you can get a more esthetic result with less than 4 implants. You don’t necessarily place one implant for each tooth lost. We will also have to evaluate the rest of your mouth to see what is appropriate and logical for you.
Please consider making an appointment for an implant consultation so that we can give you our opinion of what is the best advice for YOU.
Chuck Campbell, DDS
Dale Brant, DDS
Labels: cosmetic dental implants, cost of dental implants
Regular Denture Care
Patient Instructions for Immediate Dentures
Randy F. Huffines, D.D.S. 2008
Regular denture care after the first 24 Hours
When you remove your denture for the first time, rinse it after every meal and snack and put it back in your mouth. Keep your denture in at all times except to clean it. Do not use mouthwash for five days unless told to do so by your dentist. You can, however, use a salt water rinse.
Cleaning is a very important part of regular denture care.
To clean your denture, partially fill the sink with water. Use a liquid dishwashing detergent and denture brush to clean the inside and outside of the denture. Do not use a regular toothbrush; it is too abrasive. After your gums have healed, you can use a soft bristle toothbrush to clean them. You should also clean your tongue to remove germs that cause bad breath.
Take your denture out every night, beginning the sixth day after receiving your immediate denture. Soak it in denture cleanser and let your gums relax while you sleep. If you have to leave your dentures in due to mitigating circumstances, be aware you are at a higher risk for oral yeast infections. You should discuss with your dentist additional ways to keep oral tissues healthy if this is the case.
Standard dental care is essential to regular denture care.
Many people think that after losing natural teeth, they don’t have to go to the dentist anymore. This is a dangerous myth. Supporting tissues that are under your denture will change over the course of your lifetime. You’ll notice the greatest change during the first 6 months-1 year after the removal of your natural teeth.
If the change is very significant, your dentist may call your immediate denture a temporary denture. This means that you will get a totally new denture after the healing process is complete.
At other times, your denture will need to be relined. Relinement involves adding new material to the denture so it maintains contact with the gums and conforms to the shape of your mouth.
Your dentist may also place a tissue conditioner, which is a temporary soft liner, in your denture. This will remain until healing is complete. It can be changed from time to time as the gums shrink so you stay comfortable throughout the healing process.
Gums will shrink over the course of a lifetime. You will probably not notice this until great damage has been done, and you may require surgery. This is why it is so important to see a dentist regularly so he or she can examine your gums and detect problems early on.
Your dentist will also closely observe your tissues for signs of oral cancer. Nearly half of the oral cancers diagnosed in North America occur in people that have dentures.
Myths about regular denture care abound.
Although well meaning, friends and relatives may give you advice that can be damaging to your new dentures and your mouth. Each individual is very different, and what might work for some may create problems for others. Never adjust your denture yourself; a minor alteration might be very expensive to correct. Your dental staff is trained to give you the best advice based on your unique needs. Ask questions – they want to help!
Labels: regular denture care
Talk to Your Dentist about Denture Adhesives and Denture Care
Denture Adhesives: A Guide for Patients
Randy F. Huffines, D.D.S. Ó 2008
What are denture adhesives?
They are powders, creams, and liquids that can stick to both dentures and gums and increase denture retention.
If my new denture has been made correctly, why might I need an adhesive?
It can improve retention and chewing. It also helps with conditions such as dry mouth. If you have had a stroke or have suffered bone loss beneath the gums, a denture adhesive will certainly help.
Which denture adhesive should I use?
Avoid pads and cushions because they can alter denture bite. Powders do not last as long as creams, but they are easier to clean off your gums and dentures. Follow your dentists advice on which is best for you.
How should the denture adhesive be applied?
Powders: The mouth and denture should both be cleansed and kept wet. Tap a thin layer of powder over the entire tissue side of the denture. Gently shake off the excess. Insert the denture and press in place for 5 seconds. Close your teeth together, swallow, and clench your teeth together tightly for 10 seconds. If you have a dry mouth, it may help to first coat your mouth with saliva substitute or water before placing the denture on your gums.
Creams: Clean your mouth and denture well. Dry the denture. For the upper denture apply 5 pea-sized dabs of adhesive equally spaced to the side of the denture that contacts your gums. For the lower denture apply 3 pea-sized dabs. If you have a dry mouth, immerse the denture in cool water for 30 seconds to let the adhesive soak up moisture. Insert the dentures and press in place for 5 seconds with your fingers. Close your teeth together, swallow, and clench your teeth together tightly for 10 seconds. If you have used the right amount, only a little should ooze out from under the denture borders. Over time you will find out just how much cream you need.
How should I clean out the adhesive?
You can brush out powder denture adhesives from your dentures with warm water. You can also brush powders away from the gums. Creams are harder to remove. You have to scrub under the denture with very warm water like a denture brush. If it is hard to remove the adhesive, soak it overnight and then brush it. You can also scrub the denture with an electric toothbrush while the denture is immersed in a sink of warm water. Remove the cream from your gums by holding hot water in your mouth to soften the adhesive and scrub with a moistened washcloth that is wrapped around a finger.
Why are regular checkups still important?
If you no longer have natural teeth, you may assume that you do not need to see your dentist. This is a dangerous misconception. Dentists work on more than teeth. The supporting tissues beneath your dentures, for one, will continue to change throughout your life. As your gums shrink, your dentures and gums will become mismatched. Many people do not notice this is happening until the mismatch becomes so severe that it requires surgery to rectify. The dentist can find these problems early on and deal with them. Your dentist can also check for oral cancer, which threatens 50 percent of people with dentures.
Labels: denture adhesives, denture care
Adjusting to Dentures
Patient Instructions For Immediate Dentures
Randy F. Huffines, D.D.S. Ó 2008
More than likely, you will have a harder time than you expected adjusting to dentures.
Your mouth detects even the smallest foreign object, so something as large as a denture is bound to be noticeable. It takes a while for you to feel like it belongs in your mouth, and it takes longer for you to adjust to the lower denture than it does for you to adjust to the upper denture. In most cases, a lower denture will cause more problems than an upper denture. The lower denture often feels lose, so you many need to get a denture adhesive to hold it in place. Ask your dentist which one is best for you.
You may also feel like gagging because the upper denture creates a feeling of fullness in the mouth. This will decrease as the mouth gets used to it.
Sore spots can occur even in a denture with a “perfect fit.”
This is due to the fact that the tissue the denture rests upon varies from place to place. Some areas are very thick and tough; others are thin and easily injured. You should contact your dentist as soon as a sore develops so an adjustment can be made; trying to “tough it out” can lead to a larger sore that is harder to treat. You can buy ointments to numb the area until you can get to the dentist, but these can mask the problem area and lead to larger sores if used too long. Never attempt to adjust the denture yourself.
If you suffer from dry mouth, adjusting to dentures is going to be more difficult because you have less saliva to help hold your dentures in place. Ask your dentist about products that are made for this condition that you can use to make your denture more comfortable.
Eating during the first week
It is very important to maintain good nutrition while you are adjusting to dentures. It is necessary to drink plenty of fluids. During the first 24-36 hours you must eat food that does not require chewing. We recommend the following food groups:
Bread/cereal group: thin oatmeal or Cream of Wheat
Vegetable group: juices, thin soups
Fruit group: juices, blended drinks and shakes
Milk group: Milk, cheese soup, yogurt, Carnation Instant Breakfast, Ensure, Sustacal (these last two products are nutritionally complete, lactose free drinks)
Meat group: Pasteurized eggnogs, meat broths or soups, pureed meats
After the first or second day you can slowly increase the consistency of the food. In addition to the foods above, consider soft foods like small pastas, well-cooked carrots and green beans, mashed potatoes, creamed vegetables, soups, well-cooked fruits (no seeds), canned fruits, scrambled or soft-boiled eggs, and chopped meats.
It is best to cut your food into small pieces and eat it slowly. Eating with dentures is very different from eating with natural teeth. It helps to put food on both sides of your back teeth and chew straight up and down. It is better to bite food off at the corners of the mouth rather than the very front because is common with natural teeth. Nevertheless, it is hard to predict exactly what biting and chewing movements will work best for you because they vary widely from person to person. Experiment and find what is right for you, and be kind and patient to yourself.
You may have problems speaking while you are first adjusting to dentures.
To overcome this, read out loud in private to retrain your mouth. Over time your speech will return to normal.