After-care guide to wisdom teeth removal

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It is estimated that 95 percent of American teenagers develop impacted wisdom teeth. While not generally detrimental to health, impacted wisdom teeth are generally recommended to be removed if they pose the risk of gum disease. Most individuals opt for the removal because it also frees up space in the mouth and relieves pressure on the jaw structure. The actual procedure will take a maximum of a few hours. Being a generally standard dental practice, recovery time and after-care guidelines are short and easy to follow. Still, it is important to take the following into consideration after undergoing the procedure:

There may be bleeding and/or swelling: There may be some oozing of blood during the first day after a wisdom teeth removal. Patients should avoid excessive spitting so as not to dislodge the blood clot and encourage the recovery process. Patients should also replace the gauze over the extraction site at the recommended time frame set by their dentists. Bruising and swelling may also occur. For these cases, an ice pack is used as directed by the dentist or surgeon.

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Avoid smoking and drink plenty of water: This is a simple extraction process, but it is still a traumatic event for the body. In order to hasten the recovery process, patients should drink plenty of water after the surgery and avoid tobacco use for at least 72 hours after the procedure.

Be careful around the site: Most dentists will tell their patients to not brush, rinse, spit, or use mouthwash during the first 24 hours after surgery. Normal dental activities can resume after that, although one should be particularly gentle around the wound and rinse their mouth with warm salt water every two hours and after their meals for around a week.

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Following these guidelines should make the recovery process painless and easy. If there is excessive bleeding, swelling, or pain after 24 hours, patients should see their dentist or surgeon immediately.

Dr. John Pasqual is a practiced oral surgeon. Find out more about oral health by following this Facebook page.

REPOST: Is Happy Hour Hurting Your Teeth?

Sugary snacks and acidic fruit juices don’t do the teeth any favors. And now, another hidden source of damage to molars has been discovered by the Australian Dental Journal.

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If you’re a vino-lover, you might sometimes worry about your favorite red staining your teeth. But discoloration isn’t the only downside to drinking wine: The acid in the drink can eat away at your tooth enamel too, leaving you at risk for cavities, sensitivity, and pain. Plus, the damage can happen faster than you might expect. A new study in Australian Dental Journal found that just 10 one-minute wine tasting sessions can significantly soften enamel. And while you may not be tasting wine so much as gulping (er, sipping) it, all it takes is a few minutes of repeated exposure to cause harm.

To protect your choppers from your Cab habit, order water alongside your wine. When you finish a glass of the latter, swish with the former to rinse away any acids clinging to your teeth, suggests Thomas Schell, D.M.D., a dentist in Lebanon, NJ. Just make it flat water; some sparkling types are more acidic, which can worsen damage. (Or if you’re really brave, try oil.)

Also smart: munching on cheese between sips, says Schell. Cheese is alkaline, so it can neutralize the acids in wine, preventing them from eating away at your enamel. (Learn How To Whiten Teeth Naturally with Food.)

Finally, if you’re really worried about the state of your teeth, consider asking your dentist for a prescription-state fluoride toothpaste or rinse, recommends Schell. This will help re-harden weakened enamel and can ward of future damage.

But avoid brushing with it (or any toothpaste) immediately after drinking wine (or other acidic beverages, like OJ), warns Schell. This will just work the acid deeper into your teeth, accelerating the damage.

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REPOST: Check dentist’s experience before getting costly implants

Before getting expensive treatments and procedures, it's best to do your research. This Star Telegram article discusses the importance of having an experienced dentist when getting dental implants.

The cost of a dental implant can be prohibitive, ranging from $3,000 to $4,500 per tooth. | Image Source: star-telegram.com

Dental implants are taking off as an alternative to bridges, dentures and single-tooth partials.

But patients should be cautious before jumping into the expensive procedure: All dentists can do an implant regardless of whether they’ve had specific training. And prices for the three-step process can vary widely.

“It’s a very, very popular procedure,” said Dr. Amerian Sones, executive director of continuing education for the Texas A&M University Baylor College of Dentistry in Dallas. “It’s our most popular course for continuing education.”

About 3 million Americans received 5.5 million implants in 2006, according to the American Academy of Implant Dentistry. The service is growing by 500,000 patients a year, according to the academy.

One reason is the aging population, Sones said. About 25 percent of Americans over 60 have lost all their natural teeth, according to the Centers for Disease Control and Prevention. Almost 70 percent of Americans ages 35 to 44 have at least one tooth missing.

Sones said that implants have become the standard in addressing missing teeth and that the success rate is in the high 90 percentile.

But the cost can be prohibitive, ranging from $3,000 to $4,500 per tooth, according to Angie’s List.

Marianne Marriott, a senior citizen in Fort Worth without dental insurance, said she was surprised by an implant center’s estimate of more than $50,000 for eight implants. Another office gave her a $1,000 estimate for a full set of dentures to address her problems, she said.

Sones said major insurers are starting to cover at least some of the cost for implants. The procedure is lengthy and includes surgery to screw a titanium post into the jaw, place an abutment atop the implant so gum tissue grows over it and then secure a permanent crown over the abutment.

The finished product takes up to six months.

“A lot of insurance companies are seeing the benefits of a long-term solution like implants,” she said.

Some discount dental plans, like DentalPlans.com and Brighter.com, offer price breaks on implants of up to 25 percent, but be sure to check on pricing and coverage before you join.

For those who don’t have the coverage and can’t afford the procedure, consider using a dental school. Baylor offers a full treatment — surgery, abutment and crown — for $1,975 per tooth that is open to new patients, Sones said. A $278 screening fee is also required. To get on the waiting list, call 214-828-8981 or go to http://bcd.tamhsc.edu/patients.

“We’re always looking for new patients,” she said. “But they have to be cases that fit our training criteria,” including having adequate health and quality bone for the procedure, she said.

For those who have been missing adult teeth all their lives, the American Academy of Implant Dentistry is starting a foundation within months to provide free implants for those who can’t afford them, said Max Moses, spokesman for the academy.

Training in implants is imperative for a good outcome, Moses said.

“The bottom line in dentistry is if you’re licensed, you’re licensed to do anything,” Moses said. “There is no implant dentistry recognized by the American Dental Association, like pediatrics or orthodontics.”

Even having a specialty in oral surgery or other advanced dentistry doesn’t mean a dentist is trained in implants, he said.

Besides going through continuing-education programs at dental schools, dentists can become fellows at the academy, Moses said.

Fellowships require having five years of experience and 400 hours of education in implant dentistry; passing a written and oral exam; and presenting 10 personal complex cases before peers.

For a list of area dentists with the certification, sorted by ZIP code, go to the directory at www.aaid-implant.org.

Prospective patients should also ask which type of implant is being used. The original implants, by a Swedish manufacturer, have been found to have a high success rate. But newer generic implants have not been studied.

“There are probably hundreds of different implants and knockoffs,” Sones said. “Companies see a big financial gain for being in this business. You do have to look at good long-term clinical outcomes and research. Find out what their statistics are.”

Bottom line: Do your homework before getting an implant, and make sure your dentist has, too.




Dr. John Pasqual is an experience oral and maxillofacial surgeon. Like this Facebook page for more oral health care tips.

Study: Sports drinks can ruin teeth

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Broken bones, pulled muscles, and sprained ankles aren’t the only hazards in endurance sports. Athletes have a high risk of dental erosion through frequent consumption of sports drinks.

Research shows that these energy drinks contain so much acid which can cause tooth erosion and staining only after five days of consistent consumption. Since athletes consume so much of these drinks during endurance exercises, training, and marathons, the enamel of the tooth softens and weakens, leading to severe tooth damage. It could also cause hypersensitivity to touch and to temperature changes.

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In this study, the oral status of 35 triathletes and 35 non-exercising controls was assessed and compared. After an oral examination, saliva test, and questions about their habits (eating, drinking, oral hygiene, plus training and beverage consumption for the triathletes), researchers found that the more an athlete trains, the more he or she is at risk of dental caries (also known as tooth decay).

Many fitness experts note that there are better hydration alternatives available for athletes to get that energy boost without affecting their oral health. Examples of these alternatives are coconut water and regular drinking water with a pinch of natural salt and a squeeze of lemon or lime.

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Dr. John Pasqual is an experienced oral and maxillofacial surgeon. For more information about his practice, visit here.

REPOST: Ask Ila: Dental care in pregnancy

Ila Shebar answers a question from a concerned pregnant woman regarding oral health during pregnancy. Read about it in this Mass Live article below:

Ila Shebar is a nurse practitioner at Pioneer Valley Urology. | Image Source: masslive.com

 
Q: I am 3 months pregnant and find that my gums are bleeding frequently, especially with brushing my teeth. Is this normal?

Oral health is an important part of overall good health and you must maintain that even during pregnancy. It is very important to take care of your teeth and gums while pregnant, not just for you, but for your baby’s health as well. The hormonal changes that occur during pregnancy can increase your risk of gum disease. This can lead to health issues for you and for your baby.

You should, of course, be taking good care of your mouth even before you get pregnant. It is important to have regular check-ups and cleaning. Before you become pregnant have any oral health issues resolved.

You should schedule a dental examination if it has been more than 6 months since your last examination or if you are having any oral health problems. Prevention, diagnosis, and treatment of oral conditions, including dental X-rays (with shielding of the abdomen and thyroid) and use of local anesthesia is safe during pregnancy. Conditions that require immediate treatment, such as extractions or root canals may be managed at any time during pregnancy with care. Delaying treatment may result in more complex problems.

The increased level of the hormones estrogen and progesterone in pregnancy may make it easier for certain bacteria to grow and make gum tissue more sensitive to plaque. If you already have gum disease before becoming pregnant, pregnancy may make it worse.

After becoming pregnant be sure to let your dentist know that you are, and how far along you are. Postpone elective dental procedures until the pregnancy is completed. Routine dental care such as check-up and cleaning can (and should) be performed during the second trimester. Your dentist will want to know all medications, including prenatal vitamins that you are taking.

The hormonal changes that occur put pregnant women at an increased risk for pregnancy gingivitis. Gingivitis, inflammation of the gums, occurs in about 40% of pregnant women. It can lead to feelings of tenderness or swelling of the gums, often accompanied by bleeding. This occurs most often between the second and eighth months of pregnancy.

To help prevent this from occurring you need to continue to practice good oral hygiene during the pregnancy. It is the bacteria that cause the gingivitis, not the hormones, so you do want to clean your teeth and gums. Brush your teeth gently twice a day, or after every meal, with a fluoride toothpaste, and floss daily. Schedule that dental cleaning during the second trimester.

If you have morning sickness be sure to rinse your mouth with a baking soda solution (1 teaspoon of baking soda dissolved in 1 cup of water) after vomiting to clean the acidity off your teeth and stop stomach acid from attacking your teeth. You may need to switch to bland toothpaste if the one you are using increases nausea. Your dentist or hygienist can recommend a good brand.

You should be eating a healthy well balanced diet during pregnancy, and this is also important for your teeth and the baby’s teeth. Sugary snacks increase your risk of tooth decay. Your baby’s teeth begin to develop around the third month of pregnancy, peaking in the third trimester. Your healthy diet provides the nutrients for this to occur normally.

There have been studies that have demonstrated a link between gum disease and premature birth. One study published in The Journal of the American Dental Association found that pregnant women with chronic gum disease were four to seven times more likely to deliver prematurely (before gestational week 37) and underweight babies than mothers with healthy gums.

Mothers with the most severe periodontal disease delivered the most prematurely, at 32 weeks. This is more evidence of how important good dental hygiene is during pregnancy.

Call your dentist for an appt if you experience a toothache, gums that bleed easily and frequently, swollen, tender, or painful gums, or note any growths in your mouth, even if not painful.

Again, oral health care is an important and safe component of pregnancy and is strongly recommended.

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REPOST: 'My teeth were turning to mush': How 'bleachorexics' are stripping their enamel to the point of no return

Everyone wants to get bright white teeth but are you aware that constant bleaching can permanently damage tooth enamel? This article from The Daily Mail discusses the dangers of becoming a 'bleachorexic'.

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America's long-standing fixation with impossibly white teeth is leading some to develop what dentists refer to as 'bleachorexia.'

According to Los Angeles-based cosmetic dentist Laurence Rifkin, over-bleaching is an all too common practice; one that causes severe and permanent damage by stripping tooth enamel and causing gums to recede.

'Once the enamel has been chemically eroded away, then it’s gone, it’s gone forever,' Mr Rifkin, who has even encountered people rubbing Clorox on their teeth in a desperate bid for a megawatt smile, tells Yahoo News.

Painfully white: According to cosmetic dentist Laurence Rifkin, over-bleaching is an all too common practice; one that causes severe and permanent damage by stripping enamel and causing gums to recede | Image Source: dailymail.co.uk

World Boxing Council champion Mia St. John tells Yahoo that she became so obsessed with over bleaching her teeth, her dentist had to intervene.

'He said my teeth could basically turn to mush just because I was destroying the enamel,' she reports.

Carbamide peroxide, the bleaching agent used in most whitening treatments, can make the teeth brittle and chalky, leading to hypersensitivity.

According to a recent survey conducted by the American Association of Cosmetic Dentistry, 96per cent of adults believes a good smile can make a person more attractive, and 74per cent consider a bad one to be a career disadvantage.

All those questioned said that if they could improve one thing about their smile, it would be whiter teeth.

Which is probably why Americans spend $1.4 billion annually on tooth whitening products, a 300per cent rise since 1996, and why many are ignoring product guidelines and bleaching their teeth more frequently than is recommended.

So how do you know if you're overdoing it with the carbamide peroxide?

Spoiler - if you are exceeding the number of regular treatments advised by your dentist, or with your at-home-whitening products, you probably are.

The main warning signs are excessive sensitivity, gum irritation and translucent blotches appearing on the teeth, Van Haywood, DMD, a professor in the Department of Oral Rehabilitation at the Medical College of Georgia, writes for Wedmd.

'Some people's teeth get more transparent if you continue whitening,' he states. 'You can see right through them and see the dark shadows of your mouth.'

Cautionary tale: In one of TV show Friends' most memorable episodes, Ross Geller leaves on his at-home whitening treatment for too long and ends up in quite the predicament | Image Source: dailymail.co.uk

It should also be remembered that depending on your teeth's natural shade, brightening them up to white-as-snow levels is actually near-impossible, no matter how much you frazzle them with bleach.

Most of the megawatt smiles we see paraded by celebrities from Kim Kardashian and Blake Lively to Brad Pitt and George Clooney are the results of porcelain veneers, not bleach.

Veneers are thin shells of medical-grade ceramic that are attached to the front surfaces of teeth, and will set you back anywhere from $800 to $2,500 per tooth.

New York-based cosmetic dentist Dr Jennifer Jablow, who is thought to have first coined the term 'bleachorexic' in 2005, assures, however, that with caution and realistic expectations, getting your teeth a few shades lighter can be pretty risk-free.

'Bleaching is very effective in moderation, and it's safe in moderation,' she told ABC last year.
'It's when you're bleaching all the time, beyond what is recommended, that's when you run into problems.





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REPOST: Children as young as three suffering from severe tooth decay

Dental problems such as tooth decay and gum disease are starting to manifest in children as young as three. This article from The Guardian talks about how The National Institute for Health and Care Excellence is taking steps to address this alarming issue.

 There is misunderstanding about the importance of looking after children’s early milk teeth and gums, says Nice. | Image Source: theguardian.com

Children as young as three are suffering from severe tooth decay and people need to “act now to stop the rot”, health officials have said.

The National Institute for Health and Care Excellence (Nice) has urged local authorities to tackle a growing crisis in the state of people’s teeth in disadvantaged areas of England.

Tooth decay and gum disease are the two most common, largely preventable dental problems. Those most at risk are from the most vulnerable sections of society and who are dependent on others to care for them, such as young children and frail older people who need help to stay independent, Nice said.

The health body said schools and nurseries should help children brush their teeth, adding that severe tooth decay had been reported in children as young as three and in many cases was starting much earlier.

Professor Mike Kelly, the director of the centre for public health at Nice, said: “Children as young as three are being condemned to a life with rotten teeth, gum disease and poor health going into adulthood.

“Many children have poor diets and poor mouth hygiene because there is misunderstanding about the importance of looking after children’s early milk teeth and gums.

“They eat too much sugar and don’t clean their teeth with fluoride toothpaste. As a society we should help parents and carers give their children the best start in life and act now to stop the rot before it starts.”

Prof Kelly said there were wide regional differences in oral health, and said the situation was “bleak for many adults as well as children in disadvantaged areas”.

He added: “Diet, poor oral hygiene, smoking, alcohol and a lack of understanding about oral health are causing tooth decay, gum disease, tooth loss and increasing the risk of mouth cancers. These are also the risk factors causing many chronic conditions, including heart disease and diabetes.”

Nice suggests local authorities consider supervised tooth-brushing and fluoride varnishing programmes in nurseries and primary schools in areas where children are at high risk of poor oral health.

Professor Elizabeth Kay, foundation dean for the Peninsula Dental School in Plymouth, said: “Around 25,000 young children every year are admitted to hospital to have teeth taken out. Given that we know how to prevent dental disease this really should not be happening. If there were a preventable medical condition which caused thousands of young children (mostly around five years old) to end up in hospital to have body parts removed, there would be an outcry.”

Dr Sandra White, director of dental public health at Public Health England, said: “Tooth decay is the most common oral disease affecting children and young people in England, yet it is largely preventable.

“Whilst children’s oral health has improved over the past 40 years, one in eight (12%) three-year-olds have suffered from the disease, which can be very painful and even result in a child having teeth removed under general anaesthetic.

“Oral health is everyone’s responsibility and by expanding oral health education to the wider community so that nurseries, children’s centres and primary schools all play a role, we can reduce dental decay and ultimately improve the oral health of the local population.”

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