“Post-Surgical Care?”

Posted by drgracesun on July 18, 2009 under General Dental Knowledge, Information, Smart Smile | Be the First to Comment

Summer break is a busy time for oral surgeons, who are often busy extracting the wisdom teeth of college bound or high school students. This wisdom teeth removal surgery could be the biggest medical and dental procedure for a young person.  As long as as you are under the care of a capable and well-experienced oral surgeon, the procedure should run smoothly, but proper home care after having the wisdom teeth removed is very important to assure a healthy and speedy recovery.

Anesthetics or sedatives used during oral surgical procedures will often take a couple hours to wear away – the first 72 hours are crucial for normative recovery. Pain medication like anti-inflammatory Ibuprofen or narcotic Tylenol #3 with codeine often is prescribed depending on the severity of the procedure in addition to a 3-times-daily antibiotic, such as amoxycillin.

Regarding eating and drinking after oral surgery, avoid soft drinks for a week and avoid alcohol for 3 to 5 days .No smoking forever is the best, however if you really are dying for a draft,wait as long as possible, at least for 24 hours for being kind to your body. The first day at home should consist of using a cold compression (ice bag on 15 minute off 15 minutes for few hours), which can eliminate swelling. Stay away from straws and any mouth-opening activities to prevent loosing blood clots which lay a foundation for regenerate tissues as part of the natural healing process. Using a straw can cause the painful condition known as “dry socket.” Both preventing infection and timely healing are pivotal for post-surgery patients; follow the instructions from your surgeon on medication, diets, hygiene and habit. You’ll fully recover in no time.

Other than chipmunk cheeks for a couple days, the other common complication related with wisdom teeth extraction is the discomfort associated with dry socket. What causes dry socket and the prevention of dry socket are still being researched, but as a general rule the surgeon’s technique should be gentle and precise, so as to not traumatize the bone during the procedure. If the tooth is impacted or laying side ways, instead of forcing it out with forceps (which can create excessive compression on the bone), the surgeon should use a rotary tool with a saline cooling system to create access to the impacted molar . The molar will be dissected into smaller pieces and removed, without traumatizing the bone. On the patient’s part, there should be no rinsing, spitting, smoking or sucking of any kind for the first 24 hours after oral surgery. This will prevent disruption of the blood clot from a physical force in the mouth. Better oxygen saturation and circulation of the blood from not smoking is also important for healing. A good diet rich in antioxidants and vitamin c, lean proteins are good for tissue regeneration, for overcoming the negative influence on our body from consuming antibiotics. Eat yogurt or take acidophalus to restore the friendly flora in our body to prevent a yeast infection.

If your are healthy, forget all the above mentioned, you will be just fine after surviving the oral surgery!

“Wisdom Teeth – Save or Extract?”

Posted by drgracesun on February 28, 2009 under Healthy Smile, Information, Smart Smile | Read the First Comment

Only one out of every 25 people get to keep all 32 teeth to chew our food; most of us end up with only 28, and a story to tell about our wisdom teeth!

Anthropologists and evolutionary biologists think the wisdom teeth have become non-functional due to evolution: we do not have the same diet of coarse, rough food that our ancestors did, who had larger active jaw muscles. Evolutionary history lead us to our smaller jaws which can no longer accommodate wisdom teeth.

Wisdom teeth are the third set of molars, which usually start forming around age 10, and emerge in a young adult’s mouth between the age of 17-25, but often they are impacted or blocked by the second molars. Also, if the tooth is partially erupted, food can get trapped in the gum without access to clean. This leads to infection and decay. Wisdom teeth which come in tilted or remain tucked away can also lead to crowding or other problems. Completely impacted wisdom teeth can potentially develop into a cyst, forming a sac of tissue around the tooth leading to bone destruction.

Impacted Wisdom Teeth

Impacted Wisdom Tooth

There are lucky big-jawed or small-toothed people who develop wisdom teeth that function properly, they do not need to see an oral surgeon for extraction, but most of us face the unavoidable trip to the oral surgeon to prevent or treat wisdom teeth complications.

Unfortunately, there are risk factors for removing your wisdom teeth as well. Besides common surgical complications (like swelling, pain and infection), paresthesia (numbness) of the lower jaw, lip, chin or tongue could be quite annoying. If the wisdom teeth are positioned very close to or are intertwined with nerves, the process of extraction can bruise or damage these nerves. Paresthesia is rare and usually temporary, but in some cases can be permanent. Dry socket, when blood of the socket of the extracted tooth fails to coagulate (or a blood clot becomes dislodged due to trauma like sneezing, or playing a musical instrument) can cause irritation, pain and inflammation, but generally heal within a few weeks on their own. To lower the risk factors of extraction, have your wisdom teeth removed at the appropriate time, when the root has formed two-thirds of the way (approximately age 18-24) for easier handling and fewer complications. Because bone density is less developed in teenage years than in later adulthood, it is less resistant, carrying fewer risks of extraction. With age, the jaw becomes dense and extraction becomes increasingly complicated.

So it is very important to have an examination and consultation with your dental professional regarding your specific situation. Clarify the elective removal of wisdom teeth, whether the potential risks associated with the procedure exceed the benefits, or whether it’s time to get them out – for a better environment for the rest of your teeth.

“How Do Teeth Grow?”

Posted by drgracesun on February 1, 2009 under Information, Smart Smile | Be the First to Comment

Sure, we develop two sets of teeth (baby and permanent) over the course of our lives, and they are made of enamel and dentin . But what do you really know about tooth development?

Tooth development is a complex process by which form from embryonic cells, grow and emerge into the mouth. The key to a healthy oral environment in which teeth can thrive, enamel, dentin, cementum and periodontium must all develop properly at the right time during fetal development. Baby (primary) teeth begin to develop at the 6 – 8 week mark in the womb. Adult (permanent) teeth develop at the 20 week mark in the womb. Formation of tissues within the branchial arch is the process that actually initiates tooth development. During pregnancy, proper prenatal care is essential for the future smile of the young life.

There are four stages your teeth develop into before becoming fully fledged teeth. The first stage, the bud stage, is characterized by the appearance of a tooth bud with no clear cell arrangement. This stage occurs when the fetus is approximately 6 weeks old. The second stage, the cap stage, is when cell arrangement becomes evident. Extracellular substances are produced resulting in an aggregation of these cells, as the tooth bud takes on the appearance of a cap, and becomes the enamel (dental organ). This is also the stage when supporting structures of the tooth are developed. The third stage, the bell stage, is characterized by a bell-shaped dental organ. The bulk of the tooth’s biological development and maturation take place during this stage. The final stage, the crown stage, is when tissues (like enamel and dentin) are hardened and important cellular changes occur, including adding new material to the outer developing surface of the  tooth. Dentin formation, called dentinogenesis, is the first discernable sign of the crown stage, and occurs before enamel can be formed. Enamel formation, called amelogenesis, occurs after dentinogenesis. Environmental influences (like if the child suffers from fever, or is taking tetracycline antibiotics) can cause discoloration of permanent teeth.

Tooth eruption, which occurs between 6 months and two years of age, is the process of tooth development when teeth break the gum layer and become visible. Primary teeth stay in the mouth until around 6 years of age, at which point they are gradually replaced by permanent teeth. The first set of permanent teeth come in behind the twenty primary teeth at age 6. Sealant can be placed on to these teeth to prevent tooth decay. The last primary teeth will exfoliate around age 12 to be replaced by second bicuspids. This is called the mixed stage, when both primary and permanent teeth are present. Orthodontic treatment can be performed at the mixed stage; the most common age to receive braces is between 9 and 12.

The 3rd molars erupt around age 16 to 18. This is the stage when people are supposed to be wiser, so they are called wisdom teeth! Due to evolution, only one out of every 25 people have a jaw size that can accommodate all 32 teeth, so most of us need to have our wisdom teeth removed (lest problems be created with crowding or crooked teeth, which can lead to tooth decay and gum problems). Most of us have 28 teeth; with proper care, all 28 teeth can be kept throughout our life!

If you end up missing one or more permanent teeth, proper restorations should be made to assure the adequate support of your facialmuscular system to maintain its health. Such restorations will also help to prevent oral conditions from deteriorating due to shifting or tilted teeth (causing difficulty in maintaining healthy oral conditions). There are options for missing tooth problems; be sure to consult with your dental professional!