As your teenage ages, his or her wisdom will start coming in. Some may come in crooked. Some may come in impacted. Most of the time, all four wisdom teeth come in just fine (although nine out of 10 people have at least one wisdom tooth that comes in slightly impacted).

If your teen’s teeth come in crooked and/or impacted, your dentist may recommend that you have your teen’s wisdom teeth pulled (extracted). The dentist’s reasoning probably is this: it’s far easier to pull wisdom teeth, with a reduced risk of complications, when a person is younger (under 25). The wisdom teeth roots haven’t formed completely yet, making them easier to extract.

Makes sense, no, especially if your teen’s wisdom teeth are coming in crooked, are impacted (there’s not enough room for them to emerge fully) or are showing some other problems? (By the way, 9 out 10 people have at least one impacted wisdom tooth.)

But is it really wise to pull the wisdom teeth?

Read below for some information to help you decide.

WebMD.com reported in 2005 on a study conducted in the Netherlands that found that while many teens have their wisdom teeth pulled, “there’s no evidence this painful procedure prevents future trouble.”

The study found that if the teens’ wisdom teeth were impacted but “not causing any trouble,” there was “no evidence that removing [the teeth] helps or hurts future health.”

But, the study added (according to the WebMD article), “some evidence that removing teens’ impacted wisdom teeth ‘to reduce or prevent late incisor crowding cannot be justified.’”

The article went on to say that according to two dentists interviewed for the article, “troublesome” wisdom teeth should be removed, but that “perfectly healthy teeth” should stay put.

If your teen’s wisdom teeth are coming in healthy and straight, it may be perfectly OK to not pull them from her mouth.

Wisdom teeth extraction is a serious surgical procedure, the dentists added, and should only be done when there’s a real medical reason to do it.

What is a real medical reason?

Your teen’s wisdom tooth probably should be pulled if it’s impacted AND lying horizontally. Another wisdom tooth that should be pulled is one that comes up from the underlying bone of the jaw but comes up only part of the way through the skin.

If a tooth is leaning sideways (isn’t completely horizontal as described above), you and your teen’s dentist will have a bit of a chat because there may be chance the wisdom tooth could rub against its neighbor tooth over time, causing crowding in your teen’s front teeth.

If you do decide to remove your teen’s wisdom teeth, rest assured that they aren’t necessary at all to your child’s health as he or she grows older.

Bottom line, if your teen’s wisdom teeth are otherwise healthy, so long as your child keeps a good eye on them, has regular dental checkups, practices good oral hygiene daily, it may be OK to keep them.

Talk to your dentist before deciding.

Image courtesy of Stuart Miles/FreeDigitalPhotos.net

If you’re scheduled for your dentist to pull a tooth in the near future, read below for some things you should know beforehand, as well as some suggestions regarding what to do both before and after the procedure.

First, before having a tooth pulled be sure to tell the dentist about any medications you’re taking for any conditions you may have. You pretty much should provide your dentist with your complete medical history.

As for the extraction itself:

• Your dentist will do different things, depending on why he’s decided the tooth needs to go. If he’s pulling the tooth, for example, because it’s become impacted, he will cut the gum and bone tissue that cover the tooth and will use forceps to first, rock the tooth gently back and forth to loosen it and then pull it out.  (He will have given you’re an anesthetic of some type before this, of course!)
• Once the tooth is out, a blood clot more than likely will form in the socket. Your dentist will tightly pack sterile gauze in the socket, asking that you bite down on it to help stop bleeding.
• Your dentist may place a few self-absorbing stitches to close the gum’s edges over the socket.

Rest assured, complications are rare, although full recovery can take a few days. You should be able to return to school or work after 24 hours have passed.

Your dentist may prescribe non-habit-forming pain killers. Take them as he prescribes.

The blood clot in your socket will continue to bleed for a bit, so be sure to change the gauze pads your dentist placed in the socket before they become soaked. (You probably won’t leave the dentist’s office until he has determined the bleeding has stopped.)

Once the bleeding stops, you should keep the gauze pad(s) in place for three or four hours. Your dentist also probably will apply an ice pack to the area right after the extraction to keep swelling down. Apply ice for no more than 10 minutes at a time.

Relax at home for the following 24 hours and take it easy for the two or three days following.

Don’t spit or rinse too strongly for 24 hours as you could dislodge the blood clot. After 24 hours, you should rinse your mouth with a mixture of 8 ounces of water mixed with ½ teaspoon of salt.

You should eat soft foods (yogurt, soup, applesauce, and so on) for 24 hours after the extraction and then slowly reintroduce more solid foods as you heal. You also should continue to brush/floss your other teeth, being careful to stay clear of the where your tooth was pulled.

You should expect to feel some pain and an achy feeling after the extraction, especially after the anesthesia has worn off. You also could have a bit of bleeding.

If the bleeding and/or pain are excessive four hours or more after the extraction, call your dentist. You also should contact your dentist if you have a fever, nausea/vomiting, cough, shortness of breath, pain in your chest, and/or excessive redness or swelling near the extraction site.

If your child’s presses up against his teeth or behind them while swallowing, he may have a condition known as orofacial myofunctional disorder (OMD), colloquially called tongue thrust.

Some cases of tongue thrust see the child moving his tongue to the side of his mouth, instead of forward toward his teeth. In addition, your child could position his tongue improperly while at rest. If so, it may lie too far forward in your child’s mouth.

You also might notice that your child tends to keep his lips open and may even stick his tongue out enough that you can see it.

One indication of tongue thrusting is when a child tends to keep his or her tongue a bit exposed outside the mouth.

A tongue thrust may not seem like such a big deal, but it can adversely affect how your child’s teeth align. It also could affect his speech, possibly eventually resulting in a lisp.

Also, just as when a child’s sucks his thumb, tongue thrusting can bring pressure against the front teeth, possible pushing them out of alignment. This can lead the teeth protruding, causing an overbite.

Additional signs of tongue thrust are chapped lips or sores on your child’s lips. You also may notice that your child tends to breathe through his mouth most of the time, rather than through his nose.

Many parents have never heard of tongue thrusting, so don’t be surprised if your child’s dentist, orthodontist, pediatrician, or even someone at school mentions or diagnoses the condition.

A good percentage of tongue thrusting actually is diagnosed when a child starts displaying a speech impediment, such as a lisp.

Treatment may be handled in two different ways:

• The first involves placing a device in the child’s mouth (a dentist performs this procedure) that helps prevent your child from thrusting his tongue forward.
• The second is retraining this habit. Your child will be given exercises that will help him retrain the muscles that are associated with swallowing. A trained speech therapist oversees this type of retraining.

The oral therapy method/retraining tends to have the highest percentage of successful results.

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Fixing Tooth Decay Without Drilling

If you or a loved one have a cavity, it’s absolutely necessary that your dentist drill a hole in your tooth to fill the cavity, right?

Maybe not.

New technologies are becoming available to your dentist that help him identify the start of tooth decay so that he may catch the tooth as it starts to lose some of its minerals, but before it starts to form a cavity.

If there’s no hole, there may not be a need to drill/fill it.

Believe it or not, you and your dentist just may be able to say “No!” to drilling cavities.

Most tooth decay actually can take up to three years (!) to move from the early signs of decay (which appears on the surface of a tooth) to a major cavity that goes all the way to the center of the tooth (the pulp, where the tooth’s blood vessels and nerves are located). Cavities in the early part of the 20^th century often could reach a tooth’s pulp in just a few months.*

If your dentist finds decay on your tooth enamel (the start of a cavity), you may not need a filling (unless you’re in pain or the cavity’s hole is obvious).

In fact, if there’s no hole and you’re not in pain, the decay may be able to heal itself!

Decay starts when your mouth’s acids trigger your tooth’s enamel to leach minerals, breaking the enamel down and forming a cavity.

But treatments and technologies today can help reverse decay with dental office fluoride treatments, changes to your diet (watch the sugar, starches, etc.) and making sure you floss and brush twice daily. This helps minerals build up in your mouth once again, strengthening tooth enamel.

In addition, “drill-free fillings” may be coming, in which a dentist can use electrical currents to repair your tooth’s minerals. The British newspaper Independent.com.uk reported in June that the procedure (developed at King’s College in London), is called Electrically Accelerated and Enhanced Remineralisation (EAER). It could be offered on the market within three years.

Until then, go to your dentist regularly for checkups, and so that he can look to see if you have the start of tooth decay on your tooth enamel. If so, work with him and take the steps he recommends to help you re-mineralize your enamel and possibly repair it naturally.

*Interesting side note: we can thank the addition of fluoride to toothpaste and public drinking water to delaying the full-blown onset of tooth decay. Tooth decay in the early years of the 20^th century could make its way to the pulp in a matter of just months. The American Dental Association approved the addition fluoride to toothpaste in the mid-1950s; adding fluoride to public drinking water took off after the 1940s and water fluoridation now benefits more than 200 million Americans in cities across the country.

In fact, so beneficial is fluoride to delaying the formation of cavities that the Centers for Disease Control in 1999 named water fluoridation as one of the ten top public health achievements of the 20^th century.

Image courtesy of Stuart Miles/FreeDigitalPhotos.net

While tooth erosion can’t be reversed, there are several treatments to help counteract and repair the damage.

Most of us will have some tooth erosion during our lifetime. The amount and severity will depend on how well we take care of our teeth, any oral habits we may have (smoking, chewing tobacco, eating a lot sweets and candy, etc.) and even our genetics – some people naturally excrete more plaque than others (a major cause of tooth erosion).

First a bit of background on the causes of tooth erosion:

Erosion occurs on a tooth’s enamel, the thin outer layer of a tooth.

Enamel actually is clear; the color of our teeth comes from the main part of the tooth, the dentin.

Our enamel protects our teeth from the wear and tear that naturally occurs living our day-to-day lives: eating, biting, grinding, etc. And, while enamel is very hard, it can crack and/or chip.

If the enamel becomes eroded – or if the tooth chips/cracks – that’s it. Damage done. Enamel has no living cells; our bodies can’t repair or replace it.

By far the best treatment for tooth erosion is prevention; regularly visit your dentist for teeth cleaning and checkups.

Acid is by far the main culprit when it comes to tooth erosion: the acid found in many of the foods we eat and drink wears the enamel away over time.

Common foods and drinks we consume that erode enamel include:

• Soft drinks (the drinks contain a good deal of citric and phosphoric acids)
• Acid reflux disease (GERD)
• A diet that includes a lot of sugar and starches
• Fruit juice such as orange juice
• Medications such as antihistamines and even aspirin
• Dry mouth (low salivary flow found in those who have xerostomia)
• Inherited conditions (such as excessive plaque excretion)

Tooth enamel also erodes due to friction (via the natural use of your teeth biting, chewing, etc.), brushing your teeth too hard, flossing poorly, chewing tobacco, and biting on things you shouldn’t bite on (removing a bottle cap from a bottle, for example).

Plaque can sometimes cause tooth erosion because plaque transforms the starches found in food into acids and those acids can start to eat way (erode) the tooth enamel. Regular flossing and brushing (done correctly) can help keep plaque at bay and prevent it from leading to enamel erosion.

Treatments for tooth erosion include:

• Using a remineralizing gel that contains fluoride and phosphate when you brush your teeth. This can help restore minor erosion caused by acid erosion and day-to-day wear on teeth.
• Your dentist can place dental crowns as caps on your teeth if the erosion is moderate or extensive. Crowns restore your teeth to their original shape.
• Veneers can be bonded (glued) to the front of the affected teeth and can cover chipped, eroded, cracked, and even broken teeth. Veneers also help prevent further damage.

The best treatment for tooth erosion is prevention: watch the sodas, the sweets and juices. Don’t smoke or chew tobacco. Visit your dentist regularly for cleaning and removal of built-up plaque deposits. Good oral hygiene is the best defense when it comes to tooth erosion.

Image courtesy of Stuart Miles/FreeDigitalPhotos.net

Some of the greatest pleasures of summer are the wonderful foods that become available during this season of fun in the sun: hot corn on the cob, salt water taffy, peanut brittle, kettle corn – they all scream summer fun.

But they can also do a real number on your teeth.

Read below for some typical foods freely available in the summer that can harm your teeth.

• Corn on the cob. As delicious as it is – freshly cooked and slathered in butter – corn on the cob should be avoided in the summer, especially if you have removable dentures or braces. Why? Because biting into the cob can loosen the dentures and/or get in between the denture and your gum, possibly causing an infection if you can’t get at the food particle to remove it. The same goes for braces: bits of corn get stuck in the braces and unless you brush your teeth immediately and thoroughly, the food bits can add to tartar and plaque, which could lead to cavities.

One of summer’s greatest pleasures is enjoying hot corn on the cob slathered in butter. But those kernels can be very unfriendly to your teeth.

• Kettle corn and Cracker Jack-like popcorn. A baseball game on a Sunday afternoon at the professional ballpark often isn’t a real baseball game without a hotdog, a soda and a bag of Cracker Jack candy. But the sticky Cracker Jack popcorn could chip a tooth and popcorn bits can fall between teeth with possible results as described above.
• Peanut brittle. This delicious candy can be very hard to bite upon, risking the danger of a chipped tooth.
• Salt water taffy and extremely chewy candy bars such as Abba-Zaba. We’re not out to pick on particular brands, but taffy-like candy bars such as Abba-Zaba can be so hard to pull a bite from that, if your teeth are even a bit loose, could help loosen them a whole lot more. Taffy and even gum should be avoided by those wearing braces – it’s too easy for the gooey stuff to get caught in the wires.
• Whole apples. There’s little that’s more refreshing than biting into a tart green or red apple on a hot day. The problem is, if you wear braces or dentures, a firm apple can wreak havoc on your teeth.
• Soda drinks. As with apples, enjoying a nice cold glass of cola or other soda is just delicious on a hot summer afternoon. But the citric, carbonic and phosphoric acids in the sodas over time can erode your tooth enamel.

We certainly don’t want to be a summertime Scrooge and tell you that you absolutely shouldn’t enjoy these delicious foods at all. But forewarned is fore-armed: decide for yourself. Certainly having the occasional box of Cracker Jack or an Abba-Zaba bar won’t do too much – if any damage.

What’s more, it’s often easy to make just a few adjustments in order to enjoy summer’s delicious bounty. You could, for example, remove the corn kernels from the cob before eating. Cut the apple into slices. Cut a taffy bar or peanut brittle into really small pieces, and so on.

You should indulge in the glorious foods of summer; we’re just advising that you be careful not to overindulge.

Image courtesy of phasinphoto/FreeDigitalPhotos.net

Are You a Good Candidate for Dental Implants?

If you’ve lost – or are definitely going to lose – one or more of your adult teeth, you may be wondering if you’re a good candidate for dental implants. After all, false teeth such as dentures have to be removed regularly from your mouth for cleaning. Many people don’t like the feeling of the “impermanence” of these types of false teeth.

A dental implant, in contrast, is an artificial tooth root that a dentist places into your jaw to support a bridge or replacement tooth. Once surgery is complete, they feel and look like real teeth.

Basically, there are two different types of implants: endosteal (in the bone) and subperiosteal (on the bone).

Subperiosteal implants are put on the top of the jaw.  The posts of the metal frameworks protrude through the gum in order to hold the false tooth. Fast, subperiosteal implants are best for patients who can’t wear conventional dentures and whose bone height is minimal.

Endosteal are the most common type of implants. The different types include blades, cylinders and screws that your dentist places via surgery into the jaw bone. Each of these implants holds at least one, sometimes more, prosthetic teeth. This type of implant is ideal for individuals who wear – or can wear – removable dentures and/or bridges.

Implants can be used to replace a single tooth, several teeth, or even all of your teeth.

Can YOU Get Dental Implants?

An experienced implant dentist will need to examine you thoroughly to see if you’re a candidate and, if so, which type of implant would be best for you. Generally, however, if you’re health is good, your oral hygiene is good, you have enough bone in your jaw to support the implant, and if your gum tissue is healthy, you should be able to have dental implants.

Important note: because implants are connected with bone and gum tissue, seriously consider working with an experienced periodontist when it comes to getting dental implants. Periodontists specialize in gum and bone issues and they also have the experience to ensure your implants look and feel as real as possible.  You can work with a dentist as well as with a periodontist, or you can find a periodontist who offers dental implants.

As you look for an implant dentist you’ll want to be sure he or she has had a minimum of 300 or more hours of postdoctoral/continuing education in both endosteal and subperiosteal implants. He or she also should be certified in dental implants.

While cost probably will be a factor, beware of going with the least-expensive dental implant practitioner. Your comfort factor with the doctor should also be noted – you’re going to be spending a lot of time in his or her office and so you should feel at ease in the facility and interacting with the dentist’s team members.

If you are interested in finding out if you are a good candidate for dental implants or have any questions feel free to contact the office of Dr. Brent Cornelius at (817) 431-4200 or visit our website at www.brentcornelius.com today!

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Cavities tend to plague the young; gum disease gets us when we’re older.

Sure, most of us brush our teeth at least once a day (maybe lackadaisically, but we still brush). And since we aren’t getting cavities any more (we’re brushing, after all!) we assume that we’re home free.

Hardly. If we don’t take care of our gums as we get older we very likely will lose at least one tooth after 65 – if not sooner.

What’s more, gum disease – its clinical term is periodontal disease – can also lead to other health risks such as heart attack and stroke.

Periodontal disease starts out as gingivitis – the least severe form of the disease. Symptoms can include swelling, redness, and bleeding gums (often when you brush your teeth). You’ll probably feel no pain with gingivitis, but if left untreated (and most people can take care of gingivitis with better oral care under the direction of their Keller dentist), it can develop into periodontitis.

This happens because plaque spreads beneath your gum line and the toxins produced by plaque cause irritation. Your body responds with inflammation, causing the tissue and bone beneath your teeth to degrade, with your teeth and gums growing more and more separate from each other. Infection can set in and the cycle continues, with the destruction of more supporting tissue and bone. Given enough time, your teeth can loosen and need to be removed.

But wait! There’s more: there are multiple types of periodontitis. What’s known as aggressive periodontitis usually shows up in healthy people. This type of periodontitis is characterized by rapid destruction of bone and loss of attachment. Chronic periodontitis is the most common type and it’s known for the inflammation of supporting tissue and a slow progression of attachment loss.

As hinted at above, periodontitis can also be a product of another disease (respiratory disease is common), diabetes, heart ailments, and so on.

Finally, a particularly bad form of the disease is necrotizing periodontal disease. This is where the periodontal ligaments, gum tissues and bone die. This type of periodontal disease is most common in patients who have suppressed immune systems.

The treatment for periodontal disease depends on how severe it is. As mentioned above, gingivitis can be tamed with good oral hygiene habits (flossing regularly, brushing for at least one minute each time, regular dental checkups with tooth cleaning and plaque and tartar buildup removed from your teeth).

Scaling and root planning are other non-surgical treatments. Treatments that require surgery include flap surgery/pocket reduction surgery, bone grafts, soft tissue grafts, guided tissue regeneration, and bone surgery.

Most gum disease can be treated non-surgically; the surgical procedures listed above are almost always necessary when the tissue around the teeth is unhealthy and can’t be repaired otherwise.

As serious as periodontal disease is, it’s relatively easy to prevent: take care of your teeth and gums!

For more information about Dr. Brent Cornelius please visit www.brentcornelius.com