When teeth cannot be preserved by fillings, crowns or root canals removal may become necessary.
New methods and medications are now available to numb your teeth:
• Lidocaine (which replaced Novocaine long ago) is no longer the only anesthetic available. Stronger, more powerful anesthetics numb faster with greater comfort for you and better pain control.
• Gels used on your gums (before local anesthetics are given) are much stronger.
• Numbing the teeth has become an easier, less invasive, more reliable and predictable experience with new anesthetics, medications and techniques.
For the “unbelievers”, Sedation Dentistry is also available. Patients who are fearful, even phobic, are able to relax, answer questions and respond to our instructions throughout the entire appointment. The same “unbelievers” become believers, when they have no memories of pain, fear, or anxiety and no dread or memory of dental procedures. If you’re able to put a little blue pill under your tongue and let it dissolve, then you’re fully able to overcome barriers and receive the dental care you need.
Of course, antibiotics, pain pills and/or anti inflammatory medications are prescribed as needed. Cold compresses applied to affected areas help to minimize swelling and improve healing. During the first 24-48 hours after tooth removal, swishing and spitting, energetic brushing, smoking or drinking through straws is not advised because it may interfere with normal healing.
Eating or drinking foods or beverages that are hot (temperature) following tooth removal may cause excessive bleeding. Apply pressure to extraction sites using the gauzes we give to you. Apply pressure for 20 minutes, remove the gauze and repeat until any bleeding subsides. Should swelling, bleeding or pain seem to become excessive or fails to resolve, please call Dr Tinney. Even if you think you might have a problem, call Dr. Tinney (office: 916-683-7222 cell: 916-825-1611).
Do You Have Third Molars? Wisdom Teeth?
About Third Molars | Wisdom Teeth
There are three sets of permanent molars.
• First molars come in (erupt) behind the last baby teeth around age 6.
• Second molars erupt behind the first permanent molars around age 12.
• Third molars typically erupt behind the second molars between ages 18-21. When these molars fail to erupt, you won’t see them because they are either buried under the gums (impacted) or missing since birth.
“Normal” Wisdom Teeth | Remove or Keep Them?
You may have third molars which have erupted “normally”, meaning they came in just like other molars. If your wisdom are like this, you may have been told removal is not necessary. However, most adults eventually have problems with “normally” erupted wisdom teeth. We see problems with tooth decay and gum disease later in life which lead to higher risk extractions and complications to other teeth in the mouth.
Second molars, for example, are frequently damaged by tooth decay and gum disease due to the positioning of wisdom teeth. This is a common problem which can lead to extractions of both wisdom teeth and second molars.
The frequency of gum disease around wisdom teeth is high. Gum disease in third molar regions spreads into other areas of the mouth making treatment and elimination of gum disease and Halitosis (bad breath) extremely difficult.
How to Avoid “Normal” Wisdom Tooth Extractions
If your second molars AND wisdom teeth remain free of tooth decay and also free of gum disease, it means you are able to keep them clean enough to avoid complications.
1) Excellent and efficient oral hygiene (at least once every 24 hours ) is vital in preventing extraction of “normal” wisdom teeth.
2) Regular visits to the dentist is critically important by allowing early detection and minimally invasive care to prevent extractions.
Common Problems when Keeping “Normally” Erupted Wisdom Teeth
We see many patients who were told their wisdom teeth did not require extractions. We also see frequent complications in these patients later in life, including:
• Tooth decay in both wisdom teeth AND second molars later in life.
• Tooth decay in second molars leading to crowns and root canals
• Tooth decay deep under the gums, on the roots of second molars which require extraction of second molars
• Retention of wisdom teeth is a frequent cause of gum disease around second molars.
• Gum disease around wisdom teeth also spreads to other parts of the mouth causing resistance to the treatment and elimination of gum disease and bad breath.
• “Normally” erupted wisdom teeth often lead to bite problems and increased risk of damage to TMJ (jaw joints).
• After age 40, when extraction of wisdom teeth becomes necessary, complications increase dramatically. Healing is better earlier in life. Extractions can be more difficult. Risk of nerve damage increases.
• Few patients past age 65 are able to avoid extraction of wisdom teeth.
• Why expose yourself to these increased risks?
• In most cases, early diagnosis and treatment to remove wisdom teeth with referral to a specialist (Oral Surgeon) is good advice.
Impacted Wisdom Teeth
Most people present to my office with impacted wisdom teeth. Their third molars are buried beneath the gums and never erupt.
Frequent complications of impacted wisdom teeth are:
• Encroachment into the root form of the second molars. This can lead to premature extraction of the second molars. In this case, referral to an Oral Surgeon and an Orthodontist is advised. These specialists are qualified to:
1) Extract the second molar (Oral Surgeon).
2) Orthodontically move the wisdom tooth into the second molar position (Orthodontist).
3)This is a costly procedure which could be prevented by early removal of the wisdom teeth.
• Tooth decay and gum disease occur on second molar roots as well.
• Crowding of other teeth making them crooked is frequently attributed to the growth of impacted wisdom teeth
• Impacted wisdom teeth can become cystic (growth of cysts) which can expand, requiring extraction by an Oral Surgeon.
• Impacted wisdom teeth can become infected, painful, and harmful to your dental health.
In my experience, most patients are better off having their wisdom teeth removed. In my opinion, the risks of complications in keeping wisdom teeth far exceeds the risks of having an Oral Surgeon remove them. Of course, a comprehensive dental examination by your general dentist and an Oral Surgeon are necessary prior to accepting or declining treatment recommendations.
Dr Thomas Tinney 916-683-7222 7915 Laguna Blvd. Suite 105 Elk Grove, CA 95758