Dentist Livermore - Dental cavities linked to lower risk of head and neck cancer - Smiles by Design in Livermore

According to a surprising new study, people who have more dental cavities are at lower risk of being diagnosed with head and neck cancer, compared with patients who have few or no cavities.

 

Dental cavities (or caries) are caused by tooth decay. This is when the bacteria present in the mouth make lactic acids that strip away minerals in the tooth by fermenting carbohydrates.

According to the researchers from the University at Buffalo, NY, previous studies have shown the bacteria that causes tooth decay is linked to an immune response, which may be protective against cancer.

 

For this study, published online in JAMA Otolaryngology - Head and Neck Surgery, the researchers set out to determine if there is a significant link between dental cavities and Head and Neck Squamous Cell Carcinoma (HNSCC).

 

The study involved 399 patients newly diagnosed with HNSCC, and 221 participants without the cancer who were all selected from the Department of Dentistry and Maxillofacial Prosthetics at Roswell Park Cancer Industry between 1999 and 2007.

 

The researchers analyzed the dental history of all patients, particularly their history of dental cavities, by measuring the number of decayed, missing and filled teeth.

Dental cavities a form of 'collateral damage'

Of the 399 patients with HNSCC, 146 (36.6%) had oral cavity squamous cell carcinoma (SCC). Oropharyngeal SCC occurred in 151 (37.8%) patients, while 102 (25.6%) had laryngeal SCC.

The results of the study overall showed that those who had high cavity numbers and who placed in the top third of participants were less likely to have HNSCC, compared with participants who had low cavity numbers in the bottom third.

 

The study authors explain:

"Caries is a dental plaque-related disease. Lactic acid bacteria cause demineralization (caries) only when they are in dental plaque in immediate contact with the tooth surface. The presence of these otherwise beneficial bacteria in saliva or on mucosal surfaces may protect the host against chronic inflammatory diseases and HNSCC.
We could think of dental caries as a form of 'collateral damage' and develop strategies to reduce its risk while preserving the beneficial effects of the lactic acid bacteria."

The researchers say that a potential strategy to reduce the risk of dental cavities while still preserving the lactic acid bacteria could be to implement mechanical plaque control, preservation of saliva and use of fluoride, as well as controlling diet and other risk factors.

They add:

"Future studies assessing the potential effects of the oral microbiome and associated immune responses on HNSCC will help elucidate the biological mechanism of the clinical association that we have observed in this study."

Medical News Today recently reported on a study that suggested poor oral health and gum disease could lead to a higher risk of throat cancer.

Written by Honor Whiteman

source: http://www.medicalnewstoday.com/articles/265996.php

Academic Journal

 

http://www.smilesbydesigninlivermore.com

Pleasanton Dentist - What is Good Oral Hygiene - Smiles by Design in Livermore

What is Good Oral Hygiene?
Good oral hygiene results in a mouth that looks and smells healthy. This means:

• Your teeth are clean and free of debris
• Gums are pink and do not hurt or bleed when you brush or floss
• Bad breath is not a constant problem

If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.

Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.

How is Good Oral Hygiene Practiced?
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

• Brushing thoroughly twice a day and flossing daily
• Eating a balanced diet and limiting snacks between meals
• Using dental products that contain fluoride, including toothpaste
• Rinsing with a fluoride mouthrinse if your dentist tells you to
• Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.

Proper Brushing Technique
Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline.	Gently brush the outside, inside and chewing surface of each tooth using short back-and-forth strokes.	Gently brush your tongue to remove bacteria and freshen breath.

Proper Flossing Technique
Use about 18" of floss, leaving an inch or two to work with.	Gently follow the curves of your teeth.	Be sure to clean beneath the gumline, but avoid snapping the floss on the gums.

source: http://www.colgate.com/app/CP/US/EN/OC/Information/Popular-Topics/Oral-Health-Basics/article/What-is-Good-Oral-Hygiene.cvsp

Tracy Dentist - Diabetes and Oral Health Problems - Smiles by Design in Livermore

For the nearly 21 million Americans that have diabetes, many may be surprised to learn about an unexpected complication associated with this condition. Research shows that there is an increased prevalence of gum disease among those with diabetes, adding serious gum disease to the list of other complications associated with diabetes, such as heart disease, stroke and kidney disease.

Is There a Two-Way Street?
Emerging research also suggests that the relationship between serious gum disease and diabetes is two-way. Not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. Research suggests that people with diabetes are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). People with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums.

The Surgeon General's Report on Oral Health states that good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups.

If I Have Diabetes, am I at Risk for Dental Problems?
If your blood glucose levels are poorly controlled, you are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control.

Other oral problems associated to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.

How Can I Help Prevent Dental Problems Associated with Diabetes?
First and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking and, if you wear them, remove and clean dentures daily. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.

What Can I Expect at My Checkup? Should I Tell My Dental Professional About My Diabetes?
People with diabetes have special needs and your dentist and hygienist are equipped to meet those needs — with your help. Keep your dentist and hygienist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.

 

source: http://www.colgate.com/app/CP/US/EN/OC/Information/Popular-Topics/Diabetes-and-Oral-Care/article/Diabetes-and-Oral-Health-Problems.cvsp

 

Livermore Dentist - Treatment Options for Tooth Sensitivity - Smiles by Design in Livermore

Tooth Sensitivity – Overview

Tooth sensitivity is due to the exposure of dentin, the part of the tooth which covers the nerve, either through loss of the enamel layer or recession of the gums. Temperature changes and certain foods (acidic or sweet) can cause the tooth or teeth to be painful. The pain usually subsides after a short period of time.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

The best way to find out why a tooth is sensitive is to have dental professional examine you. They can look for the signs of dentin exposure, and run tests to determine what the true cause of the sensitivity is. Sometimes, the sensitivity is due to a cavity or gum disease – these can be treated to address the sensitivity. Other times, the cause of the sensitivity is because the enamel has been lost through abrasion or erosion, or the gums have receded, causing the roots to be exposed.

What Can Be Done?

If the sensitivity is due to a cavity, a restoration can be placed. If gum disease is the cause, the dental professional can perform a thorough cleaning of the area.

However, if the cause is from dentin being exposed, then there are a number of professional and at home treatments that can be used to reduce the sensitivity.

• In Office Procedures:
  • Fluoride varnish can be applied to exposed areas, strengthening the enamel and dentin
  • Fluoride foam or gel can be placed into a mouth tray; you then sit with this in your mouth for 3-5 minutes, providing the teeth with a high concentration of fluoride to strengthen the areas
  • Bonding agent, the material used to stick tooth colored restorations to teeth, can be used to seal the dentin surface and provide a barrier to the stimuli that cause sensitivity
• At Home:
  • Use a very soft bristle tooth brush, with low abrasive tooth paste
  • Brush correctly and do not over brush
  • Use a tooth paste specially formulated to soothe the nerve endings in the tooth
  • Use a high concentration fluoride toothpaste (given to you by the dental professional) to strengthen the tooth surface

There are a number of treatments available, and your dental professional can help you find those that will work best, depending on your situation. Always seek a dental professional's help – do not try to diagnose this problem yourself. It may be the sign of something more serious, and only a dental professional can tell you what it really is.

 

source: http://www.colgateprofessional.com/patienteducation/Treatment-Options-for-Tooth-Sensitivity/article

Pleasanton Dentist - Stress of daily grind takes toll on Teeth - Smiles by Design in Livermore

The foreclosures, the financial meltdowns, the freaky environmental disasters — they’ve all become part of our daily grind.

But for some, that's not just a metaphor.

“I’ve gone several years without grinding but now it’s back,” says Betsy Riley, a 57-year-old program manager from Washington, D.C., who’s cracked five teeth and suffered a world of dental woes due to anxiety-provoked grinding. “All the stories about the economy, all the people who’ve lost their jobs.  Plus every time you turn on the TV, there are mudslides, earthquakes, volcanoes.”

Grinding and clenching — otherwise known as bruxism — is indeed on the rise, say dentists across the country.

“I would absolutely say there’s been an uptick of about 20 percent in terms of the number of appliances or chipped teeth or things directly related to bruxism that I attribute to these stressful times,” says Manhattan dentist Dr. Michael Sinken. “I have a friend who has a practice that’s 90 percent TMJ. He says he’s absolutely seen an increase in business. People are hurting.”

Chewing over our problems A recent study in the journal Head & Face Medicine found that sleep bruxism is more common with people who claimed to experience daily problems and trouble at work, a finding that hardly surprises former journalist Heather Draper.

“I was a business editor at a daily newspaper and had to cover the economy going into the crapper, at the same time realizing how bad it looked for my industry,” says the 46-year-old who now works as a nonprofit communications manager in Denver.

Looming layoffs and financial uncertainties (Draper was eventually laid off, forced to sell her house and take a job at a drastic pay cut) wore her down.

In turn, she wore her teeth down.

“I’ve done it for years — I have several crowns — but I’ve had a ton of anxiety in the last two years and it’s gotten worse,” she says.

Dr. Matthew Messina, a Cleveland-area dentist and consumer advisor for the American Dental Association, says his patients’ teeth are feeling the pressure, too.

“My office is close to a major NASA facility and when the Obama administration [made cutbacks], a large number of my patients worried about what that would mean for their future,” he says. “That led to a lot of stress and that led to grinding. We see it through headaches, joint pain, muscle pain and an increase in broken teeth, chipped teeth, broken old fillings, and fractured corners of teeth.”

Type A teeth According to the Academy of General Dentistry, about one in three people suffers from bruxism, particularly “people who are aggressive, competitive and hurried” (bruxism has also been linked to sleep apnea and as a side effect of certain antidepressants).

Unfortunately, many people who chew on their problems at night don’t know they’re doing it until they break a tooth. There are warning signs, though, including headaches, sore teeth, sore jaw muscles, flattened teeth, tooth sensitivity, ringing in the ears, and popping and clicking of the temporomandibular joint.

For those who sleep with a partner, there’s also that telltale creaking.

“My husband told me I was grinding again,” says Riley. “He can hear it at night.”

Figuring out you’re a grinder doesn’t necessarily cut the stress, though. Thanks to high cost of dental work – one crown can run from $500 to $3,000 — it sometimes just amps it up.

“You worry ‘If I go and do this how much is going to be?’” says Riley, who in the past two years has required two new crowns. “Just for laughs, I checked my dental insurance and they give you one dental night guard in a lifetime. When I was using night guards, I went through five in a space of two to three years.”

Teeth relief Riley says she mainly uses biofeedback techniques taught her by her dentist to control her bruxing but others swear by their dental night guards.

“I call my night guard my ‘fafa’, like the way a baby calls a pacifier a ‘binky,’” says Mark Naples, a 47-year-old media consultant from Philadelphia who’s had 10 teeth replaced thanks to his stressed-out grinding. “I have multiples — one at home, one in my shaving kit, one in my briefcase — I don’t ever want to be without one.”

Messina says these custom-fitted plastic dental appliances (which can run from $400 on up) are covered by some dental plans, but not everyone needs one.

“For some, just identifying that they’re under stress is enough to start them on the process to getting better,” he says. “We can teach techniques to notice when they’re clenching and show them how to relax.”

For others, though, a dental appliance (or occlusal guard) may be just the thing to get them through these dark nights (metaphorical and otherwise).

“One night guard is a lot less costly than fixing a broken tooth,” says Sinkin.

source: http://www.nbcnews.com/id/37557066/ns/health-oral_health/
by Diane Mapes

http://www.smilesbydesigninlivermore.com

Tracy Dentist - Cheers! Red Wine and Cranberries are Good for your Teeth - Smiles by Design in Livermore

When you pop open that bottle of red wine this holiday season, consider toasting its benefits to your teeth. After all, compounds in red wine can prevent cavities and plaque build-up, researchers say.

The compounds — called polyphenols — block a molecule made by the bacteria streptococcus mutans, which are found in all our mouths, said researcher Hyun Koo, a microbiologist at University of Rochester Medical Center in New York.

Normally, these bacteria break down sugar we eat and make sticky molecules called glucans, which let bacteria to cling to our teeth and damage their surfaces, Koo told MyHealthNewsDaily.

These bacteria also produce an acid that erodes the tooth enamel, leading to cavities, he said.

But the fermented grape stems, seeds and skins left over from wine production contain high amounts of polyphenols. The polyphenols can block the ability of S. mutans to make glucans, letting the good bacteria in the mouth thrive, while disabling the bad bacteria from sticking to the teeth, Koo said.

"The oral cavity is a very rich microbial environment, so you can't just smoke [the bad bacteria] out," he said. "There are beneficial and pathogenic organism.

Koo, who was a dentist for two years before becoming a microbiologist, also found that compounds in cranberries work similarly — they block the molecules that enable the sticky surface to form on our teeth.

When researchers fed rats the cranberry compounds, called A-type proanthocyanidins, they found that the bacteria's production of acid and glucans were reduced by 70 percent, and cavities were reduced by 45 percent, according to a study Koo published in March in the dental health journal Caries Research.

But Koo warned that eating heaps of cranberry sauce or downing glass after glass of red wine won't help you reap the dental benefits of these compounds. Cranberry products, such as cranberry sauce or cranberry juice cocktail, contain a lot of sugar and aren't good for the teeth, and red wine can stain the teeth, he said.

Instead, Koo and his colleagues hope to find a way to add these compounds to mouthwashes, toothpastes or chewing gum to combat plaque and cavities. He hopes to test the findings in a clinical setting in the next four years.

Pass it on: Compounds in cranberries and red wine can help prevent of plaque and cavities.

source: http://www.nbcnews.com/id/40719935/ns/health-healthy_holidays/
by Amanda Chan
my Health News Daily

http://www.smilesbydesigninlivermore.com

Livermore Dentist - Eat and Drink Your Way to a Healthier Smile - Smiles by Design in Livermore

Stars like Jessica Alba and Scarlett Johansson need killer smiles for their livelihood, but for us mere mortals, a whiter, brighter smile can do wonders for our appearance and self-confidence. Plus, surveys reveal that one of the first things that people notice about others is their smile, and as that old saw goes, you only get one chance to make a first impression.

Dr. Timothy Chase, a 15-year veteran of cosmetic dentistry in New York City says white teeth and healthy gums can take 10 years off your appearance. And while professional dental products work best for whitening,  what you eat and don’t eat can play a huge role in how white your teeth are.  It seems certain fruits, vegetables and other foods can aid in your quest for whiter teeth. Here’s what you should know about the white smile diet:

The crunch factor

Apples, cauliflower, celery and carrots work to whiten because they function as an abrasive scrub for teeth. These foods are nature’s toothbrush. They also stimulate the production of saliva, which helps keep plaque from forming. Stain sticks to plaque.

Orange ya glad?

The acid in oranges and pineapples may whiten and brighten the surface of the teeth. The acid also contains enzymes that kill bacteria that cause tooth decay and bad breath. “Saliva is the body’s wonder fluid,” says Chase, and eating juicy citrus increases saliva production that washes away foods that stain like coffee, soda and red wine.

Strawberry patch

Strawberries contain an enzyme called malic acid that can whiten teeth. Munch berries several times a week to naturally whiten chompers.

Pass the cheese, please

Dairy products such as yogurt, milk and hard cheeses like cheddar contain lactic acid, which may help protect teeth against decay.  Researchers think proteins in yogurt may bind to teeth and prevent them from attack by harmful acids that cause cavities. Dairy is also loaded with calcium, which guards and strengthens bone that holds teeth in place. Plus, chewing hard cheese creates saliva that helps remove food particles that stain.

Nix these

You can also try to avoid stain-causing foods.  Any food that causes a stubborn laundry stain can discolor teeth, too.  If you look at a tooth under a microscope, it looks like a kitchen sponge with many little nooks, crannies and holes. When stain-causing foods and beverages get stuck in those nooks and crannies, especially over time, dark stains develop. While we hear a lot about coffee, tea and red wine, soda is actually one of the worst offenders. It not only contains acids that open up those nooks but then stains them with cola color.

While you're at it, be sure to go easy on other teeth-staining food and drink, such as coffee, tea, blueberries, red wine, soy sauce and tobacco.

“It only takes seven minutes for destruction to start, but you can stop it by rinsing with plain water for seven seconds until you can brush and remove plaque,” says Dr. Joe Kravitz, a Washington D.C. dentist and author of “Dirty Mouth.”  If you can’t get to a toothbrush or drink water, chew sugarless gum to remove stain food causing particles.

source: http://www.nbcnews.com/id/44008827/ns/health-oral_health/
by Jennifer Nelson

http://www.smilesbydesigninlivermore.com

Pleasanton Dentist - A Brief Overview of Dental Implants - Smiles by Design in Livermore

Using titanium inserts, dental implants replace missing teeth with a natural look and feel.  Tooth loss, also known as Edentulism, can create several problems to one's health.  Nutrition may suffer, as foods that were once enjoyed become too hard to chew.  Remaining teeth may suffer as well, as they have to bear the load of the missing teeth.  This ends up straining and possibly damaging themselves.

Fortunately, dental implants can combat Edentulism. Because implants “mimic” natural teeth, they allow the patient to go on with their lives as before the tooth loss occurred.  The same foods can be eaten, and the risk of resorption is greatly reduced.

Tracy Dentist - What is Tooth Sealant - Smiles by Design in Livermore

                 

Tooth decay is a major problem affecting most people.  When it begins to cause problems in the mouth, it simply looks like a black line, seemingly unthreatening, When the dental disease process is allowed to progress in the mouth it can cause bigger problems that is more serious than a dark line on the occlusal or biting surfaces of the teeth. Bacteria will eat the hard tissues of the mouth, breaking it; and when the bacteria has come deep enough to expose and infect the pulp tissues, the patient will begin to feel some pain and sensitivity. If the infection spreads is left on its own course, the pulp can become inflamed, indicating a need for a pulp therapy or an even more unfortunate dental extraction.
The disease process in the mouth usually follows a slow progression, but once the disease is full blown, you are left alone to suffer the consequences. The best way to deal with dental cavities is to completely avoid them and that is where tooth sealants will become very important.

Investigations on the effectiveness of dental sealants began in the 1960s and after a decade, it was approved for use by the FDA, for use on dental patients. They are plastic-like coatings that are meant to seal the deep grooves and fissures on the tooth or teeth, so that food particles cannot accumulate and provide a perfect breeding ground for bacteria. Sealants can actually be applied on any kind of tooth, but since the molars have deeper grooves and they are subjected to most of the masticatory forces of the mouth, they are most susceptible to tooth decay and dental infection. For this reason, the molars are most indicated for dental sealants; and although adult teeth can also be applied with sealants, it is most commonly done on the molars of children between the ages of 5 and 12 years.

source: http://www.teethcenter.com/what-is-tooth-sealant/

 

Livermore Dentist - Can Cavities be Prevented with Good Brushing and Flossing? - Smiles by Design in Livermore

Brushing and flossing the teeth on a daily basis is the backbone of good oral hygiene, but can these two actions really work to prevent cavities from forming on the teeth?  If not, what other actions can be taken in order to effectively prevent the occurrence of cavities?


What is a Cavity?
Before we can begin to tackle the topic of whether or not cavities can be prevented through brushing and flossing, it is important to understand exactly what a cavity is and how it is formed.
Cavities are decayed spots on the teeth that present as black or brown spots, and/or holes in the surface of the teeth.  These are a result of a build-up of food particles that attract bacteria to feed on them.  This breaks down the enamel of the teeth, leaving areas of decay or holes.

Does Brushing and Flossing Prevent Cavity Formation?
The simple answer to the question of whether or not brushing prevents cavity formation is “yes”.  Dentists agree that brushing is a huge part of good oral hygiene, and good oral hygiene helps in the prevention of cavities.  Brushing the teeth serves to remove food particles left over after eating, and when the saliva of the mouth is unable to fully clean the teeth.  And, because brushing is not able to fully reach all areas of the mouth, flossing is extremely important.  Floss is able to reach in-between the teeth where foods can get caught and bacteria can thrive.  Flossing daily removes these particles, thus preventing a build-up of bacteria that can breakdown the teeth causing serious damage to the enamel, and ultimately cause a cavity.

Brushing alone can greatly assist in preventing cavities, but the rate of cavity prevention goes up when both brushing and flossing are used together.  It is recommended that an individual brush at least twice a day (in the morning after breakfast and at night before bed) in order to have the best effect on preventing tooth decay and tartar build-up.  Flossing is recommended at least once a day (at night) to remove all leftover food particles and bacteria before bed.  Because cavities are more likely to form overnight when the mouth is idler, flossing before bed has the greatest effect.  While flossing during the day does contribute to the overall health of the teeth, the effect is much greater when flossing is done at night, removing all cavity causing agents before sleep. 

Other Methods of Cavity Prevention
Brushing and flossing are excellent methods to prevent cavities.  In fact, they are the primary at-home activities for preventing cavities.  However, they are not the only methods out there.  Other methods that assist in cavity prevention are: using a fluorinated mouthwash, seeing a dentist at least two times a year, chewing sugar free gum between meals (keeps saliva moving throughout the mouth, thus removing bacteria), getting a new tooth brush every six months or less, and limit the consumption of foods containing large amounts of sugar (such as candy and cake).

source: http://www.teethcenter.com/can-cavities-be-prevented-with-good-brushing-and-flossing/

Pleasanton Dentist - Tooth Extraction - Smiles by Design in Livermore

What Is It?

Tooth extraction is the removal of a tooth from its socket in the bone.

What It's Used For

If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there's too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can't be saved, even with bone replacement surgery (bone graft).

Here are other reasons:

• Some people have extra teeth that block other teeth from coming in.
• Sometimes baby teeth don't fall out in time to allow the permanent teeth to come in.
• People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
• People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
• People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
• Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
• Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly come in during the late teens or early 20s. They need to be removed if they are decayed, cause pain or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually taken out at the same time.

Preparation

Your dentist or oral surgeon will take an X-ray of the area to help plan the best way to remove the tooth. Be sure to provide your full medical and dental history and a list of all medicines you take. This should include both prescription and over-the-counter drugs,vitamins and supplements.

If you are having wisdom teeth removed, you may have a panoramic X-ray. This X-ray takes a picture of all of your teeth at once. It can show several things that help to guide an extraction:

• The relationship of your wisdom teeth to your other teeth
• The upper teeth's relationship to your sinuses
• The lower teeth's relationship to a nerve in the jawbone that gives feeling to your lower jaw, lower teeth, lower lip and chin. This nerve is called the inferior alveolar nerve.
• Any infections, tumors or bone disease that may be present

Some doctors prescribe antibiotics to be taken before and after surgery. This practice varies by the dentist or oral surgeon. Antibiotics are more likely to be given if:

• You have infection at the time of surgery
• You have a weakened immune system
• You will have a long surgery
• You have specific medical conditions

You may have intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia. If so, your doctor will have give you instructions to follow. You should wear clothing with short sleeves or sleeves that can be rolled up easily. This allows access for an IV line to be placed in a vein. Don't eat or drink anything for six or eight hours before the procedure.

If you have a cough, stuffy nose or cold up to a week before the surgery, call your doctor. He or she may want to avoid anesthesia until you are over the cold. If you had nausea and vomiting the night before the procedure, call the doctor's office first thing in the morning. You may need a change in the planned anesthesia or the extraction may have to be rescheduled.

After the extraction, someone will need to drive you home and stay there with you. You will be given post-surgery instructions. It is very important that you follow them.

How It's Done

There are two types of extractions:

• A simple extraction is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called a forceps to remove the tooth.
• A surgical extraction is a more complex procedure. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet. Surgical extractions commonly are done by oral surgeons. However, they are also done by general dentists. The doctor makes a small incision (cut) into your gum. Sometimes it's necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it.

Most simple extractions can be done using just an injection (a local anesthetic). You may or may not receive drugs to help you relax. For a surgical extraction, you will receive a local anesthetic, and you may also have anesthesia through a vein (intravenous). Some people may need general anesthesia. They include patients with specific medical or behavioral conditions and young children.

If you are receiving conscious sedation, you may be given steroids as well as other medicines in your IV line. The steroids help to reduce swelling and keep you pain-free after the procedure.

During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your doctor.

Follow-Up

Your doctor will give you detailed instructions on what to do and what to expect after your surgery. If you have any questions, make sure to ask them before you leave the office.

Having a tooth taken out is surgery. You can expect some discomfort after even simple extractions. Usually it is mild. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can greatly decrease pain after a tooth extraction. These drugs include ibuprofen, such as Advil, Motrin and others. Take the dose your doctor recommends, 3 to 4 times a day. Take the first pills before the local anesthesia wears off. Continue taking them for 3 days. Ask your doctor for complete instructions.

Surgical extractions generally cause more pain after the procedure than simple extractions. The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth. Your dentist may prescribe pain medicine for a few days and then suggest an NSAID. Most pain disappears after a couple of days.

A cut in the mouth tends to bleed more than a cut on the skin because it cannot dry out and form a scab. After an extraction, you'll be asked to bite on a piece of gauze for 20 to 30 minutes. This pressure will allow the blood to clot. You still have a small amount of bleeding for the next 24 hours or so. It should taper off after that. Don't disturb the clot that forms on the wound.

You can put ice packs on your face to reduce swelling. Typically, they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is sore and stiff after the swelling goes away, try warm compresses.

Eat soft and cool foods for a few days. Then try other food as you feel comfortable.

A gentle rinse with warm salt water, started 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Most swelling and bleeding end within a day or two after the surgery. Initial healing takes at least two weeks.

If you need stitches, your doctor may use the kind that dissolve on their own. This usually takes one to two weeks. Rinsing with warm salt water will help the stitches to dissolve. Some stitches need to be removed by the dentist or surgeon.

You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was.

Risks

A problem called a dry socket develops in about 3% to 4% of all extractions. This occurs when a blood clot doesn't form in the hole or the blood clot breaks off or breaks down too early.

In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. Typically dry sockets begin to cause pain the third day after surgery.

Dry socket occurs up to 30% of the time when impacted teeth are removed. It is also more likely after difficult extractions. Smokers and women who take birth control pills are more likely to have a dry socket.

A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.

Infection can set in after an extraction. However, you probably won't get an infection if you have a healthy immune system.

Other potential problems include:

• Accidental damage to nearby teeth, such as fracture of fillings or teeth
• An incomplete extraction, in which a tooth root remains in the jaw — Your dentist usually removes the root to prevent infection, but occasionally it is less risky to leave a small root tip in place.
• A fractured jaw caused by the pressure put on the jaw during extraction — This occurs more often in older people with osteoporosis (thinning) of the jaw bone.
• A hole in the sinus during removal of an upper back tooth (molar) — A small hole usually will close up by itself in a few weeks. If not, more surgery may be required.
• Soreness in the jaw muscles and/or jaw joint — It may be tough for you to open your mouth wide. This can happen because of the injections, keeping your mouth open and/or lots of pushing on your jaw.
• Long-lasting numbness in the lower lip and chin — This is an uncommon problem. It is caused by injury to the inferior alveolar nerve in your lower jaw. Complete healing may take three to six months. In rare cases, the numbness may be permanent.

When To Call a Professional

Call your dentist or oral surgeon if:

• The swelling gets worse instead of better.
• You have fever, chills or redness
• You have trouble swallowing
• You have uncontrolled bleeding in the area
• The area continues to ooze or bleed after the first 24 hours
• Your tongue, chin or lip feels numb more than 3 to 4 hours after the procedure
• The extraction site becomes very painful -- This may be a sign that you have developed a dry socket.

If you have an infection, your dentist usually will prescribe antibiotics.

 

source: http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-and-Dental-Procedures/Tooth-Removal-Extraction/article/Tooth-Extraction.cvsp

 

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