► What are wisdom teeth, and why are they such problem?
Wisdom teeth usually appear at the back of your mouth during your late teens or early twenties. Often there is no room for them to ‘erupt’ (come through the gum) and the teeth fail to emerge properly. A wisdom tooth can erupt partly through the gum, or remain trapped below the gum – this is known as ‘impacted’ wisdom tooth.
► Why don’t my wisdom teeth fit my mouth?
There are a few theories as to why wisdom teeth don’t fit many people’s mouths. Some experts think genetics may play a part – for example, you may have inherited one parent’s small jaw, and another parent’s large teeth. Another theory suggests the size of our mouths has decreased over the countries, because our diet has changed and our jaws don’t need to be as large and strong as they were in prehistoric times.
► Do I need to have my wisdom teeth removed?
Your wisdom teeth only need to be removed if they cause problems. For example;
1. Wisdom teeth can be very difficult to clean, and are prone to tooth decay, gum disease, and recurring infections.
2. Cysts and tumours can develop in tissues around impacted wisdom teeth.
3. If your wisdom teeth are unable to erupt, they may cause pressure and damage or crowed the neighboring teeth.
► If my wisdom teeth need removing, who will do it?
Straightforward removal of wisdom teeth may be done in your own dentist’s surgery. If your case is more complex, your dentist may decide to refer you to an oral surgeon.
► Will it hurt?
Surgical removal of wisdom teeth can cause more discomfort than routine extractions. You may experience;
1. Some swelling and minor bleeding
2. Difficulty in fully opening your mouth
3. A change of sensation or numbness of your lip or chin
All of these symptoms are temporary, and in most cases your mouth will be feeling normal a week after your surgery
Inside a tooth is a fine space called the root canal. The root canal contains the dental pulp which consists of nerves and blood vessels. If the dental pulp becomes diseased or dies, a toothache or an abscess may occur. In the past these problem teeth were extracted but now your dentist can offer you root canal treatment to care for these teeth.
► Is root canal treatment painful?,
Local anesthetic and modern painkillers are used to provide comfortable treatment. Usually painful symptoms improve once treatment is started.
► How a tooth is restored following root canal treatment?
It is very important that any restoration adequately seals the root filling from infection by bacteria from the mouth.
Teeth requiring root canal treatment often have large fillings or extensive damage and will require a crown to restore them properly. These teeth are also weaker and the added protection of a crown is recommended.
► How successful is root canal treatment?
If the root canals are able to be fully cleaned and sealed and the tooth properly restored, then treatment has a very high success rate.
► What can Dysport do for you?
Whenever you laugh, frown, concentrate or squint into the sun, your facial muscles contract and your skin creases. As you get older your skin loses it’s elasticity and those creases deepen into lines that become permanently etched on your face. Frown lines between your eyes can become particularly noticeable at a relatively young age, making you look angry or worried even when you’re not.
By temporarily immobilizing the muscles you use to frown, Dysport can smooth out those lines, restoring a more youthful, less stressed expression to your face. Because you will be physically unable to frown after treatment, you may even lose the urge of frown. The lasting effect of treatment with Dysport can differ between individuals after which further courses of treatment may be necessary. Speak with your specialist about the results you can expect with Dysport.
► What exactly is Dysport?
Dysport is a protein taken from the bacteria Clostridium botulinum. The protein was initially used for the treatment of motor disorders and various kinds of involuntary muscular spasms, including cerebral palsy.
In New Zealand, Dysport now has registration approval under the Medicines Act for the treatment of frown lines that appear between the eyebrows.
► How is Dysport used?
Tiny amounts of Dysport are injected directly into the facial muscles underlying the frown lines. It usually takes three to five small, almost painless injections between the eyebrows for an effective treatment. No local anaesthetic is usually required, but if you are concerned your doctor can numb the skin over the area before injecting. You can expect treatment to take around 10 – 20 minutes.
Over the next few days, the muscles gradually relax. You probably won’t notice it happening – you’ll just become aware that you can’t contract your frown muscles. But because you can still blink normally and raise your eyebrows, you will not look unnatural. Rather, you can enjoy a more youthful appearance while maintaining a natural expression.
1. Whitening, or “tooth bleaching”, is the most common cosmetic dental procedure. While many whitening options are now available, including over the counter products, dentist-supervised treatments remain the recommended procedures for lightening discoloured teeth.
► Teeth Whitening Procedures Can Help:
1. Lighten coffee-stained teeth.
2. Remove cigarette and tobacco discolorations.
3. Correct yellowing in teeth due to aging.
Choices for Whiter Teeth As in any dental procedure, we recommend that you consult with your dentist to find out which teeth whitening procedure is best for you.
2. Teeth reshaping (sculpting) and bonding performed in one office visit. Tooth reshaping removes parts of the enamel to improve the appearance of the tooth. It may be used to correct a small chip, or to alter the length, shape or position of teeth; it can be used to correct crooked or excessively long teeth. This procedure offers fast results and can even be a substitute for braces under certain circumstances.
► Dental Bridges
Dental bridges are false teeth, which are fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.
Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many as ten years or more.
3. Veneers are ultra-thin, custom-made porcelain laminates that are bonded directly to the teeth. They are an option for closing gaps or disguising discoloured teeth that do not respond well to whitening procedures. Depending on the procedure, tooth reduction may be necessary.
► Benefits of Veneers
1. A minimal amount of the natural tooth must be altered to fit the veneer.
2. Veneers can be matched to make even the darkest teeth appear to be bright white.
3. Minor twists and overlaps, as well as small gaps, can be quickly corrected through the use of veneers.
4. Gum lift is a cosmetic dental procedure that raises and sculpts the gum line. The procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or more symmetrical teeth.
5. Bite Reclamation Patients who have had years of excessive wear to their teeth due to grinding or acid reflux can alter their vertical dimension. This gives them a closed or shorter look to their face and smile. By opening up their bite, we can reclaim their vertical dimension and sometimes even remove unwanted wrinkles as well. This gives a more youthful appearance and can often eliminate the need of plastic surgery.
► Chipped, Cracked and Broken Teeth
Tooth or dental trauma is injury to the mouth, teeth, soft oral tissues or jawbones. Tooth trauma can be caused by sports, car accidents, fights, and falls, biting on hard foods/objects and drinking hot liquids. Injuries affecting the mouth and teeth are often quite painful, resulting in bleeding, lacerations and/or punctures.
Common types of tooth trauma include the following:
► Cracked Teeth:
Apart from injury to the tooth, habits such as teeth grinding, clenching and chewing on hard objects can cause cracked teeth. Symptoms of cracked teeth include erratic pain from chewing and temperature extremes. Pulp irritation and dama
Since pulp damage is common with cracked teeth, root canal treatment often is needed. Following root canal treatment, your dentist will restore your tooth with a crown to hold the pieces together and protect the cracked tooth. If the crack spreads below the gum line, or if the cracked tooth has irreparably deteriorated, tooth extraction will be necessary. However, pulp damage and root canal treatment are not always consequences of cracked teeth. For example, when the pointed part of a tooth’s chewing surface (cusp) breaks off naturally or has to be removed by a dentist, the pulp is seldom damaged and rarely needs root canal treatment. Instead, your dentist usually will place a full crown restoration.
► Chipped, Fractured and Broken Teeth:
While minor chips or fractures do not require immediate care, they should be treated to avoid sharp edges that can cut soft oral tissue (tongue, lips) and for esthetic reasons. If a piece of the outer tooth is chipped off, but the pulp is undamaged, your dentist may simply smooth out the rough edges or replace the missing portion using tooth-colored composite. In other instances, it may be possible to bond a broken tooth fragment back in place. If you lose a larger part of the tooth, but the pulp is not irrevocably damaged, your dentist may restore and protectively cover the tooth with a porcelain veneer or crown (“cap”). If the pulp has been seriously damaged, the tooth will require root canal treatment before a crown can be placed. A tooth that is vertically fractured or fractured below the gum line will require root canal treatment and a protective restoration. If there isn’t sufficient structure remaining to hold
► Dislodged (Luxated) Teeth:
When injured, a tooth may be pushed to one side, or out of or into its socket. Luxated teeth need to be repositioned and stabilized by your dentist as soon as possible. The quicker the stabilization, the better the long term potential for saving luxated teeth. Dislodged permanent teeth usually need root canal treatment; treatment should begin approximately one week after the injury. Children between seven and 12 years old may not need a root canal since their teeth are still developing. Research indicates that stem cells present in children’s pulp tissue can be stimulated to complete root growth and heal the pulp after injuries and/or infection. Consult an endodontist to see if this might be the case with your child’s injured tooth.
► Knocked Out (Avulsed) Teeth:
If a tooth is completely knocked out, you must seek dental/medical care immediately. If possible, it’s best to put the tooth back in its socket (except with children under 12 years old, who may swallow it). Hold the tooth by the crown (chewing edge), never the roots. If dirty, rinse with saliva or water. Do not use soap or other cleaning agents; never scrape, scrub or brush the tooth. Making sure it’s facing the right way, place the tooth back into its socket as quickly as possible. The less time the tooth is out of its socket, the better the chance of saving it (two hours is the most for survival). To stabilize the tooth and minimize bleeding, gently bite on clean gauze, a wet tea bag or a wad of cloth until you reach your dentist/hospital emergency room. If you’re unable to put the tooth back in its socket, it’s critical to keep the tooth moist. Immediately place the tooth in a cup of cold milk, saliva, cool water with saline solution (not contact lens solution or tap water), or special first- aid solutions (such as Save-A-Tooth) available at drugstores. You also can put the tooth between your gum and cheek or underneath your tongue.
If you can get to dental/medical care within 30 minutes and the tooth has been properly preserved, chances are good that it can be successfully re-implanted. In most cases, only permanent (adult) teeth are re-implanted. Primary (baby) teeth usually are not re-implanted to avoid injury to the developing permanent tooth growing inside the bone.
► Broken Jaws:
After an accident, if you can’t bring your upper and lower teeth together, your jaw may be broken. Seek immediate attention from your dentist/hospital emergency room. A broken jaw must be set back into its proper position and stabilized with wires as it heals (six weeks or more, depending on your age and severity of fracture). An oral/maxillofacial surgeon usually performs this procedure.
► Tooth Injury Treatments
Treatment depends on the type, location and severity of the tooth trauma. Any dental injury, no matter how minor, should be examined thoroughly by a dentist, who will be able to detect and effectively treat unnoticed injury to the tooth and its neighbouring teeth, gums and bones.
Minor tooth trauma, such as soft tissue injuries, may only require ice or a cold compress to reduce swelling and pain. To help control bleeding, apply direct pressure with gauze. Cuts and punctures may require stitches. For pain, take acetaminophen (Tylenol) or ibuprofen (Motrin). Check with your dentist for advice on which might be appropriate for your type of injury or your personal medical history. Eat soft foods and avoid liquids with extreme temperatures.
In cases of non-emergency tooth injuries, such as simple tooth fractures, you can schedule a regular dental appointment. Other non-emergency reasons to see your dentist after tooth injuries include tooth sensitivity to hot/ cold fluids, increased pain or tooth darkening. Professional dental bleaching may be advised in cases of tooth discoloration, which can result from bleeding in the pulp chamber.
Sedation dentistry is used to provide a relaxing and anxiety-free experience for certain people receiving dental treatment. It enables individuals too afraid to go to the dentist to receive the dental care they need while avoiding the common apprehension known as dental phobia.
According to to the Dental Organization for Conscious Sedation (DOCS Education), a professional dental organization dedicated to ensuring that patients receive safe, comfortable and anxiety-free dental care, 30 percent of the population avoids the dentist due to fear. This all-too-common “dental phobia” prevents people from receiving necessary routine dental care, potentially compromising the health and functionality of their mouth and smile.
Sedation is a process used to establish a relaxed, easy and calm state through the use of sedatives. Sedative drugs (tranquillizers, depressants, anti-anxiety medications, nitrous oxide, etc.) can be administered in a variety of ways. In the past, intravenous (IV) sedation – sedatives delivered via injection into the blood vessels of the hand or arm – was predominantly used to sedate a dental patient.
IV sedation is both safe and effective when administered by a trained professional. Today, however, sedation dentistry has evolved to be even more conducive to a relaxing experience. Patients have alternatives to the traditional modalities of inhalation (nitrous oxide or “laughing gas”) and IVs, such as those offering a “no needle” (meaning, no injection) approach that many people find more appealing.
Oral sedation dentistry is now the most common technique used in the United States and Canada to quell patient fears. The technique is easy and requires no needles. Best of all, the medications create such a comfortable experience that most patients do not remember the visit; it is as if they slept through the treatment. In reality, oral sedation dentistry maintains a level of consciousness in the patient for safety and cooperation. To learn more, visit SedationCare.com. Note that sedation is different from anesthetic injections. Although some forms of sedation (such as nitrous oxide gas) may raise your threshold for pain, most dental treatments still require a local anesthetic injected in the mouth, even when sedation dentistry techniques are performed. This local anesthetic will temporarily block pain impulses from the affected teeth and gum tissue. However, this injection will occur after you are already sedated and comfortable, so most likely you won’t be bothered by or remember the sensation of having the injection. Regardless of the type of sedation dentistry you receive, it is important to have a responsible caregiver accompany you to the procedure (and drive you there if you must take oral medication before arriving for your appointment). The caregiver should drive you home after the procedure is complete and stay with you for an additional two to four hours at home.
One of the major benefits of sedation dentistry is that people often feel like their dental procedure lasts only a few minutes, when in fact it might have taken hours to perform. Therefore, complex dental procedures such as smile makeovers or extensive rebuilding procedures that normally require multiple visits can often be performed in fewer appointments.
If you are reluctant to change the appearance of your smile because you are afraid or anxious about undergoing long or complicated dental procedures, sedation dentistry can make you feel comfortable during the treatment process and help you achieve a smile you can be proud of.
Also, because sedation dentistry addresses some of the fears that keep people from going to the dentist on a regular basis, sedation dentistry patients are more likely to receive recommended routine care. As a result, they are less likely to neglect their oral health or allow oral health problems to build to the point when drastic dental treatments become necessary.
Sedation dentistry has occasionally been dubbed sleep dentistry, but this term is misleading. In actual fact, you do not sleep during the procedure, but because of the effects produced by the sedative, you may feel sleepy. Sedation dentistry enables you to be kept awake throughout the entire procedure, but you will feel relaxed and likely won’t remember much about your treatment. The use of general anaesthesia is not considered sedation dentistry.
if you are not sure whether or not you are having a true dental emergency, answer the following questions:
* Are you bleeding from the mouth?
* Are you in severe pain?
* Do you have any loose teeth?
* Have you been hit in the face or mouth?
* Do you have any swelling in the mouth or facial area?
* Do you have any bulges, swelling or knots on your gums?
If you answered yes to any of these questions, you might be having a dental emergency and should call your dentist immediately. It’s important to describe to your dentist exactly what has happened and what you are feeling.
If you experience extreme pain caused by hot or warm foods or beverages, try drinking ice water. It might relieve the pain. Sip on ice water and hold some in your mouth until you see the dentist.
If you are having sensitivity to cold or if it causes pain to breathe in air, avoid cold foods and beverages. Breathe through your nose and call your dentist’s office.
If you experience pain in a tooth when biting down, it might indicate an abscess. This is an emergency and you should call your dentist’s office.
► How to Avoid a Dental Emergency
Many dental emergencies can be easily avoided by having routine check ups with your dentist to ensure that your mouth and teeth are healthy, strong and free from decay.
Wearing a mouth guard during sports activities will help to prevent teeth from being chipped, knocked out or broken. Avoid chewing on ice and hard foods that may break or fracture your teeth. If you are planning to travel out of the country or leaving for an extended vacation, during which you may not have ready access to dental care, it is important to see your dentist for a routine check up before you leave. Your dentist can make sure that you don’t have any loose crowns or teeth, decay close to the nerve of a tooth that could cause you pain or develop into an abscess or other problems that could be easily fixed before becoming a dental emergency later. For more information about safe care in the event of a dental emergency while traveling, contact the Organization for Safety and Asepsis Procedures (OSAP), or the International Association for Medical Assistance to Travelers (IAMAT).
Being Prepared for a Dental Emergency Because a dental emergency can happen at any time and place, the best thing to do is be prepared and don’t panic. Pack and keep with you a small dental first aid kit containing the following:
* Small container with a lid
* Name and phone number of your dentist
* Acetaminophen (not aspirin or ibuprofen because they can act as a blood thinner and cause excessive bleeding during a dental emergency).
► What is Involved with Extraction and What Does it Cost?
When it comes to dental procedures, tooth extraction — or having teeth “pulled” — is among patients’ most dreaded prospects. Also referred to as exodontia, tooth extraction involves removing a tooth from its socket in the jaw bone. Before your dentist considers extraction, every effort will be made to try to repair and restore your tooth. However, sometimes a tooth extraction is necessary.
► Reasons for Tooth Extraction
There are several reasons for extracting a tooth. These include:
1. Severe Tooth Damage/Trauma: Some teeth have such extensive decay and damage (broken or cracked) that repair is not possible. For example, teeth affected by advanced gum (periodontal) disease may need to be pulled. As gum disease worsens, the tooth — supported by less surrounding bone — often loosens to such an extent that tooth extraction is the only solution
2. TMJ Symptoms
Is your jaw pain the sign of a serious problem?
◆ Malpositioned/Non-functioning Teeth:
To avoid possible complications that may result in an eventual, negative impact on oral health, your dentist may recommend removing teeth that are malaligned and/or essentially useless (teeth that have no opposing teeth to bite against).
◆ Orthodontic Treatment:
Orthodontic treatment, such as braces, may require tooth extraction to make needed space for improved teeth alignment.
◆ Extra Teeth:
Also referred to as supernumerary teeth, extra teeth may block other teeth from erupting.
Head and neck radiation therapy may require the extraction of teeth in the field of radiation in order to help avoid possible complications, such as infection.
Chemotherapy weakens the immune system, increasing the risk of tooth infections, heightening the risk of extraction.
◆ Organ Transplant:
Immunosuppressive medications prescribed after organ transplantation can increase the likelihood of tooth infection. As such, some teeth require removal prior to an organ transplant.
► Commonly Extracted Teeth
Wisdom teeth removal is one of the more common categories of tooth extraction. Many dental professionals will recommend removing wisdom teeth (third molars) before they are fully developed — usually in the adolescent years — to help eliminate potential problems. One problem that could occur is development of an impacted tooth that has surfaced and has no room in the mouth to grow. Other problems associated with impacted teeth include infection, decay of adjacent teeth, bite interference and gum disease. Extractions of some permanent teeth that have not erupted — such as the canines, which are also known as fangs or eye teeth — may be required in order to make space for orthodontic treatment.
► Types of Tooth Extractions
There are two types of tooth extractions:
◆ Simple Extractions:
These are performed on teeth that are visible in the mouth. General dentists commonly do simple extractions, and most are usually done under a local anesthetic, with or without anti-anxiety medications or sedation.
◆ Surgical Extractions:
These involve teeth that cannot easily be seen or reached in the mouth, either because they have broken off at the gum line or they have not fully erupted. Performed by dentists or oral surgeons, surgical extractions require some type of surgical procedure, such as bone removal, removing and/or lifting and folding back all or part of the gum tissue to expose the tooth, or breaking the tooth into pieces (called tooth sectioning). Surgical extractions can be done with local anaesthesia and/or conscious sedation. Patients with special medical conditions and young children may receive general anaesthesia.
The term immediate denture is applied to any denture that is planned and constructed with the intention of placing it in your mouth immediately upon the removal of teeth. They have the advantage that you do not have a waiting period with no teeth present. This can deal with possible embarrassing appearance problems, but a rigid timetable of follow-up treatment is required for the most successful outcome.
It is important that the denture/s be placed immediately after surgery, and that it is left in place for 24 hours.
You will then return to your dentist who will remove the denture/s, examine the mouth and make any necessary adjustments to the denture/s. .
During the following seven days you should follow the post-surgery instructions, removing the denture/s after eating so that the mouth can be thoroughly rinsed and the denture/s cleaned, and the placing the denture/s back in the mouth. .
After about seven days you should see your dentist again so that the denture/s can be removed in order that the biting surfaces may be made more regular. This is achieved by recording the relationship between the upper and lower dentures and grinding the tooth surfaces to achieve an even bite. .
No denture is permanent in the sense that once you have a denture/s it will last a lifetime. Immediate dentures require regular checks because of the changes in the underlying bone that occurs after your teeth have been removed. You will therefore be called in at around three- monthly periods for up to 12 months after the denture/s have been inserted. At any of the review visits the dentist may recommend tissue conditioning, relining, rebasing or remaking to ensure denture fit and comfort, and to avoid damage to the valuable underlying bone that helps hold the denture in place. .
You should discuss the ongoing fees for these treatments with your dentist, as each of these steps have costs that will need to be met by you, so it is important that you understand these fees.