Wisdom teeth, or third molars, are the final teeth to develop in the back of your mouth. Most people have four wisdom teeth, which erupt during our late teens or early twenties.

Oftentimes, problems develop that require the removal of your wisdom teeth. When the jaw isn’t large enough to accommodate them, they can become trapped or impacted. Wisdom teeth may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone. In most cases, it is recommended that impacted wisdom teeth are extracted (removed).

Wisdom tooth surgery is performed, usually under local anesthesia, in your dentist’s or oral surgeon’s office, an outpatient surgical facility, or a hospital.

You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

There are many risks involved with oral piercings including chipped or cracked teeth, blood clots, or blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.

Tobacco in any form can jeopardize your health and cause incurable damage. Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. People who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If you are a tobacco user you should watch for the following that could be early signs of oral cancer:

1. A sore that won’t heal
2. White or red leathery patches on your lips, and on or under your tongue
3. Pain, tenderness or numbness in the mouth or lips
4. Difficulty chewing, swallowing, speaking or moving your jaw or tongue; or a change in the way your teeth fit together

Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.

The best advice is to avoid tobacco in any form. By doing so, you will avoid bringing cancer-causing chemicals in direct contact with your tongue, gums and cheek.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development. The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, a blow to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection

Signs of pulp damage include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. Sometimes, there are no symptoms.

When a root canal is necessary, the dentist, or endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards, you will return to your dentist who will place a crown or other restoration on the tooth to protect and restore it. After restoration, the tooth continues to function like any other tooth.

According to the American Dental Association (ADA), oral cancer kills more people nationwide than either cervical cancer or melanoma (skin cancer). Currently only half of all patients diagnosed with oral cancer survive more than five years. Good news is that it is now easier than ever to detect oral cancer early, when the opportunity for a cure is great.

Regular dental check-ups are essential in the early detection of cancerous and pre-cancerous conditions. You may have a very small, but dangerous, oral spot or sore and not be aware of it. In about 10% of patients, the dentist may notice a flat, painless, white or red spot or a small sore. Although most of these are harmless, some are not. To ensure that a spot or sore is not dangerous, your dentist may choose to perform a simple test, a biopsy, which can detect potentially dangerous cells when the disease is still at an early stage.

Signs of oral cancer that you may want to be aware of may include:

1. A sore that bleeds easily or does not heal
2. A color change of the oral tissue
3. A lump, thickening, rough spot, rust or small eroded area
4. Pain, tenderness, or numbness anywhere in the mouth or on the lips

Although oral cancer occurs most often in those who use tobacco in any form, more than 25% of oral cancers occur in people who do not smoke and have no other risk factors.

Remember to see your dentist regularly because in many parts of the mouth you may not be able to see a small spot or sore yourself. If you do notice any of the above signs, you should call your dentist as soon as possible.

Tooth loss can have an effect on your dental health and personal appearance if not dealt with properly. When you lose or have one or more permanent teeth extracted, your remaining teeth can drift out of position. This can lead to a change in your bite, and/or decay and gum disease, not to mention a change in your personal appearance.

Dental implants are an effective method in replacing one or several teeth. Each implant consists of a metal post that is inserted into the jawbone under your gums. During a healing period, the bone grows around the implant. Then the post is outfitted with an artificial tooth, which is similar to your natural tooth. Implants can also support a bridge, replace a partial denture or secure a fixed denture.

Toothache: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the gum or on the aching tooth. If face is swollen, apply cold compresses and contact your dentist immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

Knocked Out Permanent Tooth: If possible, find the tooth. Handle the tooth by the crown, not the root portion. You may rinse the tooth but DO NOT clean or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in its socket. Have the patient hold the tooth in place by biting on a gauze or clean cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk, NOT water. The tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

A crown can be used to cover a fractured tooth, a tooth with a large, old filling, or a tooth that is severely damaged by decay. Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your smile. Crowns are also used to cover teeth that are discolored or badly shaped or to cover a dental implant. Types of crowns include the full porcelain crown, the porcelain-fused-to-metal crown and the all-metal crown. Your dentist can recommend the crown that is best for you.

Fitting a crown requires at least two visits to your dentist. Initially, the dentist removes decay and shapes the tooth. Then he makes an impression and fits a temporary or transitional crown of plastic or metal. On the next visit your dentist will remove the temporary crown, fit and adjust the final crown, then cement it into place.

The Cause of teeth grinding in children is mostly the same as in adults: the teeth don’t fit together properly and 90% of the time the clenching and grinding is a natural and well intentioned unconscious effort on the part of the body to make things fit right.

Just like if you go to the beach in summer and put y our chair down where the sand is not level it will wobble back and forth. No one sits all day on a wobbly chair. Without even thinking you dig it in to fit. But if you try to do that in the parking lot where it is hard, you will never get the chair to sit evenly. Same thing with teeth. The unevenness does not self correct.

Some children (and adults) wear or break their teeth. Some also get a lot of headaches as a result of all that muscle hyperactivity.
Headaches
Headaches in children are very common and OFTEN are due to muscles from clenching or grinding teeth. If your child gets more than occasional headaches associated with fevers etc. you can arrange a consultation with our specialist in the adult practice, Dr Jerry Simon, author of the book, “Stop Headaches Now”. More information on that is available on our sister web page www.Headaches-TMJ.com.
Worn Teeth
If the only concern is wear of teeth and the six year molars have come in we might suggest an orthodontic consultation to see if some early interceptive orthodontic treatment might help.

Until the child has lost all of their baby teeth and adult teeth have come in the bite is changing too much to suggest long term treatment. Keep us informed of any concerns.

Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

When one or more teeth are missing, the remaining teeth can shift out of position, which can lead to a change in your bite, the loss of additional teeth, decay and gum disease.

In the case of missing teeth, your dentist may recommend the placement of a bridge. A permanent bridge is one or more replacement teeth anchored by one or more crowns on each side. A removable bridge, or removal partial denture, usually consists of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework.