As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
Dental implants are all the rage. And why not — not only are these tooth replacements life-like and highly functional, they have an amazing 95% ten-year success rate.
Some of that success is due to their unique design. Technically a root replacement, an implant's metal titanium post is surgically placed in the jawbone, where bone grows and adheres to it over time. This creates a strong connection that stands up well to the forces created by biting and chewing.
But there's more to their longevity than design. Success also depends on a careful, planned process that begins long before surgery.
It starts with a detailed oral examination to determine the best placement for the implant. Besides regular x-rays, we may also perform CT scans to create a three-dimensional view of your jaw. With this we can locate and avoid nerves, sinus cavities or other structures near the implant site.
The examination also helps us determine if you've experienced any bone loss, a normal occurrence after tooth loss. Implants require an adequate amount of bone to achieve the best position. A good position ensures future bone integration and the best appearance result.
The same attention to detail extends to the actual surgery to place the implant. We fashion the site to receive the implant by sequentially drilling larger tapered channels until we achieve the right size fit for the implant. During drilling we avoid overheating the bone, which could ultimately weaken and damage the implant's stability.
We'll also need to provide protection for the implant while it integrates with the bone. In most implantations, we do this by suturing the gum tissue over the implant. We take a different approach with a “Tooth in a Day” procedure where we attach a crown (the visible portion of the tooth) right after implant surgery. In this case we'll install a crown (which is actually temporary) that's a little shorter than the adjacent teeth. The natural teeth around it will absorb the forces produced while chewing and not the implant crown.
Focusing on these and other factors will greatly reduce the risk of implant failure. Paying careful attention to them helps ensure your new smile is a lasting one.
If you would like more information on dental implants to restore your smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants: A Tooth Replacement Method That Rarely Fails.”
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
Dental disease doesn’t discriminate by age. Although certain types of disease are more common in adults, children are just as susceptible, particularly to tooth decay.
Unfortunately, the early signs of disease in a child’s teeth can be quite subtle—that’s why you as a parent should keep alert for any signs of a problem. Here are 3 things you might notice that definitely need your dentist’s attention.
Cavities. Tooth decay occurs when mouth acid erodes tooth enamel and forms holes or cavities. The infection can continue to grow and affect deeper parts of the tooth like the pulp and root canals, eventually endangering the tooth’s survival. If you notice tiny brown spots on their teeth, this may indicate the presence of cavities—you should see your dentist as soon as possible. To account for what you don’t see, have your child visit your dentist at least twice a year for cleanings and checkups.
Toothache. Tooth pain can range from a sensitive twinge of pain when eating or drinking hot or cold foods to a throbbing sharp pain. Whatever its form, a child’s toothache might indicate advancing decay in which the infection has entered the tooth pulp and is attacking the nerves. If your child experiences any form of toothache, see your dentist the next day if possible. Even if the pain goes away, don’t cancel the appointment—it’s probable the infection is still there and growing.
Bleeding gums. Gums don’t normally bleed during teeth brushing—the gums are much more resilient unless they’ve been weakened by periodontal (gum) disease (although over-aggressive brushing could also be a cause). If you notice your child’s gums bleeding after brushing, see your dentist as soon as possible—the sooner they receive treatment for any gum problems the less damage they’ll experience, and the better chance of preserving any affected teeth.
If you look in the mirror and feel dissatisfied, smile enhancement from Great Meadows Dental Group may be what you need. From improving tooth size, shape and color to normalizing a gummy smile, cosmetic dentistry services build on the foundation of healthy teeth and gums. Dr. Nicholas Papapetros, Dr. Leo Kharin, and Dr. Jessica Ristuccia are the go-to dentists in Bedford, MA, for one of today's most popular treatments: porcelain veneers. Learn all about them here.
What are porcelain veneers?
Basically, they are tooth-colored laminates. Thin, strong, tooth-shaped and permanently bonded to selected teeth, veneers cover detracting flaws such as stains, gaps, chips, and more. Your Bedford, MA, dentist often uses veneers as part of a complete smile makeover, but also, they are a great stand-alone treatment, adding a measure of resiliency to healthy teeth.
Are veneers right for you?
They can be as confirmed on examination and digital imaging at Great Meadows Dental Group in Bedford, MA. You and your dentist agree upon realistic smile goals before you begin treatment, and they will fully explain the process and aftercare.
If you qualify, your doctor will take oral impressions--either with putty and trays or digitally. Additionally, the dentist always removes a thin slice of enamel from each tooth which receives a veneer. This allows veneers to feel comfortable and bite properly. Temporary laminates protect your teeth in between visits.
When your veneers arrive from the lab, you'll return to Great Meadows Dental Group for permanent placement. The temporaries are removed, and the dentist bonds the permanent ones in place using a special adhesive. This adhesive can be varied in color so your veneers blend right in with your other teeth. After the adhesive is hardened and bite...checked, you're done!
Adjusting to veneers
It may take a week or so for your porcelain veneers to feel natural within your mouth. Be sure to continue your careful oral hygiene habits at home, and see your dentist every six months for your usual check-up and hygienic cleaning.
Additionally, stay away from hard foods, such as candy apples or ice, and never use any of your teeth to open packaging or bottles. Limit dark foods and beverages to reduce the chance of staining. The American Academy of Cosmetic Dentistry says veneers are stain-resistant--not stain-proof.
Find out more
You just may love what veneers can do for your smile. Why not find out more by coming to Great Meadows Dental Group for a consultation with Dr. Ristuccia, Dr. Kharin or Dr. Papapetros? Call the office for an appointment, won't you? Phone (781) 275-7707.
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