Posts for: December, 2015
You’re ready to have that missing tooth replaced with a dental implant or other life-like restoration. But we may first have to address another problem — moving the teeth around the missing tooth space back to where they should be.
That empty space is the primary reason those teeth are no longer in the right position. Through their attachment to the periodontal ligament that lies between them and the bone, teeth are able to move slightly over time in response to mouth changes. This same mechanism, however, may also cause teeth to “drift” toward each other across the empty space left by a missing tooth; too much drift and there won’t be enough room for the replacement tooth.
A fairly straightforward orthodontic treatment can restore drifted teeth to their original position to make room for the replacement. There is one situation, however, that can complicate this treatment — if you also have periodontal (gum) disease, a plaque-induced bacterial infection. During normal tooth movement bone dissolves (resorbs) in front of the tooth in the direction of movement, while new bone forms behind it to help stabilize the tooth in its new position. Gum disease, however, can weaken the bone around these teeth, inhibiting the natural rebuilding process of bone and connective tissue that could jeopardize the success of the orthodontic treatment.
It’s important, then, to first treat and bring the gum disease under control to restore health to both the gums and bone. It’s also just as important during orthodontic treatment to prevent another infection flare-up through renewed brushing and flossing and regular office cleanings and checkups. Choosing clear aligners over traditional braces to move the teeth could also help — unlike fixed braces that often make oral hygiene difficult, clear aligners can be removed to allow easier cleaning of teeth and gums.
Depending on your situation, the process for preparing your mouth for a tooth replacement can involve several procedures and healing time. But the end result — a brand new tooth that looks amazing — will be something to smile about.
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”