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.”
For years people tuned in to enjoy one of David Letterman's "Top 10 lists," a frequent gag performed on his show Late Night. Each countdown list poked fun at off-the-wall topics like "Top 10 New York City Science Projects" or "Top 10 Questions People Ask when Shopping for an Umbrella."
Recently, the American Dental Association presented their own kind of list—"America's Top 3 Oral Health Problems"—based on surveys of around 15,000 people across the U.S. But unlike the popular Late Night lists, this one is no laughing matter.
Coming in at #3, 29% of the respondents indicated they had experienced tooth pain at some time in their life. Tooth pain is the body's way of alerting to trouble in the mouth, anything from a decayed tooth to a gum abscess. The best thing to do if you have any persistent oral pain is to see your dentist as soon as possible for a thorough examination. And you should do this even if the pain goes away.
The second most prominent oral problem among people is difficulty biting or chewing, about 31% of those in the surveys. As with tooth pain, the reasons can vary greatly, including cracked, loose or deeply decayed teeth, dentures or jaw joint disorders (TMD). Because dental disease is usually the ultimate culprit, the best way to avoid this is to practice daily brushing and flossing and regular dental visits. And, as with tooth pain, you should see your dentist if you're having symptoms.
At 33% of respondents, the number one oral problem in America is chronic dry mouth. It's a constant inadequate flow of saliva often caused by medications or certain systemic conditions. Because saliva helps protect the mouth against infection, a restricted flow increases your risk of disease. If you notice your mouth is dry all the time, you should talk to your dentist about ways to boost your saliva. If you're taking medications, ask your doctor if they could be causing your symptoms and if you could change to something else.
While any of these Top 3 oral problems can be a stepping stone to more serious dental problems, it doesn't necessarily have to lead to that. You can improve your dental health through daily oral hygiene and regular dental treatment. And it might help you stay off this unpleasant list.
If you would like more information on treating dental disease, 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 “Top 3 Oral Health Problems.”
You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?
The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.
Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.
And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.
Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.
Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.
Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.
An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.
There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.
But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.
But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.
After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.
As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.
This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.
If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.