My Blog
By Tamara Simons, DDS
October 26, 2020
Category: Oral Health
Tags: dry socket  
HowtoAvoidThisPainfulConditionAfterToothExtraction

Dentists and oral surgeons remove millions of teeth every year, most without any adverse aftereffects. But about 2% of patients experience a dry socket, a condition that, although not dangerous to health, can be quite painful.

Also known as alveolar osteitis, a dry socket occurs when the blood clot that normally forms right after extraction doesn't form or becomes lost later. The clot serves as a barrier for the underlying bone and nerves during the healing process; without it these tissues can become irritated from contact with air, food or fluids.

Dry sockets (which usually occur in the back, lower molars) are fortunately rare, mainly in patients over 25, smokers or women using oral contraceptives. Patients also have a higher risk of developing a dry socket if they attempt certain activities too soon after tooth extraction like vigorous chewing or brushing that may dislodge the protective clot.

You can reduce your chances of a dry socket after a tooth extraction with a few simple guidelines. Unless advised otherwise by your dentist, avoid brushing the day after extraction and gently rinse the mouth instead. It also helps to avoid hot liquids and eat softer foods for a few days. If you smoke, you should avoid smoking during this time and use a nicotine patch if necessary.

Over the next few days, you should remain alert for any signs of a dry socket, often a dull, throbbing pain that radiates outward toward the ears, and a bad taste or mouth odor. A prompt visit to the dentist will help alleviate these symptoms, often in just a few minutes.

To treat it, a dentist will typically irrigate the socket and apply a medicated dressing, which you would need to change every other day for up to a week. After that, you'll leave the dressing in place for a while as you heal.

A dry socket doesn't interfere with the healing process: Your extraction site will heal whether or not you have one. But prevention and treatment for a dry socket will help ensure your healing after an extracted tooth is much less uncomfortable.

If you would like more information on dry socket after tooth extraction, 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 “Dry Socket.”

HowtoEnsureYourChildsTeethandGumsStayHealthyNowandLater

Being a parent can be a rewarding role. But it's also hard work, especially the effort required in keeping children healthy. In that respect, there's one area you don't want to overlook—their dental health.

Taking care of their teeth and gums has two aspects: their current state of dental health and their ongoing development that impacts future health. Fortunately, you can address both the present and the future by focusing on the following areas.

Prioritizing oral hygiene. From the moment your child is born, you'll want to practice daily oral hygiene to keep their teeth and gums clean of disease-causing bacterial plaque. This starts even before teeth erupt—simply wipe their gums with a clean wet cloth after feeding. As teeth emerge, begin brushing each one with a small amount of toothpaste. Around your child's second birthday, start training them to brush and floss on their own.

Limit their sugar intake. The biggest threat to your child's teeth is tooth decay, which is caused by bacteria. These bacteria multiply when they have plenty of sugar available in the mouth, one of their primary food sources. It's important then to reduce the sugar they eat and limit it to mealtimes if possible. Also avoid sending them to bed with a bottle filled with sweetened liquids, including juices and even formula.

Visit the dentist. You're not in this alone—your dentist is your partner for keeping your child's teeth healthy and developing properly. So, begin regular visits when your child's first teeth appear (no later than their first birthday). You should also consider having your child undergo an orthodontic evaluation around age 6 to make sure their bite is developing properly.

Practice oral safety. Over half the dental injuries in children under 7 occur in home settings around furniture. As your child is learning to walk, be aware of things in your home environment like tables and chairs, or hard objects they can place in their mouths. Take action then to move these items or restrict your child's access to them.

Good habits in each of these areas can make it easier to keep your child's teeth and gums healthy and on the right developmental track. That means good dental health today that could carry on into adulthood.

If you would like more information on children's dental care, 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 10 Oral Health Tips For Children.”

YouDontNeedtoPassaFootballLikePatrickMahomestoRemoveaLooseBabyTooth

Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.

Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.

It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.

In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.

If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.

Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.

If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”

TargetedToothRemovalCouldAidTreatmentforCertainBiteProblems

Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?

Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.

This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.

For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.

If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.

But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.

Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.

Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.

If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”

By Tamara Simons, DDS
October 06, 2020
Category: Oral Health
Tags: mouth sore  
TheresaQuickFixForThatIrritatingMouthSoreYouKeepBiting

As the old Fifties song goes, “Little things mean a lot.” They can also be the most irritating, like a hangnail, a papercut—or a certain kind of oral sore. Although rarely concerning to health, this particular kind of “bump” in the mouth can be unnerving.

Although known as a traumatic fibroma, it's not as dire as it sounds: It's simply a small wound created when your inside cheek gets in the “line of fire” between your teeth while biting or chewing. It's an experience most of us have had, and though it's a minor occurrence, it can make us wince with pain.

But the pain usually lasts only a few seconds—until the next time, which is a distinct possibility. The body creates a protective callous over the wound made of fibers (hence the name fibroma) of a protein called collagen. This creates a rise in the skin surface that increases the chances the area will again get in the way of the teeth and be bitten. Each bite leads to another layer of collagen, a more prominent rise and even greater probability of another bite.

Rather than let this irritating situation repeat itself, you can undergo a minor surgical procedure to remove the fibroma. Usually performed be an oral surgeon or periodontist, the area is numbed first with a local anesthetic and the fibroma removed with a scalpel; the resulting wound is then closed with a few stitches or a laser, in which case no stitches are necessary. As a result, the cheek surface flattens out and becomes less likely to get in between the teeth.

The dentist may also preserve some of the removed tissue and submit it for a biopsy to check for any cancer cells or other abnormalities. You shouldn't be concerned about this: Examining excised tissue is a routine step performed for a variety of surgical procedures. It's used to verify the tissue in question is benign, which in this case is the vast majority of the time.

After the procedure, you might experience some minor discomfort for a few days, usually manageable with a mild pain reliever like aspirin or ibuprofen. The procedure itself only takes about fifteen minutes, but it can provide you lasting relief from that bedeviling little sore in your mouth.

If you would like more information on treating mouth sores, 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 “Common Lumps and Bumps in the Mouth.”





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