There are instances when a general dentist will remove (extract) a problem tooth. At other times, though, the same dentist may refer a patient needing an extraction to an oral surgeon. Why the difference?
The procedure performed by a general dentist is referred to as a “simple tooth extraction.” “Simple” doesn’t mean easy and requiring no skill or expertise — it certainly does. In this case, the term refers to the anatomy of the tooth being extracted, particularly its roots.
Teeth that respond well in a simple extraction have an uncomplicated root system. The path of removal, usually with a single root involved, is fairly straight and without extreme angles. In the hands of a skilled and experienced dentist, it can be removed with little to no discomfort.
Dentists actually must use finesse to remove a tooth from its socket. The tooth is held in place with tiny collagen fibers that extend from a tough, elastic gum tissue known as the periodontal ligament, which lies between the teeth and the bone. With some manipulation, a dentist can loosen these fibers, which then makes removing the tooth much easier. All of this can usually be performed with local anesthesia.
Of course, to determine if a tooth can be removed this way, we must conduct a thorough dental examination first, including x-ray imaging to determine the exact nature and location of the roots. If the exam reveals the root system is more complex, or that there are defects to the bone or the tooth that could make a simple extraction difficult (resulting, for example, in not removing the crown and root in one piece), then the tooth may need to be removed surgically.
Such situations require the skill and resources of an oral surgeon. These specialists perform a number of surgical procedures related to the mouth and face; as procedures go, extraction is among the most routine. Using local anesthesia and post-operative pain management, undergoing a surgical extraction involves only minimal discomfort and a very short recovery time.
After examining your tooth we’ll recommend the best course for extraction, whether simple or surgical. In either case, we’ll see that your problem tooth is extracted as efficiently and painlessly as possible.
If you would like more information on tooth extractions, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?”
Even though teeth are resilient, they're not indestructible. An accidental collision involving the face could damage teeth, even knocking a tooth completely out of its socket.
At first, it might seem like the end of the line for that particular tooth. But it doesn't have to be—if you know what to do. But you'll have to act quickly: The longer the tooth is out of its socket, the less chance it will survive long-term.
Here are the steps you should take to save a knocked-out tooth.
Find the tooth. It's important that you locate the missing tooth quickly. When you do, don't handle it by the root end: It still contains delicate periodontal cells that are essential if the tooth is going to rejoin with the ligaments and bone. Use clean water to rinse off any dirt or debris.
Reinsert the tooth. Holding it by the crown and not the root, reinsert the tooth into its empty socket, hopefully within an hour (the faster the better). You want to make sure it's good and snug, so apply a little force when you do this. Place some clean gauze or cloth between the tooth and its opposite on the other jaw, then have the person bite down and hold it in place.
Get immediate dental care. It's preferable to find a dentist as soon as possible (if not, then the nearest emergency medical facility). The dentist will x-ray the tooth to make sure it's positioned properly, and may adjust it further if necessary. They may also splint the tooth to adjacent teeth to help stabilize it until it fully reattaches with the jaw.
Again, time is of the essence—the quicker you can perform the above steps, the better the tooth's chances. Any delay could jeopardize the tooth's ability to reattach, or it could shorten its lifespan.
You can also get guidance on treating a knocked-out tooth and other dental emergencies with a free mobile app developed by the International Association of Dental Traumatology (IADT). Just look in your Android or IOS app store for ToothSOS.
If you would like more information on what to do during a dental emergency, 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 “When a Tooth is Knocked Out.”
Your child’s current dental care sets the stage for good oral health later in life. It’s essential, therefore, that you know how best to protect their teeth and gums. In recognition of February as National Children’s Dental Health Month, here’s a short true or false quiz to test your knowledge of proper dental care for your child.
- Your child’s dental hygiene begins when their first teeth appear.
False: The bacteria that cause dental disease can take up residence in an infant’s mouth before their first teeth come in. To help curb this bacterial growth, wipe your baby’s gums with a clean, wet cloth after nursing or bottle-feeding.
- Kissing your newborn on the mouth could lead to tooth decay.
True. Any mouth-to-mouth contact with your infant could transfer oral bacteria from you to them. Their immune system isn’t mature enough to handle these “new arrivals,” which can increase their risk for tooth decay. Instead, kiss your child on the cheek or forehead or use other ways to show affection.
- Primary (baby) teeth don’t need the same care from disease as permanent teeth.
False: Although they have a limited lifespan, primary teeth play a huge role in a child’s dental development by protecting the space intended for the incoming permanent teeth. If primary teeth are lost prematurely due to dental disease, it could lead to incoming teeth erupting out of position.
- It’s best to start your child’s regular dental visits around their first birthday.
True: By age one, children already have a few teeth that need preventive or therapeutic care by a dentist. Starting early also gets them used to seeing the dentist and reduces their chances of developing dental visit anxiety.
- Your infant or toddler sucking their thumb isn’t a cause for concern.
True: Thumb-sucking is a nearly universal habit among infants that typically begins to fade around ages 3 or 4. If the habit continues, though, it could begin affecting their bite. It’s recommended that you encourage your child to quit thumb-sucking around age 3.
- The best time to consider your child’s bite health is right before puberty.
False: Signs of an emerging bite problem can begin appearing even before a child starts school. It’s a good idea, then, to have your child undergo an orthodontic evaluation around age 6. If the orthodontist finds a problem, it may be possible to intervene to correct or minimize it before it goes too far.
One last thing: Your child’s dental care isn’t entirely on your shoulders. We’re here to partner with you, not only providing preventive and therapeutic treatment for your child, but also advising you on their day-to-day dental care and hygiene. Together, we’ll help ensure your child’s dental development stays on track.
If you would like more information about dental care for children, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dentistry & Oral Health for Children.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
While celebrating all that a new year brings, take a moment to remember the New Year's Day birthday of a true American patriot: the legendary Paul Revere. Ironically, he became a legend some 80 years after his midnight trek to warn colonists of approaching British troops, thanks to Henry Wadsworth Longfellow's 1861 poem “Paul Revere's Ride.” He was much better known to his fellow Bostonians as a prosperous silversmith, engraver—and “artificial teeth” maker.
That's right. Among his many business endeavors, Revere's résumé also included dental prosthetics, specifically custom dentures made of ivory. For the time, his work was state-of-the-art technology that far surpassed older tooth replacement methods.
But when we compare Revere's foray into the dental arts and today's restorations, his high quality 18th Century dentures were the proverbial “horse and buggy,” while modern denture technology seems like “supersonic transport.” Not only are today's dentures made of superior materials that are more “toothlike” in appearance, the means to create them using digital technology gives wearers a more secure and comfortable fit.
The modern denture—an appliance that replaces multiple or all lost teeth—is composed of a polymer base, usually acrylic that is colored to resemble gum tissue. Attached to this base are the prosthetic (“false”) teeth that replace those lost along the jaw. These new teeth are usually made of a durable dental material like porcelain that looks and functions like real teeth.
The basic design of today's denture hasn't changed much in the last century. What has changed is our ability to create dentures that follow an individual jaw contours much more precisely. Using the latest digital technology, we're able to obtain highly accurate impressions of the mouth to guide the manufacturing process. Fit is critically important for how dentures feel and function in the mouth. If they are too loose, they become uncomfortable and limit which foods you can eat.
If that weren't enough, recent advancements with dental implants have taken dentures to an entirely new level, beyond anything imaginable in Revere's day. We're now able to create dentures that connect or are permanently affixed to implants set within the jaw, which makes them more stable and secure. An implant-supported denture also helps prevent bone loss, a weakness of traditional dentures, causing them to loosen over time.
As amazing as they are, we wouldn't have the modern version of dentures without craftsmen like Paul Revere who helped advance the cause of dental restoration. So, lift a glass of holiday cheer this season to this hero of the American Revolution—and of American dentistry.
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