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Posts for: January, 2022

By A Brilliant Smile
January 25, 2022
Category: Dental Procedures
Tags: wisdom teeth  
DecidingtheFateofWisdomTeethMoreNuancedThaninthePast

If you're of a certain age, there's a good chance you've had your third molars—wisdom teeth—removed. At one time, extracting these particular teeth was a common practice, even if they hadn't shown any signs or symptoms of disease or dysfunction. But now, if you have a son or daughter coming of age, your dentist may recommend leaving theirs right where they are.

So, what's changed?

Wisdom teeth have longed been viewed as problematic. As the last of the permanent teeth, they often erupt on a jaw already crowded with other teeth. This can cause them to come in out of position—or not at all, remaining partially or totally submerged (impacted) beneath the gums.

Misaligned teeth are more difficult to keep clean of bacterial plaque, which in turn raises the risk of tooth decay or gum disease. Impacted teeth can put pressure on the roots of neighboring teeth, which further increases the risk for disease or bite problems.

To avoid these common problems associated with wisdom teeth, dentists often remove them as a preemptive measure. Given their size and possible root complexity, this is no small matter: Removing them usually requires oral surgery, making wisdom teeth extraction one of the top oral surgical procedures performed each year.

Today, however, many dentists are taking a more nuanced approach to wisdom teeth. While they still recommend removal for those displaying signs of disease or other problems, they may advise leaving them in place if the teeth are healthy, not interfering with their neighbors, and not affecting bite development.

That's not necessarily a final decision, especially with younger patients. The dentist will continue to monitor the wisdom teeth for any emerging disease or problems, and may put extraction back on the table if the situation merits it.

The key is to consider each patient and their dental needs regarding wisdom teeth on an individual basis. If warranted, removing the wisdom teeth may still be warranted if will help prevent disease, keep bite development on track and optimize oral health overall.

If you would like more information on wisdom teeth, 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.”


By A Brilliant Smile
January 15, 2022
Category: Dental Procedures
StayonAlertforaDecayRepeatEvenAfteraRootCanal

A deeply decayed tooth is in serious trouble, and something a regular filling may not fix. You may instead need a root canal, a common tooth-saving procedure performed by general dentists or, in more difficult cases, endodontists (specialists in interior tooth treatment).

Regardless of who performs it, though, the basics are the same: The dentist accesses the tooth's decayed interior by drilling a hole and removing diseased tissue from the pulp and root canals through it. They then fill the empty spaces with a rubber-like substance before sealing the tooth and later crowning it to prevent re-infection.

For most, a root canal gives a decayed tooth a new lease on life that can last for years, if not decades. Occasionally, though, a root canaled tooth may become reinfected from tooth decay. There are a number of possible reasons for this unfortunate outcome.

For one, the decay might not have been caught until it had advanced into root canal filling, resulting in contamination. Although root canal treatment may still be effective, the chances of success are much lower than for a decayed tooth diagnosed before it had advanced this far.

Teeth with multiple roots or complex root canal networks are also difficult to treat. The challenge is to ensure all the root canals within the tooth have been thoroughly treated. These types of situations are usually best undertaken by an endodontist with microscopic equipment and advanced techniques that can better infiltrate intricate root canal networks.

These and other situations could make it more likely a root-canaled tooth is reinfected. Depending on the extent of damage, it may be best to extract the tooth and replace it with a dental implant or other restoration. But it's also possible to repeat the root canal—and the second time may be the charm.

As with many other dental conditions, the best outcome regarding a reinfected tooth after root canal is early detection and treatment. You can increase your chances of this with regular dental visits that include monitoring of any root-canaled teeth. You should also see your dentist as soon as possible if you notice pain or gum swelling associated with the tooth.

Root canals are highly effective at saving decayed teeth. But the rare reinfection is possible—so be on the alert.

If you would like more information on root canal treatment, 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 “Root Canal Treatment: How Long Will It Last?


RussellWilsonsFunnyVideoAsideRemovingWisdomTeethisNoLaughingMatter

There are plenty of hilarious videos of groggy patients coming out of wisdom teeth surgery to keep you occupied for hours. While many of these have turned everyday people into viral video stars, every now and then it really is someone famous. Recently, that someone was Seattle Seahawks quarterback Russell Wilson.

The NFL star underwent oral surgery to remove all four of his third molars (aka wisdom teeth). His wife, performer and supermodel, Ciara, caught him on video as he was wheeled to recovery and later uploaded the clip to Instagram. As post-wisdom teeth videos go, Wilson didn't say anything too embarrassing other than, "My lips hurt."

Funny videos aside, though, removing wisdom teeth is a serious matter. Typically, the third molars are the last permanent teeth to erupt, and commonly arrive late onto a jaw already crowded with other teeth. This increases their chances of erupting out of alignment or not erupting at all, remaining completely or partially submerged within the gums.

This latter condition, impaction, can put pressure on the roots of adjacent teeth, can cause abnormal tooth movement resulting in a poor bite, or can increase the risk of dental disease. For that reason, it has been a common practice to remove wisdom teeth preemptively, even if they aren't showing any obvious signs of disease.

In recent years, though, dentists have become increasingly nuanced in making that decision. Many will now leave wisdom teeth be if they have erupted fully and are in proper alignment, and they don't appear to be diseased or causing problems for other teeth.

The best way to make the right decision is to closely monitor the development of wisdom teeth throughout childhood and adolescence. If signs of any problems begin to emerge, it may become prudent to remove them, usually between the ages of 16 and 25. Because of their location and root system, wisdom teeth are usually removed by an oral surgeon through one of the most common surgeries performed each year.

This underscores the need for children to see a dentist regularly, beginning no later than their first birthday. It's also a good idea for a child to undergo an orthodontic evaluation around age 6. Both of these types of exams can prove helpful in deciding on what to do about the wisdom teeth, depending on the individual case.

After careful monitoring throughout childhood and adolescence, the best decision might be to remove them.  If so, take it from Russell Wilson: It's worth becoming the star of a funny video to protect both current and future dental health.

If you would like more information about wisdom teeth removal, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”