Bozart Family Dentistry Tip of the Week: Wisdom Tooth Extraction: What to Expect

Once you're dentist has identified that you do indeed need to have a wisdom tooth removed, the process really just begins. Let’s take more of a look at the process you will go through after this diagnosis.
Where to have Wisdom Teeth Removed?

Wisdom teeth can be removed by a number of different dental professionals and locations. An oral and maxillofacial surgeon, separate from your dentist office may be referred if you're dentist can not perform the surgery themselves, or if they can perform oral surgery as well, such as Dr. Bozart, they can do it right in house. If it looks like more complications may arise due to your medical background or complications with the wisdom teeth themselves, then in rare instances the surgery may be located at your local hospital. However, in most instances this will not be the case.

What to Expect Before and During Wisdom Tooth Extraction Surgery

Before having the surgery, you're dentist will apply a local anesthetic to numb the area of which the tooth will be removed from. If removing all wisdom teeth at once, a general anesthetic may be used to help you to sleep through the entire surgery. In preparation for the surgery, you will most likely be asked not to eat or drink from midnight on the evening before surgery is scheduled.

In order to remove the wisdom tooth itself, your dentist will open up the gum tissue over the tooth, and take out any bone covering the tooth. After this, your dentist will separate the tissue connecting the tooth to the bone, and then remove the wisdom tooth. After surgery is complete, you may need stitches and your dentist will most likely place a cotton gauze over the effected area to stop any remaining bleeding.

What to Expect After Wisdom Tooth Extraction
In most cases, the recovery period lasts only a few days. Take painkillers only as prescribed by your dentist or oral surgeon. These tips will help to speed up your recovery time:
• Bite gently on the gauze pad periodically, and change pads as they become soaked with blood. Call your dentist or oral surgeon if you still have bleeding 24 hours after your surgery
• While your mouth is numb, be careful not to bite the inside of your cheek lip, or tongue
• Do not lie flat as this may prolong the bleeding. Instead, prop your head up with pillows
• Try using an ice pack on the outside of your cheek for the first 24 hours. A moist heat, such as a washcloth soaked in warm water and wrung out may help over the following 2 - 3 days.
• Relax after surgery, as physical activity may increase bleeding.
• Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
• Do not use a straw for the first few days. Sucking on a straw can loosen the blood clot and delay healing.
• After the first 24 hours, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain.
• Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. In addition, smoking decreases the blood supply and can bring germs and contaminants into the surgery area.
• Avoid rubbing the area with your tongue or touching it with your fingers.
• Continue to brush your teeth and tongue, but very carefully.
Your dentist will then remove the stitches after a few days, if needed.


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Keep your pet's teeth in tip top condition

It’s not only people who need to "brush up" their dental routine. Dental disease is the number one health problem in cats and dogs aged three years and older. Dr Cedric Tutt, a veterinary specialist in dentistry, explains how to keep your pet’s mouth in tip top condition:

Daily brushing: “Brushing is the best way to remove plaque. Otherwise plaque hardens into calculus which needs to be removed under general anaesthetic.”

Feed them special foods that help keep their teeth clean: “I recommend Hill’s Prescription Diet t/d for animals with oral health problems. The kibbles have a special fibre that prevents the biscuit from disintegrating when bitten; instead it helps to physically clean the teeth.”

Toys and treats: “Hooves and bones appear to be one of the biggest causes of teeth fractures and hard plastic Frisbees are not ideal. Rather use softer toys made of rubber or rope.”

Annual check-up: “Ask the vet to examine your pet’s mouth during their annual visit. If you ever notice bad breath or bleeding gums, immediately take your pet to the vet.”

For expert advice, speak to your vet. 

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Find ways to lower dental health care cost

(Photo: AP File)

Most of my adult life I have not had dental care. As a result, I have experienced severe pain that turn into bigger problems.

The only time I see the dentist is when I am desperate for relief and have to use money I cannot afford to spare from our household budget. I've got used to tooth problems and live with the pain because I don't have the money and the costs of dental care are ridiculous. Two hundred dollars and up to have a tooth pulled.

I cannot afford out of pocket to have dental insurance. Government health plans for low income people do not provide dental. When the pain is the worst, I have to take a day off work (that I can't afford, I don't have paid sick days) and go to a regular doctor to get antibiotics for the infection from the bad teeth. This cycle repeats itself over and over.

My wife and I make sure our children brush their teeth every day and since in Vermont, children's dental is covered, they get regular check-ups and cleanings. They do not have the problems that we do.

I am speaking out now because to me ,it seems like only the elite can afford dental care and many of us don't have paid sick days to use when our teeth problems have to be taken care of.

A bill that allows a new type of oral health provider, a licensed dental practitioner, would help me and others in my situation a lot. It would decrease the wait to see a dentist. It would give me somewhere to go when I'm in pain other than the emergency room. It would make dental care more affordable and more accessible for families like mine.

I urge my elected representatives to listen to the people in need of this important care. There are many of us.

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What's the Best Way to Brush Your Teeth?

If you're unsure about the best way to brush your teeth, you're unlikely to get much help from experts.

Dental associations and toothpaste and toothbrush companies don't agree on the most effective method to brush teeth, and their advice is "unacceptably inconsistent," a new study says.

Researchers at University College London in England examined the brushing recommendations from dental associations in 10 countries, toothpaste and toothbrush makers, and in dental textbooks.

The investigators found a wide range of recommendations on brushing technique, how often to brush and for how long, according to the study published Aug. 8 in the British Dental Journal. The findings highlight the need for better research on proper brushing, the study authors said.

"The public needs to have sound information on the best method to brush their teeth," said study senior author Aubrey Sheiham, professor of dental public health.

"If people hear one thing from a dental association, another from a toothbrush company and something else from their dentist, no wonder they are confused about how to brush. In this study we found an unacceptably inconsistent array of advice from different sources," Sheiham said in a university news release.

"Dental associations need to be consistent about what method to recommend, based on how effective the method is," Sheiham added. "Most worryingly, the methods recommended by dental associations are not the same as the best ones mentioned in dental textbooks. There is no evidence to suggest that complicated techniques are any better than a simple gentle scrub."

The study found that the most commonly recommended method is to gently jiggle the toothbrush back and forth in small motions in order to loosen food particles, plaque and bacteria. However, there is no proof that this is any better than basic scrubbing, the researchers said.

"Brush gently with a simple horizontal scrubbing motion, with the brush at a 45-degree angle to get to the dental plaque. To avoid brushing too hard, hold the brush with a pencil grip rather than a fist. This simple method is perfectly effective at keeping your gums healthy," Sheiham said.

More information

The U.S. National Library of Medicine has more about dental health.

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Do you have patients with jaw pain? Tips for taking their impressions

With more than 10 million Americans suffering from orofacial pain, alternative methods for completing dental procedures in order to accommodate sensitive patients are necessary.(1,2) Orofacial pain, specifically jaw pain, can present in a variety of forms, including restricted mouth opening, pain while moving the jaw or mouth, and fatigue while the mouth is open. However, many patients suffering from these problems still require impressions for different dental procedures.

Ideal impressions capture the fine detail of the oral cavity, which include excellent margins and exact replicas of the soft and hard tissues, in order to serve as the foundation for future dental treatments. For patients suffering with jaw pain, the impression taking procedure can be an anxiously unclear and uncomfortable experience. However, with the following tips, dental professionals can relieve patient reservations while still obtaining accurate impressions.

Calming patient anxiety
Initial identification of patient fears, concerns, and pain level prior to taking the impressions conveys trust, sensitivity, and understanding. Explaining the impression taking procedure to patients, including estimated time for placement and setting, can reassure patients and help them feel safe and in control. Additionally, answering any questions a patient may have and encouraging them to share any anxiety they may feel also helps to reinforce their trust and confidence.


Ideal material selection
An ideal impression material for patients with jaw pain works quickly and minimizes discomfort, reducing the possibility for a gag reflex and increased jaw pain. Fast set impression materials help to minimize the amount of time that a patient’s mouth is open and therefore, reduce discomfort. Tasteless and odorless impression materials reduce the chances of gag reflex problems that may exacerbate jaw pain the patient is already experiencing. Additionally, a thixotropic consistency also limits gag reflex potential by ensuring that the impression materials will not slump or run.

Modifying impression technique
Many dental professionals routinely use the same technique for taking impressions, regardless of the patient. While this practice can be effective and efficient for most patients, those with jaw pain may require the use of a modified technique to minimize pain and still achieve a detailed impression. Smaller plastic impression trays provide greater flexibility and a potentially better fit than the typical metal trays. Some patients may even require and benefit from pediatric trays, providing the trays can capture complete margins and anatomic details.

Other modified trays and techniques may also be necessary to minimize patient discomfort while achieving accurate impressions. An open mind and a problem-solving attitude with a thorough understanding of impression techniques and materials increases the likelihood for taking accurate impressions of a patient with jaw pain.

While many patients may demonstrate anxiety during impressions taking procedures, patients with jaw pain typically exhibit increased discomfort when impressions are made. However, you can ease a patient’s mind, reduce discomfort, and obtain the precise impressions you need. By completing all of the prep work thoroughly, explaining the process to the patient, and working efficiently and quickly, accurate impressions can be achieved with reduced pain and discomfort.

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DentistryIQ

Start early for good oral health habits

Good oral health habits start in early childhood. / Getty Images/Flickr RF

You may wonder whether it’s important to take care of your child's first teeth, which will fall out in early childhood. However, healthy adult teeth start with healthy teeth during childhood. That’s why starting infants off with good oral care can help protect their teeth for decades to come.

A baby’s 20 primary teeth are already present in the jaw at birth. Baby teeth that begin coming through the gums around six months help set the stage for future smiles by keeping space in the jaw for adult teeth. The American Dental Association recommends that parents take children to a dentist no later than their first birthday and then at intervals recommended by their dentist.

To help ensure you are well prepared to provide your little one a lifetime of good dental health, the experts at Ameritas offer this information about the leading oral health concerns for youngsters:

• Cavities. Early childhood caries (cavities) is the number one chronic disease affecting young children. It is five times more common than asthma and seven times more common than hay fever. Tooth pain keeps many children home from school or distracts them from learning.

Consumption of sugary foods, soda, juice or energy drinks increases the risk for tooth decay and gum disease, so minimizing these items is an important aspect of dental health. It’s also important to always brush teeth twice daily for two minutes and floss once a day.

Another option to protect children’s teeth is sealants, which act as barriers to cavity-prone areas. They are applied to the chewing surfaces of the molars after the teeth erupt and are completely above the gum. Both primary and permanent teeth can benefit from sealants.

• Sports Injuries. Mouth guards can help protect children from a dental emergency. They should be worn whenever children participate in sports and recreational activities. Mouth guards cushion blows that can otherwise cause broken teeth, injuries to the lips and face, and even jaw fractures. Mouth guards are available at many retail stores or may be custom-made by a dentist.

• Jaw and bite problems. Malocclusion, or bad bite, is a condition in which the teeth are crowded, crooked, out of alignment or the jaws don’t meet properly. This may become particularly noticeable between ages six and 12, when a child’s permanent teeth are developing.

If not treated early, a bad bite can make it difficult to keep teeth and gums clean where teeth are crooked or crowded, increasing the risk for cavities and gum disease. Bad bites can also affect proper jaw development, making protruding teeth at risk for chips and fractures. It can also affect eating and speaking, and make some teeth more likely to wear abnormally or faster than those that are properly aligned.

Teaching children good oral hygiene habits early is a simple way to create a lifetime of happy, healthy smiles. Remember, modeling your own good oral hygiene habits not only reinforces your advice, it improves your own dental health.

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Keep your smile: Oral symptoms can be indicator of serious health condition

Good oral health, regardless of age, is integral to overall good health.

This important component of heath is often an overlooked aspect of a baby boomer’s general health. Good oral health, including regular dental care, must be a lifetime commitment. Unfortunately, for many adults, oral health care is a luxury.

Daily oral hygiene (brushing, flossing and denture care), access to oral health services and oral health education are all key factors that can improve the oral health of the baby boomer generation.

Too many older adults suffer from long-term oral pain and periodontal disease, severely limiting regular activities and maybe even impeding their independence. And it is commonplace to ignore dental symptoms, putting off making a dental appointment until it becomes an emergency. Others are unaware of long-term health consequences. A survey commissioned by the Academy of General Dentistry, demonstrated that 63 percent of boomers – people born from 1946 to 1964 – with an oral symptom considered to be a key indicator of a more serious health condition were unaware of the symptom’s link to the condition. Severe gum disease, for example, can exacerbate serious and complicated overall health problems that increase with age, such as diabetes, heart disease, stroke and respiratory disease.

Whether caring for natural teeth or dentures, daily oral hygiene can mean adults of all ages will be free of oral pain, can maintain a well-balanced diet and can have a positive self-image. Without practicing good oral health, advancing age may put adults at risk for a number of oral health problems, including:

• Dry mouth (often a side effect of medications).
• Diminished sense of taste (also a side effect of some medications).
• Root decay (which can worsen with heavy brushing technique).
• Gingivitis and periodontal disease, sometimes known as gum disease.
• Uneven jawbone caused by tooth loss.
• Denture-induced tissue inflammation.
• Overgrowth of fungus in the mouth, known as thrush.
• Attrition (loss of teeth structure by mechanical forces).
• Oral cancer (early detection is key to increasing the survival rate for these cancers).
• Best practices in oral hygiene through our boomer years can preserve our smile and maintain a healthy active lifestyle throughout our senior years.

According to the Centers for Disease Control and Prevention, one-fourth of people age 65 and older have no remaining teeth. Nearly one-third of older adults have untreated tooth decay. Poor oral health – either from neglect or lack of access – may result in the deterioration of overall physical health.

Oral health problems make it more difficult for adults to consume a healthy diet. Oral health-related physical factors directly affecting nutrition include changes in chewing ability, dry mouth, untreated tooth decay, loose or missing teeth, dentures or implants, and ill-fitting bridges or dentures. Regular oral health care can improve and prevent oral health problems.

Good oral hygiene, choosing a healthy lifestyle and getting regular dental checkups – for most adults, this means at least once a year – are all important steps to a healthy mouth.

While it can be difficult for some people to access medical care, it can be even more difficult to access the oral health care system. Barriers to accessing affordable oral health care include:

• Busy lifestyle.
• Cost of oral health care.
• Limited or lack of dental coverage in work-site benefit plan.
• Oral health programs that offer affordable services.
• Limited dental insurance for retirees (not included in Medicare).
• iving on a fixed income.
• Mobility/transportation limitations.
• Many boomers are caring for their parents or older friends and relatives. Accessing dental care can be especially difficult for nursing home residents. Surveys have shown that nursing home residents with teeth suffer particularly from untreated tooth decay, while those without teeth also have a variety of oral health problems. This lack of access to oral health care is compounded by a shortage of skilled geriatric dental care professionals.

Resources are available to help overcome barriers to accessing affordable oral health care.

Community health centers care for people even if they have no dental health insurance, and can provide preventive and basic dental care. There are also a number of local dentists willing to treat Medicaid patients.

Other options to help overcome barriers include contacting the state or local chapter of the American Dental Association and reading “Finding Low-Cost Dental Care,” a resource from the National Institute of Dental and Craniofacial Research.

Even with regular checkups and good habits, dental problems can still occur. If you notice anything out of the ordinary with your teeth, gums or tongue, make an appointment with your dentist as soon as possible. It is important not to ignore such problems. Don’t wait for your next scheduled appointment. Pick up the phone and talk with your dental provider. Issues are easier to treat the sooner they are caught, and unnecessary discomfort can be avoided.

Don’t put your dental health on the back burner. It’s not too late to start taking care of that smile and increase your chances of improved overall health to enjoy life to the fullest.


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I Brushed My Teeth With the World's First Bluetooth Toothbrush

Being an adult is boring. It's a long checklist of necessary acts of maintenance that, in the end, fail us. That's why we rely on fun-enhancing phenomena like color runs and adult kickball leagues—and gadgets like Oral-B's new Bluetooth-enabled toothbrushes and app, which are designed to make one of life's most mundane tasks seem like fun.

At first glance, it sounds like a punchline to a New Yorker cartoon about the wiles of modern technology. After all, who needs an app to tell them how to scrape their teeth down every morning? But after I had my first cavity last month, I was ready to try anything that could right the wrong creeping from molar to molar inside my mouth.

What Is It?

Oral-B's SmartSeries 7000 is a Bluetooth 4.0-enabled toothbrush that connects to a free app that tracks how often you're brushing, whether you're doing it right, and for how long. It will retail for $220 when it's available in the US in January (it's already on sale in the UK). A cheaper version, the SmartSeries 5000, will retail for $160 when it arrives this fall.

For all that money you get the following bells and whistles: The SmartSeries counts to 120 seconds for you, vibrates when you're pushing too hard, records your daily "times," and tries to entertain you with tips and news headlines while you brush. One of the headlines was about prostitutes.

Why Does It Matter?

In the most basic sense, it matters because keeping your teeth clean matters. Going to the dentist is scary and terrible enough when it's for routine maintenance. Cavities and root canals are another level of (potentially avoidable) nightmare.

But more specifically, given the fact that internet connectivity has wormed its way into everything from your dog's fitness level to the very cup you're swilling your morning beer from, a connected toothbrush seems inevitable. The fact that we're all still scraping at our gums with bits of $2 molded plastic seems hopelessly old-fashioned. What are we, indentured servants?

With this new-fangled device, Oral-B is banking on the popularity "quantified self" movement, in which consumers track every aspect of their lives and record them in minute detail for later meditation. The whole point is to make the utterly mundane task of going about adulthood a little less boring. Even oral hygiene, a task most of us feel nothing but an ever-so-slight dread about.

Design

The app is, surprisingly enough, a joy to use: It's pretty, well-designed, and against all odds, pretty damn fun to use.

But what about the toothbrush itself? It feels slightly clunky compared to the sweet Sonicare toothbrush I was given as a gift (a hint?) by my parents years ago; its motor is quite loud, and its body is a little larger than you'd expect. It has six cleaning modes, which you adjust with a button on the body, and arrives with a nice-looking case and small recharging port.

If you don't mind the bulk, this is a brush you won't be ashamed to have in your bathroom (unless you mind people asking why the hell your toothbrush is Bluetooth-enabled, as many guests have asked me over the past few weeks). There's a band of plastic-covered LEDs at the oscillating head, which flash red when you're pushing on your teeth too hard thanks to a pressure monitor; when you're brushing, the red glow is clearly visible just in front of your face. Other than that, it's pretty standard as far as mid-2010s design goes: Sinuous curves and plenty of white plastic.

Using It

The point of this product is to trick you into taking better care of yourself. As someone who's managed to outsmart (or at least outlazy) a whole host of other life-improving gadgets, I was not hopeful.

But the app is actually a case study in how to leverage user experience design to get people to do things they don't enjoy. To do so, it uses a classic good dentist/bad dentist strategy, starting with positive reinforcement—good job messages, cool graphics showing your progress—followed up with negative warning signs—a red flashing light when you're pushing too hard, or an iOS notification that you haven't used your toothbrush for a while.

But when all else fails, which it inevitably does because humans are lazy, the app uses the oldest trick in the book: Distraction. As you brush, it pulls up headlines. I read an update to Google news as I focused on my lower right quadrant. Another day, it showed me some pictures of lion cubs.

Needless to say, I kept brushing. Then it told me some things about how coffee is turning my teeth yellow. When I finished, a little emoticon popped up: Bravo.

Yet humans are pretty good at evading unpleasant or boring tasks. By the end of the first week, I wasn't really looking at the app when I brushed. Soon I wasn't even remembering to bring my phone into the bathroom so the toothbrush would link up to record my brushing.

Oral hygiene is an odd segue into a discussion of humans' behavioral flaws, but this thing revealed mine. I took the brush on vacation, where I was constantly distracted, tired, or in a hurry, and my progress... suffered:

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Like

Despite my misgivings, the app is actually the highlight: And luckily, anyone can download it for free and use it manually with their own toothbrush. It's well-designed and actually quite fun to use, if a bit of overkill for anyone not interesting in tracking the minutia of their own lives.

It also bears mentioning that setup was dead simple, which is important given the fact that this would make a great gift for a kid or an older adult who might not be well-versed on setting up Bluetooth-enabled gadgets.

The same goes for usability within the app itself. Oddly enough, the smartest thing about this toothbrush is the UX design, not the actual product design. Other companies looking to develop their own mobile applications would do well to study this one.

No Like

One concern, for me, is that the brush wouldn't record my activity unless I had my device nearby when I was brushing. Now, sure, that might not seem like a huge deal. After all, who doesn't have their phone nearby these days, even in the bathroom (especially in the bathroom)?For starters, tired people. Drunk people. Forgetful people. People who just want to scrub the bare minimum of gunk off their teeth and get to sleep.

In theory, the SmartSeries is designed to store information on your last 20 sessions so that when you do connect with the app, your history is synced. I had trouble getting this functionality to work, and it turned out I was doing it wrong: You need to go to the main screen and then hit the "mode" button to initiate the sync. It's not exactly intuitive, but it works.

The brush itself is fine, though I did notice an ever-so-slight aftertaste that filters through—presumably from the motor—at times. It doesn't make brushing unpleasant, but it's worth noting given the price of this thing.

Should You Buy It?

Do you need a $220 toothbrush that tracks your every move and analyzes your technique? No. Do you want one? Judging from the straw poll I very scientifically carried out over the past two weeks, a surprising number of people do. And given that you're spending the money on improving a part of your body you rely on to survive, some may find it easy to rationalize as a purchase.

The Oral-B Bluetooth brush does exactly what it says it does. It will get you thinking about your routine more than you normally do. The question is how much you're willing to spend to gameify even the most banal aspects of life as an adult human in 2014, right down to taking care of your chompers.

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Stem cells from nerves form teeth

Researchers at Karolinska Institutet in Sweden have discovered that stem cells inside the soft tissues of the tooth come from an unexpected source, namely nerves. These findings are now being published in the journal Nature and contribute to brand new knowledge of how teeth are formed, how they grow and how they are able to self-repair.

Our health and quality of life is closely linked to our dental health. With age, our teeth become more susceptible to infection, wear and damage, and it is important for the health services to help people maintain good dental health. It was previously known that the living, soft part of the tooth, or the pulp, in addition to connective tissues, blood vessels and nerves also contains a small reserve of stem cells. These stem cells are capable of repairing the tooth when it has been damaged by assisting the reformation of both hard and soft tooth tissue. Researchers have long been discussing the origin of these stem cells. By studying the teeth of mice, the researchers behind this new study have been able to map the fate of individual cells.

"We have identified a previously unknown type of stem cells that surprisingly enough belong to the nerves of the tooth; these are nerves that would normally be associated with the tooth's extreme sensitivity to pain," says Kaj Fried at the Department of Neuroscience, one of the head researchers responsible for the study.
The researchers discovered that young cells, which at first are part of the neural support cells, or the glial cells, leave the nerves at an early stage of the foetal development. The cells change their identity and become both connective tissues in the tooth pulp and odontoblasts, i.e., the cells that produce the hard dentin underneath the enamel. Today we do not have the possibility of growing new teeth in adults, but the discovery of this new type of stem cells is an important step towards the knowledge and technology that is required to make it a future possibility.

"The fact that stem cells are available inside the nerves is highly significant, and this is in no way unique for the tooth. Our results indicate that peripheral nerves, which are found basically everywhere, may function as important stem cell reserves. From such reserves, multipotent stem cells can depart from the nerves and contribute to the healing and reformation of tissues in different parts of the body," says Igor Adameyko at the Department of Physiology and Pharmacology, who has headed the study along with Kaj Fried.



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Medical Express