Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.
Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.
Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.
People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.
Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:
- brushing the surgical area (if advised by your surgeon);
- rinsing too aggressively;
- drinking through a straw or consuming hot liquid;
If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.
While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.
If you would like more information on oral surgery, 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: A Painful but Not Dangerous Complication of Oral Surgery.”
As in other parts of medicine, lasers are beginning to change the way we provide dental care. More and more dentists are using lasers to make earlier diagnoses of dental disease or provide surgical treatment. One area prime for change is the treatment of teeth with deep decay and in danger of being lost.
For decades now, the best way to save teeth in this condition is with root canal treatment. In this common procedure we access the pulp, remove the infected tissue with specialized hand instruments, and then fill and seal the pulp chamber and root canals with a special filling.
We can now potentially improve the efficiency and increase the success rate of this treatment with laser technology. With their focused light, lasers emit a concentrated burst of energy that's extremely precise. In many instances laser energy can remove the target diseased tissue without damaging nearby healthy tissue.
In this form of root canal treatment, we use lasers to remove tissue and organic debris within the pulp and then shape the root canal walls to better receive the filling. We can also utilize the heat from laser energy to soften and mold the filling, so that it better conforms within the walls of the root canals.
Using lasers in root canal treatments may require less local anesthesia than the traditional approach and also eliminates disturbing or discomforting sounds and vibrations. Dentists who've used the new technology also report less bleeding during the procedure and less pain and occurrences of infection afterwards.
But there are a couple of disadvantages for using lasers in root canal treatment. For one, light travels in a straight line — and many root canal networks are anything but straight. More complex root canal networks may still require the traditional approach. Laser energy could also increase the tooth's inner temperature, which could potentially damage tissues even on the tooth's outer surfaces.
Used in the right circumstances, though, lasers can be an effective means to treat diseased teeth. Â As laser technology continues to advance and becomes a mainstay in dental care, you may soon find it part of your next dental procedure.
You have a problem with your teeth. Functionally, there's nothing wrong with them — but it's another story when you look in the mirror: discoloration, wearing or maybe a slight gap between them.
Fortunately, you don't have to settle for a smile you're not happy with. Less costly than crowns or bridgework, porcelain veneers can nonetheless correct many mild to moderate cosmetic problems with teeth and transform them into an attractive smile.
Like the name implies, a veneer is made of thin layers of dental material custom-designed and bonded to the outside of a tooth. Veneers can correct problems with color, tooth shape and size, and mild misalignments or spacing. It's akin to installing new siding on a house.
To begin your journey with veneers, we must first examine your teeth to fully assess your dental needs and ensure you have no issues that could prevent applying them. Then, we prepare your teeth: although not to the extent as for a crown or bridge, we must remove a small amount of tooth material so the veneer will appear natural and not bulky.
We then make an impression mold of your prepared teeth that a dental technician will use to create your veneers. During this process they build up layer after layer of liquid porcelain until they achieve the right thickness, shape and color to match your teeth.
In the meantime, we can fit you with a temporary set of veneers made of acrylic plastic so you can chew, speak and smile normally. These provisional veneers also give you and your friends and family a chance to see what your new smile will look like.
When your veneers are ready, we'll create micro-etches in your teeth that will help keep the veneer secure after we've bonded them. Once bonded, the veneer will feel like an inseparable part of the tooth and look it too. No one except you and us need know you're wearing veneers.
If you take care of them — keeping up daily hygiene habits, not biting into hard surfaces, and visiting us regularly for checkups — your veneers can last for many years. And so will that beautiful, new smile.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”
Tara Lipinski loves to smile. And for good reason: The Olympic-gold medalist has enjoyed a spectacular career in ladies' figure skating. Besides also winning gold in the U.S. Nationals and the Grand Prix Final, in 1997 Lipinski became the youngest skater ever to win a World Figure Skating title. Now a sports commentator and television producer, Lipinski still loves to show her smile—and counts it as one of her most important assets. She also knows the importance of protecting her smile with daily hygiene habits and regular dental care.
Our teeth endure a lot over our lifetime. Tough as they are, though, they're still vulnerable to disease, trauma and the effects of aging. To protect them, it's essential that we brush and floss every day to remove bacterial plaque—that thin accumulating film on teeth most responsible for tooth decay and gum disease.
To keep her smile in top shape and reduce her chances of dental disease, Lipinski flosses and brushes daily, the latter at least twice a day. She also uses a tongue scraper, a small handheld device about the size of a toothbrush, to remove odor-causing bacteria and debris from the tongue.
Lipinski is also diligent about visiting the dentist for professional cleanings and checkups at least twice a year because even a dedicated brusher and flosser like her can still miss dental plaque that can then harden into tartar. Dental hygienists have the training and tools to clear away any lingering plaque and tartar that could increase your disease risk. It's also a good time for the dentist to check your teeth and gums for any developing problems.
The high pressure world of competitive figure skating and now her media career may also have contributed to another threat to Lipinski's smile: a teeth-grinding habit. Teeth grinding is the unconscious action—often while asleep—of clenching the jaws together and producing abnormally high biting forces. Often a result of chronic stress, teeth grinding can accelerate tooth wear and damage the gum ligaments attached to teeth. To help minimize these effects, Lipinski's dentist created a custom mouthguard to wear at night. The slick plastic surface of the guard prevents the teeth from generating any damaging biting forces when they clench together.
The importance of an attractive smile isn't unique to celebrities and media stars like Tara Lipinski. A great smile breeds confidence for anyone—and it can enhance your career, family and social relationships. Protect this invaluable asset with daily oral hygiene, regular dental visits and prompt treatment for disease or trauma.
Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.
One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.
Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.
Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.
Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.
Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.
Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.
Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.
If you would like more information on orthodontic options, 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.”
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