Myteethnvd's Weblog

Should I get my wisdom teeth out? Part 2

myteethnvd — Mon, 19 Dec 2011 02:59:36 +0000

I have already given a detailed blog about various wisdom teeth and the pros and cons about their removal. Basically, a wisdom tooth is like any other tooth – if it erupts normally into the mouth it is fine but at risk of decay. If decay gets into the nerve area it causes pain, swelling and infection. It is often inaccesable to treat, so the wisdom tooth to be removed. If this risk appears high, or the teeth are not erupting normally and your dentist suspects future problems – he or she may recommend the tooths removal to reduce the risk to you of a serious infection or complications. The older you get, the more the wisdom teeth roots can grow towards the nerve in the jaw, and the harder your jawbone can get, increasing the risks of complications of surgery (such as permanent lip numbness or tingling – called paraesthesia). Your dentist is always trying to wiegh up the best alternative based on the information at hand.

I have taken some random photos of wisdom teeth we have seen in our practice. Some were fine, others were at risk, some were removed, and some required specilaist intervention. Don’t let anyone say you should or should not remove wisdom teeth without knowing your specific case – everybody is different.

To the right of each photo I have drawn and approximate line showing the roots of the teeth in black, the nerve in the jaw in blue, any obvious infection in the bone in yellow, and obvious decay in red.

Dark Root Filled Tooth

myteethnvd — Sun, 30 Oct 2011 07:32:01 +0000

This fellow’s tooth was wacked when he was young. Wear a mouthguard when playing sport please guys! The existing filling was leaking and broken and the tooth had gone dark. The blood in teeth stains when the nerve dies, and also the medicaments used in root fillings may stain the tooth. Ideally the tooth would be bleached as a conservative option. The filling was failing so the next best option would be a crown. Unfortunately this tooth is on its way out – it is so hollowed an weak it wont hold a crown but we had to do something because the current filling is failing.

We built him a new tooth using a carbon fibre post into the root, and bonding dental composite resin over the top. It is much cheaper than a crown, and if the tooth fails he is looking at a gap, denture, or implant. Hopefully we have delayed these options for some time to come and given back a smile.

Composite Bonding Rehabilitation

myteethnvd — Sun, 30 Oct 2011 07:22:02 +0000

This lady had worn and chipped her upper teeth on the inside until they were so thin they were about to break. The yellow tooth on the right second from the middle is an old crown which the patient couldn’t afford to redo so we had to match it in colour and shape. Crowns are hard and durable but bonding often means less tooth needs to be removed and they are cheaper. Because all of this patients teeth had worn we were needed to build them all up (or at least 10 of them) – compare $250-$300 per tooth for bonding vs. $1500 per tooth for crowns. They may not last as long or be quite as perfect in appearance but they can be a great low cost option without losing teeth and getting dentures. It was done in one day and crowns would take weeks or even months. I would be happy to get 5 years up to 10 years for this kind of procedure. Despite the cost, in the long term I would still prefer porcelain crowns.

More on Wisdom Teeth

myteethnvd — Wed, 22 Jun 2011 22:33:34 +0000

Wisdom Teeth – Why do we need to remove wisdom teeth? Often we don’t, but because they are hard to reach, they are harder to clean and more likely to get decay. Some wisdom teeth may be growing in the wrong direction and get stuck (impacted) and this leads to problems as well.

This young patient has an impacted lower wisdom tooth causing no pain. It is under the gum and can’t be seen in the mouth. Sadly, the lower picture shows the decay highlighted in black – there is decay in the upper and lower wisdom tooth, but also the second back tooth has decayed almost to the nerve. This tooth may now need very expensive root canal therapy or extraction. The pink line shows that the lower wisdom tooth is touching the nerve in the jaw and will need specialist attention. This will require time and careful planning but unfortunately the decay has made the situation urgent.

Even older patients can have wisdom teeth problems. Not long ago one of our dentists removed a wisdom tooth from an 89 year old!

This picture shows how a cyst is damaging the jaw.

Many people have wisdom teeth come through perfectly just like any other molar. Thank goodness we are all different. If you have any queries see your dentist and get an Xray to check.

Loose Dentures? No worries

myteethnvd — Mon, 06 Jun 2011 07:51:04 +0000

Over the years I have been grateful to have studied under some great professors regarding denture making because full dentures. Many newer graduates are seeing fewer cases of full dentures and find it harder to gain experience. Nevertheless, even well made full dentures are often a nightmare for both dentist and patient. Bottom dentures especially have little going for them – the jaw atrophies when you loss teeth which leaves no support to bite against, no jawbone left to hold the dentures firm, and the end result is poor diet, discomfort, ulcers and unhappy people.

I have been excited to see mini dental implants as another option for us to help retain full dentures. Traditionally, full implants were required at great cost, and many patients don’t have enough bone to support these implants, or the money to pay for them. The mini dental implant is an in between option – aimed at stabalising the denture against loosening or falling out, but still being removable. I have just finished a case and the patient is thrilled. he lost his teeth 3 years ago and hasn’t been able to wear a denture since – now he is regained his confidence an smile.

General Dental Enquiries – Help

myteethnvd — Thu, 17 Mar 2011 13:06:02 +0000

Dental help – your question may already have been answered here. This site has many previous posts which may be on interest to you. If not and you have a general or specific dental enquiry I will endeavour to answer it personally as soon as possible. Leave me a comment on this post.

Marc Miller

Nundah Village Dental

White Spots on my Teeth

myteethnvd — Sun, 19 Dec 2010 05:31:18 +0000

People end up with white spots on their teeth for various reason. A white spot is usually because the crystals in the tooth enamel are disrupted so instead of looking see through like glass, it becomes opaque like chalk. This chalkiness may be from early decay such as below.

This was the result of poor hygiene around braces.

The following, however, is a developmental defect in the growth of the enamel and is not weak or decayed. The cool thing is that many of these white spots can be removed in less than 10 minutes with a simple application of a couple of products. I heard about it in a course this year and tried it on the kids of one of our staff. Then this young woman came in last week and said ‘I’ve always hated these white spots on my front teeth’ – less than 10 minutes later they were almost completely gone, no pain – no fuss, great fun!

Have a Merry Christmas or holiday period. Look forward to your company at Nundah Village Dental next year!

Adult with baby teeth – bonding

myteethnvd — Wed, 10 Nov 2010 05:21:13 +0000

This dental patient was missing her lateral incisors and the adult canines erupted into the space, with the baby teeth canines still in place. You can see the baby teeth have worn down severely, and the adult eye teeth look bulky in this position.

The best way to treat this would be by extracting the baby teeth, moving the eye teeth to where they should be with orthodontics, and then placing implants in the spaces. Unfortunatley this would be expensive and take many months to complete.

While our patient is saving for the best long term solution, we were able to provide a great compromise using dental composite resin. This will prevent further wear and is completely reversable. It was done in one appointment for the cost of less than 1 crown.

You can see the compromise is the position of the gum due to the adult eye tooth being so large. That is why orthodontics and implants in the long term will be the best option for the missing insicor teeth.

My gums are receeding

myteethnvd — Tue, 19 Oct 2010 10:02:43 +0000

This 21 year old came to see me today complaining of pain and receeding gums. The tissue is very thin and fragile on some people and the gum can receed from brushing too hard, or leaving bacteria on the gumline from brushing too soft.

We cleaned the hard calculus and build up off the teeth and prescribed a toothpaste for sensitive teeth. Rubbing with salt and gentle brushing with a soft brush will help maintain the area – an electric toothbrush can be of benefit here.

Unfortunately the gum won’t repair (it may do slightly as the patient is very young). What we want to do is be very diligent and stop it getting worse. If it gets into the soft part of the lip it can speed up and long term the tooth could then be at risk of getting loose and falling out! Sometimes a specialist can do a graft to cover the sensitive root. If it is well maintained then receeding gums can be stabalised with regular check-ups.

Decayed Teeth

myteethnvd — Thu, 14 Oct 2010 07:19:20 +0000

This patient is likely to have further complex problems with his front teeth due to the extent of the decay. Decayed teeth if untreated eventually get damage to the nerve inside and end up needing root canal treatment to save, and also the tooth can be so weakened that it can break off. Fortunately, we have been able to repair these teeth with filling for now. These teeth are still at great risk, but the fillings will stabalise the problem and should be serviceable for a few years. The advantage is that all this could be fixed in one day for a few hundred dollars with a very cosmetic result.

The front tooth without any decay is a root treated and crowned tooth treated many years ago.