Posts for: July, 2019
Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.
Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.
It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.
But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?
That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.
For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.
More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.
Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.
Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.
But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.
In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.
We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.
If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.
Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.
If you would like more information on the care and treatment of baby 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 “Importance of Baby Teeth.”
There are a few mouth conditions so rare most of us have never heard of them. Geographic tongue would fall into this category, affecting only one to three percent of the population. Even so, these irregular reddish patches resembling land masses on a map (hence the name) might be alarming at first glance—but they pose no danger and usually cause very little discomfort.
Geographic tongue is also known as benign migratory glossitis. As its clinical name implies, the unusual red patchy areas (often surrounded by a grayish white border) aren't cancerous nor contagious. The patches also appear to change shape and move around ("migrate") the tongue.
The reddish appearance comes from the temporary disappearance of tiny bumps on the tongue surface called papillae, which can leave the tongue smooth to the touch in affected areas. The lost papillae may reappear again a few hours or days later, and may occasionally disappear again. While it's not painful, you can experience a stinging or burning sensation emitting from these patchy areas.
We're not sure how and why geographic tongue erupts, but it's believed high emotional or psychological stress, hormonal imbalance or certain vitamin deficiencies might be factors in its cause. There may also be a link between it and psoriasis, a condition that can cause dry, itchy patches on the skin.
If you're one of the rare individuals who has episodes of geographic tongue, the good news is it's harmless, only mildly uncomfortable and usually temporary. The bad news, though, is that there's no known cure for the condition—but it can be managed to ease discomfort during outbreaks.
It's been found that highly acidic and spicy foods, as well as astringents like alcohol or some mouthrinses, can increase the level of discomfort. By avoiding these or similar foods or substances, you can reduce the irritation. Your dentist may also be able to help by prescribing anesthetic mouthrinses, antihistamines or steroid ointments.
For the most part, you'll simply have to wait it out. Other than the mild, physical discomfort, the worst part is often simply the appearance of the tongue. But by watching your diet and other habits, and with a little help from us, you can cope with these irritations when it occurs.
If you would like more information on geographic tongue and similar oral issues, 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 “Geographic Tongue: No Cause for Alarm.”