Braces and Wisdom Teeth?

Q: I already had braces but now I need to get my wisdom teeth out – Will my teeth shift?

A: No!

There is no evidence in studies that says wisdom tooth removal affects the alignment of straightened teeth in front of them! Also, if there is crowding in the front of your mouth, removal of the wisdom teeth will NOT fix it. Sometimes orthodontic treatment can ‘relapse’ or go back to the position of the teeth before treatment but this is usually due to not wearing a retainer!

Q: Can my dental implant get a cavity?

A: No! 

Implants are made of a different material than natural teeth, which makes them resistant to tooth decay. This doesn’t mean that you don’t have to brush and floss! Dental implants can still experience inflammation of the tissues surrounding them and even bone loss! This is called peri-implantitis. Your implants can be best maintained with diligent home care (brushing and flossing) and hygiene visits to have them professionally cleaned along with the rest of your teeth.

So many people get their wisdom teeth removed... Is it really necessary?

The quick answer is: sometimes! 

Your wisdom teeth, also known as third molars, are the most posterior teeth in the mouth and they erupt last. Some people have lots of room in their jaws and the third molars are able to grow into the arch and function well – in this case there is no need for removal. 

Unfortunately, a lot of the time this isn't the case. Usually there is not enough room in the jaws for these teeth to come in. When there is not enough room, sometimes the wisdom teeth only partially erupt. Sometimes they don’t erupt at all and remain ‘impacted’ or stuck in your jaw bones. Sometimes,  they can even grow in the wrong direction – sideways, downwards, horizontal etc.  These improper eruption patterns can cause problems. 

Math and Beauty

The golden proportion [1.618:1] can be found in plants, butterflies and elsewhere in nature. It has also been proposed that we perceive teeth to be more esthetically pleasing when the width of a central incisor related to the lateral is found at a ratio of 1.618:1.This ratio is also found in nature in butterfly’s wings, plant’s leaves and more. When things are arranged in this ratio, we perceive them to be more esthetically pleasing.

So you have a dental emergency...

My tooth just came out? What do I do?!

If it is a permanent (adult) tooth, your dentist may be able to put it back if you see them within about 1 hr of the incident!. Here’s what to do to improve your outcome:

• Handle the tooth by the crown only (the whiter part  -avoid touching the root)
• If dirty, rinse in salt water
• The tooth can be transported in milk,  saline, or if there’s nothing around just keep it in your own mouth! Don’t put it in plain water!
• Go to your nearest dentist or emergency center

More information for parents from Sick Kids Hospital: http://www.sickkids.ca/pdfs/dentistry/12902-dentalinjuries.pdf




I broke a piece of my tooth! What do I do?!

If you can find the piece, bring it to the dentist. Depending on how large the fracture is you may need either a filling or a crown (cap). If the nerve was injured or exposed, you may need a root canal as well.

Blood Pressure & Teeth

Q: What is a normal blood pressure for an adult over 18 years?

A: 120/80

Stage 1 Hypertension > 140/90

Stage 2 Hypertension > 160/100

Why is it important for my dentist to check my blood pressure? What does that have to do with my teeth?

Checking blood pressure at the dental office is a great way to screen for high blood pressures and make an early referral to your doctor if an abnormal blood pressure is encountered. High blood pressure is a risk factor for heart disease. 30% of people with hypertension are unaware

If you know you have high blood pressure, be sure to inform your dentist. Some local anaesthetic agents (dental freezing) contain epinephrine. Epinephrine is also found in your body normally and can increase your blood pressure. This is especially possible in people with an already elevated blood pressure. If your dentist is aware of your high blood pressure, they can be sure to use just the right amount of local anaesthetic to make sure you receive the best care.

What Causes a Toothache?

A toothache usually means that the nerve of your tooth is inflammed. In dental terms this is called ‘pulpitis’. The inflammation can be caused by a number of factors: trauma, bacterial ingression from cavities, biting pressure (clenching and grinding) or anything that irritates the nerve of your tooth. There are two types of pulpitis – reversible or irreversible. With reversible pulpitis, the nerve can become healthy again and remain vital. With irreversible pulpitis, the nerve is doomed to die.

Death of The Nerve

So what if the nerve dies, there’s no more feeling? If the nerve dies, it is a great environment for the growth of bacteria. If left alone bacteria can collect at the apex (end of the root) and cause a granuloma or a cyst. This can flare up and cause a toothache that can be more painful than the one felt with the pulpitis while the nerve was still vital.

Treatment

What is the treatment? The treatment for this is a ‘root canal’. A root canal is a procedure in which the entire nerve is removed from the tooth. The canal is cleaned out to remove as much bacteria as possible and then the canal is sealed with a  material. Antibiotics can help calm the infection down but only to a certain extent, eventually the canal must be physically cleaned out. Also the tooth can be extracted to remove the infection, this is usually the option if the tooth is broken and there is not enough structure left to place a crown or filling.