According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.
At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.
And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.
As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.
Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.
Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.
Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.
If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”
Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.
That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.
GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.
Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.
But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.
If you're diagnosed with GERD, here's what you can do to protect your teeth.
- Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
- Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
- Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).
You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.
GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.
If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”
On the way to adulthood, permanent teeth steadily erupt until, if all goes normally, you have a full set of teeth. Sometimes, though, one or more teeth may fail to form. This not only can affect your dental health, but it could also diminish your smile.
For example, if the lateral incisors on either side of the central incisors (the two teeth front and center) don't develop, it could create a smile that's “not quite right.” But we can vastly improve such a smile in one of three unique ways.
The first is to fill the resulting gap through canine substitution. This is an orthodontic method in which we use braces to move the pointed canine teeth, which normally position on the other side of the missing laterals, closer to the central incisors. This choice is determined by the size of the canine teeth. If they are slim in width, they can be re-shaped to make them appear more like a lateral incisor, and the gums possibly reshaped as well around them through cosmetic surgery.
We can also install a dental bridge, an appliance that fills the missing lateral space with prosthetic teeth. A traditional bridge requires the teeth on either side of the gap to be reduced in size, which becomes a permanent alteration to accommodate these crowns. This is a disadvantage in a young person. We can also use a “bonded bridge” which uses adhesives to attach extended pieces (or “wings”) of dental material from either side of the prosthetic tooth to one or more supporting teeth. These wings are behind the permanent teeth. Though not as durable as a traditional bridge, it does avoid altering the support teeth.
Finally, we can replace the missing teeth with dental implants. In this method, we install titanium metal posts into the jawbone at the missing tooth locations and then attach a life-like crown to each one. Implants may be more costly than other restorative methods and can take several months to complete. But they are life-like, highly durable, and don't require any alteration to other teeth. A disadvantage is that you should wait until at least 19 years of age to consider this option. What many people do is use a temporary solution until the proper age to do a dental implant.
Each of these methods have their advantages and disadvantages, which should be thoroughly reviewed in consultation with your dentist. And each may also require other dental work, such as initial orthodontics to open adequate space for a restoration. But any of these methods for correcting a missing lateral tooth can be effective and help restore both a healthier mouth and a more attractive smile.
If you would like more information on treating congenital dental defects, 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 “When Permanent Teeth Don't Grow.”
Although teeth are quite durable, we can still lose them—even all of them—to disease or injury. The good news, though, is that we have effective ways to restore teeth after they're lost. One of these, the removable denture, has given people their teeth back for several generations. And with recent advances in technology, today's dentures are even better.
Although more advanced, today's dentures share the same basic structure as those from a century ago: prosthetic (false) teeth set in a plastic resin colored to resemble the gums. The traditional denture is molded to fit snugly over an individual patient's alveolar jaw ridges, which once supported the former natural teeth. The denture stays in place primarily through a suction effect between the denture and the ridges.
Modern technology, though, has greatly improved today's dentures. Digital imaging can be used to generate highly accurate impressions of the dental ridges that can lead to denture bases with better fit. Dentists using photographs of the patient, especially in earlier years, are better able to identify facial landmarks, which enables them to position the new teeth to more closely recreate the patient's former smile.
These technological aids now help dentists to create more attractive dentures with better support and comfort. But the fit that makes this possible may not last due to a particular weakness inherent in traditional dentures—continuing bone loss. When teeth are missing, the underlying jawbone can lose bone volume over time. Dentures don't stop this process and can accelerate it due to constant friction and pressure on the dental ridges.
But a new modification incorporating dental implants with dentures can help solve these problems. By placing a few strategically positioned implants in the jawbone that then connect with the denture, the appliance not only gains more stability, but also produces less pressure on the dental ridges. In addition, bone cells naturally grow and adhere to the titanium implant posts, which helps to stop or slow bone loss.
If you've experienced total tooth loss, dentures are an affordable and effective option. Thanks to modern dental advances, you can get back the smile and dental function you once lost.
If you would like more information on denture restorations, 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 “Removable Full Dentures.”
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.
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