Jeffrey L. Hardenburg DDS

Many patients ask whether wisdom teeth are really necessary since so many people have them removed.

The fact is that wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned.

However, problems can occur that sometimes make it better to have them removed.

For example, when the jaw isn’t large enough, the wisdom teeth can become impacted – misaligned or unable to grow in properly. They may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.

The reasons wisdom teeth may have to be extracted include:
– The teeth have only partially erupted. This leaves an opening for bacteria which cause infection.
– There is a chance the wisdom teeth will damage adjacent teeth.
– A cyst forms which may destroy surrounding structures such as bone or tooth roots.

Ask your dentist about the health and positioning of your wisdom teeth.

Your dentist will tell you if there are any issues and will recommend any steps needed.

Dental plaque is a film that builds up on your teeth and, if it is not removed through good oral hygiene, it can lead to tooth decay and gum problems.

Over time it can ultimately form a hard, rough sediment known as dental tartar or calculus, which attracts further plaque buildup.

Calculus has to be removed by a trained professional such as a hygienist or dentist.

They may do this by manual tooth scaling or using an ultrasonic device.

If the buildup is light or moderate, the dentist or hygienist may use manual scaling instruments of various shapes and sizes.

If the buildup of tartar and stains is heavy, an ultrasonic cleaner may be used. This may be followed by hand scaling.

Build up of plaque can cause inflammation of the gums leading to breakdown of the connection between the teeth and the supporting structures.

Root planing is a procedure to treat gum disease by thoroughly scaling the roots of teeth to establish a smooth, calculus-free surface.

This treatment may require local anesthesia to prevent pain. Thorough periodontal scaling customarily involves several dental visits

If conditions are more advanced, surgery may be needed for complete debridement of the roots to arrest the disease process.

Some people tend to have more buildup of calculus than others and some may be more prone to periodontal inflammation or the development of tooth decay.

It’s therefore important to follow your hygienist’s advivce on how often to return for regular cleanings – even if your insurance only covers two a year.

The sugar content in the food you eat has a big effect on your teeth and gums.

When bacteria (plaque) come into contact with sugar in the mouth, acid is produced, which attacks the teeth for 20 minutes or more. This can eventually result in tooth decay.

That�s why drinking sugar-filled sodas, sweetened fruit drinks, and non-nutritious snacks can take a toll on teeth.

This is particularly true for children as their eating patterns and food choices affect how quickly they develop tooth decay.

Foods that contain sugars of any kind can contribute to tooth decay. However, almost all foods, including milk or vegetables, have some type of sugar. Many of them also contain important nutrients that are an important part in our diet.

To help control the amount of sugar you consume, read food labels and choose foods and beverages that are low in added sugars. Soft drinks,candy, cookies and pastries often contain added sugars.

If you sometimes find the taste of something hot or cold painful on your teeth, you may suffer from sensitive teeth.

Sensitive teeth is a common problem which may be caused by cavities and fractured teeth.

But it can also be caused by worn tooth enamel, a cracked tooth or an exposed tooth root.

Tooth enamel is the strongest substance in the body and it protects the crowns of healthy teeth. A layer called cementum protects the tooth root under the gum line.

The part underneath the enamel and the cementum is called dentin, which is less dense than enamel or cementum.

The dentin contains small hollow tubes or canals called tubules. When the dentin loses its protective covering, the tubules allow hot, cold, acidic or sticky foods to reach the nerves and cells inside the tooth.

This causes hypersensitivity and occasional discomfort but fortunately, the irritation does not cause permanent damage.

Following proper oral hygiene helps prevent the gums from receding and causing the pain of sensitive teeth.

Brushing your teeth incorrectly or even brushing too much can cause gum problems.

Your dentist will advise you on the best daily routint to maximize your oral hygiene.

Everybody wants the best smile possible and there’s no need to have it spoiled by gaps in your teeth or by teeth that are stained or badly shaped.

Whether the problem was caused by nature or by an injury, you may be able to have a veneer placed on top of your teeth to restore or improve your smile.

Veneers are thin, custom-made shells crafted from tooth-colored materials designed to cover the front side of teeth.

Your dentist will usually make a model of your teeth and the veneers will be made by a specialist dental technician.

A small amount of enamel has to be removed from your teeth to accommodate the shell so having veneers is usually an irreversible process.

In order to make the most of your veneer, your dentist may suggest that you avoid foods and drinks that could discolor them, such as coffee, tea or red wine.

It’s also possible that veneers might chip or fracture.

But, for many people, veneers are well worth it as they give them a completely new smile.

When you put food in your mouth, it immediately meets the bacteria that live there.

Plaque, for example, is a sticky film of bacteria.

These bacteria love the sugars found in many foods. So, when you don’t clean your teeth after eating, the bacteria and the sugar can combine to produce acids which can destroy the enamel – the hard surface of the tooth.

In time, this can lead to tooth decay. The more often you eat and the longer foods are in your mouth, the more damage occurs.

Many foods that are nutritious and important in our diet contain sugars – such as fruits, milk, bread, cereals and even vegetables.

So the key is not to try and avoid sugar but to think before you eat.

When you eat is also important because each time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.

This means that foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, helping to wash foods from the mouth and reduce the effects of acids.

Here are some tips to follow when choosing your meals and snacks.
– Eat a variety of foods from different food groups
– Limit the number of snacks that you eat
– If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a piece of fruit

It�s also important to brush your teeth twice a day and to clean between your teeth daily with floss or interdental cleaners.

And of course regular visits to your dentist will help prevent problems from occurring and catch those that do occur while they are easier to treat.

Tooth decay or cavities result from destruction of the tooth enamel and can lead to a range of problems from toothache to bad breath.

Cavities occur when foods containing carbohydrates (sugars and starches) such as milk, sugared drinks, cakes or candy are frequently left on the teeth.

Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Many people associate cavities with children but the changes that occur with aging make cavities an adult problem, too.

Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque.

Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges of fillings is also common to older adults. As many of them did not benefit from fluoride and modern preventive dental care when they were younger, they often have a number of dental fillings.

Over the years, these fillings may weaken, fracture and leak around the edges.

Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

– Brush twice a day with fluoride toothpaste
– Clean between your teeth daily with floss or interdental cleaner
– Eat nutritious and balanced meals and limit snacking

It�s also worth asking your dentist about supplemental fluoride, which strengthens your teeth, and about dental sealants, a plastic protective coating which is applied to the chewing surfaces of the back teeth to protect them from decay.

In addition, it�s important to visit your dentist regularly for professional cleanings and oral examination.

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants � these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.

Some women worry about whether it�s safe to have an X-ray exam while they are pregnant.

This can cause them to put off treatment they need.

However, untreated dental infections can pose a risk to the fetus, and dental treatment may be necessary to maintain the health of the mother and child. Sometimes this will mean an X-ray is necessary.

Radiation from dental X-rays is extremely low but every precaution is taken to minimize radiation exposure.

For example, a leaded apron reduces exposure to the abdomen and should be used when a dental radiograph is taken.

In addition, a leaded thyroid collar can protect the thyroid from radiation, and should be used whenever possible. The use of a leaded thyroid collar is strongly recommended for women of childbearing age, pregnant women and children.

Overall there is no reason to avoid dental radiographs (X-rays) while pregnant, breastfeeding or trying to become pregnant.

Follow your dentist�s advice and ask questions if you have any concerns.

Osteoporosis is a disease that weakens bones and increases the risk of fractures.

It affects about 10 million Americans � of whom 8 million are women � and another 34 million are at risk of developing it.

So this is a disease that affects more women than cancer, heart disease and stroke combined.

But what does it have to do with your dental care?

Well, many people in these categories are treated with a group of prescription drugs called oral bisphosphonates. Studies have reported that these drugs reduce bone loss, increase bone density and reduce the risk of fractures.

But some people have been alarmed and confused by recent news reports about oral bisphosphonates because of uncommon complications that have been linked to these drugs.

The drugs have been associated with osteonecrosis of the jaw (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone.

The true risk posed by oral bisphosphonates remains uncertain, but researchers seem to agree that it appears very small.

Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should not stop taking these medications before discussing the matter fully with your physician.

If your physician prescribes an oral bisphosphonate, it�s important to tell your dentist so that your health history form can be updated.

In this case, some dental procedures, such as extractions, may increase your risk of developing ONJ, so your dentist needs to be able to take your full health picture into account.