Impacted Wisdom Tooth: Do You Have One?

8 out 10 young adolescents suffer from a dental condition called "impacted third molars" or others may refer it to "impacted wisdom tooth". Others may experience pain and some may not and remains to be asymptomatic for a long time. The procedure to remove an impacted tooth is called "Odontectomy". This procedure is considered as a minor surgery for removal of bone is needed  take out the impacted tooth. 

Impacted Molars (seoral.com)

What causes it?

Impaction of the molars happen when there is insufficient space in the jaw for it to erupt. Improper angulation of the molars could also be the cause of its impaction.








What are the indications for removal?

• If there is pain involved.

• If there is an infection on the site or what we call "pericoronitis". The gums that surrounds the impacted tooth becomes infected due to biting forces or a food debris that is difficult to remove. 

Pericoronitis (healthtap.com)

• If the adjacent tooth is at risk of damage.
  

  

  Damage to the Distal of the Adjacent tooth. (drsimonrosenberg.com)
  

  
  

• If there is an existing pathology/tumor. 

Cyst development due to impacted 3rd molar (theparentsguidetowisdomteeth.com)

• If it is necessary for orthodontic therapy.
  
   

Post Op Care after Odontectomy:

1. For the next 24 hours do not drink from a straw, do not spit, and do not rinse mouth.
2. Diet: Today, soft diet is best. For example: soups, eggs, mashed potatoes, casseroles, etc. You can advance your diet as tolerated over the next few days.
3. It is very important to keep your mouth clean to prevent infection. Tomorrow start brushing your teeth after every meal and at bedtime, and then rinse your mouth with ½ teaspoon of salt in 8 ounces of warm water.  This rinse should also be used after meals and at bedtime for the next seven (7) days.
4. Following anesthesia or the use of pain and antibiotic medications, you may experience slight nausea. To prevent this, never take your medication on an empty stomach. If nauseated, avoid milk products for the next 24 hours. Take small sips of ginger ale until you feel better. Then you may start on applesauce and toast.
5. Bleeding:  A certain amount of bleeding is to be expected.  It is often possible to control mild oozing by placing folded, moist gauze over the area and biting down for 30 minutes. If bleeding continues, repeat.
6. Often, sutures (stitches) have been placed in the surgical site(s). These needs to be removed after 7 days. 
7. Discomfort:  You will experience some discomfort for a few days. If pain or swelling gets worse, please call our office. For mild pain, you may take two Advil or Tylenol. Otherwise, use the prescribed pain medication.  If antibiotics are prescribed, take them as directed.
8. Return to our office for postoperative appointment, if one was given.
9. Please remember that our care does not end after your surgery. Our goal is to make your surgical experience as comfortable as possible. If you have any questions, please feel free to call us.

What You Need To Know About Tooth Decay

                According to the Department of Health (DOH), 87.4 % of Pinoys are suffering from dental caries or what we all know as tooth decay. This recent statistics is somehow alarming and this condition may weaken our immune system to fight against diseases. This condition may open the doors to other systemic diseases such as endocarditis, gastrointestinal conditions even rheumatoid arthritis. 

So how does tooth decay starts?

Bacteria found inside our mouth and onto our  teeth are also like humans.They need food in order to survive. And they too, have a weakness on sweets. They love sugars and starches as their source of food. As a part of the digestion process, they also need to remove their waste out of their system and thus, called a by-product. These by-product produce by these bacteria are are acid in nature and it is responsible for the demineralization of a tooth. So if you always munch on sugary food products, the colony inside your mouth will be so happy. 

Tooth Decay (http://www.mchoralhealth.org)

What are the signs and symptoms of having a tooth decay?

• A white spot lesion may indicate of an early sign of tooth decay. It is caused by the decalcification process brought about by the acid from the waste product of the bacteria. 
• Symptoms will not occur unless the tooth has a cavity or has been infected. The presence of toothache may differ depending on the size of the cavity. Persistent toothache may indicate that the cavity has already reached the pulp.
• Bad breath is also a symptom of dental cavity.

How do we eliminate dental cavity?

• Brushing

Dental cavity can be eliminated by brushing with a fluoridated toothpaste at least 2 times a day. Fluoride can prevent the process of decay.

• Limit your sweet intakes

It's okay to eat cakes, ice cream or chocolates but on a limited intakes to avoid the frequency of acid attacks on our tooth. 

• Neutralize your mouth

You can do this by drinking at least 8 glasses of water a day. It is better to drink more water after dessert. This way, you can flush out the remaining sticky food particles. 

• Consider Sealants

Pits and Fissure Sealant
www.daytondentalonline.com

Dental sealant are tooth colored coatings that is applied on molars. It can help eliminate dental cavity by covering the uneven grooves on the tooth that can be a potential site for food impaction.

From Baby Teeth to Adult Teeth: Stages of Tooth Eruption

Did you ever wonder when your child's teeth are going to emerge? Here's a video for parents to know at what age you should expect your kids to have their baby teeth emerge as well as the age of transition from baby teeth to adult teeth. 

- The Inquisitive Dentist 

Having a Bad Breath???

There are a lot of factors why a person is having a bad breath. It could be from the food that you eat to having an alert sign that you might be having a systemic condition. Oftentimes, it is not you who notices it first. To save you from further embarrassment of having a bad breath, I want to share the following information regarding halitosis and how you can save yourself from it.

Gum Disease (therabreath.com)

What are the causes of Bad Breath?

Here are some common causes of bad breath:

• Poor Oral Hygiene

             If the patient doesn't brush and floss at least once a day, then we have a problem. Food can sometimes lodge in between the teeth and bacteria can harbor the site. This could lead to dental caries (tooth decay) and gum problems.

• Cigarette/Tobacco Use

              Smoking can  leave the mouth dry. Having a dry mouth could initiate bad breath since the cleansing ability of the saliva is reduced. Also, the chemicals found in cigarettes are considered oral irritants that can cause gum disease and oral cancers.

• Untreated Tooth Cavities

  

  Advanced Tooth Decay (toothandteeth.com)
  
  

                  Tooth decay that has been untreated are one of the causes of halitosis especially deep cavities. Oftentimes, food debris lodge inside the cavity which adds to the foul odor if it is not removed. 

• Related Medical Conditions

             Patients with medical conditions such as Diabetes, Sjorgrens Syndrome, Bulemia Nervosa and patients who are undergoing chemotherapy and radiotherapy for cancer can sometimes suffer halitosis. The salivary flow of these patients are compromised due to the condition. Also, these patients are suffering from immunodeficiency. It is either the immunity is compromised or totally absent.
Respiratory tract infection such as tonsillitis and bronchitis can cause oral malodour too.




Here are some helpful and simple tips to get rid of Bad Breath.

• Complete Oral Hygiene

Brush-Floss-Rinse

           Oral hygiene is not only limited to brushing alone. A complete cycle of oral hygiene includes brushing, flossing and rinsing with specialized mouthwash. Flossing is an important step but often neglected in the cycle. It removes food debris in between the teeth. Failure to remove those can lead to gum disease and therefore, develop a bad breath. Don't forget to brush your tongue too! According to recent studies, 90% of bad breath comes from a dirty tongue.

• Have your Regular Dental Check Up

 Visit your dentist regularly. There might be dental concerns that needs to be treated like removal of stubborn tartar through Oral Prophylaxis or Composite Restorations of dental cavities. Having regular check ups can help you save money and your smile. 

• Always Hydrate!

       Keeping yourself hydrated is vital for your overall health.Water helps flushing out food debris inside your mouth. It also aids in neutralizing the pH of your oral environment as well as your entire body. Keeping your body at a neutral state will help you lessen the chance of developing cancer.

•  Specialized Oral Hygiene Adjuncts

Xylitol Gum

         Patients who are experiencing dryness of the mouth can use over-the-counter saliva substitute such as Biotene Products. The patient can also chew a xylitol gum. Xylitol can help increase salivary flow, it enhances remineralization of the teeth, and it stops the bacteria from producing acid that can damage the teeth.








These are some of the simple information about halitosis and how can you prevent it from occurring.






- The Inquisitive Dentist

A letter for the Dentist-To-Be

Dear Dental Student,

        If you happen to be a dentistry student who is currently struggling and trying juggle all those academic and clinical requirements plus extra curricular activities for those who are into organizations, this letter is for you. If you feel stressed, depressed, frustrated or whatever negative vibes you have right now, I'd like to say that you are not alone. I've been been into several challenging moments during my time as well. I almost questioned myself of being into the program from time to time. It wasn't all bad experiences, I also had a fair share of achievements and countless happy times with my friends and colleagues. But you know what, I never regret those challenging times I had during my undergraduate days. 

So this was me completing one of my clinical requirements in my school. It was a diastema closure procedure I think (if my memory serves me right). My horizons as a student was open, and still it is. I wasn't afraid to invest and try new things. Things that could make my life a little easy as a clinician. If someone  introduce me or if my curiosity arises about a new dental material, I'd say why not try it. One of the things I introduced to my classmates then was the Low Speed Air Turbine by Foshan. One summer afternoon, I called every dental supplier in town to look for the turbine only at a good deal and I happened to came across DSC Inc. where they sell it without the hand pieces. Why am I looking for this equipment? Simple. To make things easy. I was having a hard time carrying my micro motor and the setting up part was a little bit time consuming. Little did I know that I was aiming for ergonomics. For me, I just want to make things hassle-free. When I found that it was very effective for me, I introduced it to my classmates and they were happy to use it as well. I'm not saying that you throw away your micro motor. NO! It is one of the things that you'll be needing in your future practice. Therefore, it is worth keeping.

Low Speed Air Turbine
Pros: Easy to install
Wont take up space too much
Light weight
Con: You need a dental chair to operate this

Dentamerica Rotex 782 Micromotor
Pros: Heavy duty for Prosthodontic works
Portable; You can use it on a tabletop
Cons: Extra baggage when you bring it everyday
Little bit pricey

    VS

Another brand that I introduce before was the Tokuyama Estelite Sigma Quick. I remember so vividly that I was having a difficulty placing a Class IV restoration on one of my patients. The composite was very sticky and I had a hard time placing it on the cavity. It kept adhering on my hand instrument! My clinical instructor noticed it and gave it a try. But she also had a hard time too. With that experience, I decided to switch brands. I approached one of my mentors who happen to be in the dental trading. I told her my story and I ask for probable pocket-friendly brands that she could recommend. That was when Tokuyama Dental was introduced to me.

 I bought a three-syringe system. Before it comes with a bonding agent. She even said that the adhesive included in the package was a Self-Etching bond. I was so amazed to know that because I purchased a material that can lessen my chair-time and save money on etchants! Not only that, they even gave me two flowable composites for free. I was so happy then I took it on a test. It's true that doesn't stick to your instrument. From then on, all of my patients with Class III, IV and V classifications I restored it using Tokuyama Estelite Sigma Quick. Of course, I shared this information to my classmates and some of them purchased too! Some of them borrowed mine and tried it on their patients. We all shared the same feedback that it cuts the chair time in half and it is not technique sensitive. Again, another hassle-free material! 

Don't be afraid to try new things. Explore other dental materials or brands that could make your life less complicated. It can save you time, money and energy. It pays when you work smarter too, you know.  

*the inquisitive dentist is not under or related to any dental company. These write ups are from experience-based situations.*



- The Inquisitive Dentist

The Mind Wanderer in the World of Dentistry

Hopefully in the future, I can write reviews about the latest and the not-so latest materials that are used in Dentistry. So going to be like the YugaTech style but focusing more in the pros and cons of every dental materials and gadgets that I can hold on to. I'm excited about it! I hope that these reviews can help rookie dental professionals like me. Yes, I still consider myself as a rookie! But I could also write anything about it such as patients' information regarding treatments, or certain legal procedures that concerns the dentist. It could be anything and everything about dentistry.

 I have been attending numerous dental exhibitions locally and internationally. Thank God, I've been given a chance to experience conventions outside of the country. And, I must say, technologies in the field of Dentistry are very promising. With hundreds of brands of dental materials out there competing in the market, we need to know which material would do justice without hurting our expenses.

Ever since I was an undergraduate student, some of my classmates are asking me for feed backs about certain dental materials but it's not only limited to that. Up to now, some of them still ask me. So, why not write a blog about their frequent inquiries/questions and if there are future rookie colleagues who will ask the same questions, I will just link them my blog. Right?

This is it, and I hope this endeavor will help the future rookie dentist in setting up their practices.




The Inquisitive Dentist