Thanks, Kenneth

Dear Kenneth,

It is very common for dipping tobacco to cause a white chalky wrinkly appearance on the oral tissues in the mouth. Smokeless tobacco irritates the gum tissue leading to periodontal disease and tooth decay besides cancer of the mouth, tongue, lips, and pancreas as well as colon, bladder, and esophagus. We will not lecture you on your habit, however will advise you to visit your dentist to have your oral tissue evaluated. The only way to diagnosis oral cancer is usually through a biopsy. There are many toxins in smokeless tobacco just like cigarettes that can cause cancer. Some of the signs and symptoms of oral cancer are irritation of the tissue where it may become tender with a burning sensation, pain or numbness, wrinkled or bumpy patch that changes color like gray, white spots, or red as well as difficulty chewing or swallowing. Our advice to you is that if you continue this habit to not keep your chewing tobacco in the same place all the time to allow your tissue to heal where it is irritated.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Thanks, Joyce

Dear Joyce,

Probing depths should decrease over time ranging from 1 to 3mm in reduction after treatment, however not always the case. The clinical attachment loss that has occurred does not change once the disease is under control however you may gain some clinical attachment but it is usually minimal without surgery.

Let’s say for example you had an 8mm pocket before your treatment and after your dental scaling the pocket remained the same. Even if you have immaculate oral hygiene habits, flossing an 8mm pocket is almost impossible. Floss can usually reach a 4mm pocket but not greater, this is why it is vital to go in for your periodontal maintenance appointments every 3 or 4 months so your dental hygienist can maintain those deeper areas and clean them out to prevent further bone from dying around the tooth. By doing this those deeper area’s can see a reduction in tissue inflammation which overtime decreases your pocket measurement. Sometimes when pocket measurements don’t change it is an indicator that the pocket is not healing properly especially when bleeding upon probing occurs and may need more attention or possibly a sign that some type of periodontal surgery is recommended.

Do not get discouraged, maintain excellent oral hygiene habits, and see your dental hygienist for your cleanings as recommended. If you are not satisfied overtime with your measurements ask your dentist or dental hygienist what options are available for you to get the disease under control.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

My dentist said I have two sets of wisdom teeth. I have never heard of this before. Is it possible to have a second pair of wisdom teeth?

Thanks, Marc

Dear Marc,

Yes, believe it or not some people have two and even three sets of wisdom teeth, however its rare. Usually when one has a second or third set of wisdom teeth these teeth are a lot smaller and are not fully developed, so in order to properly diagnosis this x-rays are needed. It is not a big deal to have more then one set however we would recommend having both sets of wisdom teeth extracted to prevent periodontal issues as well as overcrowding of the teeth

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Thanks, Katie

Dear Katie,

Usually your first appointment after your initial evaluation with your orthodontist consists of dental impressions, photos of your teeth, and the placement of rubber bands. Dental impressions are taken and a mold of your teeth is made so the orthodontist can correctly know which direction your teeth need to shift for proper alignment. Photos of your teeth and face are usually taken too. Rubber bands are usually placed in front and behind your molars to make room for the metal bands that will go on the teeth that hold the wires. Usually this is all that is done on the first visit. Your orthodontist will have you come back to place the braces on once the rubber bands have made enough room for the mental bands.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Thanks, Chris

Dear Chris,

It sounds like you may have an abscessed tooth. In dental terms a pimple like bump below the gum area that has puss excreting from it is called a fistula. Most of the times people have no idea their tooth is infected because the infection is draining in the mouth and there is little or no pain coming from the tooth. Most teeth that get infected have pain upon chewing, ache on their own, or are sensitive to temperature because the infection stays at the base of the root of the tooth and not draining into the mouth which causes a toothache. If the tooth is truly infected, antibiotics will be prescribed and it will require a root canal and dental crown. We advise you to consult with your dentist to see if your tooth is indeed infected or if it’s some other condition.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Thanks, Carol

Dear Carol,

An infected tooth with an abscess left untreated can drain into the nearby tissues of the infected area causing some facial swelling.  In some cases the lymph glands can swell and even make you feel like your experiencing a headache because pain can transfer from the infected area. Pain is fairly common on the side of the face where an infected tooth is located.

A severe tooth infection left untreated can lead to sepsis, in other words blood poisoning, which is an all over body inflammatory response due to an infection. Sepsis has been known to happen from an infected tooth however not too common. This is a serious condition which requires hospitalization and can be deadly. Some early signs of sepsis are flu like symptoms, dehydration, a racing heart rate, and shallow breathing however when it becomes severe one experiences difficulty swallowing, infrequent urination, and mood swings.

Due to the fact that this tooth has been left untreated along with the symptoms your experiencing we highly recommend you see a dentist who will most likely prescribe an antibiotic to decrease the infection. Ask the dental office about financial options they may offer and see if they are willing to work with you on making payments.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Loretta,
When a tooth becomes infected, the tissue inside it dies. Then, since there is a small opening in the tooth at the apex of the root, infected matter continues to spill out into the bone around the end of the tooth. Your body fights the infection in the bone, but there is no way to get antibodies or white blood cells into the tooth to actually eliminate the infection, because that tissue is dead and there are no longer any blood vessels in it.

When the tooth is extracted, two important things happen. First, the source of the infection is eliminated, enabling your body defenses to quickly wipe out the remnants of the infection in the bone. Second, the missing tooth leaves a wide drainage opening into the bone to the heart of the infection. Because of this, there is rarely any problem with residual infection after a simple extraction.

Now in the case of an infected and impacted wisdom tooth, the infection is not inside the tooth and spilling out into the bone, but is in the space between the tooth and the gum. Additionally, the surgery to remove an impacted wisdom tooth requires cutting into the tissue and the bone, which can allow the infection to spread into that surgical area. Then the wound is usually sutured closed. For these reasons, an infection after the removal of an impacted wisdom tooth is not rare, and many dentists routinely prescribe antibiotics during the healing period to help prevent infection.

This blog is sponsored by Cleveland implant dentist Dr. Brad Hylan.

Click here to read reviews of Clear Choice Dental Implants Centers.

Cameron

Dear Cameron,

There are dentist that provide sleep sedation within their dental practices to help you become more relaxed and in a sleep state of mind however most dental insurance plans do not pay for this service which can cost several hundred dollars. Nitrous oxide, otherwise known as laughing gas can be used which helps relax you and takes the edge off but you are still aware of what is going on around you. If cost is a concern this will be good option for you and take away most your anxiety during your dental treatment. Oral sedation is another way to calm you down and puts you in a more sleepy state of mind yet you are still conscious. This is more expensive then nitrous oxide but a better option if your fear of the dentist is great. Most patients have very little or no memory of the dental visit after oral sedation is administered. Ask your dentist is they are qualified to perform sleep dentistry and if not ask them for a recommendation as to who is in your area.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Bertie,
It would be a shame to not replace this tooth after all the money you have invested in your mouth, with your porcelain veneers which have hopefully given you a beautiful smile. Let me explain why this is important.

Have you ever wondered how all of your teeth seem to get into the right positions? Each tooth touches the teeth on either side with just the right amount of force to keep food from packing in those spaces. And then when you close your mouth, each tooth on your upper jaw meets each tooth on your lower jaw at exactly the same time, so they all fit and you can clench all your teeth together. The way your body accomplishes this is that there are drifting forces built into the positions of the teeth. When your teeth erupt, they keep going until they hit something, and then they stop. And then your back teeth have a tendency to drift forward until they hit something, which keeps the adjacent teeth touching each other.

If you have a missing tooth, that completely screws up the system. So what happens, if you’re missing an upper first molar (which is the second tooth from the  back) is that the tooth behind it will tip into that space, and the lower first molar will drift up looking for its mate on the upper jaw. This has several bad effects. First of all, it throws your bite out of harmony, and this is one of the main causes of TMJ disorder. It can result in spasms of the jaw muscles and headache pain. Second, it affects the long-term health of these other teeth. When the lower tooth super-erupts, it comes out of the bone somewhat and now that tooth is weaker because it has much less bony support. And when teeth start to tip, they form food traps and create other difficulties in keeping the teeth clean. Additionally, this creates unnatural angled stresses on the teeth which leads to vertical bone loss, which also weakens the teeth.

The first molars are anchor teeth, and when one of them is allowed to stay missing, it will disrupt your entire bite on that side of the mouth. If a second molar is missing, it may only compromise the companion tooth on the opposite arch. The reason for that is that there is no tooth behind it to tip into the space.

But you don’t have to replace the missing tooth with a dental implant. A dental bridge would also work fine. And if that is too expensive for you, I would at least put in a removable clip-in tooth, such as a flipper or other type of removable partial denture.

I’ve heard that dental implants can cause bone erosion. I am 60 years old and have always been in pretty good dental health. But a few years ago, I had to have two teeth extracted. And now it seems like I have one tooth standing all by itself and there is space on each side and the gum looks like it is receding in the area around the lone tooth. Do you think I should get a dental bridge?

- Janice from Michigan

Janice,

Dental implants actually prevent the erosion of bone or what is otherwise known as bone resorption. But you are correct that when you are missing teeth your body resorbs the minerals to be used elsewhere in the body which in turn causes bone loss. This process also contributes to the receding of your gumline that you mentioned and is not surprising after you have been missing teeth for a couple of years.

One of the great things about a dental implant is that when it is used to replace a tooth, the body senses the implant is there and will not dissolve away the bone. So implants actually prevent bone loss.

Although, based on what you have described it doesn’t necessarily mean that dental implants are your best option. There are many factors that will come into play like how much bone you actually have left in that area, the location of surrounding nerves, where your sinuses are, and other issues. It would be beneficial in your decision-making process to meet with an experienced implant dentist. He or she would be able to give you specific recommendations for your case. If the implant doesn’t sound like it will work well, a dental bridge should work just fine.

This post is sponsored by Cleveland implant dentist Hylan Dental Care.

Related links: facial collapse, dental implant vs. bridge