Edentulism

By: American Association of Oral and Maxillofacial Surgeons

Edentulism is the condition defined by the loss of at least one functional tooth. It can be classified as partial edentulism (one or more lost teeth) to complete edentulism (when a patient has lost all teeth). Whether due to decay, periodontal disease, or trauma, edentulism has a significant effect on a patient’s oral health. 

While there are many solutions to replace a patient’s missing teeth, dental implants are the only potentially long-term solution to this lifelong problem.  

Why Replace Missing Teeth 

For many patients, the thought of missing one or more teeth is a cosmetic issue. Smiling with one or more missing teeth might be embarrassing, but edentulism poses much greater risks. Missing one or more teeth can lead to: 

  • Impaired chewing ability and bite strength, limiting food choices, which could lead to a lower intake of fruits, vegetables, fiber, and carotene in favor of increased cholesterol and saturated fat.
  • Bone loss that impacts the soft-tissue profile of the mouth and face. 
  • Exacerbated jaw joint and TMJ problems (in patients prone to joint issues) due to missing teeth – especially the back teeth. 
  • Increased rates of chronic inflammation causing changes in the lining of the stomach. 
  • Increased rates of peptic or duodenal ulcers. 
  • Increased risk of noninsulin-dependent diabetes. 
  • Increased risk of chronic kidney disease. 

Edentulism also has an association with sleep-disordered breathing (such as obstructive sleep apnea). 

Treating Edentulism 

Although bridges and dentures can be used to restore the appearance and some functionality in patients with missing teeth, both will eventually need replacement and can damage the mouth. Fixed bridges can impact neighboring teeth, while dentures can lead to bone loss in the jaw. Dental implants have the following benefits:

  • Safety and long-term solution – Dental implants are a safe way to replace missing teeth and can offer a permanent solution when properly placed and cared for. 
  • One or more teeth – A single dental implant can replace one or more teeth. Patients who have lost most or all their teeth can have them replaced via full-mouth dental implants
  • Natural-looking – The dental implant procedure involves placing a titanium implant in the jawbone that fuses with the bone to create a solid anchor. An abutment and a crown are placed on top to create the appearance of a natural tooth.  
  • Restore the balance of teeth –Dental implants can help improve function and reduce unhealthy forces on the jaw joints (TMJs). 

Patients suffering from edentulism should consult an oral and maxillofacial surgeon as soon as possible to minimize the risks detailed above. While temporary solutions may help an edentulous patient’s smile, dental implants offer a long-term solution to missing teeth. 

Article source: https://myoms.org/what-we-do/dental-implant-surgery/edentulism/

Corrective Jaw Surgery

By: American Association of Oral and Maxillofacial Surgeons

Corrective jaw surgery – also called orthognathic surgery – is performed by an oral and maxillofacial surgeon (OMS) to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth. Surgery can improve breathing, chewing, and speaking. While the patient’s appearance may be dramatically enhanced as a result of the surgery, orthognathic surgery is performed to correct functional problems.

The following are some of the conditions that may indicate the need for corrective jaw surgery:

  • Difficulty chewing or biting food
  • Difficulty swallowing
  • Chronic jaw or jaw joint (TMJ) pain and headaches
  • Excessive wear of the teeth
  • Open bite (space between the upper and lower teeth when the mouth is closed)
  • Unbalanced facial appearance from the front or side
  • Facial injury
  • Birth defects
  • Receding lower jaw and chin
  • Protruding jaw
  • Inability to make the lips meet without straining
  • Chronic mouth breathing
  • Sleep apnea (breathing problems when sleeping, including snoring)

Your dentist, orthodontist, and OMS will work together to determine whether you are a candidate for orthognathic surgery. The oral and maxillofacial surgeon determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your OMS and orthodontist understand this is a long-term commitment for you and your family, and they will try to realistically estimate the time required for your treatment.

Article source: https://myoms.org/what-we-do/corrective-jaw-surgery/

Is Removal of All 4 Wisdom Teeth Necessary?

By: American Association of Oral and Maxillofacial Surgeons

Patients often ask their oral and maxillofacial surgeon (OMS) if it’s necessary to have all four wisdom teeth extracted even though the teeth might not yet be visible inside the mouth or they have erupted without any known problems.

The decision can be difficult. Even if all four wisdom teeth are free of infection and not causing pain – or if only one tooth is problematic – an OMS may still recommend they all be removed.

Wisdom Teeth Management: Why Remove All 4

Because of their location in the back of the mouth, wisdom teeth are frequently difficult to keep free from plaque and food and might trap harmful bacteria that can contribute to gum disease, decay, and infection. Even wisdom teeth that are buried under the gum tissue may cause these same issues.

But why not adopt a wait-and-see approach to wisdom teeth coming in (or yet to erupt) that haven’t caused any trouble? Here are some items to consider:

  • Typically, it is easier to remove wisdom teeth in younger patients because the roots of the wisdom teeth are not completely formed, the surrounding bone is softer and there is less chance of damaging nearby nerves or other structures. The overall risk of surgical complications is more common in adulthood.
  • Each visit will take more of a patient’s time, including time off from school or work.
  • Each additional visit for a tooth extraction requires an additional healing period with a restricted diet.
  • Properly caring for any remaining wisdom teeth requires routine inspections and X-rays.
  • It can be more expensive to visit an OMS multiple times for additional wisdom tooth extractions should they become problematic later.

For these reasons, you and your oral surgeon should discuss whether you should have all four wisdom teeth extracted at the same time.

Risks of Keeping Wisdom Teeth

The decision not to extract wisdom teeth is reasonable in some circumstances and should be made by the patient, a guardian/parent (if applicable), and the oral and maxillofacial surgeon. However, the patient must understand the wisdom teeth that are not removed can:

  • Cause damage to neighboring teeth.
  • Develop pathologies such as cysts, abscesses, and tumors.
  • Develop cavities that can’t be restored.
  • Lead to infections and other periodontal diseases.

Learn More from an OMS

Questions about wisdom tooth removal should be discussed with a patient’s oral and maxillofacial surgeon. Your local OMS will evaluate each patient individually and make a recommendation based on disease or high risk of disease.

We recommend regular checkups with your general dentists, who may recommend a referral to an oral surgeon if problems with the wisdom teeth or other teeth begin to develop.

Source: https://myoms.org/what-we-do/wisdom-teeth-management/why-remove-all-4/

What is Diastema?

By: Jayne Leonard, Medical News Today

A diastema is a gap between the teeth. It is not harmful, and it appears in children and adults. In children, the gap typically closes when their permanent teeth come through.

A diastema is a gap between teeth that is wider than 0.5 millimeters. It can develop between any teeth.

Treatment is not usually necessary for medical reasons. But if a person dislikes the appearance of their diastema, it is possible to close or narrow the gap.

In this article, we explore the causes of diastemas and describe their treatment and prevention.

Causes

A diastema may result from the following:

The size of the teeth in relation to the jawbone

If a person’s teeth are too small, relative to the size of their jawbone, gaps may develop between the teeth.

Jawbone and tooth sizes can be genetic, which is one reason that diastemas can run in families.

Missing or undersized teeth

If some teeth are missing or smaller than others, a diastema can develop.

This often involves the upper lateral incisors — the teeth to either side of the two upper front teeth. If the upper lateral incisors are missing or relatively small, a gap can develop between the two front teeth.

Oversized labial frenum

The labial frenum is the tissue that extends from the inside of the upper lip to the gum above the upper front teeth.

If this tissue is especially large, it can cause a gap to form between these teeth.

Gum disease

Tooth migration is a typical sign of advanced gum disease.

In people with gum disease, inflammation results in damage to the bone that supports the teeth.

Eventually, the teeth may become loose, and gaps can appear.

Incorrect swallowing reflex

When the swallowing reflex happens correctly, the tongue presses against the roof of the mouth.

A person may instead push their tongue against their front teeth when they swallow. Over time, this repetitive pressure against the front teeth pushes them forward, causing a gap to form.

Habits

Thumb sucking, lip sucking, tongue thrusting, and similar habits can put pressure on the front teeth, pushing them forward.

This can lead to diastemas.

Loss of primary teeth

Children can develop temporary diastemas when their primary teeth, or baby teeth, fall out. When their permanent, or adult, teeth come in, these gaps typically close.

This type of gap is common enough that dentists consider it to be a normal developmental phenomenon in children. No treatment is usually necessary.

A 2012 study reports older findings that these diastemas may be present in approximately two-thirds of children in whom only the central incisors have erupted. The central incisors are the two flat teeth at the front of the upper jaw.

Symptoms

The only indication of a diastema is a visible gap between teeth.

If the teeth become loose because of gum disease, the person may experience pain and discomfort, especially while eating.

Other symptoms of gum disease include:

  • bright red gums
  • swollen, tender gums
  • bleeding gums
  • receding gums
  • bad breath
  • loose teeth

Diagnosis

Diagnosis of a diastema is straightforward — the dentist spots the gap while examining the teeth.

Typically, the individual will notice the gap first, while brushing or flossing.

Treatment

Treatment for a diastema may not be necessary — especially if the gap arises from a mismatch between the size of the teeth and the jawbone, or if it results from the loss of primary teeth.

If treatment is not medically necessary, but the person wishes to close the gap for aesthetic reasons, a dentist can help determine the best approach.

Treatment options include:

Braces

Dentists commonly treat diastemas with braces. The braces put pressure on the teeth, closing the gap over time.

It may be necessary to wear a full set of braces, even if there is just one gap, because moving any teeth affects the entire mouth.

Veneers or bonding

As an alternative to braces, a dentist can fit veneers or perform dental bonding.

These options may be especially suitable if the diastema results from having smaller teeth.

Dental bonding involves applying resin to the surface of the teeth, then hardening the resin with a light source.

Fitting veneers involves securing thin, custom-made pieces of porcelain to the surface of the teeth.

Dental implants or a bridge

If a diastema exists because the person is missing teeth, they may need more extensive dental work, such as implants or a dental bridge.

Placing dental implants involves inserting metal screws into the jawbone and attaching the replacement teeth.

A dental bridge is a false tooth held in place by a device that attaches to the teeth on either side of the gap.

Surgery

When a diastema results from an oversized labial frenum, the dentist may recommend a frenectomy — a procedure to remove the excess tissue.

Older children and adults may then require braces or another treatment to close the gap. In younger children, the space may close on its own.

Gum disease treatment

Gum disease requires treatment to stop the infection and prevent complications such as tooth loss.

Treatment may include scaling to remove tartar from the gums. Scaling also removes the bacteria causing the infection. In addition, topical or oral antibiotics may help.

In severe cases, surgery may be necessary to remove deep tartar from beneath the gums.

Once the gums are healthy again, the dentist may use one of the above treatments to close the gap.

Prevention

It is not possible to prevent all cases of diastema.

However, if gum disease or habits are the cause, it can help to practice good oral hygiene, by:

  • brushing the teeth twice daily
  • flossing daily
  • seeing a dentist for regular examinations and cleanings
  • avoiding thumb sucking and helping children break the habit
  • correcting improper swallowing reflexes

Outlook

The outlook varies, depending on the underlying cause. However, treatment can eliminate or reduce most diastemas.

The gap will typically remain closed after treatment, unless the individual returns to habits such as thumb sucking or does not follow their dentist’s instructions.

When to see a dentist

People should speak to their dentists if they or their child have a diastema and are concerned about it.

The American Association of Orthodontists recommend that orthodontists evaluate all children by the age of 7.

A dentist or orthodontist can diagnose the underlying cause and, if necessary, recommend a course of treatment.

Summary

A diastema is a gap between the teeth.

A range of factors can cause a diastema — from gum disease to the ratio of tooth size to jawbone size. A dentist can determine the exact cause.

In many cases, treatment is not necessary. Some people decide to have treatment anyway, for aesthetic reasons.

There are many methods of treating a diastema, and the results are usually permanent.

Article source: https://www.medicalnewstoday.com/articles/diastema#prevention

Dentist or Detective? Major Health Clues Your Mouth Provides

Chew on this for a minute: just by glancing inside your mouth, your dentist can tell you a number of things that may be news to you and your doctor! Surprising as it may sound, your oral health can speak volumes about the rest of your body, and something as simple as a routine dental checkup can benefit your health and wallet big time.

🔎 From harmful habits to life-threatening diseases, find out what clues your mouth can provide about your wellbeing. The Oral Surgery DC Team

The Presence of Disease

Many connections between your mouth and larger health issues have to do with bacteria. Studies have shown that heart disease and endocarditis (inflammation of the lining of your heart), in particular, are linked to gum disease – a bacterial infection of the mouth. Inflamed gums can also signal a vulnerable immune system, which can be due to diabetes or disorders such as Sjogren’s syndrome. Furthermore, patients who are pregnant and are diagnosed with periodontitis may be at a heightened risk for birth-related issues, as studies have shown a connection between gum disease and both premature birth and low birth weight.

In addition to gum problems, other oral matters are also telling. Tooth loss, for instance, has commonly been linked with both osteoporosis and Alzheimer’s. And lesions of the throat occur often in individuals suffering from HIV or AIDS. Last but not least, a dental exam can detect both oral and throat cancer, which typically present themselves via sores or patches that don’t go away. Suffice it to say, dental checkups can prove themselves invaluable when it comes to early detection of life-threatening health conditions.

Incompatibility With Certain Medications

While you may already be aware of and treating a health condition, a dentist can help identify whether or not the medicine you are taking is causing other complications. Dry mouth, a condition that causes oral issues such as halitosis, fungal infection, and tooth decay, is a known side effect of hundreds of commonly prescribed medications including:

PainkillersAntibioticsAntidepressants
AntihistaminesAsthma InhalersDiuretics
SedativesCorticosteroidsStatins

If you’re currently undergoing medical treatment and/or using prescription drugs, be sure to have your dentist examine your mouth for any harmful side effects.

Harmful Habits

It may not necessarily mean life or death, but some habits can cause a world of trouble–and costly mouth problems are proof of that. How you sleep, for example, has a direct impact on the health of your mouth. Constantly breathing with your mouth open can cause dry mouth, and grinding your teeth overnight is a leading cause of enamel damage.

Smoking, chewing and other forms of tobacco use pose serious threats, not just to your lungs, but also to the look and health of your teeth and gums. Red flags that alert your dentist that smoking is starting to do dental damage (and possibly much worse) are the telltale yellowing of teeth, white patches along the inside lining of the mouth, persistent bad breath, and lumps that can signal oral cancer.

Finally, your mouth can offer clues about the safety and healthfulness of your diet. Severe tooth erosion and swelling of the throat and salivary glands are typical problems seen in patients with eating disorders, due to constant vomiting. Tooth decay and sensitivity can also come with excessive acid in your diet, and many times, signs and symptoms of gastroesophageal reflux disease (“GERD” or simply, “acid reflux”) become apparent to your dentist even before your doctor. Even your breath can be telling of certain food choices, such as garlic or onions, which have long been known to cause halitosis.

Get Peace of Mind

Given everything a brief dental exam can uncover, there’s no denying the benefits of a routine checkup. More often than not, tooth, gum and other oral problems may simply be due to poor hygiene, but it’s better to be safe than sorry. Remain diligent about seeing your dentist regularly, and don’t hesitate to schedule a checkup in between your typical visits if you notice anything amiss.

Sources:

Your Mouth, Your Health. (2015, July 23). Retrieved July 25, 2015, from http://www.webmd.com/oral-health/ss/slideshow-teeth-gums

What conditions may be linked to oral health? (2013, May 11). Retrieved July 14, 2015 from http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475?pg=2


The Story on Soda: Your Soft Drink Questions Answered

🥤 Sorry to burst your bubble, but the reality is that no matter how refreshing that sweet, fizzy soda (or “pop”) tastes, there’s a chance it could be doing some damage to your teeth. But with so many products on the market, are they all really that bad for you? The Oral Surgery DC Team

Answers to some of your most pressing soft drink questions are about to be answered. Get to the bottom of various soda claims, and find out if there’s a workaround that lets you keep your favorite carbonated beverages on tap without traumatizing your teeth.

Q. Is it better to choose clear-colored sodas over darker-colored ones?

Neither option is a healthy choice for your teeth, but upon regular consumption, caramel-hued soft drinks have been known to stain teeth more quickly. Cosmetic differences aside, the extremely high sugar content of any soda, regardless of color, causes lasting damage to tooth enamel, resulting in decay, cavities and/or tooth loss in extreme situations.

Q. Do diet sodas get a pass since they’re sugar-free?

The appeal of diet sodas is understandable, especially when the packaging comes with alluring labels of “sugar-free” or “calorie-free”. But the fact of the matter is, even with sugar substitutes, diet soda is still extremely acidic. This means diet soda will still have the same corrosive effect on the enamel and should be avoided to prevent tooth damage.

Q. Is corn syrup a more harmful soft drink sweetener than cane sugar?

Similar to the misconception about diet sodas, the threat of tooth decay, cavities, and other oral health problems aren’t based on the type of sweetener used. No matter the source of sugar, enamel erosion will happen with regular consumption of any sweetened soft drink.

Q. If I drink soda through a straw, will this protect my teeth?

Using a straw can limit contact of sugar and acid with the surface of your teeth, but only when positioned correctly. Ideally, the opening of the straw should be directed towards the back of the mouth, but the likelihood of accidental contact is still high if you become distracted or inadvertently swish the liquid in your mouth. Ultimately, the best way to prevent tooth decay due to soft drinks is to avoid drinking them altogether.

Q. What are teeth-friendly alternatives to soda?

If you find carbonated beverages especially refreshing, switch to a seltzer. You’ll get the same fizz without the threat of tooth decay. For a flavorful spin, dress up seltzer or plain water with cut-up fruit (instead of turning to juice, which can erode tooth enamel due to its fructose content). Milk is also another good choice due to the enamel-fortifying calcium it contains; however, it does contain natural sugar, lactose — so never have a glass before bed without brushing your teeth.

Q. What can I do to combat enamel erosion if I can’t quit drinking soda?

For those unable to put aside their love of soft drinks, take these steps to minimize tooth decay and other soda-related oral problems:

  • Rinse your mouth and brush your teeth afterward to clear away sugar and acid
  • Use fluoride-rich toothpaste and mouthwash to help strengthen tooth enamel
  • See your dentist regularly to get professional help in preventing tooth damage

Speak To Your Dentist

New drinks are always hitting the shelves, but many may not live up to their health claims. Before making something your beverage of choice, get your dentist’s perspective to understand how it can impact the health of your teeth.

Sources:

Soda or Pop? It’s Teeth Trouble by Any Name. (n.d.). Retrieved May 24, 3015 from http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Oral-Hygiene/Oral-Hygiene-Basics/article/Soda-or-Pop-Its-Teeth-Trouble-by-Any-Name.cvsp

Melnick, M & Klein, S. (2013, March 13). Soda Myths: The Truth About Sugary Drinks, From Sodas To Sports Drinks. Retrieved May 25, 2015 from http://www.huffingtonpost.com/2013/03/13/soda-myths-facts-sugary-drinks_n_2863045.html

Black History Month Spotlight: Dr. Annie Elizabeth “Bessie” Delany

For Black History Month, we’d like to pay tribute to trailblazers and honor lesser-known people of color in the dental and oral surgery fields. 

In 1919, Dr. Annie Elizabeth “Bessie” Delany entered the freshman class at Columbia University College of Dental Medicine (at the time known as the School of Dental and Oral Surgery) where she was one of only 11 women, and the only African-American woman, out of 170 students. 🎓 In 1923, she graduated and became the second African-American dentist to be licensed in New York state. 

During her career, Dr.  Delany took care of the teeth of many Harlem notable figures, such as nightclub owner Ed Small, civil rights leader Louis T. Wright, and author James Weldon Johnson. 🦷 Known in her community as Dr. Bessie, she was applauded for treating the rich and poor equally as well as performing thousands of free children’s dental exams. 

🏆 In 1994, Columbia’s School of Dental and Oral Surgery awarded her its Distinguished Alumna Award for “her pioneering work as a minority woman in dentistry”, a year before her death at 104.