Wisdom teeth: are a third set of molars in back of your mouth. They usually come in between the age of 17 and 25. Wisdom teeth extraction is one of the most common forms of oral surgery in dentistry along with other teeth. Sometimes Impacted wisdom teeth (Hidden in jaw) don’t cause any symptoms. Wisdom teeth which come in crooked can lead to painful crowding and disease. The only way your dentist will know they are impacted is from examining your regular dental x rays.

Teeth removed before age of 20 have less developed roots and fewer complications. American Dental association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.

Sometimes they can cause problems like following:

• Jaw pain
• Swelling around gums and jaw
• Bleeding gum
• Bad breath
• Difficulty opening mouth
• Unpleasant taste in your mouth

Reasons for removing wisdom teeth

1. Extensive Tooth Decay: Wisdom teeth gets cavities very easily as most of the people miss brushing that far in their mouth leading to caries and eventually tooth decay.                                                                                                                                                     
2. Tilted / Erupted Sideways: Wisdom teeth erupting at wrong angle start putting pressure on crown or roots of adjacent tooth which will eventually damage the neighbouring tooth. Routine dental checkup and x rays can help Dentist find that out for patient and extract the tooth before further damage to neighbouring tooth.
3. Pericoronitis: Tooth partially covered by gums has more chances of infection as food gets trapped under the gums easily leading to inflammation of gums around the tooth and decay eventually.
4. Impacted tooth: which means tooth hasn’t erupted in mouth properly as space is not enough and its hidden in the jaw completely or partially.
5. Cyst: unerupted wisdom tooth can be enclosed in a cyst which can damage the nerves around in that area.
6. Preventive efforts: Just because your wisdom teeth are not a source of pain doesn’t mean there is nothing wrong. There can be various reasons why your dentist wants to remove them like there is not enough space for wisdom teeth to erupt as your mouth is small and wisdom teeth can cause crowding and complications.

Impaction: Different kinds

Impaction of wisdom teeth means they are not erupted all the way into your mouth. Wisdom teeth can be impacted in different ways like:

• Mesial impaction: tooth is angled towards front of the mouth.

This is most common type of impaction.

• Vertical impaction: tooth is erupting straight but there is not enough space in the mouth to accommodate.
• Horizontal impaction: tooth is lying on its side in the jaw.
• Distal: tooth is tilted towards the back of the mouth
• Soft tissue impaction: tooth has erupted through the mouth.
• Bony impaction: tooth is still in the bone but has emerged through the gum.

Removal of wisdom teeth: different ways

Local anesthesia: Tooth which is fully visible in mouth is removed by simple procedure which involves numbing the area with anaesthesia and taking the tooth out. You should feel alert again shortly after the procedure.

IV Sedation: Surgeon will numb your mouth and also give you drugs through vein in your arm to make you drowsy. You might sleep through out the procedure.

General anesthesia: You get drugs through the vein or breath gas in your mask and you sleep through out the procedure.

Your dentist might have to cut through gum and bone to remove the tooth. Sutures might be placed to seal the wound if needed. Gauze is placed to control bleeding after extraction.

What to expect after surgery

In most of the cases, the recovery lasts only few days. The dentist usually prescribes some pain killers and antibiotics if needed.

These tips can help in better healing

1. Bite gently on gauze for an hour. Change it if soaked in blood. If there is continuous bleeding see the dentist or go to the emergency. Your dentist would have given you the list to follow after the tooth removal.
2. Use ice pack outside your cheek for 15 to 20 mins at a time for the first 24 hours. Ask your dentist for more details on using it.
3. While your mouth is numb, try not to bite your cheek, lip or tongue.
4. Relax and limit your physical activity as it may increase bleeding.
5. Eat soft food like soup, pudding, pasta etc. Avoid hard crunchy, spicy food for few days.
6. Do not use straw for few days. Sucking can loosen blood clot and delay healing.
7. After 24 hours gently use warm salt water several times a day to reduce pain and swelling. This also keeps the extraction site clean.
8. Do not smoke for at least 24 hours after surgery. Smoking decreases the blood supply and delays the healing process.
9. Maintain good oral hygiene by brushing your teeth and tongue carefully.
10. The dentist will remove the stiches after few days if needed.

Tooth Decay

Tooth decay is also known as dental caries or cavities.

Anatomy of a tooth:

A tooth has outer Enamel followed by Dentin and Pulp, Cementum covers the root portion.

The Enamel is the hardest structure of the tooth.

The Dentin has the sensory nerve endings.

The Pulp is the innermost part which contains the blood vessels and nerves.

How tooth decay occurs:

Bacteria causes the breakdown of the hard tissues of the tooth, the enamel, dentin or the cementum. For tooth decay to occur there should be three factors which include, Bacteria, tooth and time. The acid produced by the interaction of bacteria and food causes demineralization of the tooth.

How do you know you have a cavity?

The early stages of tooth decay do not have any symptoms. The earliest carious lesions appear as a white chalky spot, which turns to brown and later on to black. When the cavity turns black there will be a definite cavity. By this time the cavity may be a little sensitive and if ignored further might result in constant pain that is not reversible.

Signs and Symptoms:

1. White, brown or black spot on tooth
2. Tooth may be soft.
3. Tooth may be sensitive to hot, cold or sweets.
4. Pain which can be momentary or sometimes prolonged.
5. Sudden fracture of tooth due to internal decay.
6. Foul taste in mouth.
7. Pain while chewing which can be sharp, acute or dull and throbbing.

How to prevent tooth decay:

1. Brush twice a day – Brush your teeth at least twice a day with the proper brushing technique. Give enough time for brushing both the inside and outside of the tooth surfaces. Two minutes is the minimum time you should devote to brushing. Using a toothpaste that contains fluoride is helpful in the prevention of cavities as it hardens the enamel.
2. Floss – Floss at least once a day preferably before going to bed. Flossing dislodges any food debris stuck between the teeth where the toothbrush cannot reach.
3. Rinse – After eating it is helpful to rinse with water to clean the mouth when a toothbrush is not available.
4. Eat Healthy – Eating healthy food such as fruits and vegetables. The food rich in fiber cleanses the teeth and also increase saliva which keep the mouth clean. Food like chocolate, candies and chips can remain in the grooves and pits on the teeth and cause decay. Also avoid sugary liquids like pop which can weaken the tooth enamel.
5. Frequency of eating – Every time you eat the reaction between the bacteria and food causes acid, making it more likely to get a cavity.
6. Dental Sealants- Some teeth have deeper grooves and pits than normal. These regions act as retentive spots for food and are highly prone for cavities. Dentists then decide to put sealants, a liquid which flows into these grooves and hardens to prevent cavities.
7. Fluoride Treatments – Dentists might recommend some professional fluoride application in those people who have higher tendency to develop cavities.
8. Visit your Dentist regularly – Regular dental check-ups and cleanings are important in detecting and preventing early caries.

Gum Disease

This is one of the most common form of diseases in the oral cavity. This is also one of the most neglected one as the patient does not have pain.

How do I know that I have Gum Disease?

If you have one or more of the following signs and

symptoms you are probably suffering from

a gum disease:

1. Red, swollen and tender gums.
2. Bleeding while brushing teeth or flossing.
3. Bad breath.
4. Pus draining from the gums.
5. Bad taste in the mouth.
6. Loose teeth.
7. Mild pain at times.
8. Receding gum line with sometimes sensitive teeth.

What happens to a person with gum disease?

There is an inflammation of the gums which is caused by plaque. Plaque is a soft sticky film that build around the teeth and has millions of bacteria. If the plaque is not promptly removed the gum inflammation worsens and affects the bone surrounding the teeth. The bone gets resorbed due to infection and the tooth becomes loose. If not treated immediately the tooth might be soon lost.

How can the gum disease be treated?

1 Proper brushing and flossing can reverse the very early stages of gum disease.

2 Professional cleaning is done by the Hygienist who removes the hardened plaque which is known as tartar. Tartar built up below the gum is not reachable by the tooth brush.

The Hygienist with special instruments reaches these spots and cleans them.

Professional Dental cleaning is recommended every four to six months. The factors that affect the duration of the cleaning are:

1. Amount of tartar present.
2. Location of tartar. (Above or below the gums)
3. Personal hygiene -Brushing, flossing.
4. General health of person.
5. Age of person.
6. Diet

Other factors that affect gum disease

There are other systemic factors that can affect or contribute to gum disease.

They are:

1 Diabetes

2 Smoking

3 Hormonal fluctuations

4 Nutritional deficiency

5 Puberty

6 Stress

7 Genetics

8 Aging

9 Certain medications

10 Diseases like HIV

How can you prevent?

1. By maintaining good oral hygiene.
2. By proper brushing and flossing regularly.
3. Going for regular check up with the dentist.
4. By getting teeth cleaned regularly by dental hygienist                 .
5. By maintaining good overall health.

Nowadays, dental diseases have a greater impact on the total body health of the people. The number of persons suffering from dental issues increases day by day. This is due to the unhealthy intake of foods such as junk foods, chocolates, cold food items etc. The treatment that is provided to prevent dental issues is commonly known as dentistry. This will help people to maintain the optimal health of their teeth, jaws, and gums. Maintaining a good dental health is very important for everyone.

A person those who provide treatment for dental issues are called as a dentist. A dental surgeon is a person who is a specialist in dentistry. A dental surgeon can diagnose, prevent and give treatment for any kind of dental problems. A dental surgeon checks up patient’s teeth and tissues in the month in order to diagnose the problem and then provide treatment to the problem that the patient suffers from.

There are different kinds of treatments are provided to dental problems. Some common dental treatments includes

• Removing tooth decay
• Filling cavities
• Repairing damaged teeth and
• Removing teeth and some other treatments

But these are the advanced dental treatments. These treatments are provided to patients when they are suffering from a serious dental problem.

There are several types of dental surgeons are there who are a specialist in some particular treatment.

Orthodontists – These surgeons straighten the teeth of a patient with the help of devices such as braces and retainers.

Oral and maxillofacial surgeon – These surgeons perform the operation on the mouth and jaws of a patient.

Pediatric dentists – They are dental surgeons who treat children

Periodontists – these types of dental doctors treat gums and the bone which give strength to the teeth

Prosthodontists – These specialist change missing teeth with dentures and bridges

Endodontists – Specialists those who perform root canal therapy

Public health dentists – Doctors those who promote good dental health among people

Oral pathologists – Doctors who diagnose oral conditions and diseases

Oral and maxillofacial radiologists – These are specialists those who diagnose diseases in the head and neck using imaging technologies

These doctors provide a range of corrective and preventative services, such as straightening, repairing and removing decay from teeth, in addition to providing instruction regarding diet, flossing and other keys to good oral health. A Dentist treats patients those who come for basic check-ups or issues based on the condition their teeth and gums.

In addition to providing protective care and treatment, dentist surgeon help instructs patients on how to manage their dental health. Dentists hold doctoral or professional degrees and often operate their own practices. These dental surgeons help patients to keep their teeth and mouth clean and healthy. With the help of a dental doctor, people can overcome any kind of dental issues they face in their day to day life.

Dental surgeons help people to achieve the greatest smile on their face. Similarly, dental hospitals and doctors are available in anywhere for the people. Patients can visit those dental hospitals and doctors to cure any issues that spoil their oral health.

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