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This is a topic that has received considerable attention as mandibular fractures are relatively common after trauma to the face. Fractures of the mandible (broken jaw) may be seen after any kind of trauma that generates enough force to the lower face. This may include contact sports or any other activity that places one at risk of falling or being struck by any object. Various studies have supported the findings that having third molars (wisdom teeth) present, especially if they are not completely erupted, increases the likelihood of breaking the mandible approximately 4 fold. One such study suggested that having the wisdom teeth in place only requires 60% of the force to fracture the jaw as if the teeth were not present.
According to the American Dental Association (ADA), an athlete is 60 times more likely to suffer harm to teeth when not wearing a mouthguard. While mouthguards are most commonly used for contact sports, the ADA suggests athletes might need a mouthguard when participating in any of the following activities: acrobatics, baseball, basketball, bicycling, boxing, equestrian events, extreme sports, field hockey, football, gymnastics, ice hockey, inline skating, lacrosse, martial arts, racquetball, rugby, shot-putting, skateboarding, skiing, skydiving, soccer, softball, squash, surfing, volleyball, water polo, weightlifting and wrestling. When considering a mouthguard it is important to recognize ones options. Most are familiar with the semi-custom mouth pieces which you “boil and bite”. These work well but may be a little bulky and lead to decreased use. Custom mouthguards may be made which are fabricated in a lab to exactly fit the person’s mouth. While these are more expensive, they do offer an improved fit and many people find it easier to breath well and tolerated the custom forms. The most important thing is to have a mouthguard in place, whether custom or semi-custom, whenever there is a chance of being struck in the face. Think of your mouthguard as cheap insurance for your teeth and jaws.
This is a great question that has a variable answer. To answer this it is best to understand how this treatment works. Botox is the brand name for a chemical that acts on nerves entering the muscles to block their communication. This creates an inability of the muscle to contract, which in turn does not allow gathering of the overlying skin causing wrinkles. So what’s an easy way to decide if Botox will work for you? Look in a mirror and scowl. You may notice that this causes vertical wrinkles between the eyebrows, commonly referred to the “11’s”. Now squint your eyes to see if the “crow’s feet” wrinkles appear on the outside of the eyes. These and other wrinkles that are caused by muscles activity are the wrinkles that are easily treated with Botox. Many people also develop wrinkles in these areas that are present even at rest which can see improvements over time. There are of course wrinkles that are not treatable with Botox, such as relaxed wrinkles under the eyes, but these can easily be treated with separate procedures. In general, Botox gives us a great nonsurgical treatment of most wrinkles around the eyes and forehead for people in their late 20’s to 60’s.
Visits to the dentist and oral surgeon can be a significant source of stress and anxiety to our patients, many times because of the fear of the unknown as they usually have not had a similar experience before. This patient is typically concerned about possible pain- specifically whether the procedure is going to hurt. The good news is that whether your procedure requires local or intravenous anesthesia, today’s technology makes it possible to perform complex surgery in the oral and maxillofacial surgery office with little or no discomfort for the patient. Knowing this should start to reduce your level of anxiety. When patients are given the option of local anesthesia or general anesthesia by the Oral and Maxillofacial Surgeon for procedures such as wisdom teeth extractions, they almost invariably choose to have a general anesthesia. This allows the patient to be completely asleep for the entire procedure which leads to a considerable more pleasant experience and less stress about the procedure. General anesthetics may be used for minor procedures as well, allowing those with dental anxiety to be at ease. Having a general anesthetic is a great and very safe option for any of us needing oral surgery procedures, especially if you are at all nervous.
Perhaps the best way to understand dental implants is to compare them to our own teeth. Our natural teeth are composed of two basic parts: the root and the crown- or the part that you see in the mouth when you smile. In a similar fashion, a dental implant restoration is composed of two parts. The actual dental implant functions as a replacement root for the lost tooth, which can then have a new crown constructed to match your own teeth. This allows for replacement of the lost tooth with a “tooth” that looks and functions like the natural tooth. These implants are also very useful to patients that have dentures. Attachments can be placed with the implants to hold the dentures in place, making it easier to talk and chew. Additional benefits that the implants provide are preservation of the bone in the jaws as well as the normal healthy contour and appearanceof the gums. These “replacement roots” are an excellent option for just about anyone missing one or more teeth and give an option for a dental restoration that can last the rest of one’s life.
The third molar is the last tooth to develop and erupt into the mouth, which usually occurs around the age of 18, give or take a few years. This can be accompanied by discomfort which may come and go in cases where there is insufficient room for the teeth to erupt, often leading to small gum infections in the area. Crowding of teeth may also be a consequence of leaving the teeth in place, and many orthodontists request their removal to facilitate the movement of the molars. Malpositioned third molars may also lead to cavities on the tooth just in front of them, and also increase the risk of developing periodontal gum disease. Most wisdom teeth are removed prior to developing symptoms when there will not be enough room in the mouth for them to fully erupt. The ideal time to remove these wisdom teeth is before the roots have fully developed. This leaves more room between the tooth roots and the nerve that gives feeling to the lower lip, generally making it a safer time to remove them with fewer risks of complications. People develop their teeth at different rates, but most people’s wisdom teeth are at the ideal stage of development for removal between 15-18 years old.
It is true that after a tooth is taken out that the bone that used to support it begins to dissolve away. This is usually a slow but progressive problem that may continue throughout one’s life. In most situations the ideal time to have an implant placed is at approximately 6 months after the tooth is removed (if not at the time of the extraction). However, there are many times when one may be unable to proceed with the procedure until several years have passed which increases the chance of bone loss in the area. Fortunately, even if there is significant loss of bone in an area that would benefit from an implant, minor bone grafting may often be used to replace the missing bone, creating a sound foundation in which to place the implant. Some people show much less bone loss than others, and even though many years may have passed, they still may have sufficient bone to proceed with the placement of the dental implant. Evaluation of the bone is one of the first things that your implant surgeon will look at when the consultation is performed, and fortunately replacement of lost bone is usually a relatively simple problem to fix.
Visits to the dentist and oral surgeon can be a significant source of stress and anxiety to our patients, many times because of the fear of the unknown as they usually have not had a similar experience before. This patient is typically concerned about possible pain- specifically whether the procedure is going to hurt. The good news is that whether your procedure requires local or intravenous anesthesia, today’s technology makes it possible to perform complex surgery in the oral and maxillofacial surgery office with little or no discomfort for the patient. Knowing this should start to reduce your level of anxiety. When patients are given the option of local anesthesia or general anesthesia by the Oral and Maxillofacial Surgeon for procedures such as wisdom teeth extractions, they almost invariably choose to have a general anesthesia. This allows the patient to be completely asleep for the entire procedure which leads to a considerable more pleasant experience and less stress about the procedure. General anesthetics may be used for minor procedures as well, allowing those with dental anxiety to be at ease. Having a general anesthetic is a great and very safe option for any of us needing oral surgery procedures, especially if you are at all nervous.
If left in the mouth, impacted wisdom teeth may damage neighboring teeth, or become infected. Because the third molar area of the mouth is difficult to clean, it is a site that invites the bacteria that leads to gum disease. Furthermore, oral bacteria may travel from your mouth through the bloodstream, where it may lead to possible systemic infections and illnesses that affect the heart, kidneys and other organs. Research has shown that once periodontal gum disease is established in the third molar areas, the problem is persistent and progressive, but may improve following extraction of the teeth. In some cases a fluid-filled cyst or tumor may form around the untreated wisdom tooth. As the cyst grows it may lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other structures. (AAOMS.org) By taking the wisdom teeth out before their development is complete, most of these problems can be prevented.
Do I still have enough bone for a dental implant?
It is true that after a tooth is taken out that the bone that used to support it begins to dissolve away. This is usually a slow but progressive problem that may continue throughout one’s life. In most situations the ideal time to have an implant placed is at approximately 6 months after the tooth is removed (if not at the time of the extraction). However, there are many times when one may be unable to proceed with the procedure until several years have passed which increases the chance of bone loss in the area. Fortunately, even if there is significant loss of bone in an area that would benefit from an implant, minor bone grafting may often be used to replace the missing bone, creating a sound foundation in which to place the implant. Some people show much less bone loss than others, and even though many years may have passed, they still may have sufficient bone to proceed with the placement of the dental implant. Evaluation of the bone is one of the first things that your implant surgeon will look at when the consultation is performed, and fortunately replacement of lost bone is usually a relatively simple problem to fix.
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