What You Should Know About Wisdom Teeth Extraction

Wisdom Teeth Extraction
A wisdom teeth extraction is the surgical procedure by which one or more wisdom teeth are removed. Wisdom teeth are the four permanent adult molars located at the very back of your mouth, two on top and two on the bottom. Their rather imaginative name stems from the fact that they erupt much later than the other permanent teeth (approximately between the ages of 15 and 25). The person has already achieved adulthood and is, supposedly, 'wiser'.

Many people have wisdom teeth that erupt normally and cause them no problems. However, countless others are not quite as lucky, in which case wisdom teeth extraction is the simplest course of treatment since our softer, easier to chew, processed and cooked foods have made them largely redundant. While the jury may still be out, many believe that primitive societies needed this third molar in order to be able to chew their coarser food.

While some oral surgeons and dentists recommend wisdom teeth extraction as insurance against future problems, many others are of the opinion that routine prophylactic removal is ill-advised, and wisdom teeth should only be extracted if they develop problems. Wisdom teeth that are symptomatic, i.e., aren't causing problems should be left alone. Most problems with wisdom teeth occur at the time they erupt, i.e. between the ages of 15 and 25. It is very rare that someone over the age of 30 develops any problem with these third molars. During a consultation, we will let you know whether or not yours should be removed.

When Wisdom Teeth Extractions Become Necessary
Many of the problems that surround wisdom teeth are connected with the fact that many people's jaws are not large enough to accommodate a third molar. In these cases, the tooth is said to be "impacted" which means it is so wedged in between the jawbone and the tooth beside it that it cannot emerge normally. In some cases, the wisdom tooth remains under the gums. In others, it erupts only part of the way or at an angle with the top of the tooth facing one of the two sides, or even forward or backward.

An impacted wisdom tooth can cause a number of serious problems including damage to the tooth immediately next to it, or even to the bone itself. If the tooth has only emerged slightly above the gum line, a flap of gum tissue has been known to grow over the tooth. Bacteria from food can flourish in this 'protected' area causing an infection and tooth decay. Besides which, if there isn't enough space for the tooth to erupt properly, often means that it will be hard to reach and, therefore, hard to manipulate a toothbrush around it. Thus if a wisdom tooth is impacted (doesn't have room to grow normally), causing an infection, pain or other complications, it is more than likely that you will have to have it pulled.

The Surgery
Wisdom tooth extraction is almost always performed on an outpatient basis in our clinic. However, if you are considered a high risk for complications or are having all four wisdom teeth extracted at the same time, it may be necessary to have the surgery in a hospital.

Most often, just like most other extractions, wisdom teeth are removed using a local anesthetic that will completely numb the area. Once again, should you opt to have all four teeth removed in one go, a general anesthetic may be used, in which case, you should  not eat or drink anything a certain number of hours before the surgery.  If we have to cut into the gum and remove any bone that is covering the tooth, it is likely that some stitches will be necessary. These will either dissolve over time or be removed at a later date. Regardless, we will ensure that your wisdom teeth extraction is completed in a way that allows you to relax and feel comfortable.

New York Dental Office  >  Tooth-Colored Fillings

Visit a Cosmetic Dentist to Improve the Appearance of Your Gums

As a cosmetic dentist, we are best known for the services that we provide in the realm of appearance. Our primary goal, our bread and butter if you will, consists of helping people to have a better smile. To do this, we work hard on giving you perfect teeth. As a result of the association, many of our patients know us by the work that we do and the procedures that have become common as more people visit us to discuss how their teeth look. Some of the more frequent procedures that we, as a cosmetic dentist, perform are teeth whitening to give you that perfectly white smile, straightening of teeth with braces or Invisalign, replacing of teeth with either bridges, dentures, or dental implants, and fixing teeth that are cracked, chipped or broken with dental veneers or a dental crown. While most of these have applications beyond the cosmetic, they are largely associated with how the teeth look and hence have fallen within our repertoire.

There are a couple of other procedures that we perform, which have even more crossover between the health and function of the teeth and gums, and how they look aesthetically. These are gingivectomies and gum contouring.

There are numerous, cosmetic dentist, procedures that have found use both aesthetically and in the protection of the health of a person's mouth. Among these, gingivectomies are one of the most frequently used for both. A person who has a gum diseases or periodontitis will often find that their gums become separated from their teeth as a result of the illness. This creates an extremely unattractive smile, but more importantly it creates these deep pockets within the gums that allow plaque to build up. Since it is virtually impossible to clean in these pockets, the plaque builds up and becomes a breeding ground for infections. A person who already has an existing condition does not need the added complication of frequent bacterial infections, and so we can remove these pockets. To do so, we will numb the gums around the site with a local anesthetic, so as to perform the procedure without causing discomfort. Then the loose gum tissue will be surgically removed using a scalpel, radiosurgery, or lasers. While we are removing the excess tissue, we will also be sculpting your gums. This is done to prevent your gums from losing their shape after the procedure is completed. Finally, we cover the gums with putty to allow them some time to heal and become normal again.
The gums are an integral part of the mouth. They are responsible for supporting and protecting the teeth and are also an important part of your smile. We know that when the gums get too long they can cause you to have a gummy, and hence unattractive smile. When they get too short, often as a result of gum recession or some other condition, they can expose the root and cause your teeth to appear too large. A gum contouring, done in the clinic where we would lengthen, shorten, or shape your gums, can solve any of these issues very easily and painlessly. As a cosmetic dentist, these are only some of the ways that we can improve the appearance of your gums and smile.

Dental Implant  >  Invisalign Dentist

What Does Science Have To Do With Teeth Whitening?

The science behind teeth whitening is what makes it so effective.  If you use teeth whitening as a way to brighten your teeth and give yourself a better smile, you have stumbled upon the most effective, and inexpensive, way to improve yourself. There is a solution available to you at virtually any price point. So regardless of whether you come in to see us, your teeth whitening specialist or do your whitening at home with a do it yourself kit, you can get your teeth whitened for a very affordable price. Still, the level of results you get will be based on what is happening inside of your tooth (science).
How it works.
A chemical process, teeth whitening should always be carried out with the supervision or oversight of a dentist. This is not because the products available over the counter are harmful, but working with our office can ensure that you have no conditions that could hinder the whitening or become exasperated by the teeth whitening process. Teeth whitening involves a chemical interaction between the chemicals used to whiten and your teeth's organic make up. In order to make the teeth appear whiter, we need to make them more colorless. All matter reflects natural light, bending it so that the brain sees that particular frequency as a unique color. For the teeth, this color is white. Teeth whitening products work because of the oxidization process. However, many of the solutions you buy in the store on remove surface stains and do not start the process of oxidization.
The peroxides used in our solution quickly penetrate the enamel and release free radicals into the organic make-up of the teeth. These free radicals cause the tooth to appear more colorless, and to the brain makes them appear whiter. Since this is a chemical process, it is always advisable to be under the care of a dentist before engaging in teeth whitening. It is also advisable to be careful not to overdo it when it comes to the use of these products. Repeated and frequent exposure to peroxides can cause the teeth to become overly sensitive, and may lead to other challenges.
The two main components used in the manufacture of teeth whitening solutions are carbamide peroxide and hydrogen peroxide. Typically when you are whitening at home, with a do it yourself kit, the solution is hydrogen peroxide based. In the clinic, we will use a carbamide peroxide based solution, which also contains around 35% hydrogen peroxide. Our solution is stronger and produces better results than what you can buy in the store.
Why so many people need to whiten their teeth.
Given the exposure most people have to a variety of foods that stain and discolor their teeth, whitening is a very good option. If you stop and think about the enormous amount of coffee, alone, that is consumed and the effect these gallons can have on teeth, you begin to realize the price your teeth pay for living in the fast paced modern world. On average, 54% of adults drink at least one cup of coffee each day, 68% of those within the first hour of the day. There are over 53 thousand coffee shops to serve you a pick me up, accounting for over $4 billion in imports each year. In terms of this spending a few hundred dollars to fight off the discoloring effects of the chromogen rich coffee we drink, sounds like a bargain. 

Dental Veneers  >  Cosmetic Dentist

Tooth-Colored Fillings Are Ideal For All Ages

We use tooth-colored fillings to restore our patients teeth and highly recommend them.  Many of our patients don’t understand why a filling is necessary in the first place so we get a lot of questions about it.  Contrary to popular belief, this is not an optional dental treatment but necessary for restoring the appearance and, more importantly, the functionality of a tooth.

When you eat throughout the day, sugar and bacteria are placed on your teeth and gums.  When you brush and floss, most of it is removed.  However, bacteria will often remain in the mouth, trapped in harder to reach places.  The bacteria can then create acid which will start to attack your teeth.  As it does, the tooth starts to decay or die.  How large of an area that experiences tooth decay will depend on how long you go in between teeth cleanings.  By having your teeth cleaned twice a year, we can catch and treat it right away.

In order to treat a cavity, the decayed portion of the tooth is removed.  This will leave a small or large indent or hole in your tooth.  You cannot live like that because you would experience discomfort and irritation every time that you bit down.  Instead, the tooth must be restored.  In order to do so, we will use tooth-colored fillings.  In this situation, once the decayed portion is removed the tooth needs to be cleaned. Once done, a tooth-colored ceramic material will be applied to your tooth and shaped into place.  A dental light will then be used to cause the material to harden.  Once done, you will have a durable filling that makes it possible to use your tooth like normal again.

In our dental office, we prefer to use tooth-colored fillings because of how natural they look.  The results are just as effective as traditional amalgam but when you smile, no one will see a mouth full of metal.  In fact, these fillings blend in so well that it is nearly impossible to tell which tooth ever had a cavity to begin with.  Most of our patients even forget which of their teeth were worked on.  This speaks volumes when you compare it to a smile of someone who has had a lot of amalgam fillings.

If you have a mouth full of metal currently, we can help by removing your old fillings and giving you new ones.  This procedure needs to be completed anyway since fillings are not meant to last forever.  Replacing them early simply helps to accomplish a cosmetic or appearance goal while addressing a future health need. Remember, that fillings are an essential part of restoring the tooth structure and keeping your natural teeth in place.  If you go too long without dental care, the original space that you had the filling in may expand, creating the need for a larger filling. Regular dental checkups can prevent this from happening or at least identifying if it has so that you can receive an updated filling to protect your tooth.

Oral Surgery May Be Necessary As Part of Your Orthodontics Procedure

We perform oral surgery for patients with a variety of oral health concerns.  What many people don’t realize is that when getting an orthodontics treatment, surgery is often part of the overall process. This is because when straightening your teeth, there are multiple aspects that must be addressed.  In our office, we can help you to straighten your teeth with a smile makeover or work with your orthodontist to address any challenges that they are unable to correct.

In order to understand why, it helps to understand what must be addressed when using orthodontics to straighten your teeth.  First, your teeth must be moved into position.  If you have teeth that came in crooked, there are gaps in between them, or they are behind each other, braces or aligners can typically be used to move them into position.  Before doing so, however, there must be enough room in the mouth for all of your teeth and, at times, the palate must be expanded using an oral appliance.

As a provider of oral surgery, we often work with orthodontics offices when a tooth is simply not responding to braces or aligners.  There are times, were certain teeth simply aren’t moving into position and in this situation, the only choice is to leave the tooth intact or replace it with a dental implant.  An implant functions like a natural tooth and by securing a titanium post into the jawbone, it will behave like one as well.  In fact, the body will think that the post is a natural root due to the process of osseointegration.  While we typically don’t recommend replacing your teeth for no reason, if you have undergone years of orthodontics, leaving one crooked tooth can be beyond frustrating. If this happens to you, we can finish the process by replacing the tooth with a straight and beautiful one. 

The second aspect of straightening your teeth is correcting your jaw.  If you have a misaligned jaw, it will negative influence your smile and even your facial appearance.  For example, if you have a severe overbite, underbite, or crossbite, it won’t matter how straight your teeth are, your entire appearance will still suffer.  This makes aligning your bite critical.  This can often be done by an orthodontist using oral appliances.  This is a non-invasive method and by using things like rubber bands strung from an upper to lower bracket, the jaw can start to move into position.  However, if the jaw is too far misaligned, it may not respond to oral appliances, creating the need for oral surgery.

Correcting your jaw is more important than simply improving your appearance. A misaligned jaw, can place undue pressure onto your teeth and cause damage, irritation, and even headaches.  For this reason, many people will seek to correct their jaw and oral health issues, regardless of whether or not they like their smile.  As an oral surgeon, we can examine your mouth and provide a recommendation for the steps you should take to correct your smile.  

In our office, we provide dental laminates for those that are looking to improve the appearance of their smile.  Laminates, also known as veneers, are an excellent way to create a uniform smile – one without stains, chips, cracks, etc.  They can even close gaps in between teeth and change their overall shape and size, making them incredibly versatile.  Since they are created to match the shade of your other teeth, you can use a laminate over one or all of your teeth in order to create a perfect smile.
If you are considering transforming the appearance of your smile, we invite you to call and schedule a consultation so that we can discuss the goals that you have and the best way to achieve them.  We will start the process by completing a thorough examination and taking x-rays.  This will provide us with information we need to make a recommendation regarding how to proceed.  Simultaneously, we will look for any signs of infection or cavities because health issues need to be corrected before starting any cosmetic work.  If your teeth and gums look healthy, we will make an impression of your teeth so that we can send the dental lab the information they need to create the laminates.
It can take the lab one to two weeks to prepare your dental laminate, during which time your teeth will need to be prepared.  In order to do so, we will need to remove a portion of the enamel from the surface of your teeth.  The laminate serves to replace that enamel and this process ensures that it lays flat instead of protruding out from the other teeth.  Since the enamel serves to protect your teeth, once it has been removed, a temporary will need to be worn until your permanent laminate is ready.  This is typically secured with a water-based removable glue that can easily come off when it is time to make the switch.  Given that it is designed to be removable it is important to practice caution while eating to ensure that it doesn't accidentally become dislodged.  Fortunately, it is only worn for a short time before you come back in.
Once the lab is finished completing your dental laminates, you will come back in for the bonding procedure.  In this appointment, we will check to make sure that the laminates have been created to our exact specifications and after removing your temporaries, will place them onto your teeth to double check how they look. If any small adjustments are necessary, now is the time to make them.  Next, we will place dental cement onto your tooth and secure the laminates in place, bonding them with a special dental light for strength and durability.  Once hardened, your teeth will look amazing and you can go about life eating your favorite foods and enjoying your new smile.  There are no restrictions on what you can do so long as you treat your dental laminates as though they were a natural tooth.  For example, you can't eat ice or chew a pencil now, nor should you in the future.

Cosmetic Dentist  >  New York Dental Office

Here Are the Steps For Getting Dentures Fitted

For replacing missing teeth, dentures are by far the most popular and well-known technology. This is because dentists` have been successfully replacing teeth with this method for centuries. Today there are traditionally three types of dentures that all dentists work with. These are the full, the partial denture, and the immediate denture. Today's dentures are nothing like what they used to be in the past. They are made to your specifications, look and feel like real teeth, and are no longer at risk for falling out. In order to accomplish this, your dentures will need to be custom fitted and fabricated, in a process that typically takes most people four to five visits to complete. Naturally there are exceptions since the dentures are dependent on your mouth, and sometimes there are additional steps that need to be taken. For most people, however, here is how the visits will go:

Denture visit number one could be called the examination and preparation visit. During this visit, we will be taking a lot of measurements, examining your mouth thoroughly, taking x-rays to check on the underlying bone, and ensure that your mouth and tissue are healthy enough to get dentures. Occasionally we will make recommendations, like removing the flabby tissue around the gums that may cause the dentures to be less stable.  Another example would be when we recommend that a patient consider reshaping the underlying bone so that they get an optimum fit on their dentures. We will also be taking a plaster impression of the gums, preferably without teeth, so that the laboratory has a perfect match of your gums on which to fabricate the dentures. Finally, we will go over the options that you have with regard to the size, shape, and shading of the teeth in the denture itself.
Denture visit number two is the center jaw relationship (CJR) or the maximum mandibular retrusion (MMR) visit. Basically, this visit focuses on making sure that your teeth are the correct length, that your teeth are on the right plane, and that there is the correct alignment of the upper and lower jaws. Having your jaws in alignment is critically important to the ability to speak and chew without clicking, so we will be using a loose-fitting denture base and wax rim, taking the place of teeth, to determine what length your teeth need to be. Adjustments will be made so that your jaws are properly aligned when you bite together.

Denture visit number three is the “wax try-in” visit when you will get to try on the actual plastic or porcelain teeth. The teeth will be in a loose fitting base that fits over the gums and will be embedded in wax instead of the final plastic. This enables us to see what the dentures will look like once it is completed and make adjustments to the fit as required. We can then let the lab know what adjustments are needed to create the final denture.

Denture visit number four is when you leave with a completely new set of dentures after we make a few minor adjustments to the plastic.

Tooth Extraction  >  Root Canal Treatment