Posts for: November, 2017
The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.
Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.
An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.
It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.
If you would like more information on wisdom teeth and your oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removing Wisdom Teeth.”
Millions of Americans regularly use ibuprofen to manage minor pain and swelling. As with other fields in healthcare, the drug is a mainstay in dentistry especially for post-procedural discomfort. But ibuprofen and similar drugs also have side effects that can lead to serious health problems. So, should you be concerned about its safety?
For most people, ibuprofen is safe and effective — but only if used properly. Like aspirin, ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by blocking the effect of substances called prostaglandins, released by injured or damaged tissues. NSAIDs differ in mechanism from pain relievers like steroids or narcotics and don’t have the same side effects, especially the addictive qualities and impaired consciousness potential of narcotics like morphine or codeine. While these more potent drugs are usually reserved for serious injuries or illnesses, NSAIDs like ibuprofen are ideal for mild to moderate pain following routine dental work.
The biggest concern for the use of an NSAID is its tendency to thin the blood, especially if used continuously over several weeks; this can make bleeding control more difficult after an injury. Prolonged overuse has also been linked to erosion of the stomach lining leading to ulcers or bleeding, kidney failure, early miscarriage and repeat heart attacks for patients with cardiovascular disease.
With this in mind, we recommend that adults take no more than 2,400 milligrams of ibuprofen during one twenty-four hour period for short-term pain relief unless otherwise recommended by a doctor. Research has shown that a single 400-milligram dose of ibuprofen is safe and effective for relieving even severe post-operative pain for about five hours in most people. On the other hand, we don’t recommend a NSAID during pregnancy or for people with a history of intestinal bleeding or heart attacks.
Taking into account your medical history and the procedure you’ll be undergoing, we will recommend the best pain management medication for your situation. In most cases, ibuprofen will be an effective means to reduce your discomfort level and, taken properly, will not pose a danger to your overall health.
If you would like more information on dental pain management, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Pain with Ibuprofen.”