Reasons for Wisdom Teeth Extractions

It’s common for dentists to recommend that people have their wisdom teeth removed, but you might not understand why this is. It’s not because dentists perfunctorily recommend extractions; although safe, those aren’t a first resort. Instead, it’s because wisdom teeth often put a patient at risk for gum disease and misalignment. At All Coast Dental in Pacific Beach, we provide care to patients of all ages and provide wisdom teeth extractions as well as gum disease treatment, so we wanted to explain to patients the danger of pericoronitis.

The wisdom teeth are the largest molars, and they usually don’t erupt until a person is on the cusp of adolescence. This is a problem because modern people’s mouths usually aren’t large enough to allow their wisdom teeth to erupt fully. Instead, the wisdom teeth become impacted, which is what dentists call a tooth that is stuck and only partially exposed. This creates problems for the other teeth because the wisdom teeth are pushing on them, moving them out of place. The partly-erupted teeth also tend to be difficult to clean. Food debris gets trapped under the gum flap partially covering the teeth, which is called an operculum, and bacterial infections result. “Pericoronitis” is the term we use to refer to inflammation in the area surrounding a tooth’s crown.

During a routine cleaning, we can remove food debris from the operculum and prescribe antibiotics for an infection. But the problem is likely to recur, and even if the operculum is removed, the impacted tooth is still hard to brush and puts pressure on other teeth. Extracting an impacted tooth might be more complicated than a regular extraction if we need to make an incision in the gum, but in those cases, we will monitor the patient’s recovery and help them to understand how to care for themselves during the short period of recovery.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit All Coast Dental and fill out a contact sheet.

Periapical Abscesses

It’s never good to see signs of a gum infection. But a particular kind of infection called a periapical abscess is especially dangerous and requires urgent treatment. All Coast Dental is a provider of general and cosmetic dentistry in Pacific Beach and can assist people suffering from gum and tooth pulp problems, and we want everyone to know how to recognize the signs of advanced disease.

When a tooth is cracked or badly enough decayed, bacteria are able to enter the pulp at its center. They could then spread to its root(s) and create an abscess. An abscess is a pocket filled with pus, which is a mixture of dead material and bacterial secretions. The abscess may cause a fever, swelling, and bad taste, in addition to the pain and sensitivity in the infected tooth. Abscesses don’t heal on their own, and if the infection spreads, the patient could get sepsis.

We can safely drain an abscess and clean it out. But removing the infection will require a root canal. This means that the pulp chamber will be cleaned out and filled with sealant. In severe cases, saving the tooth might not be possible and it will have to be removed. We’ll discuss with the patient what kind of restoration would best suit their needs, but we hope everyone takes to heart the importance of preventing periapical abscesses by cleaning their teeth and protecting them from injury.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit All Coast Dental and fill out a contact sheet.

 

Diet and Enamel Erosion

Although everybody should brush and floss twice a day, some foods pose a greater risk to oral health than others. At All Coast Dental in Pacific Beach, we frequently repair decayed and eroded teeth, providing patients with crowns and veneers that are beautiful and dependable. But prosthetic teeth need to be cared for just like natural teeth, so we thought it would be a good idea to detail how diet contributes to tooth decay.

Tooth decay is caused by the acid oral bacteria produce as they metabolize sugar. Most decay-causing bacteria eat debris left over from our own food, with simple sugars being easier for them to metabolize. They have longer to feed on debris caught between teeth, so sticky food allows them to produce more acid. But there are also substances, including citric juice and soda, that are acidic in their own right and erode teeth directly. Citric juice is commonly used as a sour flavoring in candy and energy gel, so patients need to make sure they drink water to rinse it off quickly.

Some foods are likelier to trigger a different source of acid. Red meat, caffeine, alcohol, garlic, and onions may contribute to acid reflux. When this happens, acid rises from the stomach and enters the oral cavity, eroding the back teeth. Sealants can help protect teeth from acid reflux, but patients who suffer from it frequently may need to change their diets and use toothpaste for people with sensitive teeth.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit All Coast Dental and fill out a contact sheet.

 

Gum Abscesses

Are your gums red and swollen? Do you see blood when you spit toothpaste? If so, that’s common, but it’s not healthy. At All Coast Dental in Pacific Beach, we take gum disease very seriously, and want our patients to understand all of its signs and complications. We encourage you to see us for a cleaning soon if you’re experiencing gingivitis, because if left untreated, you could develop a gum abscess.

An abscess is a hollow space where pus accumulates. Pus is the mixture of bacteria, dead tissue, and acid that builds up as the result of an infection. When a person has gingivitis, which is the lesser form of gum disease, an abscess may develop near the gum line. This would be called a gingival abscess. By contrast, a periodontal abscess forms when a person has periodontitis, the more severe form of gum disease. When a gum infection is advanced, it will cause the walls of the gum pocket to loosen and recede from a tooth root. Pus could accumulate in this hollow space, leaving the patient not only in pain and with a persistent bad taste in their mouth, but also at risk of fever and jaw bone deterioration.

We can lance and drain the pus from an abscess, but to truly kill the infection, we’ll have to remove the dead tissue. X-rays will reveal whether a patient’s dental pulp is also infected, in which case they’ll need a root canal procedure. Once the infection is removed, we will smooth down the tooth’s root by a process called planing so it will be easier to clean at future appointments. Patients will also need to take antibiotics following treatment for an abscess to ensure the infection won’t return.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit All Coast Dental and fill out a contact sheet.

 

Sensitivity to Cold

Teeth may be sensitive for all sorts of reasons, but if you frequently feel sharp pains after ingesting something cold, you may be suffering from enamel erosion. We at All Coast Dental hope that our patients’ teeth are in good health and serving them well. If you dread a cold glass of water or biting into a Popsicle, read on.

The outer layer of a dental crown is made of enamel. It is the hardest substance in the human body, being made up mostly of minerals, but is unable to regenerate lost material. Below the gum line, the outer layer of a tooth is made of a substance called cementum. It is sticky but thin and provides little insulation. The middle layer of a tooth is made of dentin, a yellow-brown porous substance made up of mini tubules that lead to the dental pulp. The pulp is made up of blood vessels, connective tissue, and nerves, and heat is easily transferred out of it through dentin when a tooth is not sufficiently insulated, resulting in a shooting pain.

If a tooth is only sensitive when it comes into contact with something cold, the problem is likely thin enamel or recession of gum tissue around the root. These can be caused by oral bacteria secreting acid, or possibly from acid reflux. Brushing and flossing are crucial to preventing acidic erosion. A patient may also need a night guard to stop themselves from damaging their enamel by grinding their teeth in their sleep. We can help patients to obtain custom-fitted oral appliances and provide remineralization therapy for enamel that is in the process of eroding. Patients may also want to switch to extra-fluoridated toothpaste.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit All Coast Dental and fill out a contact sheet.

 

Smoking and Dental Pulp

Toothaches are often caused by problems in dental pulp. We at All Coast Dental in Pacific Beach are happy to assist patients and would rather save a tooth by performing a root canal then extract and replace it. But there are certain circumstances in which the internal health of a tooth may be compromised, and new research indicates that one of those circumstances is if the patient smokes.

Dental pulp inflammation (pulpitis) occurs when a tooth is injured or infected. The inflammatory response is triggered by the immune system as a means of limiting the spread of infection, concentrating white blood cells, and making cell membranes more permeable to antimicrobial peptides. An antimicrobial peptide is a molecule that latches onto and kills disease-causing bacteria, including the ones that secrete acid in the mouth. But smoking makes the immune system less effective. It was long-established in medical literature that smokers have high rates of gum disease, and now it appears that their dental pulp also lacks antimicrobial peptides.

Root canals are generally successful at removing infected dental pulp, but smokers’ suppressed immune systems make it easier for infections to return. We’ll use antibacterial treatments to increase a root canal’s likelihood of success, but we also want to share with patients that the study found antimicrobial peptides sometimes return when a patient stops smoking.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit All Coast Dental and fill out a contact sheet.

 

Problems with Fillings

One of the first dental procedures people learn about as children is the use of fillings to repair cavities. When patients suffer from small bits of decay (known as caries), a white-colored filling can repair the appearance of their smile and prevent bacteria from hiding in a cavity. But while the tooth may be sensitive immediately after the decayed material is removed, prolonged pain is not normal and is a sign that patients should come in for an examination.

When a filling is first placed, it may be shaped badly and prevent the patient from closing their jaws together. It also may not be large enough to fill in the gap. These are both rare events but need to be fixed immediately. More commonly, the filling becomes painful years after it was placed due to the normal wear and tear of chewing having worn out the seal holding it in place. Fillings are not permanent solutions; they usually last for about ten years. Of course, trauma could cause a filling to come loose sooner. When the area around a filling is painful, it is probably because bacteria has entered through the cracks in the seal and are causing more decay. The sooner an old filling is replaced, the less likely it is that a larger restoration will be necessary.

Drs. Julie and Joseph Boulos operate All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit AllCoastDental.net and fill out a contact sheet.

 

Causes of Tooth Sensitivity in Children

We welcome children at All Coast Dental and are happy to help them with tooth aches and sensitivity. As with adults, there are several different potential causes which should be investigated, but some are more likely to occur in children and could be the first sign of a more general health issue.

Teeth are usually a little sensitive when they first erupt, but this should dissipate within a few days. If a child is suffering from a persistent toothache, the most likely reason is a cavity. Also known as caries, cavities are caused by a certain type of bacteria that feeds on sugar and produces acid which then demineralizes tooth enamel.  This disease process usually can be prevented by better hygiene and reducing the frequency that a child eats foods high in fermentable carbohydrates (like candy, sugary drinks, cookies).

It is also possible that the child is brushing too hard and causing gum recession. This would leave the sensitive tooth roots exposed, which would make drinking hot and cold liquids painful. A dull ache in the upper teeth could be caused by a sinus infection. A toothache might also be caused by jaw grinding or clenching, which could also cause headaches and pain in the ear, jaw, and neck, as well as tooth damage.

Drs. Julie and Joseph Boulos practice at All Coast Dental at 2180 Garnet Ave, Suite 1-K, Pacific Beach, California, 92109. To schedule an appointment, call 858-270-4904 or visit AllCoastDental.net and fill out a contact sheet.