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Posts for: April, 2021

WhetherVotingforaCandidateorWisdomTeethYouCanChooseWisely

During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.

With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”

That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.

Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.

Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.

Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.

But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.

This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.

Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.

If you would like more information about what's best to do about wisdom teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”


4GuidelinestoHelpMakeSureYourChildsOralHealthStaysonTrack

As they mature, your child's teeth, gums and jaws develop—if all goes well, they'll all be healthy and functioning normally when they enter adulthood. But tooth decay and other problems could derail that development and cause lingering oral health issues later in life.

Following these 4 guidelines now during your child's early years will help ensure their teeth and gums have a healthy future.

Start oral hygiene early. There's no need to wait for their first teeth to come in to begin your child's regular oral hygiene. Start with wiping their gums right after feeding with a clean wet cloth to minimize bacterial development. Then, start brushing as soon as teeth appear—to begin with, use a slight smear of toothpaste on the brush. As they mature, teach them to brush and later floss for themselves.

Check your water. Most utilities add tiny traces of fluoride to their drinking water supply. If your water supplier does, it can make a big difference (along with fluoride toothpaste) in helping your child avoid tooth decay. If your system doesn't, then speak to your dentist about whether your child could benefit from topical fluoride applied directly to their teeth.

Keep a check on sugar. Decay-causing bacteria thrive on the sugar added to processed foods, candies and many beverages. Even milder forms of sugar like lactose found in milk or formula can stimulate bacterial growth. So, in addition to daily brushing and flossing, do your best to minimize sugar in your child's diet. And don't put infants or toddlers to bed with a bottle filled with any liquid other than water.

See the dentist. Starting around their first birthday, regular dental visits can help keep your child's dental development on track. Dental visits are also an opportunity for preventive treatments against decay like sealants or topical fluoride. Your dentist may also detect the early signs of bite problems that if addressed now, could lessen their impact later in life.

Your child's dental health could get off course before you even realize it. But partnering with your dentist, you can help make sure your child's teeth and gums have a bright and healthy future.

If you would like more information on how best to care for your child's 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 “Top 10 Oral Health Tips for Children.”


By Paul F Levy, DDS, PC
April 01, 2021
Category: Oral Health
Tags: osteoporosis  
CertainDrugsforOsteoporosisCouldImpactYourDentalCare

Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.

From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.

Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.

These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.

Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.

Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.

If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown.  If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.

Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.

If you would like more information on osteoporosis and dental 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 “Osteoporosis Drugs & Dental Treatment.”