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No one really looks forward to a wisdom tooth extraction, even a straightforward one. Fortunately, you can be confident that your oral and maxillofacial surgeon has the experience and the skill to make your extraction experience as safe and comfortable as possible.

But what happens when your situation is not quite so straightforward? Dr. Theodotou and our team have the experience and the skill to diagnose and treat these more complex extractions as well.

One of the potential complications with an impacted wisdom tooth is its close proximity to the Inferior Alveolar Nerve (IAN) of the jaw.  When the roots of the impacted tooth are fully developed, they can rest very close to, put pressure on, or, in rare cases, even wrap around this nerve.

Why is this a problem? Because these nerves supply feeling to the lower lip, gums, chin, and teeth. If a nerve is damaged during extraction, a patient might be left with pain or numbness in these areas, which can affect sensation, speech, and eating. While this nerve damage is usually temporary, in rare cases it can be permanent.

But an impacted tooth, left alone, can also have serious consequences—pain, infection, and damage to neighboring teeth and bone. So what’s the answer in this complicated case?

Talk to Dr. Theodotou. We have the training and skill to detect any potential nerve involvement when you need a wisdom tooth extraction, and we have a procedure to help prevent damage to the nerve if it lies too close to the roots. The coronectomy is a specialized surgery used only to treat impacted teeth when the nerves of the lower jaw might be compromised.

What is a coronectomy, exactly? The tooth can be thought of in two distinct segments—the crown, which is the part of the tooth that rises above the gum when the tooth erupts, and the roots below, which anchor each tooth in the jaw. A “coronectomy” means the removal (“ectomy”) of the crown (“corona”) of the tooth.

In this procedure, we will divide the tooth into two parts. After making a small incision to expose the tooth, the crown will be removed, and the root section left in the jaw. When the procedure is completed, the incision in the gums will be closed with sutures. Recovery is much like recovery for any other tooth extraction.

Once the coronectomy is completed, you might be asking, “What happens to those roots that were left behind?” Another good question!

• Very rarely, the roots become infected or cause irritation to surrounding tissue and will need to be removed.
• Occasionally, root fragments can start to emerge through the gums, just as a whole tooth would. But since they must move away from the nerve in order to erupt, they can be extracted without endangering the nerve.
• The most common result? The remaining root segment becomes permanently encased by bone tissue within the jawbone, never to cause problems again.

Are there times when, even though a wisdom tooth is bordering on a nerve, this procedure might not be advisable? Yes. Infection and decay in the tooth, tooth mobility, periodontal disease near the tooth, a horizontal tooth (where sectioning the tooth could damage the nerve), and other conditions might mean that a coronectomy is not possible. In that case, Dr. Theodotou can discuss further options with you.

No one really looks forward to wisdom tooth extraction. Fortunately, even in complicated situations, your oral and maxillofacial surgeon has the experience and the skill to provide the answers you need for an extraction experience that is as safe and comfortable as possible.

Any more questions? Contact our Pooler office to see if a coronectomy is the answer for you.

If you’re feeling a bit nervous before you visit our office for a surgical procedure, we want to make your visit as worry-free as possible. We are happy to explain procedures, equipment, and sedation options so you know just how safe and comfortable your experience can be. And if X-rays are a concern, we can put your mind at ease here as well.

What Exactly Are X-rays?

Sometimes patients feel reluctant about the process of imaging because X-rays are a kind of radiation. But the fact is, radiation is all around us. We are exposed to radiation naturally from our soil and water, sun and air, as well as from modern inventions such as cell phones, WiFi, and air travel.

Why is radiation so common? Because matter throughout the universe constantly gives off energy, and the energy that is emitted is called radiation. This radiation takes two forms—as particles (which we don’t need to consider!) and as traveling rays. This second type is known as electromagnetic radiation, created by photons traveling in regular waves at the speed of light.

We are exposed to electromagnetic radiation every day, because, whether we can see them or not, these different wavelengths and frequencies create various forms of light. Radio waves, microwaves, infrared, visible, and ultraviolet light, X-rays, and gamma rays are all part of the electromagnetic light spectrum.

Different types of radiation on this spectrum have different wavelengths and different frequencies, and produce different amounts of energy. Longer wavelengths mean lower frequencies and less energy. Because X-rays have shorter wavelengths and higher frequencies than, for example, radio waves and visible light, they have more energy.

How Do Dental X-rays Work?

An X-ray machine produces a very narrow beam of X-ray photons. This beam passes through the body and captures images of our teeth and jaws on special film or digital sensors inside the mouth (intraoral X-rays), or on film or sensors located outside the mouth (extraoral X-rays). These X-ray images are also known as radiographs.

Why are X-rays able to take pictures inside our bodies? Remember that higher energy we talked about earlier? This energy enables X-rays to pass through the softer, less dense parts of our bodies, which are seen as gray background in a radiograph. But some substances in our bodies absorb X-rays, such as the calcium found in our bones and teeth. This is why they show up as sharp white images in radiographs. 

There are many medical and dental conditions which can be treated by oral surgeons. When the problem is primarily a dental one, we have several different X-ray options which can be used as necessary, including:

• Periapical X-rays, which allow us to look at one or two specific teeth from crown to root.
• Panoramic X-rays, which use a special machine to rotate around the head to create a complete two-dimensional picture of teeth and jaws.
• Cone Beam Computed Tomography, which uses an external machine to produce digital images creating a three-dimensional picture of the teeth and jaws.

Why Do We Need X-rays?

If all of our dental conditions were visible on the surface, there would be no need for X-rays. But since they are not, we use X-rays to discover such conditions as infection in a tooth’s root or bone, a decrease in bone density, and fractures or other injuries. And to properly plan treatment, we often require 3-D images, which show the spatial relationship of teeth, roots, bone, nerves, and sinuses.

Many dental procedures benefit from X-ray imaging for diagnosis and treatment planning, among them:

• Extraction of a seriously decayed or damaged tooth
• Wisdom tooth extraction
• Dental implant surgery
• Treatment of traumatic injuries
• Root surgeries such as apicoectomies and root amputations, which can save a tooth when infection recurs after a root canal
• Replacement of an avulsed, or knocked out, tooth

How Do Oral Surgeons Make Sure Your X-rays Are As Safe As They Can Be?

First of all, the amount of radiation you are exposed to with a dental X-ray is very small. In fact, a typical panoramic X-ray provides roughly the same amount of radiation we are exposed to through our natural surroundings in just one day. Even so, Dr. Theodotou and our team are committed to making sure patients are exposed to as little radiation as possible.

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

The guidelines recommended for X-rays and other imaging have been designed to make sure all patients have the safest experience possible whenever they visit the dentist or the doctor. We ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• When treating children, we set exposure times based on each child’s size and age.

And now that we’ve talked about some things you might like to know,

Please Let Us Know If . . .

• You have X-rays from another doctor. We’ll let you know if your earlier X-rays might be useful, and how to transfer them. (With digital X-ray technology, this transfer can be accomplished electronically!)
• You’re pregnant, or think you might be pregnant. Even though radiation exposure is very low with dental radiographs, unless there is a dental emergency, dentists and doctors recommend against X-rays for pregnant patients.

X-rays play a vital part in helping us diagnose and treat our patients. If you have any concerns, contact our Pooler office. When it comes to making sure you’re comfortable with all of our procedures, including any X-rays that might be necessary, we’re happy to give you all the inside information!

When you leave on a trip, you probably double-check that evrything’s ready: your clothes are packed, your ticket is handy, and your passport waits patiently on top of your bag or in a special pocket.

The same level of preparedness should apply with regard to caring for your oral health when you’re about to leave home for a while. Whether you’re jumping in the car for a weekend camping trip or flying halfway across the globe for a longer stint, the tips below will help you keep your teeth healthy whil you’re away.

Prepare Ahead of Time

The key to maintaining good oral hygiene during travel is preparation. Schedule a regular dental appointment so your teeth are freshly cleaned and ready before you leave. This can identify potential issues that might cause problems while you’re away.

If you have any items on a dental “to-do” list, such as wisdom tooth removal, replacement of a filling, or orthodontic adjustment, it’s a good idea to get those procedures completed before your trip.

En Route

If you’re stuck on a long flight or trekking far into the woods, you might find yourself where there’s no sink or even a toothbrush at hand. We speak for everyone when we say that nothing is worse than a mouth that feels, shall we say, less than fresh.

A lemon wedge or Granny Smith apple slice can help freshen up your breath when you’re in need of a quick fix. Rinsing your mouth thoroughly with water can help to wash away bacteria that causes cavities and reduce that gritty sensation. If you’ve got toothpaste, put a dot on your finger or a damp washcloth to serve as a makeshift toothbrush.

Nowadays, travel-sized dental products are available at most grocery stores and pharmacies. You can find travel toothbrushes, mini mouthwashes, and pocket-sized floss to slip into your travel bag.

Colgate makes disposable mini-toothbrushes called Wisps that can help you freshen up when you may not have access to a regular toothbrush. Packing a few extra dental supplies may also be a good idea in case one gets damaged or lost.

At Your Destination

Traveling abroad can expose you to unfamiliar conditions. Some countries have compromised water sources that will make you extremely ill if ingested, even from the tiny amount of water with which you wet your toothbrush.

Minimize that risk and keep bottles of water on hand instead for rinsing your mouth and toothbrush. If your toothbrush comes in contact with contaminated water, swapping it out for a new one is the safest option.

Storing your toothbrush properly is necessary to prevent bacteria from growing on it. Place your brush in a Ziploc bag when you’re on the go and allow it to breathe once you get to a temporary destination.

Traveling near or far should be an enjoyable experience. Dental issues shouldn’t be a source of worry on your vacation. As long as you’re prepared and take precautions, your teeth can stay healthy even when they’re out of the country!

Of course, if you have any questions, don’t hesitate to contact our Pooler office.

Your opinions matter to Dr. Theodotou and our team! Our blog is meant to be an educational channel, but we always want to know what things you’re interested in learning more about. After all, our blog is here for you to enjoy!

We’d like to encourage you to send us any ideas about what you want to see more of. No idea is too small! Whether it involves a specific treatment or advice on what kind of toothpaste you should use, we’d love to hear from you about it.

To share your thoughts with us, simply leave your comments below or on our Facebook page! You can also fill out a comment card the next time you visit our Pooler office!