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What is a dentist?

Dentistry has been around for hundreds and possibly thousands of years. Tools and depictions of procedures using those tools have been discovered among many different early civilizations throughout history. The field of dentistry became solidly mainstream in the 1800s when “dentists” organized their practice as a primary professional activity, rather than as one of an array of services.

Modern dentists require a medical license that is awarded after completion of a number of years of rigorous schooling. These medical professionals are taught to address the maintenance of healthy teeth and gums, though some obtain additional licenses that focus on more specific areas of oral health.

General dentistry is usually sought for cleaning and mending of slightly damaged teeth, while providing advice on future prevention of decay and other problems. As society has seen a dramatic shift in the cosmetic direction, many dental professionals have trained to offer whitening procedures as well.

Where does an oral surgeon come in?

Patients are often referred to an oral-maxillofacial surgeon if a procedure exceeds the abilities of a general dentist. While dentists are often capable of handling simple extractions, teeth that have become severely impacted usually require someone with greater expertise. In many cases, the patient will be put under sedation for the duration of the more complex procedure, and may require several days for sufficient healing.

In addition to more difficult extractions, oral surgeons commonly handle:

• Implant surgery
• Reconstructive surgery on the jaw or face to resolve problems with speech and proper function
• Corrective surgery of the jaw to improve structure and alignment
• Grafting of the bone or soft tissues in order to resolve defects and injuries
• Repair of birth defects that have affected the face or jaw

Which medical professional should you see?

Teeth are extremely important and should be treated with care. As the surface of a tooth wears down, more sensitive tissues can become exposed, and in cases where decay is allowed to continue, even the nerve can be affected.

When it comes to identifying which of these practitioners you should see, a consultation is almost always necessary if you have special concerns. Seeing Dr. Theodotou on a regular basis is highly recommended, but many clients fail to do so until they begin to experience pain or discomfort. If you are diligent in receiving routine care, though, you are more likely to prevent problems that will require the services of an oral surgeon, and will probably be happier with your smile in general.

If you were to put your toothbrush bristles under a high-powered microscope, what you would see might give you nightmares: millions of bacteria, busily crawling up and down your toothbrush bristles, consuming proteins that came from your mouth, and still clinging to the bristles even after you’ve rinsed them with water.

Rinsing your toothbrush after brushing removes some of those ferociously hungry bacteria, but not all. The American Dental Association says that bacterial infestations develop on toothbrushes within a month of daily use. The ADA also states that unless a toothbrush is sterilized before being packaged, it’s going to come with bacteria – free of charge!

Germs and Frayed Bristles: the Demise of a Toothbrush

Dr. Theodotou and our staff recommend that you toss your old toothbrush in the trash and purchase a new one every three months. Children tend to bite on their toothbrushes, which makes the bristles degrade and fray faster. Chances are kids may need to have their toothbrushes changed more frequently.

Where do they hide?

Bacteria are tenacious little germs that head for those concealed areas between toothbrush bristles. They are highly adaptable and exist in every type of extreme environment. Some people actually go so far as to put their toothbrush in a microwave for a few seconds to kill germs, but this doesn't always work either. In fact, you may only end up with a toothbrush that’s as bendable as a Gumby doll – and still covered with germs.

Feed a Cold, Starve a Fever, and Get Rid of Your Toothbrush

When you have a head cold, your mouth is teeming with bacteria gleefully roaming around, and gobbling mucus and dead skin cells. If you brush your teeth while suffering a sinus condition, the brush will act like a magnet for ravenous bacteria. Use your old toothbrush while you are sick, but as soon as you feel better, throw it away and get a new one. Otherwise you could possibly re-infect yourself with the same cold germs!

Between the huge number of toothpaste brands on the market today, the different flavors, and claims from most to do different things, it isn’t surprising that people feel so confused when it comes to something that should be as simple as buying a tube of toothpaste. This guide will help you identify the common ingredients in toothpaste, and help you understand the important factors to consider before buying toothpaste again.

Toothpaste comes in gel, paste, and powdered forms. When it comes to the type of toothpaste, the choice is more a matter of preference.

Basic Ingredients

• Abrasive Agents – Abrasive agents are the scratchy substances added to toothpastes to help in the removal of food particles, bacteria, and minor stains. Calcium carbonate is one of many abrasive materials, and arguably the most common.
• Flavor – When toothpastes are flavored, they almost always have artificial sweeteners to enhance the flavor of the toothpaste and increase the likelihood that you’ll use it. Flavors run the gamut from traditional mint to cinnamon that may appeal to adults, and bubble gum or lemon lime – flavors to target children.
• Humectants – Humectants are moisturizing agents that keep paste and gel toothpastes from drying out. Glycerol is commonly used as a humectant.
• Thickeners – Thickeners are used to give toothpaste its distinctive consistency, and to make it maintain a uniform consistency and come out of the tube easily.
• Detergents – Sodium lauryl sulfate is the most common detergent used in products that foam up, like toothpaste does in your mouth.

What to Look For in Toothpaste

Fluoride is naturally occurring mineral. It is the most important ingredient to look for in a toothpaste. Although there are people who argue against using fluoride toothpaste, dental professionals like Dr. Theodotou emphasize that the fact that the incidence of tooth decay has decreased so significantly in the past 50 years is because of fluoridated toothpaste.

The suggestion that fluoridated water gives you enough fluoride to protect your teeth is wrong. Fluoride toothpaste is the best cavity protection there is. In addition to strengthening tooth enamel and protecting teeth from acid erosion (from acidic foods and drinks,) it remineralizes the surfaces of teeth that are suffering from early acid damage and may prevent developing tooth decay from worsening.

Tartar Control

Tartar is the result of hardened plaque buildup on the teeth. Good oral hygiene and in between twice yearly cleanings from a dental hygienist are the best defense against plaque buildup. Plaque turns to tartar when people neglect their oral hygiene. Over time, tartar can build up on teeth and under the gums, increasing the risk of gum disease.

Your best bet is to use a toothpaste that has a combination of anti-plaque agents. Products containing more than one plaque reducer may be more effective than products that only one. Common ingredients to look for are zinc citrate or pyrophosphates. Triclosan is an antibiotic that is believed to kill bacteria in the mouth, and it can be found in some anti-plaque toothpaste.

Look for toothpaste that bears the seal of the American Dental Association. That seal is an endorsement of the ADA – and it means that many dentists agree that that particular toothpaste does what toothpaste is designed to do. We can also recommend toothpaste to meet your specific oral health concerns at your next visit to our Pooler office.

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.