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Posts for: June, 2018

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Removing a problem tooth (extraction) is a common dental procedure. But not all extractions are alike — depending on the type of tooth, its location and extenuating circumstances, you may need an oral surgeon to perform it.

Fortunately, that's not always the case. Teeth with straight or cone-shaped roots, like an upper front tooth, have a fairly straight removal path. A general dentist first carefully manipulates the tooth loose from the periodontal ligament fibers that help hold it in place (experienced dentists, in fact, develop a “feel” for this process). Once it's loosened from the fibers it's a simple motion to remove the tooth.

But as mentioned before, a “simple extraction” won't work with every tooth or situation. To find out if it can we'll first need to determine the true shape of the tooth and roots, as well as the condition of the supporting bone. We might find any number of issues during this examination that make a simple extraction problematic.

For example, teeth with multiple roots (especially in back) may have complicated removal paths. If the roots themselves are unhealthy and brittle from previous injury or a root canal treatment, they can fracture into smaller pieces during removal. A tooth could also be impacted — it hasn't fully erupted but remains below the gum surface. It's these types of situations that require surgery to remove the tooth.

During a surgical extraction, the oral surgeon will first numb the area with a local anesthetic, as well as a sedative if you have issues with anxiety. They then perform a surgical procedure appropriate for the situation to remove the tooth. More than likely they'll insert bone grafts before closing the site with stitches to deter bone loss (a common occurrence after losing a tooth).

Afterward, your provider may prescribe antibiotics and an antibacterial mouthrinse to ward off infection. You'll also be given care instructions for the extraction site to keep it clean. Any discomfort should subside in a few days and can be managed effectively with a mild anti-inflammatory drug like ibuprofen or aspirin.

It can be overwhelming having a tooth removed. In your dentist's capable hands, however, the experience will be uneventful.

If you would like more information on tooth extraction, 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 “Simple Tooth Extraction?


By Denise A. Perrotta DMD
June 10, 2018
Category: Dental Procedures
GumDiseaseisStillaThreattoYourDentalImplants

You’ve invested quite a bit in your new dental implants. And it truly is an investment: because of implants’ potential longevity, their long-term costs could actually be lower than other restorations whose upfront costs might be less.

But to better ensure their longevity, you’ll need to keep your implants and the natural tissues supporting them clean of bacterial plaque, a sticky biofilm that can cause periodontal (gum) disease. Although the implant itself is unaffected by disease, the natural tissues around it can be.  An infection could ultimately weaken the bone supporting the implant and lead to its failure.

Such an infection involving implants could advance rapidly because they don’t have the natural defenses of the original teeth. Our natural teeth are connected to the jaw through the periodontal ligament, a collagen network that attaches to both the teeth and the bone through tiny tissue fibers. This connection also provides access to antibodies produced by the body to fight infection.

By contrast, we place implants directly into the jawbone. While this creates a very secure attachment, the implant won’t have the same connection as teeth with the body’s immune system. That means any infection that develops in surrounding tissues can spread much more rapidly—and so must be dealt with promptly.

Treating this particular form of gum disease (known as peri-implantitis) is similar to infections with natural teeth and gums, with one important difference involving the tools we use to remove plaque from them. While natural teeth can handle metal scalers and curettes, these can create microscopic scratches in the porcelain and metal surfaces of an implant and create havens for further bacterial growth. Instead, we use instruments made of plastic or resin that won’t scratch, as well as ultrasonic equipment to vibrate plaque loose.

To avoid an infection, it’s important that you brush your implants and surrounding tissues just like you would your natural teeth (be sure you use a soft-bristled brush). And keep up regular dental visits for thorough cleanings and checkups to stay ahead of any developing gum infection. Maintaining your dentures will help ensure they continue to brighten your smile for a long time.

If you would like more information on dental implants, 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 “Dental Implant Maintenance: Implant Teeth Must be Cleaned Differently.”




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