Thursday, March 7, 2013
Top 10 Reasons to have wisdom teeth removed
Wisdom Teeth- Southern Georgia Oral Surgery
Why We Should Remove Wisdom Teeth
Roger Myers DMD
Why do they cause so many issues for us?
The more patient evaluations for wisdom teeth that I perform, the more I ponder on their lack of necessity. When a wisdom tooth is erupting, I call it the adult teething stage and the symptoms for a tooth erupting for a child appear to the same. The infection, erythemas, swelling and pain appear and removal of the tooth is warranted. Called "wisdom teeth" because they emerge later in life, the upper and lower third molars generally cause problems because there is not enough room in the mouth for them to erupt, or break through the gum, into a normal position. As a result, these molars are often left impacted in the gum or jawbone. Impacted teeth can lead to a variety of problems including pain, infection, crowding, or damage to adjacent teeth, and can contribute to more significant inflammation that can spread to other teeth, which can compromise the integrity of adjacent teeth.
2. Oral inflammation associated with wisdom teeth may contribute to preterm or low birth weight infants. Extremely important to pregnant patients.
3. Fully erupted wisdom teeth rarely provide meaningful use and are difficult to keep clean. Their incidence of developing caries is very high.
1. Limited space for wisdom teeth to erupt can lead to infection and by, the risk of caries is always present.
4. Impacted wisdom teeth may develop associated cysts and/or tumors that could require extensive procedures to remove & repair jaw function and appearance.
5. Chance of complications related to the removal of wisdom teeth increases with age. The tooth position and roots may compromise the nerves and blood vessels.
6. Gum disease and inflammation associated with wisdom teeth may lead to receding gum tissues, deterioration of the jawbone and tooth loss.
7. Full eruption of wisdom teeth may lead to crowding of nearby teeth. Normally the lower anterior mandible is affected with the canine to canine area being most compromised.
8. Even wisdom teeth that seem to be problem-free remain a breeding ground for oral infection & inflammation. This inflammation can enter the bloodstream and contribute to the development or progression of diabetes, heart disease, and stroke.
9. Wisdom teeth removed at an early age allows for easier and faster recovery. TRUE
10. They serve absolutely no function at all.
Monday, February 25, 2013
Pediatric Oral Surgery-Removal Of A Compound Odontoma.
Southern Georgia Oral Surgery
What is a compound Odontoma?
A compound odontoma has the three separate dental tissues (enamel, dentin and cementum), but may present as a lobulated appearance where there is no definitive demarcation of separate tissues between the individual "toothlets". Several small abnormal teeth surrounded by a fibrous sac tumor of enamel and dentin arranged in the form of anomalous miniature teeth. The associated tissue usually appears as characteristic dentigrous cyst type. It usually appears in the anterior maxilla and in some instances a compound odontoma can be positioned in a manner that compromises the adjacent teeth. It is usually asymmtomatic and in most cases only be discernable with utilization of a radiograph. However, cases have been reported to exhibit focal swelling of the affected site. This appearance would and could be the impetus for the patient to be evaluated by a dentist.
Case Study
The patient presented as an 8yr old male, No Meds, NKDA
The patient was referred from their general dentist in order to be evaluated for a radiopaque mass in right maxillary region. The patients clinical evaluation revealed a prominence of the buccal aspect of the right maxilla, that was non-tender or fluctuant. Primary teeth "B" and "C" were present, but were mobile, decayed and required extraction. Radiographically, there was a radiopaque mass positioned above teeth "B" and "C". The mass was approximately 1cm x 1cm and inhibited the eruption of the permanant premolar. The plan was to remove the affected primary teeth and remove the mass/associated tissue for biopsy. The procedure was performed under IV sedation successfully.
It was our intention not to place bone graft material in the bony defect after the surgery. The goal was to allow full maturation of the remaining premolar, which should spontaneously assume its position in the dentition. The patient will receive follow up every 6 months for a clinical evaluation and serial radiographs.
Path Report
Post op Visit
The patient returned one week later to examine the surgical site post-operatively. Minimal swelling was evident and the patient exhibited no complaint of discomfort. A bone graft to obliterate the bony defect was not suggested as to not inhibit the eruption of the permanant tooth. The patient will be place on a 6 month recall for further observation and evaluation of the region.
www.southerngeorgiaoms.com
What is a compound Odontoma?
A compound odontoma has the three separate dental tissues (enamel, dentin and cementum), but may present as a lobulated appearance where there is no definitive demarcation of separate tissues between the individual "toothlets". Several small abnormal teeth surrounded by a fibrous sac tumor of enamel and dentin arranged in the form of anomalous miniature teeth. The associated tissue usually appears as characteristic dentigrous cyst type. It usually appears in the anterior maxilla and in some instances a compound odontoma can be positioned in a manner that compromises the adjacent teeth. It is usually asymmtomatic and in most cases only be discernable with utilization of a radiograph. However, cases have been reported to exhibit focal swelling of the affected site. This appearance would and could be the impetus for the patient to be evaluated by a dentist.
Differential Diagnosis
Compound odontomas can be detected easily due to their tooth-like appearance. Complex odontomas can be differentiated from cemento-ossifying fibromas due to their propensity to be associated with crown of unerupted molar and they are more radiopaque than cement-ossifying fibromas. They can also develop at much younger age than cemento-ossifying fibromas. A dense bony island can be included in the differential. However, the presence of a soft tissue capsule is very useful in differentiation. Periapical cemental dysplasia may resemble complex odontomas but usually they are multiple, surrounded by sclerotic borders and centered around apices of teeth, whereas odontomas are commonly found occlusal or overlapping the involved teethRadiographic Features
The borders are well-defined, often with a cortex surrounding a soft tissue capsule. The internal structure is largely radiopaque. They often interfere with normal eruption of teeth. They can be associated with impacted, malposition, malformation, and displacement of adjacent teeth.Treatment
Compound and complex odontomas are easily removed by simple excision. They do not recur and are not invasive.Case Study
The patient presented as an 8yr old male, No Meds, NKDA
The patient was referred from their general dentist in order to be evaluated for a radiopaque mass in right maxillary region. The patients clinical evaluation revealed a prominence of the buccal aspect of the right maxilla, that was non-tender or fluctuant. Primary teeth "B" and "C" were present, but were mobile, decayed and required extraction. Radiographically, there was a radiopaque mass positioned above teeth "B" and "C". The mass was approximately 1cm x 1cm and inhibited the eruption of the permanant premolar. The plan was to remove the affected primary teeth and remove the mass/associated tissue for biopsy. The procedure was performed under IV sedation successfully.
It was our intention not to place bone graft material in the bony defect after the surgery. The goal was to allow full maturation of the remaining premolar, which should spontaneously assume its position in the dentition. The patient will receive follow up every 6 months for a clinical evaluation and serial radiographs.
Path Report
Decalcified sections show multiple "toothlets" which show abnormal morphologic pattern. Fragments of bone and connective tissue also appear. Remnants of what appears to represent a dentigerous cyst associated with the lesionis also noted.
Post op Visit
The patient returned one week later to examine the surgical site post-operatively. Minimal swelling was evident and the patient exhibited no complaint of discomfort. A bone graft to obliterate the bony defect was not suggested as to not inhibit the eruption of the permanant tooth. The patient will be place on a 6 month recall for further observation and evaluation of the region.
www.southerngeorgiaoms.com
Tuesday, February 12, 2013
10 Signs Of A Canine Space Infection
Many patients come into my office to be evaluated for varying reasons, but some of the most dramatic and life-threatening cases are infections. Overtime I have assessed that one of the most serious facial infections is the canine space infection. This infection is typically associated with a severely decayed maxillary canine and deisplays the following signs/symptoms:
1. Periorbital cellulitis(Swelling)
2. Periorbital Erythema(redness)
3. Blurry vision-due to closure of the upper/lower palpebral space and associated edema
4. Exquisite pain to palpation-due to the presence of the infraorbital nerve which is approximately
one inch below the infraorbital rim
5. Cheek and upper lip swelling-cellulitis is the tissue spread of the infection which results
in inflammation, swelling and puffy tissue.
6. Focal abcess-this is a centralized and indurated area walled off with epithelium. This can
be fluctuant or hard and can enlarge as the infection progresses.
7. Limited opening due to perceived pain
8. Parathesia of the accessory sensory nerves due to swelling
9. Headaches, earaches and affected side generalized facial pain
10. Risk of cavernous sinus thrombosis
Methods of how to resolve this condition will be discussed on my next entry
Oral surgeon Statesboro, Ga. and Oral Surgeon Hinesville,Ga.Southern Georgia oral Surgery- Facebook page
1. Periorbital cellulitis(Swelling)
2. Periorbital Erythema(redness)
3. Blurry vision-due to closure of the upper/lower palpebral space and associated edema
4. Exquisite pain to palpation-due to the presence of the infraorbital nerve which is approximately
one inch below the infraorbital rim
5. Cheek and upper lip swelling-cellulitis is the tissue spread of the infection which results
in inflammation, swelling and puffy tissue.
6. Focal abcess-this is a centralized and indurated area walled off with epithelium. This can
be fluctuant or hard and can enlarge as the infection progresses.
7. Limited opening due to perceived pain
8. Parathesia of the accessory sensory nerves due to swelling
9. Headaches, earaches and affected side generalized facial pain
10. Risk of cavernous sinus thrombosis
Methods of how to resolve this condition will be discussed on my next entry
Thursday, February 7, 2013
7 Reasons To Get Dental Implants
Reasons to consider dental implants to replace teeth
1. Form and maintenance of facial profile
2. Ability to chew foods adequately
3. Esthetics and creation of a beautifule smile
4. Preservation of bone
5. Prevention of teeth from shifting
6. Abilty to have pemanant dentition
7. Securing attachments for removable prosthesis(i.e. partial, denture)
Southern Georgia Oral Surger
www.southerngeorgiaoms.com
https://www.youtube.com/watch?NR=1&feature=fvwp&v=UHlgck_Ds0U
https://twitter.com/arianna12121212
http://www.facebook.com/pages/Southern-Georgia-Oral-Surgery/400416313358775?ref=stream
1. Form and maintenance of facial profile
2. Ability to chew foods adequately
3. Esthetics and creation of a beautifule smile
4. Preservation of bone
5. Prevention of teeth from shifting
6. Abilty to have pemanant dentition
7. Securing attachments for removable prosthesis(i.e. partial, denture)
Southern Georgia Oral Surger
www.southerngeorgiaoms.com
https://www.youtube.com/watch?NR=1&feature=fvwp&v=UHlgck_Ds0U
https://twitter.com/arianna12121212
http://www.facebook.com/pages/Southern-Georgia-Oral-Surgery/400416313358775?ref=stream
Tuesday, February 5, 2013
Upper wisdom teeth and females
Southern Georgia Oral and Maxillofacial Surgery
Dentist in Hinesville and Statesboro Ga.
www.SouthernGeorgiaOMS.com
In my office we remove wisdom teeth on a regular basis. Therefore, overtime I have discovered that female patients have a high prevalence of TMJ symptoms. These TMJ symptoms are always accompanied with the presence of wisdom teeth(impacted or erupted) and an audible click is always present. I always tell my patients that there is a space descrepancy and there is not enough room for the wisdom teeth. As a result, complications manifest which present accordingly:
1. Deviation upon opening
2. Headaches
3. Earaches
4. Radiating pain to the head, jaw and neck region
5. Pronounced pressure
6. Mucosal inflammation
7. Blurry vision or eye pain
8. Locked jaw(open or closed)
9. Limited opening.
I have discovered that this desciption is applicable to patients in the following age range: 14-22
Typically, once the teeth are removed, the pain and complaints diminish.
Have you noticed this incidence in your practice and how do you manage the symptoms and/or treat the condition?
Dentist in Hinesville and Statesboro Ga.
www.SouthernGeorgiaOMS.com
In my office we remove wisdom teeth on a regular basis. Therefore, overtime I have discovered that female patients have a high prevalence of TMJ symptoms. These TMJ symptoms are always accompanied with the presence of wisdom teeth(impacted or erupted) and an audible click is always present. I always tell my patients that there is a space descrepancy and there is not enough room for the wisdom teeth. As a result, complications manifest which present accordingly:
1. Deviation upon opening
2. Headaches
3. Earaches
4. Radiating pain to the head, jaw and neck region
5. Pronounced pressure
6. Mucosal inflammation
7. Blurry vision or eye pain
8. Locked jaw(open or closed)
9. Limited opening.
I have discovered that this desciption is applicable to patients in the following age range: 14-22
Typically, once the teeth are removed, the pain and complaints diminish.
Have you noticed this incidence in your practice and how do you manage the symptoms and/or treat the condition?
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