Posts for: March, 2016
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
As a regular part of your daily hygiene you may be using a mouthrinse — or “mouthwash” — mainly to keep your mouth feeling fresh and clean. Some mouthrinses, though, do more than give you fresher breath.
While there are countless mouthrinses available, we can place all of them into two broad categories: cosmetic and therapeutic. The first refresh your mouth and breath, usually with a mentholated or minty taste and smell that masks unpleasant odors. How well they work is mainly subjective: if you feel better after using them, they’ve done their job.
Therapeutic rinses have a different role, intended to improve oral health in some way. We can divide these into anti-cariogenic (decay prevention) or anti-bacterial rinses. You can find fluoride-based anti-cariogenic rinses over-the-counter in retail or drug stores, usually containing about .05% sodium fluoride per volume. Numerous studies have shown these rinses highly effective in preventing tooth decay when used with daily brushing and flossing.
Likewise, over-the-counter antibacterial rinses have proven somewhat effective in reducing bacteria that leads to dental disease. Formulated usually with triclosan, sanguinaria extract, zinc or essential oils, they can also help reduce the incidence of gingivitis (inflammation of the gums), but only if used in conjunction with brushing and flossing.
Perhaps, though, the most widely studied and substantiated therapeutic mouthrinse is chlorhexidine, a prescription-only rinse. Chlorhexidine inhibits the formation of bacterial plaque on tooth surfaces, the main trigger for both tooth decay and periodontal (gum) disease. It’s often used as a post-surgery rinse when brushing and flossing may not be possible, but dentists will often prescribe it for patients who have a high propensity for dental disease.
Using a mouthrinse depends on your current oral health and personal preferences. Therapeutically, most people gain some added tooth strength protection from using a fluoride rinse in their daily hygiene. If fresh breath and the way your mouth feels are important to you, you should consider such a rinse that also has a pleasant taste and effect for you. We can further discuss with you whether a different type of rinse, or a prescription-strength formula, might be best for your particular needs.
If you would like more information on mouthrinses, 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 “Mouthrinses.”