Posts for: February, 2020
Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.
Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.
Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.
People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.
Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:
- brushing the surgical area (if advised by your surgeon);
- rinsing too aggressively;
- drinking through a straw or consuming hot liquid;
If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.
While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.
If you would like more information on oral surgery, 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 “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”
How do you know if you have periodontal (gum) disease? Sometimes your gums will tell you—when they’re red, swollen or bleed easily.
But your gums can also look and feel healthy while a gum infection still brews below the gum line. In this case, a regular dental visit could make the difference. Even without overt signs of infection, we may be able to detect gum disease with a slender metal instrument called a periodontal probe.
Gum disease is a bacterial infection that most of the time arises from dental plaque. This thin film of bacteria and food particles accumulates on tooth surfaces, especially because of poor or non-existent oral hygiene. A continuing infection can weaken gum tissues and cause them to pull away or detach from the teeth.
Normally, there’s a slight gap between the gums and teeth. But as the infected gums pull away, the gaps grow larger and deeper, forming what are known as periodontal pockets. They become filled with infection that soon spreads to the root and bone and increases the risk of tooth loss.
These pockets, though, could be the means for detecting a gum infection with the help of the periodontal probe. During a dental exam we gently insert the probe, which has millimeter depth markings etched on it, between a tooth and its adjacent gums. While a depth of 1 to 3 mm is normal, a probe measurement of 4 to 5 mm could be a sign of an early stage infection. A reading of 7 to 10 mm, on the other hand, may indicate more advanced disease.
Along with other factors, periodontal probing can be quite useful identifying both the presence and extent of a gum infection and then how to treat it. The goal of any treatment is to remove plaque and tartar (calculus) deposits that sustain the infection. But probing, along with other diagnostic methods like x-rays, could point to deeper infection below the gum line that require more extensive methods, including surgery, sometimes to access and remove the disease.
Achieving the best treatment outcome with gum disease often depends on finding the infection early. Periodontal probing helps to make that discovery more likely.
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”