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By J. V. Discipio D.D.S. & Assoc. LTD
August 01, 2020
Category: Dental Procedures
WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By J. V. Discipio D.D.S. & Assoc. LTD
July 22, 2020
Category: Dental Procedures
Tags: dental implants   diabetes  
DiabetesCanMakeGettinganImplantDifficultButNotImpossible

Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.

Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.

There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.

As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.

The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.

All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.

If you would like more information on managing dental care with diabetes, please contact us or schedule an appointment for a consultation.

By J. V. Discipio D.D.S. & Assoc. LTD
July 12, 2020
Category: Oral Health
Tags: mouth sore  
ThatOddLacyMouthSoreisNoCauseforAlarm

Looking in the mirror, you probably focus on your teeth and gums—i.e., your smile. Your dentist, though, will take the time to look deeper into your mouth, searching for anything out of the ordinary. That could be a type of mouth sore known as lichen planus.

Lichen planus are lesions that can appear on skin or mucus membranes, including inside the mouth. The name comes from their resemblance to lichens, a fungus found on trees or rocks (although the sore itself isn't fungi). As such, they often have a lacy pattern of lines emanating from purplish bumps.

Again, the first indication you have such a condition may come from your dentist. Sometimes, though, you may notice greater sensitivity to spicy or acidic foods and, if the gums are affected, irritation when you eat or brush.

If you find out you have lichen planus, don't be alarmed—it usually doesn't pose harm to your health and it's not contagious. Its appearance, though, could be mimicked by more harmful medical conditions, so your dentist will want to confirm the lesion observed is truly lichen planus.

It's routine, then, for your dentist to excise a small sample of the sore's tissue and send it to a pathology lab for biopsy. Although results will more than likely confirm lichen planus or some other benign lesion, it's better to err on the side of caution and ensure you're not dealing with something more serious.

If you are diagnosed with lichen planus, you may need to take steps to manage symptoms. In most people, the sore will go away on its own, although there's no guarantee it won't reappear sometime later. In the event it lingers, your dentist may prescribe a topical steroid to help ease any discomfort.

You can also minimize a future outbreak by practicing effective daily oral hygiene to reduce the bacterial populations that may contribute to the condition. And when you're symptomatic, try avoiding spicy or acidic foods like citrus, peppers or caffeinated beverages.

Lichen planus is more bothersome than harmful. Taking the above steps can help you avoid it or deal with it more effectively when it occurs.

If you would like more information on lichen planus, 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 “Lichen Planus: Mouth Lesions That are Usually benign.”

By J. V. Discipio D.D.S. & Assoc. LTD
July 02, 2020
Category: Oral Health
Tags: tooth decay  
PreventionandEarlyDetectionofRootCavitiesCouldSaveaTooth

Tooth decay is one of two dental diseases most responsible for tooth loss (gum disease being the other). In the absence of treatment, what starts as a hole or cavity in a tooth's outer layers can steadily advance toward its interior.

Most people associate cavities with the crown, the part of a tooth you can see. But cavities can also occur in a tooth's roots, especially with older adults. Root cavities pose two distinct difficulties: They can lead to more rapid decay spread than crown cavities within a tooth; and they're harder to detect.

Tooth roots are ordinarily covered by the gums, which protects them from bacterial plaque, the main cause for decay. But roots can become exposed due to receding gums, a common problem with seniors who are more susceptible to gum disease.

Unlike the enamel-covered crowns, tooth roots depend on gum coverage for protection against bacteria and the acid they produce. Without this coverage, the only thing standing between tooth decay and the roots is a thin material called cementum.

If decay does enter a tooth's interior, saving it often requires a root canal treatment to remove decayed tissue in the inner pulp and root canals, and then replacing it with a filling. But if we're able to discover a root cavity in its early stages, we may be able to fill it like a crown cavity.

The best strategy, though, is to prevent root cavities from forming. This starts with a dedicated daily regimen of brushing and flossing to remove dental plaque. If you're at high risk for root cavities, we may also recommend antibacterial mouthrinses and other aids.

Regular dental visits are also a must: a minimum of twice-a-year dental cleanings to remove stubborn plaque and calculus (hardened plaque) deposits. For added protection against root cavities, we can also apply fluoride varnish to strengthen teeth. And regular visits are the best way to detect any cavity in its early stages when treatment is less invasive.

A heightened risk of dental problems like root cavities are a part of the aging process. But partnering together, we can lower that risk and increase the longevity of your teeth.

If you would like more information on root cavities, 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 “Root Cavities.”

By J. V. Discipio D.D.S. & Assoc. LTD
June 22, 2020
Category: Oral Health
Tags: mouthguards  
BruinsZdenoCharaBreaksHisJawDuring2019StanleyCup

Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.

With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.

Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.

For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.

But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.

Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.

Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.

Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.

Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.

If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”





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