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Author: Service Lifter

Extractions

The main goal of dentistry is to preserve your natural teeth and keep them healthy for as long as possible. There are times, however, when it is in your best interest (or your child’s) to have a tooth extracted (removed). This could be the case for a variety of reasons. Perhaps you have a tooth that has been severely damaged by trauma or decay; or an impacted wisdom tooth that may cause trouble for you later on. Maybe your teenager will soon undergo orthodontic treatment and has insignificant space for his adult teeth, referred to as crowding. Or your younger child has a baby tooth that’s stubbornly adhering, even though it’s past time for it to go.

Whatever the reason, tooth extraction is more often than not a very routine procedure. How straightforward this minor surgery is will depend on where the tooth to be extracted is located in the mouth, and what its roots are like. For example, a front tooth with a single straight root is easier to remove than a molar with multiple roots. This is especially true when that molar is a wisdom tooth that is impacted, meaning it is below the surface surrounded by gum tissue and bone. Often, a wisdom tooth is blocked from fully erupting (growing in) by other teeth in its path.

Still, tooth extraction is nothing to be feared when done by an experienced hand. Keep in mind that a tooth is not rigidly fixed in its surrounding bone, though that’s how some may picture it. In fact, it is attached to the bone via a network of fibers that form what’s known as the periodontal ligament. By carefully manipulating the tooth, these fibers can be detached and the tooth freed without much trouble.

Reasons for Extracting a Tooth

As mentioned above, there can be a variety of reasons for extracting a tooth. Be sure to ask questions about the pros and cons of any dental treatment, including extraction.

  • Trauma or Disease — In both of these situations, there are several ways to try and save the tooth. The damaged tooth might need a full-coverage crown, a root canal treatment, or both. But sometimes even these methods are not enough to keep the tooth functioning well and looking good; it might be better to remove the tooth and replace it with a strong and lifelike dental implant.
  • Orthodontic Treatment — Teeth are sometimes extracted when there are too many of them for the size of the dental arches (jaws), a situation known as crowding. After an adequate amount of space is opened up through the extraction of one or more teeth, the remaining teeth can be aligned properly. The teeth most frequently removed for orthodontic reasons are the first premolars, which are right next to the eyeteeth (canines).
  • Impacted Wisdom Teeth — Early removal of impacted wisdom teeth can prevent damage to neighboring healthy teeth, bone, gum tissue, even nerves and blood vessels. If an impacted wisdom tooth is in a bad position, it’s best to remove it before its roots are fully formed.
  • Baby Teeth — If a baby tooth is out of position or not lost in the right sequence, the permanent tooth underneath it might not erupt normally. In this case, removing the baby tooth could prevent a need for orthodontic treatment later on.

The Process of Extracting a Tooth

The first step in any extraction is a radiographic (x-ray) examination to assess the position of the tooth roots and the condition of the surrounding bone. This will allow any possible complications to be anticipated. A thorough medical and drug history is taken, to ensure that you are healthy enough to undergo the procedure, and your options for anesthesia will be discussed.

Tooth extraction is usually carried out with local anesthesia, which will numb the teeth to be removed, and the surrounding bone and gum tissues. Additional sedatives might also be used, including oral sedatives (taken in pill form), nitrous oxide (which is inhaled) and/or conscious sedation, which is given intravenously (into a vein). The latter is usually required for more complicated (or multiple) tooth extractions. By the time the sedation medication has worn off, you won’t even be aware that the surgery was done.

As your tooth is being removed, steps are taken to ensure the bone that surrounds it isn’t damaged. Sometimes, in the process of removing a tooth, a small amount of lab-processed bone-grafting material is placed into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.

What to Expect After Tooth Extraction

Immediately after your tooth is extracted, the socket will be covered with sterile gauze; gentle pressure will be applied for 10-20 minutes to control any bleeding. Small sutures (stitches) might also be used for this purpose. It’s normal to experience some mild to moderate post-operative discomfort and/or swelling. Taking non-steroidal, anti-inflammatory drugs such as ibuprofen and/or aspirin the day of surgery should control most symptoms. Antibiotics may also be prescribed to ensure infection-free healing. Using ice packs on the outside of your jaw, and eating softer foods until you feel more comfortable can also be helpful. Within a few days, all should be back to normal.

Sedation Dentistry

There’s so much dentistry can do these days to make your mouth healthier and your smile more beautiful. Yet many people don’t take advantage of this because of a long-standing fear of dental treatment. If you are one of these people, rest assured that it’s possible to have an experience that’s free of anxiety and pain. This can be accomplished by blocking your sensations of pain with local anesthetics or by giving you medication that can help you relax. Sometimes both are needed to ensure maximum comfort, especially if you are someone for whom the injections that deliver local anesthetics are themselves a major source of anxiety.

When you are afraid of dental treatment, your guard goes up and your pain threshold goes down; anticipating that something will hurt makes you hypersensitive to every sensation — even sound. If this describes your experience in the dental chair, then you might benefit from sedatives that can be given during your visit to make that anxiety melt away.

Before any particular sedative is recommended, you will be asked to provide your complete health history, including any medications you are currently taking — both prescription and over-the-counter. It is also important to know if you smoke or drink. On the day of your treatment, you may need to have someone drive you to and from your appointment as certain medications take time to wear off.

Ways to Relieve Anxiety

Oral Sedation — Oral sedation (given by mouth) is a popular option for many people precisely because it does not require the use of needles. Oral sedatives are either swallowed whole in pill form or can be dissolved under the tongue. Both methods work in a matter of minutes. A variety of oral sedative and anxiolytic (anxiety-dissolving) medications have been developed through extensive research and testing to make your experience of dental treatment as comfortable and relaxing as possible. All have long safety records after decades of use, and several even have “amnesic” properties, meaning you will remember little to nothing, even though you are conscious throughout the treatment. Commonly prescribed medications include Valium®, Halcion®, Sonata®, Ativan®, Vistaril®, and Versed®. To learn more, view our chart on Types of Oral Sedatives

Inhalation Conscious Sedation — Nitrous oxide, a sedative you inhale, has been used in dental offices for nearly 100 years. It is a relatively poor pain reliever but a very good anti-anxiety medication. It is administered through a nasal hood, which resembles a small cup that is placed over your nose. The oxygen mixed with nitrous oxide provides a light-headed or even euphoric feeling, which is quick to wear off so there is no “hangover” effect. All bodily functions remain essentially normal during the use of this sedative, which is very safe.

IV Conscious Sedation — Sedatives delivered directly into the bloodstream intravenously (into the vein) are more potent than when taken orally, and the amnesic effects may be more profound. Because IV sedation has an almost immediate effect on the body and its functions — including heart rate, blood pressure and breathing — there is a higher degree of risk associated with it than with other types of sedatives. There is also a higher level of training required for those who administer it. As with all sedation (except nitrous oxide), you must be monitored with specialized equipment throughout your IV sedation treatment. The main advantage is that drugs administered this way work immediately and the level of sedation can be adjusted more quickly and easily. And with most sedatives, you won’t remember a thing about your dental procedure after the sedative wears off.

Oral Piercings

At the present time, oral piercings such as tongue bolts, cheek studs, and lip rings seem to be in vogue among a certain number of young people. Whether you find these bodily adornments appealing or repulsive is a matter of personal taste — but whichever side of the fashion divide you’re on, there are a few things you should know about the impact they can have on your oral health.

According to the Journal of the American Dental Association, the tongue and lips are the most common sites for intraoral piercings. In either location, the ornament is likely to come into contact with teeth, gum tissue, and other anatomical structures in the mouth. And that’s where the trouble may start.

The Anatomy of a Problem

The tongue, composed primarily of muscle tissue, is rich in blood supply and nerve endings; that’s why a cut on the tongue is often painful and bloody. In a tongue piercing, a metal stud is inserted through a hole made in the tongue. The possibility of infection or the transmission of a blood-borne disease like hepatitis B exists in this situation. Rarely, the piercing may also cause immediate and severe facial pain. It’s the long-term effects of an oral piercing, however, which give the most reason for concern.

As teeth regularly come into contact with the metal parts of the ornament, increased tooth sensitivity and pain may become a problem. Chipping or fracture of the teeth can also occur, which may require tooth restoration. Teeth that have already been restored (with crowns, for example) may be even more prone to damage. Plus, wherever it’s located, jewelry in the mouth can trigger excessive saliva flow, impede speech, and cause problems with chewing and swallowing.

Periodontal (gum) disease can also result from wearing an oral piercing. This may first show up as injury to the soft gum tissue, and later as gum recession. It’s important to understand that before the gums can recede, some of the underlying bone in the jaw must be lost. Following bone loss, inflammation and infection of the gums may occur.

When gums recede, tooth roots become exposed; this makes tooth decay more likely, since roots lack the protective enamel covering of the tooth’s crown. Some studies have even shown that, over time, this condition makes gum disease more likely — primarily because it’s more difficult to practice good oral hygiene with an irregular gum line. Besides causing problems in the mouth, advanced gum disease can have a potentially negative effect on your general (systemic) health.

It’s Your Health — and Your Choice

If you’re old enough to get an oral piercing, you’re old enough to take an active part in maintaining your own oral health. If you are thinking about having a tongue bolt, lip ring, cheek stud, or other ornament placed in your mouth, talk to a dental professional about it first. Due to the increased potential for dental or periodontal problems, you will likely need to have more frequent checkups, and pay special attention to your oral hygiene.

And if the time comes when you decide that the piercing you got on an impulse isn’t what you want any more, take heart: Removing it will immediately reduce your disease risk, and thus instantly improve your oral health!

Non-Surgical Periodontal Treatment

Periodontal (gum) disease is an infection caused by bacterial plaque, a thin, sticky layer of microorganisms (called a biofilm) that collects at the gum line in the absence of effective daily oral hygiene. Left for long periods of time, plaque will cause inflammation that can gradually separate the gums from the teeth — forming little spaces that are referred to as “periodontal pockets.” The pockets offer a sheltered environment for the disease-causing (pathogenic) bacteria to reproduce. If the infection remains untreated, it can spread from the gum tissues into the bone that supports the teeth. Should this happen, your teeth may loosen and eventually be lost.

When treating gum disease, it is often best to begin with a non-surgical approach consisting of one or more of the following:

  • Scaling and Root Planing. An important goal in the treatment of gum disease is to rid the teeth and gums of pathogenic bacteria and the toxins they produce, which may become incorporated into the root surface of the teeth. This is done with a deep-cleaning procedure called scaling and root planing (or root debridement). Scaling involves removing plaque and hard deposits (calculus or tartar) from the surface of the teeth, both above and below the gum line. Root planing is the smoothing of the tooth-root surfaces, making them more difficult for bacteria to adhere to.
  • Antibiotics/Antimicrobials. As gum disease progresses, periodontal pockets and bone loss can result in the formation of tiny, hard to reach areas that are difficult to clean with handheld instruments. Sometimes it’s best to try to disinfect these relatively inaccessible places with a prescription antimicrobial rinse (usually containing chlorhexidine), or even a topical antibiotic (such as tetracycline or doxycyline) applied directly to the affected areas. These are used only on a short-term basis, because it isn’t desirable to suppress beneficial types of oral bacteria.
  • Bite Adjustment. If some of your teeth are loose, they may need to be protected from the stresses of biting and chewing — particularly if you have teeth-grinding or clenching habits. For example, it is possible to carefully reshape minute amounts of tooth surface enamel to change the way upper and lower teeth contact each other, thus lessening the force and reducing their mobility. It’s also possible to join your teeth together with a small metal or plastic brace so that they can support each other, and/or to provide you with a bite guard to wear when you are most likely to grind or clench you teeth.
  • Oral Hygiene. Since dental plaque is the main cause of periodontal disease, it’s essential to remove it on a daily basis. That means you will play a large role in keeping your mouth disease-free. You will be instructed in the most effective brushing and flossing techniques, and given recommendations for products that you should use at home. Then you’ll be encouraged to keep up the routine daily. Becoming an active participant in your own care is the best way to ensure your periodontal treatment succeeds. And while you’re focusing on your oral health, remember that giving up smoking helps not just your mouth, but your whole body.

Often, nonsurgical treatment is enough to control a periodontal infection, restore oral tissues to good health, and tighten loose teeth. At that point, keeping up your oral hygiene routine at home and having regular checkups and cleanings at the dental office will give you the best chance to remain disease-free.

Dental Implants FAQS

What are dental implants?

Dental implants are small titanium posts that replace the roots of missing teeth (View Example). They are inserted into your jawbone during a minor surgical procedure that takes place in the dental office. After the implant has been placed in your jawbone, a completely lifelike porcelain tooth crown is attached. In some cases, the implant needs to fuse with the bone for several months before it is permanently crowned; in other cases, you can have new (but temporary) teeth the same day your implants are placed.

How many teeth can be replaced with dental implants?

You can replace a single tooth, multiple teeth or all your teeth with implants (View Examples). You don’t even need one implant for every missing tooth. As few as two Implants can support a removable lower denture, while as few as four implants can provide a full, permanent set of top or bottom teeth.

Is dental implant surgery painful?

Most people find dental implant surgery very easy to tolerate. Any post-operative discomfort can usually be managed with over-the-counter anti-inflammatory medication such as ibuprofen or OTC pain-relievers. Ice can also be helpful.

Are dental implants expensive?

At the outset, implants are more expensive than other tooth-replacement methods such as dentures or bridgework. But they also last many years longer and in fact should never need replacement. So they offer the best, most cost-effective option when viewed as a long-term investment in your health, comfort and well-being.

How do you care for dental implants?

They require exactly the same care as natural teeth: daily brushing and flossing, along with regular dental checkups and professional cleanings. Although implant teeth will never decay, the gum tissues around them can become inflamed or infected in the absence of good oral hygiene. Properly cared-for dental implants should last a lifetime.

Can my body reject a dental implant?

Strictly speaking, implants can’t be rejected because they contain no living cells or genetically coded material. The titanium of which they are made is completely biocompatible, and allergies are extremely rare. But an implant can fail to integrate with the jawbone if an infection develops in the absence of good oral hygiene, or if it is subjected to biting forces too soon. However, this is rare; implants regularly achieve success rates in excess of 95%.

Am I a candidate for dental implants?

There’s a good chance that you are, but this can only be determined after a complete oral examination that includes x-rays of your jaws. Please schedule a consultation to begin the exciting process of restoring your smile and bite.

Tooth Sensitivity

If your teeth seem especially sensitive after you brush them or when you consume certain foods or beverages, you’re hardly alone: By one estimate, around 35 percent of the U.S. population experiences some degree of tooth sensitivity. While the difference between sensitivity and pain may be somewhat blurry, we can say that sensitive teeth usually produce discomfort in response to a stimulus like temperature, pressure, or even the sweetness of particular foods. What causes tooth sensitivity — and what should you do about it?

In general, tooth sensitivity results when dentin, the living tissue that makes up most of the “body” of the tooth, begins transmitting sensations to nerves deep in the tooth’s inner core. The nerves relay these sensations to the brain, and they’re felt as pain. To understand how this works, let’s take an even closer look at your teeth.

Tooth Anatomy 101

Dentin is a sturdy, calcified tissue, that can’t usually be seen. It’s normally covered by super-hard enamel on the visible part of the tooth (the crown), and by softer tissue called cementum on the tooth’s roots (which typically lie below the gum line). The dentin itself is composed of many tiny tubules. When these tubules become exposed to the environment of the mouth, tooth sensitivity and pain may result.

There are several reasons why the dentin can become exposed. For one, the gums may recede (shrink down), revealing some of the tooth’s root surfaces. This can be caused by genetic factors, periodontal disease, excessively vigorous brushing — or a combination of all three. This problem may be worsened if the tooth’s roots weren’t completely covered by cementum during their development, as sometimes occurs.

Another factor that may contribute to sensitivity is the erosion of tooth surfaces due to excessive acid in the diet. While acids occur naturally in the mouth, habitually drinking sodas and sports drinks can severely erode teeth — and brushing soon after you drink actually worsens the effect. That’s because these acids soften the outer surfaces of the teeth, and brushing then makes it easy to wear them away. It’s best to wait for an hour afterwards, to give your saliva a chance to neutralize the acid.

Tooth decay can also cause sensitivity. Decay may not only expose dentin, but can work its way down to the nerves themselves — at which point, your pain level may escalate. And sometimes, even dental work itself can cause sensitivity. Because the same tooth structures are involved, it may sometimes take a few days after a cavity is filled, for example, for a tooth to “calm down.”

Dealing With Tooth Sensitivity

What can you do about sensitive teeth? If it’s a relatively minor irritation, try not to brush the affected teeth too long or hard. Make sure you’re using a soft-bristled brush and the proper, gentle brushing technique. Always use a toothpaste containing fluoride, as this ingredient is proven to increase the strength of tooth enamel, which helps resist erosion. You can also try a toothpaste with ingredients designed especially for sensitive teeth, such as potassium. Studies show that these can be effective… but it may take approximately 4 – 6 weeks for you to notice the difference.

If sensitivity persists, however — or if your tooth pain becomes more intense — don’t wait to get an examination to determine what’s causing the problem. Once diagnosed, the most appropriate way to reduce the sensitivity will be recommended. Some treatments may include concentrated fluoride varnishes, prescription mouthrinses, or materials that are bonded to the outer surfaces of teeth. But tooth sensitivity may also be an early warning sign of other dental problems — and the sooner they’re taken care of, the better off you’ll be!

Gummy Smiles

Some people feel self-conscious about smiling because they believe their gums are too prominent. Though we each have our own definition of what makes a smile beautiful — including how much gum is too much — a smile will usually be perceived as “gummy” when 4 millimeters (just over an eighth of an inch) of gum tissue shows. If your smile looks gummy to you, it’s important to figure out exactly what’s causing this. Only then can the appropriate cosmetic dental or periodontal (gum) procedures be recommended to give you a more pleasing appearance of the gums and teeth.

Causes

Gummy smiles may be caused by one or more factors relating to the gums themselves, the teeth, or even the lip or jaw. Each of these areas will require a different approach to solving the problem. Let’s look at some of the ways a gummy smile can be corrected:

Gums. If your teeth appear too short in relation to your gums, it could be that they are being covered up by too much gum tissue. This problem can be solved with a periodontal plastic surgery technique called “crown lengthening,” which involves removing and reshaping the excess tissue to expose the full length of teeth.

Teeth. There are natural variations in the tooth-eruption process that can result in shorter than normal teeth and gumminess of the smile. If that’s the case, your teeth can be made to appear longer by capping (crowning) them or covering them with thin porcelain veneers. It’s also possible that your teeth have become worn down over time, especially if you have a grinding habit. When this happens, it can cause what is known as compensatory eruption. To compensate for the wear and maintain a functional bite, the teeth actually begin to move (or erupt) very slowly outward from the gum. This makes the smile appear gummier because the gums, which are attached to the teeth, move with them as they erupt. In some cases orthodontic treatment can be used to move the affected teeth back up into correct position. Afterwards, the worn-down teeth would usually be restored with porcelain crowns or veneers.

Lip. On average, the upper lip moves 6 to 8 millimeters from its normal resting position to a full smile. If the lip is hypermobile, meaning it rises much farther up, more gum tissue will be revealed. Here the action of the muscles that control the lip will need to be modified so they don’t raise it quite so high. Treatment can range from Botox shots that temporarily paralyze the muscles (for about six months), to surgery that permanently restricts how high the lip can move, referred to as a lip stabilization procedure.

Jaw. Sometimes the upper jaw (maxilla) is too long for the face, a condition referred to as Vertical Maxillary Excess. If this is the case, the jaw would need to be repositioned with orthognathic surgery (“ortho” – straighten; “gnathos” – jaw). Of all the treatment listed here, this one is the most complex — but it can achieve dramatic results.

As you can see, there is no one-size-fits-all approach to correcting a gummy smile. However, there are various techniques that can achieve dramatic improvements.

Nitrous Oxide

Some people fail to receive the benefits of modern dental treatment because of a simple yet seemingly overwhelming problem: Fear. It isn’t uncommon to have a little anxiety about an upcoming dental procedure. But if your fears have kept you away from the dental office when you know you really should go — take heart! Conscious sedation with nitrous oxide can help you lose that anxiety, and make the whole experience so stress-free that you may not even remember it when it’s over.

Nitrous oxide, a colorless gas with a slightly sweet odor, has been used in medicine for about a century; however its outdated nickname, “laughing gas,” is undeserved. It’s a safe and effective method of administering conscious sedation — which means that you’ll stay awake during the procedure. But when nitrous oxide is used in combination with a local anesthetic, you won’t feel pain or anxiety. In fact, many patients report a feeling of well-being during this type of sedation. All bodily functions remain normal during the administration of nitrous oxide, and its effects wear off quickly afterwards.

How Is Nitrous Oxide Administered?

As a form of conscious sedation, nitrous oxide is inhaled through a small mask that fits comfortably over your nose. The gas is mixed with oxygen as it is being delivered, and both gases are always kept at a level that is safe for the body. In just a few minutes, you may start to experience a floating sensation, and perhaps some tingling in the hands and feet. That’s a sign that the sedation is working. Once it has been verified that you’re calm and comfortable, and that the dose is correct, your dental procedure can begin.

Nitrous oxide itself isn’t a substitute for a local anesthetic — it’s considered an anxiolytic, which means it makes anxiety disappear. For some procedures, you may still need an anesthetic injection. The difference is, you won’t mind. Yet, you won’t be asleep — you’ll be able to speak, be aware of what’s going on, and you will remain in control during the procedure. In fact, the dose can be fine-tuned to just the level of sedation you need.

When the procedure is over, the flow of nitrous oxide is decreased to zero, and the oxygen may be increased. After resting in the chair for a few minutes, you’ll be able to sit up, and soon you can resume normal activities like driving. Although the experience has been compared to “having a couple of drinks,” there is very little “hangover” effect afterward.

Who Can Benefit From Nitrous Oxide?

Most people whose anxiety would otherwise keep them out of the dental chair can benefit from conscious sedation with nitrous oxide. Before beginning treatment, we will take a complete medical history, including your use of both prescription and non-prescription medications. If you are pregnant, have COPD (Chronic Obstructive Pulmonary Disease) or some other pulmonary diseases, or are taking certain drugs, it may not be right for you. However, if you feel that you would benefit from a more stress-free experience in the dental office, ask about nitrous oxide conscious sedation.

Gum Injuries

When dental emergencies and pain occur, our attention is often focused on diseases and injuries related to the teeth. However, it’s important to remember that the soft tissues of the mouth — the gums, tongue, lips and cheek lining — may also be affected. While they are tough enough to stand up to the oral environment, these tissues can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses.

First Aid for Soft Tissues

Soft tissue injuries in the mouth don’t usually bleed excessively — although blood mixing with saliva may make any bleeding appear worse than it actually is. To assist someone with this type of injury, you should first try to rinse the mouth with a dilute salt water solution. If a wound is visible, it can be cleaned with mild soap and water; if that isn’t possible, try to remove any foreign material by hand, and rinse again.

Bleeding can usually be controlled by pressing damp gauze (or, if unavailable, another clean material) directly to the site of the injury, and keeping it there for 10-15 minutes. If the bleeding doesn’t stop, immediate medical attention will be needed. Try to see a dentist within 6 hours of the injury for evaluation and treatment. This usually involves determining the extent of the damage, performing initial restorative procedures, and occasionally suturing (stitching) the wound. An antibiotic and/or tetanus shot may also be given.

Foreign Bodies

Occasionally, foreign objects may become lodged in the space between teeth and gums, causing irritation and the potential for infection. There are a few foods (such as popcorn husks) that seem especially prone to doing this, but other items placed in the mouth — like wood splinters from toothpicks or bits of fingernail, for example — can cause this problem as well.

If you feel something stuck under the gum, you can try using dental floss to remove it: Gently work the floss up and down below the gum line to try and dislodge the object. Light pressure from a toothpick may also help work it free — but avoid pressing too hard or pushing the object in deeper. If that doesn’t work, see a dentist as soon as possible. Special tools may be needed to find and remove the object, and you may be given medication to prevent infection.

Periodontal (Gum) Abscesses

Sometimes called a gum boil, a periodontal abscess is a pus-filled sac that may form between teeth and gums. It is caused by an infection, which may have come from food or other objects trapped beneath the gum line, or from uncontrolled periodontal disease. Because pressure builds up quickly inside them, abscesses are generally quite painful. Symptoms may include a throbbing toothache which comes on suddenly, tenderness and swelling of the gums or face, and sometimes fever. Occasionally, pus draining into the mouth through an opening in the sac relieves the pressure and pain, but may cause a strange taste.

If left untreated, abscesses can persist for months and cause serious health problems, including infections that spread to other parts of the body. That’s why it is important to see a dentist right away if you experience symptoms. He or she will find the location of the abscess and treat it appropriately. Treatment usually involves draining the pus and fluid, thoroughly cleaning the affected area, and controlling the infection.

Professional Teeth Cleanings

Even if you brush and floss your teeth faithfully, it is important that you have your teeth professionally cleaned on a regular basis. (Of course, if you aren’t quite so meticulous about your oral hygiene, it’s even more important!) After a thorough cleaning, your teeth will feel smooth and squeaky-clean, and they will probably look a lot brighter too. But professional teeth cleanings aren’t done for looks alone.

Why do your teeth need this kind of attention? Essentially, it’s because over time they tend to build up a layer of plaque (a sticky, bacteria-rich film) and hard deposits (called tartar, or calculus) that are very difficult to remove without special tools. When these deposits are allowed to remain on the tooth surfaces or below the gum line, they provide ideal conditions for bacteria to grow and multiply. The acids produced by some bacteria cause tooth decay and gum disease; if left uncontrolled, this can lead to inflammation and infection of the gums, and possibly influence systemic (whole body) diseases.

Dentists have a special term for preventive procedures like tooth cleaning: prophylaxis, from the Greek word meaning to protect or guard against. In this case, the focus is on preventing tooth decay and gum disease. Performed in conjunction with a routine dental examination, a professional cleaning can go a long way toward controlling these two common maladies. While your teeth are being cleaned, it’s also a good opportunity to take a close look at your oral health in general and check for a few specific problems.

The Professional Cleaning Procedure

Teeth cleaning is often performed by a dental hygienist — a highly trained technician who uses a special set of tools designed just for this purpose. Because everyone’s teeth are a little different, your cleaning will be tailored to your particular needs. However, many cleanings follow a similar pattern.

First, the dental hygienist will do an oral examination to evaluate the health of your oral tissues. Then the cleaning will take place using either an ultrasonic scaler or metal instruments referred to as curettes to remove the plaque and calculus from the tooth surfaces. The ultrasonic scaler is a hand-held tool with a tiny tip that vibrates at a very high frequency. Hardened deposits are broken up by the rapid movement of the tip, which does not damage the tooth. A constant stream of liquid (called lavage) serves to cool the tip and aid in plaque removal; at the same time, it also washes away the debris.

Some hygienists prefer curettes, which are hand-held instruments that are curved and tapered to fit around and in between the teeth. If your teeth are sensitive, using hand-held instruments may be more comfortable for a professional cleaning. In the capable hands of a hygienist or dentist, it takes only moderate pressure to remove any stubborn buildup and scrub the teeth clean, regardless of which instruments are used.

Finally, your teeth are polished with a low-speed rotary brush fitted with a soft rubber tip. A slightly gritty, toothpaste-like gel is applied, and the tip spins around and polishes the teeth, making them smooth and shiny.

A Requirement for Good Oral Health

Most people don’t feel any noticeable discomfort during dental cleanings; some even report they enjoy the experience — especially the dramatic results when it’s done! If you haven’t had a cleaning in a while, however, it may take you a few moments to get used to getting your teeth cleaned. If you experience any discomfort, however, it may be possible to apply a topical numbing gel or another type of anesthetic.

If your gums are irritated due to bacterial buildup, they may become sore or bleed slightly during the cleaning. It may be possible to prevent this from occuring in the future with oral hygiene measures you can perform at home (such as improved flossing techniques or special mouthrinses); it might also indicate that you need more frequent in-office cleanings. This type of regular maintenance will help you avoid more involved dental procedures down the road — and it will give you the best chance of keeping your teeth for life!