Friday, January 29, 2016

Wisdom Teeth

Wisdom teeth are third molars that normally erupt between the ages of 17 and 21.  Since they are the last teeth to erupt into the mouth, usually at the time of young adulthood; an age associated with budding maturity and wisdom; they are more popularly known as "wisdom teeth".

Wisdom teeth, when properly positioned can add to being able to chew well but are not always necessary for optimal function.  Because of their position so far back in the mouth, they can be difficult to clean.

As we, as a society; evolve into consuming more refined foods, which require lot less vigorous chewing, the need for teeth and the corresponding jaw size diminishes. The Aborigines of Australia, supposedly still have their 42 teeth.!

 Wisdom teeth are often impacted  as a result of the discrepancy in the size of the jaws and the number of teeth.  When impacted, the third molars are trapped beneath the gum and bone and against the teeth in front of them.

 The 3 major categories of impaction are-

Horizontal Impaction or a sleeping tooth is where the third molar grows into the mouth horizontally , heading straight towards the root surface of the second molar. These teeth, unless symptomatic are best left alone.

Angular Impaction  is a third molar growing into the mouth at an angle, only partially erupting and trapping food deposits often resulting in pain, swelling  and infection. These are the teeth most likely to need removal to prevent  pain, infection and teeth migration.

Vertical Impaction is  less common and is generally found when the jaws are under developed. Often, these impactions do not cause any pain and are  discovered in dental exams with radiographs ( X rays).

Wisdom extractions can be  performed under local anesthesia and pain or anxiety- reducing medications are available when appropriate.

Teeth positions have a significant bearing on facial profile and timely removal of  impacted teeth is an important aspect of managing facial forms and dental health.

Visit for information on additional services or to schedule an appointment.

Wednesday, January 6, 2016

Why does my filling need to be replaced?

A tooth that has decay or fractures will need either a filling or other restoration depending on the extent of decay.  Poor oral hygiene, a poor diet, gum recession or a lack of saliva can contribute to tooth decay. Para functional habits like clenching and grinding and traumatic occlusion are usually the cause of teeth fractures.

Choices of restorations

Composite filling: Is a tooth colored plasticed material that is bonded to the tooth when a small area of tooth that is decayed needs to be restored.  This is a popular option considering the capability of matching shades to the tooth, conservative prep design preserving natural tooth and affordability.

Amalgam filling: This option has fallen out of vogue because of potential mercury toxicity, silver color compromising aesthetics and the technique requiring removal of a lot of tooth structure to achieve mechanical retention. Many dental offices no longer offer this procedure.

Onlay/Inlay: Is a lab processed restoration usually chosen when a small area of the tooth needs to be restored with better seal and marginal integrity for long term success. It is a two visit procedure that entails a higher cost for lab fabrication. These can be processed in tooth colored porcelain or gold based on patient preference.

Full coverage crown: restores the entire coronal portion of the tooth and is usually indicated on endodontically treated teeth (root canal), extensive breakdown of tooth from fractures and/or decay. They are lab fabricated and also entail two visits.  Crowns can be fabricated in gold, non precious metal or various porcelains depending on patient preference, cost considerations and aesthetic demands.

 A dental filling usually lasts many years before it needs replacing. However, teeth are subject to constant stress from chewing, clenching and grinding. All of these can cause a filling to gradually wear away, chip, crack or fall out.

Reasons for replacement

Recurrent decay
Fracture of filling
Fracture of tooth
Material upgrade

Regular dental examinations are important to maintain soft tissue health, assess existing restorations and maintain bite and functionality of the mouth.  Detecting a failing filling early can reduce damage to tooth and eliminate the need for more invasive and complicated procedures.

Visit or call 909 627 6699  for more information. Feel free to stop by our office on 10th street in Chino, California.