Warning Signs of Impacted Wisdom Teeth

Wisdom teeth — or third molars — are our final set of molars and usually start to emerge between the ages of 16 and 25. They are known as “wisdom” teeth in most cultures because of their late arrival compared to other molars.  Like getting your braces off, the removal of wisdom teeth has become a dental “rite of passage” for many teens and young adults.

When your wisdom teeth start to emerge it can be painful - you may have pain towards the back of your jaw and inflammation.  However, it can be even worse if your wisdom teeth become impacted. Impacted wisdom teeth are trying to erupt but are unable to because there is not sufficient room for them to emerge.  This usually means they are painfully lodged in your jawbone and removal is necessary.

There are few oral health issues that can be as painful or disruptive to daily life as impacted wisdom teeth so its important that you are able to identify the issue as early as possible and receive the necessary care.  Some of the indicators include:

• Throbbing pain in the back of the mouth. Impacted wisdom teeth can cause a great deal of pain, particularly as the condition worsens. The pain may radiate from the back of the mouth, particularly focused on the area around the wisdom teeth and other molars and will worsen as the surrounding teeth begin to become affected.
• Swollen, tender and bleeding gums.  Impacted wisdom teeth can cause the gums to become swollen and tender to the touch. They may start to bleed when pressure is applied, making flossing and brushing both painful and difficult.
• Swelling around the jaw.  Impacted wisdom teeth are often accompanied by swelling of both the gums and jaw. It can be subtle at first, but can worsen quickly to the point that it can become painful or difficult to open your mouth, talk or chew.
• Swollen glands in the shoulder and neck. Impacted wisdom teeth are often accompanied by swollen glands in the shoulder and neck.
• Headaches.  Impacted wisdom teeth can cause headaches of the temporomandibular joint (TMJ), which connects the jaw and skull. This pain may radiate to other areas of the head and face as well.

Any of these symptoms are a good reason to call your dentist or doctor.  At the Raleigh dental practice of Jeff M. Morrison& Associates, we will conduct a thorough exam, including taking x-rays, and will rule out other issues such as gum disease, infection, decay or temporomandibular disorder, or TMD.  If you, (or your teen's) wisdom teeth are impacted we will want to remove them.  This can usually be done in our office or we can refer you to an oral surgeon.

A great way to prevent the pain of impacted wisdom teeth is to continue your routine preventive care as you get older.  As part of your dental exams, we will monitor the development of your wisdom teeth by taking X-rays periodically to track their position and movement.  If we believe they are likely to cause problems down the road we may suggest you have them removed as a preventive measure.  This is often done long before the teeth emerge because the longer wisdom teeth remain in the mouth the more developed their roots become, making their removal more complicated and the recovery time longer.  Since wisdom teeth will try to make room for themselves in a tightly packed jaw, they may also shift teeth that have been previously straightened with braces or other orthodontic devices, ruining the investment you made in your orthodontics. 

If you (or your teen) still have wisdom teeth, don't wait for complications to occur before talking with Dr. Morrison about your options.   Make an appointment with us today or call us at 919 755 3450.

What should we talk about next?  Leave a suggestion below.  If you liked this blog, please comment or review!

How To Handle Dental Emergencies

Dental emergencies can occur at any time - but don't they always seem to happen over a holiday weekend, or the day your're leaving for vacation? When problems arise, at Jeff M Morrison & Associates, DDS, we are here for our patients - including weekends and holidays. If a dental emergency occurs during our regular work week we will fit you in as soon as possible - usually with a same day appointment. If it's the weekend or a holiday, we will do what is needed to save your tooth, reduce your pain, stabilize the injury, and help you to feel comfortable with your appearance. If you need to see us right away contact our Raleigh dental practice for an emergency appointment. We only see current patients of record after regular office hours for emergency care. However, we welcome all emergency cases - new and current patients - during regular hours.

Here are some tips on how to handle the most common dental emergencies until you can get to our office:

Toothaches

If you are experiencing continuous, severe tooth pain or ache, this is a common symptom of an abscessed tooth. An abscess is an infection at the root of the tooth caused by pulp decay, and usually calls for a root canal. We recommend contacting our office immediately to examine the tooth and start treatment. If you do have an abscessed tooth it will only get worse without care.  Take these initial steps:  Rinse mouth with warm water and use dental floss to remove any lodged food. If swelling appears, hold a cold compress to the outside of the mouth or cheek. Never put aspirin against the gums or on the sore tooth, because it may burn the gum tissue.

Chipped or broken tooth

Chipped or broken teeth put you at-risk for an infection to the tooth pulp. Rinse mouth and any broken pieces with warm water. If bleeding, apply a piece of gauze to the area for about 10 minutes or until the bleeding stops. Hold a cold compress to the outside of the mouth or cheek to reduce swelling and ease pain.  Take pain medication as needed.

Knocked-out tooth

When a tooth has been knocked out, the nerves, blood vessels and supporting tissues are irreparably damaged.  That is why all avulsed teeth will need a root canal. However, the bone can reattach to the root of the tooth once it's put back into place. The odds of saving a tooth are highest in young children, but adult teeth can be saved as well so always keep the tooth if it's a permanent one. A tooth has the highest chance of being saved when it is returned to the socket within one hour. 

Follow these suggestions to improve the chances of saving your tooth:

• Handle the tooth carefully. Try not to touch the root (the part of the tooth that was under the gum). It can be damaged easily. 
• If the tooth is dirty, hold it by the upper part (the crown) and rinse it with milk. If you don't have any milk, rinse it with water. Don't wipe it off with a washcloth, shirt or other fabric. This could damage the tooth. 
• Keep the tooth moist. Drop it into a glass of milk. If you can't do this, place the tooth in your mouth, between the cheek and gum. A young child may not be able to safely "store" the tooth in his or her mouth without swallowing it. Instead, have the child spit into a cup. Place the tooth in the cup with the saliva. If nothing else is available, place the tooth in a cup of water. 
• If it's a permanent tooth, try slipping the tooth back into its socket. Make sure it's facing the right way. Don't try to force it into the socket. If it doesn't go back into place easily and without pressure, then just keep it moist (in milk, saliva or water) and get to the office as soon as you can.

Extruded (partially dislodged) tooth

Apply a cold compress to the outside of the mouth or cheek to ease pain. Take an over-the-counter pain reliever.

Object caught between teeth

Use dental floss to gently and carefully remove the object. Never use a sharp instrument, because you risk cutting your gums or scratching the tooth surface.

Lost filling or crown

It important to see Dr. Morrison as soon as you can if you lose a filling or crown. The exposed tooth is sensitive to pressure and temperature, and can become more damaged without the protection of the restoration. If a crown is missing for a long time, your teeth may move and the crown will no longer fit. Here's what you can do before you get to the office:

• If you still have the crown and can place back over the tooth, make sure to clean the inside as thoroughly as possible.  If it is painful, use a cotton swab to apply a little clove oil to the tooth.
• Try to slip the crown back over the tooth. Before putting the crown back in place, coat the inner surface with an over-the-counter dental cement, toothpaste or denture adhesive to help hold it in place. Never use super glue!
• If you’ve lost the crown or filling entirely, place the over-the-counter dental cement over the tooth surface to protect and seal the area until you get to our office.  No dental cement?  Use a piece of sugarless chewing gum over the tooth until you can get in. 

Broken braces wire

If a wire breaks or sticks out and is poking you, use the eraser end of a pencil to move the wire. If that is not working, use orthodontic wax, a small cotton ball or a piece of gauze to cover the wire tip. Don’t cut the wire, because you risk swallowing it.

Loose braces bracket or band

Use orthodontic wax to reattach a loose bracket or place the wax over the braces for cushioning. If a band is loose, save it until you see the orthodontist.

Abscess

These are painful infections that sometimes look like a swollen pimple on the gum, usually at the tooth’s root or in the space between the teeth and gum. Rinse mouth with a mild salt-water solution (one half-teaspoon of table salt in 8 ounces of water) several times a day, which will help ease any pain. It is critical to have this emergency attended to immediately to avoid the infection traveling through your system.

Soft-tissue injuries

Injuries to the tongue, cheeks, gums and lips can bleed easily. Rinse mouth with a mild salt-water solution. Hold a damp piece of gauze or a teabag to the site that is bleeding for about 15 minutes. Also hold a cold compress to the outside of the mouth or cheek for 10 minutes. If the bleeding doesn’t stop, see your dentist right away or go to a hospital emergency room.

Many of the dental emergencies we treat at our Raleigh dental practice can be avoided with simple steps like wearing a mouth guard, getting routine preventive care, and following up on recommended treatment plans. We do our part to keep your teeth and mouth healthy and encourage you to do the same. Don't hesitate to contact us if you have a dental emergency - even if it's over the weekend.

For more information about Jeff M. Morrison & Associates, or to schedule an emergency dental visit please call 919.755.3450 or visit our website.