Keep Your Wisdom Teeth or Extract Them?

By Arthur Kezian

You will notice that the final teeth that will develop would be your wisdom teeth or the third molars. Yes, you have four wisdom teeth and it comes out at the age of 17-21 years old and can be found at the corner of each mouth.

Sometimes, the wisdom teeth fail to come out and they often become trapped or impacted in the jawbone area. It is termed “impacted” when it fails to erupt in the dental arch within the expected time. The reason why it fails to come out is that the adjacent teeth, overlying bone, or excessive soft tissue is preventing it to erupt. Some of the abnormal positions of wisdom teeth can be tilted, sideways, lying down or even twisted and these positions can be seen if you have a panoramic x-ray taken. Remember that your wisdom teeth are retained unless it is surgically removed.

Another reason for it to become “impacted” is that because of having inadequate space in your jaw. Sometimes, you would also experience pain or swollen gums on that area of your jaw. It means that food, bacteria and plaque has started to infect the area. This usually brings about mild to severe pain and infection can be brought about. You may have what they call “Pericoronitis”. Wisdom teeth extractions should be performed as soon as your dentist determines that the tooth is impacted or infected.

A dental surgeon would always advice you to have it remove at a younger age because the removal of impacted teeth becomes more difficult as you age. The reason behind this is that younger patients can tolerate the procedure better and recover more quickly and has less interference with their daily lives. The ideal time for removal of impacted third molars is when the roots of the teeth are one-third formed and before they are two-thirds formed, usually during the late teenage years, between ages 17 and 20.

Having impacted wisdom teeth which sometimes are in an unusual position and can cause the following:

Crowding or displacement of the other teeth

• Tooth decay


• Infections


• Gum problems

The removal of impacted third molars is a surgical procedure that is associated with a large amount of patient anxiety. In addition with this type of surgical procedure, sometimes it can involve unpleasant noises and sensations. As a result, surgeons who would routinely perform the removal of impacted wisdom teeth commonly recommend their patients some type of profound anxiety control such as conscious sedation which includes oral sedation and IM/IV sedation and even general anesthesia as well. Nitrous oxide or “laughing gas” is an option for controlling your dental anxiety as well.

Whatever method you and your surgeon would choose, rest assured that you are in good hands. Just make sure that you follow your Los Angeles Dentist pre and post operative instructions and the result of this treatment will be to your utmost comfort. The more you understand about dental procedures, the easier it is to make informed choices about all the available treatments. So if there are any dental questions you would like our thoughts on, please ask us any time. We always look forward to providing you with answers.

Dr. Arthur A. Kezian DDS 443 N. Larchmont Blvd Los Angeles, CA 90004 (323) 467-2777 

-N.S.

What to Do After Root Canal?

By Arthur Kezian

In my last post, I answered the question of what a root canal is and why a dentist would suggest that you have one done. Now, I'd like to give a little guidance as to how to take care of yourself after root canal therapy and the postoperative instructions to follow.

POSTOPERATIVE INSTRUCTIONS:

1. Discomfort is sometimes experienced after a treatment visit because of irritation of the bone surrounding the tooth and may range from a mild discomfort in the area to an occasional episode of considerable pain. This discomfort will usually maximize in approximately 48-72 hours and then subside.

Avoid chewing on the treated tooth for a few days.

2. If a throbbing sensation occurs, keep your head elevated as much as possible and place extra pillows under your head when lying down.

Avoid any strenuous activity as much as possible.

3. If your tooth has been left open to aid in drainage of an infection, place cotton in your tooth as directed.

Do not leave the cotton in the tooth between meals.

4. If your gums swell, rinse the area every 1-2 hours with a solution of warm salt water prepared by adding a teaspoon of salt to an eight-ounce glass of warm water.

5. If your face swells, apply an ice pack to the area for 5 minutes every ½ hour.

6. If antibiotic medication has been prescribed, take it as indicated until you have finished ALL of the medication.

If you encounter any difficulty in breathing, a skin rash, or gastric disturbance, discontinue the medication and call the office.

* If medication for pain has been prescribed, take it as indicated. It is important to bear in mind that narcotic medications such as Codeine, Vicodin, Percodan and Demerol may make you drowsy. Therefore, caution should be exercised in operating any potentially dangerous machinery or an automobile.

Dr. Arthur A. Kezian DDS 443 N. Larchmont Blvd Los Angeles, CA 90004 (323) 467-2777 

-N.S.

Do I Really Need a Root Canal?

By Arthur Kezian

Your dentist may have told you that you need a root canal and you're wondering if your tooth really needs it.

Years ago, a badly infected or decayed tooth was always pulled out. Today the majority of such teeth can be saved through procedures used by a trusted endodontist or general dentist. These days, however, extraction or having a tooth pulled out is a very last resort.

A root canal may be necessary if your tooth experiences any of the following:

* Spontaneous pain or throbbing while biting
* Sensitivity to hot and cold foods
* Severe decay or an injury that creates an abscess (pus accumulation) in the bone

Your dentist is the expert who can determine for sure if the tooth is in such serious condition that it needs a root canal.

Treatment consists of:

The removal of the infected or irritated nerve tissue that lies within the root of the tooth. It is this infected pulp tissue that causes an eventual abscess.

1. The first step is to obtain access to the nerve. This is accomplished by establishing a small access opening on the top of the tooth. It will be done under local anesthesia.

2. The dentist then determines the length of the root canal and removes the infected pulp.

3. During the same visit, the canal where the nerve is located will be reshaped and prepared to accept a special root canal filling material. This filling procedure will probably not occur until your next visit.

The number of visits necessary to complete your root canal will depend upon several factors including the number of nerves in the tooth, the infected state of the nerve and the complexity of the procedure.

4. The final step in your root canal will be the sealing of the root canal with a sterile, plastic material called gutta percha. The sealing is done in order to prevent possible future infection.

The tooth will then possibly need a post and core and a crown in order to re-establish normal form and function. This decision will be based upon several additional factors.

If treated early, a root canal need not be uncomfortable. With the use of local anesthetics, the entire procedure can be totally painless.

Proper restoration the tooth should mean it will last as long as your other teeth and can even be used as an anchor tooth for a partial denture or cemented bridge. The success rates for root canals have been reported to be as high as 95%.

Sometimes when there has been long-standing infection or abscess, there may be some soreness associated with the first or second root canal visit. If this should turn out to be true you will be given specific instructions to follow to minimize the discomfort. When an infection is present, it may be necessary to take an antibiotic. If pain is present, analgesics may need to be prescribed. In either case, be sure to call the dental clinic if either of these problems should arise.

Dr. Arthur A. Kezian DDS 443 N. Larchmont Blvd Los Angeles, CA 90004 (323) 467-2777 

-N.S.

About Porcelain Dental Veneers and Crowns

By Arthur Kezian

Dental veneers are a beautiful way to correct stained, chipped or crooked teeth. By placing glass-like ceramic porcelain on the surface of teeth, dentists can provide patients with bright, straight, and natural looking smiles.
The advantage over other cosmetic bonding techniques is that porcelain veneers are translucent, so when bonded onto a tooth's surface they will closely mimic the light-handling characteristics of dental enamel. Dental crowns typically encase an entire tooth whereas porcelain veneers only cover over the front side of a tooth.

How do porcelain veneers differ from dental crowns?
In comparison to a dental crown, the classic porcelain veneer is a wafer-thin shell of ceramic that is bonded onto the front side of a tooth. Whilst a dental crown covers over and encases the entire tooth, a porcelain veneer just covers over the side of the tooth that shows when the person smiles.
Dental crowns and porcelain cosmetic veneers also differ by way of their relative thickness. The classic porcelain veneer will measure 1 millimeter in thickness or less, as opposed to a dental crown that typically measures 2mm.
Here are a few of the factors that determine which type of dental restoration would be the more ideal choice for you:

Dental Crowns

1. Can be used to produce significant color and shape changes for a tooth.


2. Are often used to rebuild teeth that are badly broken or decayed.


3. Are very strong. Dental crowns are a good choice in those situations where the tooth is subject to significant chewing and biting forces or else tooth clenching and grinding (bruxism).


4. Require a significant amount of tooth reduction when made.


5. Once a crown has been made for a tooth the tooth will always require a dental crown.
   

Porcelain Veneers

1. Can be used to produce significant color and minor shape changes for a tooth.


2. Are placed on teeth whose underlying tooth structure is generally healthy and intact.


3. Are strong but brittle. Porcelain veneers typically do best in those situations where the biting forces they are subject to are somewhat passive.


4. Typically require much less tooth reduction than dental crowns.


5. For all practical purposes, once a porcelain veneer has been made for a tooth it’s irreversible.
6. 
   

What Will My Porcelain Veneers Look Like?

The glass-like ceramic that forms porcelain veneers closely resembles natural tooth enamel because, much like real tooth enamel they are translucent. This translucent effect is what gives teeth their luster. By replicating this, porcelain dental veneers provide patients with bright, natural looking smiles.

Porcelain dental veneers can also cover and repair cracked and chipped teeth. Because they are custom made and fitted to your teeth by a skilled cosmetic dentist, you can customize and improve much more than just the color of your teeth. Crooked and chipped teeth can have their appearances improved to give you a beautiful new smile and can be color matched to your natural teeth.

How Much Do Porcelain Veneers Cost?

Porcelain veneers generally cost from $1700 to $2,000 per tooth. When considering the cost of porcelain veneers, you must take into account their longevity and attractiveness. Porcelain veneers are long lasting alternatives to other treatments that cost less but must be repaired frequently.

Dr. Arthur A. Kezian DDS 443 N. Larchmont Blvd Los Angeles, CA 90004 (323) 467-2777 

-N.S.