Jennifer Flach was a college junior when her wisdom teeth started making themselves known.

"My other teeth started moving around," she remembers. "The wisdom teeth were pushing out and undoing some of the orthodontic work I had done in high school."

At the same time, her brother — who's two years younger and was also in college — had no symptoms. But the family dentist suggested his wisdom teeth should come out too.

Jen and her brother had back-to-back wisdom tooth extractions and recovered together at home during spring break. "It was quite a week at my parents' house," she says.

Patrick Grother was 26 when his dentist mentioned that his wisdom teeth might need to be removed. His bottom left wisdom tooth had partially erupted into his mouth and a flap of gum still covered it. "The dentist said food would get trapped there and it could get infected," he says. Patrick then visited a periodontist, who said that the gum flap could be cut away but it would grow back.

"I put it off for awhile," Patrick said, but he eventually had the wisdom teeth on the left side of his mouth extracted.



A few people are born without wisdom teeth or have room in their mouths for them, but like Jen and her brother, many of us get our wisdom teeth taken out during our college years. And like Patrick, many of us are first alerted to the problem when our wisdom teeth don't emerge (erupt) into the mouth properly because there is not enough toom for them to fit.

"A part of the tooth may remain covered by a flap of gum, where food particles and bacteria can get trapped, causing a mild irritation, a low-grade infection called pericoronitis and swelling," says Dr. Donald Sadowsky, professor emeritus of clinical dentistry College of Dental Medicine and the Mailman School of Public Health. This usually happens with the lower wisdom teeth. Pericoronitis and the pain it causes is the most common reason people need their wisdom teeth taken out.

Pericoronitis is just one of the reasons that you may need to have a wisdom tooth or more than one removed.

In many people, the wisdom teeth never even partially enter the mouth. Often the teeth are tilted under the gum and blocked from coming in by bone or other teeth. Dentists call these impacted teeth; they may cause pain, but you may feel nothing at all for years. You may not even be aware that you have wisdom teeth until your dentist sees them on an X-ray.

Regular dental visits are important during your teens and early twenties because this is the time when teeth are most likely to decay. Regular visits allow your dentist to follow the progress of your wisdom teeth with X-rays.

Even if your wisdom teeth aren't causing any pain or other problems, they may cause problems at some point. The most common problems are decay, infection, and crowding or damage to other teeth. But more serious complications can occur, including the development of a cyst that can cause permanent damage to bone, teeth and nerves.

However, not all wisdom teeth need to be removed.

If removing wisdom teeth is necessary, it's easier in younger people because the tooth roots are not fully developed and the bone in which the teeth sit is less dense. Extracting your wisdom teeth before any complications develop also allows for shorter recovery time and less discomfort after the surgery.

Any injury to the gums or teeth can be very painful. In some cases, however, the cause of severe dental pain is not obvious. For example, pain that comes on suddenly may be caused by particles of food that got lodged in a cavity and have started to irritate the nerve inside the tooth. If you lose a filling or a crown, the nerve inside the tooth may be exposed, and you may feel severe pain when air or hot or cold substances touch the uncovered part of the tooth.

Pain that becomes more severe over a period of time is commonly caused by debris lodged under the gum. Popcorn is a common offender. Because the hard cellulose fibers of the popcorn kernel don't break down, it can remain stuck between your gum and your tooth. The longer a food particle stays trapped between the gum and tooth, the greater the chance the gum will become irritated and infected and the pain will get worse. If you develop an infection, called an abscess, it can become a serious health problem if left untreated.

Pain when you bite or chew, especially if it is accompanied by a foul odor and a bad taste, can be a sign of an abscess that needs immediate treatment.

What You Can Do

First, call your dentist and make an appointment.

In the meantime, here are a few steps you can take at home to try to relieve some of the pain:

• Take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). However, be aware that you need to see your dentist. If you mask the pain with a painkiller and ignore it, the infection can spread and could become life threatening.
• Rinse your mouth with warm water every hour or as needed to ease the pain.
• If the pain is caused by debris lodged in a cavity, washing the area may relieve the problem.
• Floss your teeth, then run a toothpick around the gum line. This may remove debris that's lodged under the gum.
• If you've lost a filling or crown, dip a cotton swab in clove oil and apply it to the exposed part of the tooth. Clove oil, available in pharmacies and supermarkets, works well to relieve tooth pain. You also can use a topical anesthetic, such as Anbesol, also available in pharmacies and supermarkets.
• Putting an ice pack on your face over the area that hurts also may relieve the pain. Apply the ice for 10 to 20 minutes of every hour, as necessary.
• If you will be traveling in an airplane, the change in pressure when the plane takes off or lands may make you feel more uncomfortable. You should get dental treatment before traveling by air.

What Our Renton Dentist Will Do

Even when dental problems cause a lot of pain, the problems — and the treatments — often are relatively simple if you seek help right away.

If you have a cavity, your dentist will clean out any debris, remove the decayed part of the tooth, and place a filling. Once the inner part of the tooth is protected, the pain will usually disappear immediately.

If your problem is related to debris under your gums, our dentist in Renton will use special instruments to remove the debris. If you have an infection, you may be given a prescription for antibiotics and pain medicine. If an antibiotic is prescribed, it is important that you take it as directed until you have finished all the medication.

An abscess in the tooth or gum may require more extensive treatment, such as drainage of the abscess, root canal treatment or tooth extraction.

To learn more about severe tooth pain, please call our Renton dentist office today!

If you’re serious about learning what’s causing your bad breath, consider scheduling an appointment with your dental professional. Given your full medical and dental history along with an oral examination, your dentist should be able to identify the culprit. The causes of bad breath are numerous and include certain foods, alcohol or cigarettes, poor oral hygiene, periodontal disease, diabetes, dry mouth, sinus or throat infections, lung infections or abscesses, kidney/liver failure, gastrointestinal issues and severe dieting.

Treatment of Bad Breath

It is important to conduct thorough oral hygiene at home twice daily utilizing tooth brushing with a fluoride antibacterial toothpaste and flossing to remove food debris and plaque on teeth, bridgework and implants, and brushing the tongue to remove odor-causing bacteria. A published study reported that tongue and tooth brushing in combination with dental flossing significantly decreased bleeding of the gum tissue over a two week period of time as well as reduced bad breath. Another clinical study conducted by the University of Buffalo dental researchers confirmed that brushing twice a day with an antibacterial toothpaste and using a tooth brush with a tongue cleaner can eliminate bad breath.

Tongue Cleaning is the Key to Fresher, Cleaner Breath

Cleaning your tongue is very important. You can purchase a Colgate 360 toothbrush with the tongue cleaner on the back of the toothbrush for cleaning both your teeth and tongue. After tooth brushing your upper and lower teeth with an antibacterial toothpaste, flip the toothbrush over to the tongue cleaner and place the tongue cleaner in the posterior region of the tongue and move it forward to the anterior section of the tongue. After you have scraped that portion of the tongue, rinse the tongue brush off with warm water to remove any odor causing bacteria. Then replace the tongue brush in the next posterior section again and repeat as described above again.

Consult your dentist or dental hygienist when choosing oral hygiene aids to help you eliminate plaque and odor causing bacteria and review the techniques that should be utilized at home. Also, ask your dental professional what oral hygiene care products they would consider you use to help eliminate bad breath (antibacterial toothpaste, antiseptic mouth rinse, tongue brushes or scrapers and interproximal cleaning devices). The key to a clean, fresh mouth is optimal oral hygiene conducted at home on a regular basis and professional recommendations discussed with you by your dentist.

How Do I Know if I Need Treatment?

As with any trauma to the mouth, you should consult with your dentist immediately to determine if treatment is required. The dentist will examine the affected area and may take X-rays.

If you are in pain from a broken, cracked or chipped tooth, you may want to take an over-the-counter pain reliever. If possible, keep any part of the tooth that has broken off and take this with you to the dentist. If a tooth is completely knocked out of the mouth by an injury, take the tooth to your dentist as soon as possible. It may be possible for your tooth to be placed back into your mouth, a procedure called reimplantation.

How Does a Dentist Treat a

• Chipped tooth —If there is no pain and the chip is small, it's up to you to decide if, when and how the tooth should be repaired. Depending on the size of the chip, it can be smoothed or cosmetically corrected. Other options include veneers, crowns and fillings. Ask your Renton dentist to explain these options. If a filling or artificial tooth becomes chipped, it should be replaced.
  
  
• Cracked or broken tooth —Cracked and broken teeth should be repaired as soon as possible to prevent further damage. Root canal therapy or tooth extraction may be necessary. If a crack affects the enamel and dentin of the tooth, a crown is frequently the best treatment. Keep in mind that cracks are not always visible, even on X-rays. Symptoms may involve pain while chewing and Sensitivity to cold and possibly hot foods and liquids, as well as air, which may over time become more pronounced.
  
  
• Tooth knocked out —The key to successfully reattaching a tooth is to get it reimplanted in the socket as soon as possible. With each minute that passes, more of the cells on the root of the tooth die. If possible, rinse the tooth with water only, then reimplant the tooth at the site and hurry to a dentist as quickly as possible. The tooth should be picked up by the crown only and must not be allowed to dry. The best chance for success is reimplantation within the first 30 minutes, with chances still good for up to two hours. It may be necessary for your dentist to do a Root canal treatment one to two weeks after the tooth has been stabilized.
  
  
• Permanently lost teeth, whether they've been removed by a dentist or accidentally knocked out, should be replaced. This is to avoid problems such as difficulty chewing and speaking, a shifting of position among remaining teeth, temporomandibular joint (TMJ) disorders caused by chewing on the side with more teeth, and a weakening of the jawbone. Options for replacing lost teeth include bridges, dentures and implants.
  
  
• Broken jaw —If you suspect you or someone else has a broken jaw, do not move it. The jaw should be secured in place with a handkerchief, necktie or towel tied around the jaw and over the top of the head. Cold compresses should be used to reduce swelling, if present. Go immediately to a hospital emergency room, or call your dentist.
  
  

If you have any emergencies or concerns, please contact our Renton dentist today!

It is estimated that 35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease. This infection attacks the tissue that keeps your teeth attached to your gums.

On average, more than 500 species of bacteria live in your mouth.2 Some of these bacteria are beneficial, while others under the right conditions can cause disease. Living a healthy lifestyle helps you keep the harmful bacteria under control. Not taking care of your overall health and your teeth and gums can cause an overgrowth of harmful bacteria, which may lead to serious health problems beyond the mouth, in addition to the threat of losing your teeth.

35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease

Factors that predispose people to gum disease include bad oral hygiene and genetics. In fact, research has proved that up to 30% of the population may be genetically predisposed to gum disease.3

Periodontitis, a severe form of periodontal disease, is caused by plaque that develops just below the gum line, in the area called the sulcus or periodontal pocket, where it causes the attachment of the tooth and its supporting tissues to break down. The mildest form of periodontal disease is known as gingivitis and is triggered by bacterial plaque that forms at the gum line.

What Is Periodontal Disease?

Periodontal disease is an infection of the tissue that supports your teeth. It attacks just below the gum line, where it causes the attachment of the tooth and its supporting tissues to break down.


WARNING SIGNS

• Pain in the mouth
• Gums bleed when brushing
• Spaces develop between teeth
• Swollen and tender gums
• Receding gums (exposing the bottom of your teeth)
• Persistent bad breath
• Pus between teeth and gums
• Sores develop

RISK FACTORS

• Tobacco use
• Systemic diseases
• Use of certain types of medicine
• Bridges that no longer fit
• Crooked teeth
• Fillings that have become defective
• Pregnancy
• Oral cancer

If you're showing warning signs, see your Renton dentist. Mild gum disease may be controlled by routine professional teeth cleanings and more diligent home care. Gingivitis and early periodontitis can be kept under control by your dental team.

Scaling and root planing also may be a step your dentist or hygienist takes to control early to moderate periodontitis. Scaling removes hard and soft deposits of calculus from the crown of the tooth. Root planing smooths away calculus deposits that collect on the root surfaces beneath the gums.1

Local, needle-free methods are available to keep you comfortable during this process. Your dental professional may also choose to perform this treatment one area of your mouth at a time over a series of office visits.

For advanced gum diseases, surgical treatments using local anesthetics may be performed. To reduce the size of gingival pockets, a periodontist folds back the gum tissue and removes the disease causing bacteria. He or she may also reshape the bone and gum, add bone grafts if necessary, and then stitch the tissue back into place.

What is a Diastema and How do I Treat It?

A diastema is an area of extra space between two or more teeth. The two front teeth of the upper jaw area is where diastema is most frequently seen. Many children experience diastema as primary teeth fall out, though in most cases these spaces close when the permanent teeth erupt.

Diastemas may also be caused by a tooth size discrepancy, missing teeth or an oversized labial frenum, the tissue that extends from the inside of the lip to the gum tissue where the upper two front teeth are located. Secondary reasons involve oral alignment issues such as an overjet or protrusion of the teeth.1

What are My Treatment Options?

Once your dentist or dental specialist has determined the reason for your diastema, a treatment plan will be discussed. Options may include:

• Keep the diastema.
  
  
• Orthodontic treatment to move the teeth and close the diastema.
  
  
• Use porcelain veneers, very thin pieces of porcelain bonded to the outside of the teeth.
  
  
• Crown and bridge work or replacement of teeth with implants (adults only).
  
  

If you have an oversized labial frenum, you may be referred to a periodontist for an oral consultation and surgical procedure called a frenectomy. This procedure involves cutting the frenum and then repositioning to allow for more flexibility. If the frenectomy is conducted on a child, the space may close by itself. If it is a teenager or adult, the space may need to be closed with braces. A consultation with your dentist is essential to determine which option is the right option to treatment for you.

If you're having diastemas and looking for a treatment option, please contact Dr. Stephen Cho today!