Just like a losing poker hand, you need to know when to fold. Are you tired of trips to the dentist? Massive dental bills? Unsightly teeth that keep falling apart? So why not end the misery once and for all? Dental implants offer a cosmetic and permanent solution to recurring teeth problems.
If you are missing nearly half your teeth, it will cost more to fix. And keeping teeth will not last as long.
If your remaining teeth are crooked and not straight, you will get a better cosmetic result with permanent implant dentures because the teeth can be put where they look and function the best.
If you have a lot of root canals, these teeth are dead and there is a greater risk of them breaking or getting infected. See article root canal vs implant.
if you need a lot of expensive dental work on your natural teeth and you get a lot of cavities, repairs on natural teeth may not last a long time.
Replacing a Full Mouth of Teeth with Dental Implants
This is a big decision and once it is done, there is no going back. Remove all your natural teeth and you cannot put them back. What happens if you hate the new teeth? Unlike a new car, you cannot take new teeth for a test drive and give them back. Most people love their all on 4 style implant teeth, but they are different than natural teeth. You need to know what you are getting yourself into.
There are Several Different Types of Implants
Additionally, there are many different ways to replace all teeth with implants. Make sure you understand all available options. You need to know what to expect with your new teeth. And how much it costs to replace all your teeth with implants. For purposes of this article we are considering the most popular permanent way to replace teeth with implants. Removable Snap-in dentures are also an option. And you can consider replacing all your teeth with individual implant crowns and bridges, but this solution is ridiculously expensive and usually not practical or superior to permanent implant dentures.
How are Permanent Implant Dentures Different?
Permanent implant dentures is a full upper or lower set of teeth installed as one piece into the mouth. The implant teeth feel different since they are one piece and made of a different material. The teeth are smoother and thicker than natural teeth. Not necessarily a bad thing but different.
Permanent implant teeth do not have nerves. Implants do not feel hot or cold. Probably a good thing. Implant teeth can chew with more pressure and without pain. Again a good thing until something breaks. A strong set of zirconia teeth is important for longevity. Some of the acrylic implant teeth can break more easily over time. Make sure you know whether you are getting zirconia or acrylic plastic implant teeth.
Hygiene and maintenance is different around permanent dentures. Implant maintenance is done with a tooth brush, waterpik and special brushes and floss.
Our Implant Center is Located in Burtonsville Maryland
Dr. Gary Adams sees patients in a small private practice setting in Burtonsville near Columbia Maryland. Dr. Adams does implant surgery and places the teeth that go on top. He practices with a holistic approach to dentistry that combines all the advantages of conventional implant dentistry and holistic techniques including PRF, PRP and dental ozone therapy. Dr. Adams has been replacing teeth permanently with implants for over 15 years. Most people we see come from the Maryland, Virginia and DC metro area. But we also see many people who travel from across the US and abroad.
Don’t Remove all your natural teeth. Consider saving your natural teeth. Saving your natural teeth may involve removing some bad teeth that are not repairable or worth fixing.
Do a partial mouth of implants. Save some of your natural teeth and replacing some of your teeth with dental implants. Sometimes, it costs less and the result can be better when just replacing some of your teeth with dental implants.
Partial Mouth of Dental Implants:
Often times the best option is to save all your good teeth, remove only the bad ones and replace only the teeth you need with individual implants and implant crowns and bridges. Sometimes extracting all your teeth is too aggressive. While full mouth implant options are wonderful, removing perfectly good teeth may not be the best option. You should consider how long saved teeth will last relative to implants and if saving teeth will compromise your result. For example, if keeping teeth will not look as nice and your are very susceptible to losing teeth and getting cavities and gum disease, it may be better to remove all your teeth and replace with a full mouth of dental implants. On the other had is your back teeth are good and you only need to replace your front teeth, it may be better to keep your back teeth and replace your front ones with a front tooth implant bridge.
What is All on 4 Dental Implants?
Permanent implant dentures is a way to permanently replace a full upper or lower set of natural teeth with a one-piece implant bridge. They are “also knows as All on 4.” Any remaining natural teeth need to be removed. 4 or more dental implants are installed per jaw. Finally, a set of teeth are installed onto the implants. All on 4 is a great option and is a lot less expensive than replacing all your teeth with individual implants and crowns. Of course it is necessary to remove all your teeth to do All on 4. It may be better to save some of your teeth and replace only the bad ones with implants. You should discuss what implant option is best with Dr. Adams. Clear Choice dental implants is a national chain that sells the All on 4 concept as their primary product. All on four may not be the best solution for everyone. Once you have rem
Full Dental Implants with Individual Crowns and Bridges
This option is self explanatory. All natural teeth are extracted and 20-25 dental implants are used to replace all natural teeth with individual implant crowns and implant bridges.
Bone Grafting, Gum Grafting, PRF Dental Stem Cells:
Very often implants may need bone grafting with platelet rich fibrin or PRF dental treatments. Also it may not be possible in all cases to remove teeth and perform implant surgery in the same day. This is called immediate implant surgery. Due to bone loss and infection it may be necessary to remove teeth and place the implants at a later date – delayed implant surgery.
Same Day Teeth or Teeth in a Day
It is almost always possible to deliver new teeth the same day all your teeth are removed. However, you do not need to be a dentist to know implants do not heal in 10 seconds and holes in you gum will heal and change shape. Therefore no dentist can complete a full mouth of dental implant case in one day unless he/she can turn water into wine. The good news is we can sedate you with IV sedatives, remove all your teeth, place several dental implants and deliver temporary teeth the Same Day. Then you will need to heal for 2-4 months at which point we can make your All on 4 or full mouth of implants. Typically this process only involves one day of surgery and the rest is easy.
How Long will it Hurt After Dental Implant Procedures?
The usual recovery period for dental implants is usually 5-7 days when any symptoms at all should reduce to minimal or no pain at all. Normally people can return to work right away provided they have not been sedated for implants. There are many patients who never experience any pain. Dental implant surgery itself causes very little trauma and normally minimal if any pain with one reason being there are very few nerves in jaw bone. During the first 1-2 days after dental implant Surgery, there may be some dull achy pain with some occasional throbbing controlled by prescription medication. 3-5 days after an Implant procedure, you should feel mild to moderate soreness and maybe a very small amount of aching at night time. This is the absolute worst case scenario. If there is any more pain than what is described above, you should call your implant dentist.
Bone Grafting and Extractions Increases Recovery Time
If you fracture a front tooth, it needs to get fixed or replaced ASAP. If the tooth cannot not be repaired, the ideal treatment is emergency removal and replacement with a dental implant. Of course you want to get a new tooth right away. In this scenario, you would undergo a tooth extraction procedure, bone grafting and implant surgery all at one time. Of course, an accident causes trauma when a tooth is broken,
Some Bone Grafts are more invasive than Others
Bone grafts can be minor or major. During trauma, part of the bone can break with the tooth. Replacing a volume of bone, (Block Bone graft), take additional time. Longer surgical times cause more pain and swelling after. Obviously, this procedure is going to be more painful. Placement of implant is usually easy and much less traumatic than tooth removal. After extraction, the implant is placed approximately in the the same site. Once the tooth is out, any bone grafting is done, implant is placed, stitches. After, immediate implant surgery most people do not suffer more than moderate pain for 1-3 days. The pain is controlled by prescription medications.
Implant Surgery Alone Causes Very Minimal Pain
Implant surgery usually does not hurt that much because there is very little trauma. Other procedures with implants can cause additional, but manageable pain. What little pain there is with implants, the reward is permanent tooth replacement.
Average Dental Implant Recovery Time Line
Days 1-2: Possible dull achy pain with some occasional throbbing controlled by prescription medication.
Days 3-5: Mild to moderate soreness and maybe a very small amount of aching at night time.
Days 5-7: Very minimal to no pain at all
When Can an Implant be done after Tooth Removal?
The best time to install a dental implant is at the time of natural tooth extraction. That is called immediate dental implant placement. The results of Dental Implants are better when you place a dental implant at the time of tooth extraction. Removing teeth and placing implants at a later time causes bone and gum loss. It also puts a patient through two procedures versus one. Two procedures normally costs more time and money too (note: It is usually necessary to do a bone graft in an extraction site to preserve bone for a future implant. Sometimes Immediate Implants do not require a bone grafting.). In some cases where there is a lot of infection It maybe necessary to place a dental implant at a later date. It is best to wait a very short period of time to prevent bone loss. In some cases, It maybe necessary to do a bone graft and have it heal prior to placing an implant. In my experience, this happens 25% of the time.
Can I get an Implant and a bone graft at the same time?
It is best to do an implant and a bone graft at the same time. The implant Provides a structure and a base for the new bone to grow up and around. Bone grafting may need to be done before placing implants if there is too much infection and bone loss or if there is not enough bone to place an implant.
Are bone grafts always necessary with Implants?
No. If there is enough bone present to place an implant, than no bone graft is necessary. There is adequate bone when there is enough bone height, width and quality of bone to place an appropriate size implant to replace the missing tooth. Common situations where there is adequate bone is 1) a previous extraction site where the site healed favorably and enough bone remains to place a dental implant 2) a site where a tooth is extracted and an implant is placed into the same extraction site.
So, How long does it take to heal after dental implants? Really how long it takes for an implant to heal depends on what needs to be done to get an tooth replaced with an implant. There a really 3 implant healing scenarios:
implant can be placed right away with no need for a bone graft. The healing period in this case is 3 months and then there is osseointegration of bone and a crown can be placed on the implant root.
implant can be placed right away but it may be done at the time of extraction and bone grafting. In this case, the healing period is 3-4 mos.
implant cannot be placed right away. There is a need for a bone graft to be placed and a preliminary 4 month healing period prior to an implant being placed. Then an implant can be placed with upto another 4 month implant healing period. In this scenario, the total implant healing period is 8 months.
Are dental implants better than dentures?
Partial dentures will lead to more tooth loss because it connects to remaining teeth and leverages them. Partial dentures ultimately lead to more tooth loss. Dental implants replace teeth, function and prevent bone loss. Dentures artificially replace teeth with fake prosthetics that stick or clip onto teeth or gums in the mouth. Dentures are not stable and since they do not replace tooth/root structure, there is still further bone loss. Implants look, feel and function similar to natural teeth. They also usually last a lifetime.
How painful is the dental implant procedure?
Dental Implant procedures do not normally cause much pain at all. There is not much trauma caused by the procedure and there are very few nerves in jawbone. Most individuals experience very minor symptoms that go away a week after a dental implant procedure. Procedures done with dental implants such as bone grafts and gum grafts and tooth extractions that do cause additional inflammation, discomfort and pain. Most oftenThe pain during any of these procedures is well-controlled by prescription medications.
Should I replace all my teeth with Implants?
It may be more expensive, less predictable and produce a poorer result to fix all your natural teeth versus replacing all your teeth with dental implants, implant crowns and implant bridges. The decision to replace all your natural teeth with dental implants should be weighed very carefully and discussed with your dentist. A consultation with a dentist who has lots of experience doing dental implants and implant crowns and bridges on natural teeth is required.There are many considerations here including The amount time, money and health considerations that need to be weighed. Individuals who have high levels of susceptibility to cavities and gum disease may be better off replacing all their teeth with dental implants. Replacing all your teeth with dental implants is highly predictable, the results are beautiful and typically dental implants last a lifetime. People keeping natural teeth may experience future failures with cavities and gum disease and have future tooth loss. These people will find themselves spending additional money and may eventually find themselves ultimately replacing all the natural teeth with dental implants anyway.
Natural Teeth in good Condition are better than Implants
All things being equal, Individuals with natural teeth that are in good condition are typically happier than individuals with a full mouth of dental implants. Any time you are going to consider spending a lot of money on crowns and bridges and root canals on natural teeth, it is very important to consider the likelihood of future failures. People who are highly susceptible to tooth decay and gum disease are very likely to be disappointed when their teeth fail once again in the future.The key here is to understand your level of susceptibility and be comfortable with your financial investment. If you have tons of money, and do not mind receiving future dental work, It may be better to keep your natural teeth. My point here is not to provide exact advice but rather to provide the rationale and logic for helping you to make the right decision about whether or not you should replace all your natural teeth with dental implants.
Can i have braces after dental implants?
Dental implants do not respond to orthodontic movement and they do not move when in braces. It is possible to have braces with implants. Teeth need to be moved very carefully around dental implants but make not mistake only the natural teeth surrounding the dental implants will move. Implants and bridges present in the mouth will not move with braces. Only individual natural teeth will move in a predictable fashion.
There are Orthopedic Services that will effectively grow bone and move teeth such as the DNA Appliance and ALF Appliance. DNA appliances are especially effective when there is tooth crowding and a small mouth and TMJ issues.
How long does a dental implant process take?
The dental implant process can be completed in as little as 10 weeks. How long the dental implant process takes depends on what needs to be done to replace a tooth. If there is enough bone present to place an implant, the implant only needs to heal for 8 to 10 weeks, at which point a crown can be placed on top of it and the implant process is complete. Many times there is a need for extensive bone grafting. Bone grafting can take up to four months to heal prior to placement of a dental implant. As stated before, the dental implant takes 8 to 10 weeks to heal, so if a site needs a bone graft and a dental implant placed separately, the patient can wait up to eight months to complete the implant process. Every tooth replacement case is different and the condition of the jaw bone in the area where the tooth needs to be replaced, determines how long the dental implant process will take.
Does getting dental implants hurt?
Dental Implants typically do not hurt too much. In fact many individuals receiving dental implants do not feel much of any pain at all. Typically there can be a little bit of soreness and an achey pain for a couple days, but all the pain typically goes away after one week. Most symptoms are controlled by prescription strength medications.
What is the best full set of dental implants
The best full set of dental implants is when individual implants are used with crowns and small bridges to replace all the natural teeth. This solution can take up to 10 to 12 implants per jaw and many individuals will not do this solution because of the high costs. Implant solutions vary in cost based on the number of implants and the type of teeth or crowns that are placed upon the implants. The All on Four Implant solution is a one piece bridge that can be connected to 4 to 6 dental implants and can replace and entire upper or lower set of teeth. This solution is very popular because the implant bridge stays permanently in the mouth and is far less expensive than a full mouth of implants and crowns. Not all implant bridges are the same, some of the teeth are made of plastic and others are made of high quality and very natural looking porcelain and zirconia. Ask questions so you know what you are getting in your mouch. One other solution is an implant denture solution that is removable and involves far fewer implants. An implant denture just like a conventional denture is made of acrylic or plastic teeth. This solution can be very functional and cost effective.
Is Pain After Dental Implants normal?
It is not normal to have much of any pain after a dental implant. If you are having significant pain from a dental implant you should contact your implant dentist. It is normal to have a minimal amount of discomfort for a few days after a dental implant surgery at which point there should be very little to no symptoms after a week.The pain from a dental implant should be very well controlled by prescription medications.
How Successful Are Dental Implants?
Dental implants are typically between 95 to 97% successful. Success rates will decrease when there are individuals who are unhealthy or there are teeth implants being placed into jaw bone where there used to be root canals and other bad dental infections. Sometimes when there has not been a tooth present for a long period of time, implant success rate decrease due to bone atrophy (even when bone volume is good. Just because there is bone, does not mean the bone is vital and of good quality. especially where root canals have been the bone health can be especially poor). Once there has been a failure of an implant and after the site has healed, the success rates go back up to 95 to 97%. This is because the jawbone and has regained its capacity to heal and is more vital than before. Take for example, a root canal site where there has been lots of infection and lets get technical here -a root canal is a dead tooth and there obviously is a strange relationship between a dead tooth and live jawbone. Root canals seem to create an odd relationship between a dead tooth with foreign material stuffed into the root and live jawbone. Placing dental implants into sites where root canal teeth have been can be very unpredictable. I have to admit a certain amount of anxiety about placing an implant into the root canal site. I place dental implants the same way every time and theoretically there should be uniform success rates across teeth replaced with dental implants. I find that dental implants experience lower success rates when they are replacing a root canal tooth.This does not mean you should not have a root canal tooth replaced with a dental implant, It just means that there may be some difficulty in getting it replaced and you should not blame your implant dentist for the failure.
Is it necessary to replace a missing tooth?
When teeth are not replaced with a dental implant or bridge, the remaining teeth will shift and there is a tendency for more teeth to be lost. Typically the loss of one tooth will lead to the loss of several more teeth10 years down the road. If someone is serious about keeping their teeth in their mouth, it is necessary to replace a lower molar with a bridge or a dental implant. Once teeth are lost, there will be more pressure placed upon the remaining teeth and teeth will shift and there will be more gum disease and tooth cavities.
Are dental implants safe and reliable?
Implants are very safe and reliable. In fact they are more reliable than natural teeth because they are not susceptible to cavities of gum disease.
Can you get invisalign when you have implants?
You can do Invisalign with dental implants, however the natural teeth will move but the dental implant will not. Treatment should be planned so the movement will only be done by the natural teeth and not the dental implant. There are dental orthopedic appliances that will work in situations where there are implants and tooth crowding. The ALF Appliance and DNA Appliance are examples of appliances that will work with dental implants. All this being said, it is better move teeth and grow bone prior to placing dental implants whenever possible.
Oral Surgeon or Regular Dentist for Dental Implant?
Neither. It is best to find a dentist that is very experienced in placing Dental Implants and the implant crowns that go upon them. It is best to find one dentist who does both of these things. A dentist who places and restores dental implants will likely produce the best results for the patient. An implant dentist will see the case from start to finish with the end result in mind and understands every aspect and detail of replacing teeth with dental implants. An implant dentist can replace teeth with dental implants faster, more efficiently and typically for a lower price. I am sure if you asked a regular dentist and an oral surgeon, they would disagree. Everyone is entitled to their opinion, and this is my opinion.
What’s the best type of specialist to see for dental implant?
It is best to see a dental implant specialist. Unfortunately in the field of dentistry because of politics, the dental boards do not recognize any dentist as being an “implant specialist.” You will need to interview your dentist and ask them things like how many implants they have placed and whether they do implant surgery and implant crowns. It is best to find a dentist who has lots of experience with doing implant surgery and implant crowns. An implant dentist that does a lot of dental implants typically has a 3D x-ray machine also called a CBCT cone beam system. 3D Xray machines are very expensive and can only be purchased by a dentist who does a lot of implants. 3D x-ray machines are typically found in offices where they specialize in dental implants. And example of a 3-D x-ray machine is an ICAT. Many implant dentists and oral surgeons have these machines.
How long to dental implants take to heal?
Typically it takes 8 to 12 weeks for a dental implant to heal. Sometimes in areas where the bone quality is not as good or bone grafting is necessary, it can take up to eight months to successfully receive a dental implant tooth.
How old do I need to be go get dental implants?
Dental implants should not be placed before the age of 16 or 18. Individuals who are still growing and where there is significant growth still occurring, should not receive a dental implant till the growth is mostly complete.
Do you think I am too old to have dental implants done?
Any individual who wants to continue to be able to eat their food and is healthy can receive a dental implant. As stated above, someone should reach the age of 16 or 18 before receiving a dental implant.
What are the benefits of dental implants?
Dental implants can provide a permanent tooth replacements solution. Dental implants Help people continue to be able to chew and smile and carryout normal life activities. Dental implants prevent bone loss, Provide a stable chewing function and promote overall health. Dental implants do not promote tooth loss as many tooth replacement options have done in the past.
Will dental implants prevent bone loss?
Yes, dental implants absolutely prevent bone loss. Dental implants stimulate the bone as food is chewed upon them. If implants are placed in a timely fashion after teeth are lost, there really is no opportunity for bone loss.
I have metal in my mouth dental implants — anyone know if this would be a problem?
Metal in the mouth can be a problem especially if there are different metals in the mouth. For example an individual can have a gold crown, silver filling and a titanium implant. Care must be taken when there are multiple metals in the mouth. Different metals will react with one another in the mouth causing electricity to flow fromThe different metals. When electricity flows, there is also a magnetic field. This is called a galvanic reaction. Certainly the addition of another metal, Titanium, needs to be considered.
Which material implant is best for an incisor?
Probably a ceramic or Zirconia implant since it is tooth colored and will never show any metal color by the gum line.There are circumstances where the issue of titanium versus zirconia implants needs to be weighed. Generally ceramic is a better choice in the cosmetic zone.
What are the symptoms in a dental implant failure?
Moderate to severe pain or if the implant is loose.
Dental Implants versus Partial Denture
Dental Implants replace the root structure and the chewing function and power of the lost tooth. Dental Implants prevent bone loss. Partial dentures attach and put pressure on the remaining teeth. Partial Dentures a large, bulky, annoying and uncomfortable…they can rub on the gums. Partials eventually cause more tooth loss by putting pressure on the remaining teeth. Partial Dentures will cause you to lose more teeth and you will even need more implants later.
Do I need to be put to sleep for dental implants?
No. Unless you have extreme fear. It may be a good idea to be sedated if you are receiving multiple implants and extractions. We offer dental implants sedation
PRF is useful in bone grafting and dental implants because it helps the body heal faster, promotes better bone and gum tissue growth, reduces the risk of infection, and decreases pain and swelling after dental surgical procedures. It is made from the patient’s own blood which ensures it is safe and biocompatible with the body. Platelet-Rich Fibrin helps with healing in procedures such as bone grafting and dental implants. The blood sample is taken from the patient immediately before the procedure and put in a centrifuge for 8-12 minutes.
PRF offers several advantages:
Faster healing: PRF has special elements called growth factors, which speed up the healing process by helping cells move, grow, and change in the body.
Better bone growth: The growth factors in PRF help new bone form more quickly and improve the quality of the bone graft, which is important for dental procedures.
Improved soft tissue healing: PRF helps the soft tissues around the dental implant or bone graft heal faster by reducing inflammation and promoting the growth of new blood vessels.
Lower chance of infection: PRF can help fight against infections during and after dental procedures because it has natural germ-fighting properties.
Less pain and swelling: After dental procedures, patients often experience pain and swelling. PRF can help reduce these symptoms, making the healing process more comfortable.
Made from the patient’s own blood: Since PRF is made from the patient’s blood, there’s no risk of catching diseases from someone else’s blood or having an allergic reaction. This means the body is more likely to accept PRF and heal well.
How PRF bone grafting works
PRF is extremely beneficial in bone preservation, formation and new bone deposition around newly placed dental implant sites. Platelet rich fibrin, also called PRF greatly enhances and accelerates the biological process of growing bone around the surface of implants and jaw bone tissues. Successful implant healing is achieved in the presence of platelet rich fibrin which is the first and foremost step for the success of tooth replacement.
PRF helps bone defects regenerate and heal. Especially around front teeth and areas of greater esthetic concern. Platelet rich fibrin helps bone regeneration and helps in filling the defects to facilitate excellent outcomes in a short amount of time. PRF remains active in the surgical site for approximately 14-28 days as compared to 14 hours duration of platelet rich plasma.
Platelet rich fibrin dramatically increases implant surgery success rates. In addition to increasing the quantity of bone in the required dimensions, it also enhances gum tissue growth and regeneration following dental implant placement. Deposition of cementum-like tissues has been associated with platelet rich fibrin further making dental implants mimic natural teeth roots. Platelet rich fibrin has been considered as the gold standard in all procedures involving indications for bone and soft tissue regeneration and imparting beautiful smiles in areas requiring larger bone fills is quite possible now. PRF helps oral surgeons with wisdom tooth extraction sites. It facilitates at an accelerated rate. And it also reduces the risk of infection.
Platelet Rich Fibrin Preserves Bone in Extraction Sites
Successful dental implant surgery requires sufficient thickness, quality, width and quantity of healthy jaw bones in the intended socket area following loss of natural teeth. Resorption and loss of socket bone following removal of compromised natural teeth is common and approximately 1/4th of the bone around empty sockets diminishes in the first year after tooth removal. Immediate implant placement has been documented to be a successful method for preventing these unwanted consequences but cannot always be performed. Similarly, socket preservation methods leaving some portion of the root within the jaw bones have also shown less bone dissolution. Recent innovations have given rise to autologous platelet concentrates which have shown promising results. Platelet rich plasma has been in common practice for bone and soft tissue regeneration and preservation but it showed lesser efficacy and the need for an activator and associated coagulopathies due to presence of bovine thrombin limited its use.
Dr. Adams has been using PRF in his implant and oral surgery practice for years. PRF in wisdom teeth and implants presents many advantages most notable including accelerated bone healing and health. Not to mention, surgical outcomes with less pain and swelling. PRF in implants and wisdom teeth removal sites offers many advantages and adjuncts to conventional bone grafting and tissue regeneration techniques. The natural biological dental practice is located in Burtonsville near Silver Spring, Clarksville and Columbia Maryland.
Recent advancements in dentistry have given rise to the formulation of extremely beneficial and useful platelet concentrates termed PRF or Platelet Rich Plasma. These platelet concentrates or PRF, contain suspended growth factors in large quantities which can help in rapid repair, regeneration and healing of oral soft and hard tissues such as gums, teeth components and dental implants. These are termed as the promoters of wound healing and tissue regeneration. Wisdom tooth surgeries are considered among one of the major dental procedures with greater chances of bone removal around impacted teeth. Bone removal in wisdom tooth removal may lead to delayed wound healing and chances of swelling after surgical procedure. Some people report pain, swelling, limited mouth opening and discomfort for approximately one week following surgical extraction of wisdom molars. PRF with implants and wisdom teeth results in faster healing and better bone integration to the implant.
After surgical removal of third molars or wisdom teeth, blood clots are formed which start the healing and regeneration process of oral soft and hard tissues. Normally blood clots contain only 5% platelets while platelet concentrates or PRF contain approximately 90% platelets which contain important growth factors having ability to support wound healing process. Specially designed platelet concentrates such as platelet rich plasma and platelet rich fibrin ( PRF ) are basically blood derived bioactive surgical additives used a local application on the wound sites for promoting the healing process. Autologous platelet rich plasma gel (PRP) is the first generation platelet concentrate which requires an activator for performing its beneficial actions. PRP can remain active up to 7-14 hours after its application in the surgical site. PRF with Wisdom Tooth Removal is an ideal treatment.
The drawbacks of PRP have been diminished and overcame by the development of second generation platelet concentrate, platelet rich fibrin (PRF). PRF does not need any activator for performing its regenerative and wound healing promoter functions. PRF is prepared by taking patient’s own blood and functions normally once placed at the intended site of action. It has been associated with sustained long term release ranging up to 14-28 days. PRP and PRF are rich in fibrinogen in addition to growth factors. PRF has been considered as a revolution in oral and dental regeneration procedures.
Our belief is that PRF is best treatment for Implant Surgery and Wisdom Tooth Removal. In addition to their beneficial role in wisdom tooth surgeries, PRP and PRF have following applications:
Periodontal regeneration,
Bone regeneration,
Surgical repair of alveolar clefts,
Dental implant Osseo-integration,
Socket healing,
Better handling of bone grafts due to its sticky nature,
Why CBCT Cone Beam 3D Xrays are Necessary for Implants and Removal of Wisdom Teeth
Yes it is necessary to take a cone beam 3D x-ray for removal of impacted wisdom teeth because the the dentist needs to see all the nerves and arteries in the jaw to insure they are not harmed during wisdom teeth surgery. Additionally, it is helpful to know where the impacted teeth are in the jaw to avoid making surgical incisions on the wrong side of the jaw (tongue side vs cheek side).
The incidence of impacted third molars has been quite high ranging from 16%-72%. Wisdom teeth become impacted due to slow development of jaw bones, tight spaces for teeth eruption, and abnormal facial development patterns. When teeth crowding is seen expanders are needed to create room for proper occlusion, tongue function and breathing. Avoid removing teeth for braces and to straighten teeth.
Jaw infection and spread of infection into other facial spaces
Keeping Wisdom Teeth Can Cause Tooth Loss and Infection
Your dental health care provider will decide whether or not to remove impacted wisdom tooth. Most often wisdom teeth removal is recommended when impacted teeth are causing oral infections and hindrance with normal oral functions. Often wisdom teeth will put pressure against the roots of other teeth. The pressure can damage or destroy other teeth. Wisdom teeth can also be difficult to clean and cause decay to molar teeth in the back of the mouth. Wisdom teeth removal becomes necessary when keeping the teeth can cause further tooth loss and infection. Wisdom teeth may not have enough room to grow into the mouth. Special care must be taken whenever third molar surgery is planned especially in the lower jaw due to presence of vital structures including nerves and major blood vessels in close proximities of teeth.
Platelet Rich Fibrin Helps Wisdom Teeth Surgery Healing
Severe bleeding episodes and loss of nerve sensations have been associated with wisdom tooth surgery. Complete evaluation and comprehensive visual and radiographic examination is extremely necessary for prevention of complications and uneventful removal of wisdom teeth. Simple 2D xrays including periapical and panoramic views only show two dimensional details and are often insufficient for planning of wisdom tooth removal procedures. Three dimensional cone beam scan and CBCT scan are considered to be the modern modalities of choice for the assessment of proximity of vital structures in relation to wisdom tooth roots. 3D imaging should be utilized in complex cases with impacted wisdom teeth with dilacerated roots or where significant abnormalities are encountered. CBCT is also necessary for implant dentistry.
CBCT 3D lmaging is Especially Helpful When:
Wisdom teeth which lie deep either superimposing on the mandibular nerve canal or seem to be crossing it on regular radiographs,
Disrupted nerve canal outline depicted in regular x rays,
Nerve canal having a step or curve in its course where wisdom tooth roots join,
Where associated cyst or other pathology is evident.
generally any procedure where it is a tooth is going to be removed where the roots go deep into the jaws and the extraction is going to be anything other than straight forward and simple.
In conclusion, 3D Xrays and CBCT help prevent serious consequences such as permanent nerve paresthesia, numbness and discomfort following wisdom tooth removal. Cone beam xrays also help guide and assist the clinician help determine the location of roots where extractions are needed. CBCT or cone beam x rays are necessary for most lower extractions unless the tooth is already loose and can be visualized in the mouth.
A treatment that is very helpful in better wisdom teeth and implant surgery healing is PRF in implants and wisdom teeth. CBCT cone beam scan necessary – yes to protect your nerves and arteries.
Healthy Tongue Function Stimulates Jaw and Facial Growth
Early diagnosis and treatment of tongue ties and lip ties can correct crowded teeth, mouth breathing and sleep apnea. If a tongue is “tied” down it has limited range of motion. Tongue pressure while a child is growing expands the jaws so it grows to be the right size and shape. If the tongue is not working properly, healthy facial growth will not happen. Releasing ties, myofunctional therapy, breathing exercises and orthodontic expanders are the keys to treating crowded teeth, jaw under development and mouth breathing.
Tongue Tie and Mouth Breathing Link
When the palate and nose do not grow wide enough from tongue pressure, people will turn to breathing through the mouth instead of the nose. It is very important to treat tongue ties and restore the function of the tongue. And our goal needs to be to stop mouth breathing because of all the health benefits of healthy breathing patterns.
Tongue and Lip Tie Release
Dr. Adams releases tongue ties using a diode laser and a functional technique. The functional tongue untie verifies the tongue has a healthy range of motion after the procedure.There is no bleeding and minimal pain after the procedure when a laser is used. We also give myofunctional therapy and breathing exercises to improve tongue function.
A tied tongue can not reach the palate. The tongue is responsible for developing the shape of the palate and the entire mouth and nasal passageways. Tongue pressure on the palate is what causes natural palatal expansion. Palates will be high-vaulted and narrow if the tongue does not do it’s job. When jaw spaces do not grow to be large enough, air does not pass properly through small mouth and nasal spaces. Sleep disordered mouth breathing is the result. During disordered breathing, muscles in the face put irregular strain and pressure on the jaws and facial bones. This causes the jaw and facial bones to grow to be the wrong size and shape.
Many Kids Mouth Breathe and have Crooked Teeth
Did you know that 15% of children with crowded teeth have an undiagnosed moderate to severe airway or pediatric sleep apnea problem? Small mouths and airways can lead to TMJ pain and sleep apnea in adulthood. When parents see crooked teeth, they need to be concerned about more than straight teeth.
Diagnosing Lip Ties
Lip ties will draw the lips back onto the teeth, resisting outward growth of the jaws. When a tongue is un-tied it can regain range of motion and promote proper facial development. Often myofunctional therapy and tongue exercises need to be done for the tongue to properly regain normal range of motion.
Tongue tie and lip can be easily be treated in 1 min. with minimal pain and no bleeding. A diode laser treatment removes the unwanted attachment or “tie” in seconds. The Procedure is called a “lingual frenectomy”. Early treatment can prevent mouth breathing and sleep disordered breathing.
Functional Tongue Untying Procedure
Once a tongue is untied we want it to function properly. Proper function needs to be verified during the procedure. We call this functional tongue untie. Basically once the tongue is cut with the laser, the dentist will as the patient to move the tongue around to verified it has a normal range of motion. Usually the dentist will need to stretch the tongue out forwards and side to side. The tongue stretches will release adhesions and tight tendons. Occasionally, if the tongue still does not have good enough range of motions, the dentist may cut more of the posterior tongue tied area.
Myofunctional Therapy and Tongue Exercises
Myofunctional therapists are specially trained professionals who focus on improving tongue function. Myofunctional tongue exercises are very useful to help the tongue not reattach. People who do exercises after untying a tongue are 56% less likely to see re-attachment. Tongue ties that are untied using a functional technique are 63% more likely to achieve tongue function that is normal.
How Facial and Jaw Bone Grows with Expanders
The Tongue and Development of the Mouth
Tongue plays an important role in the normal development growth and function of mouth structures. Tongue is present in the floor of mouth and is attached to different bones through muscles. Tongue makes connection with the lower jaw, hyoid bone, styloid process and pharynx.
How Does the Tongue Naturally Expand the Palate?
Mastication, chewing, swallowing, taste perception and sound production are among the important functions in which tongue assists teeth and mouth structures. Tip and margin of tongue, its dorsum and inferior surfaces and its root all play their part. The tip or margin of tongue usually rests against the upper front teeth while body of tongue rests against the palate. When your tongue is placed in correct posture, it exerts an upward and forward force on upper jaws helping in proper growth and development. Abnormal tongue posture causes disturbed jaw development as well as crowded teeth.
Tongue Pressure can Easily Move Teeth and Grow Jaw Bone
Approximately 1.4 grams force is usually sufficient for causing movement of teeth and alterations in the bone structure in your mouth. Tongue muscles are capable of exerting approximately 500 grams force. These forces must work properly in a coordinated fashion according to body’s requirements in order to achieve healthy functioning and attractive smiles. These forces can be balanced if swallowing patterns are under control and upper tongue rest posture is maintained. This helps in the normal eruption of teeth around the tongue in lower jaw and prevents mal-alignment and development of rotated and crooked teeth.
Proper Tongue Position
The tongue should rest against the palate. The lips should comfortable seal the mouth. Teeth position is slightly apart or in very light contact. A perfect teeth occlusion and a beautiful smile depend upon normal tongue posture and healthy function and range of motion.
Many Adults with Tied Tongues have Airway and TMJ Problems
Most kids will benefit from some form of orthodontic treatment between the ages of 6 and 11. The most popular age to start braces is 8-9 years of age. When and how much orthodontic treatment depends on how natural jaw and facial development progresses. If your child has a very small mouth and lots of teeth crowding, they will need lots of help and they will need orthodontic treatment at an earlier age. If a child’s jaw structure grows to be the right size and shape, usually the teeth will have plenty of room to grow into the proper places and spaces.
The human head has been shrinking for over 500 years
The reality is most kids are not growing enough in the mouth and nose areas. This happens due to soft diets, genetics and developmental factors. Expanders are appliances that help the jaws to grow larger. when they are under developing. There are many different kinds of kids expanders depending on the size and shape of the teeth and jaws. The needs of each kid is highly variable. Unfortunately human jaws and face have been shrinking generation after generation due to cooked foods, softer diets and processed foods. We are not cave people anymore.
Most kids will need a combination of braces and expansion. We use a protocol called holistic orthodontics where the goal is to not only straighten teeth, but create a nice facial profile and the conditions for proper nasal breathing, posture and a balanced bite.
Expanders Should be Used Before Braces
Orthodontic expanders help the jaws grow to be large enough for all the teeth to fit. If there is not enough space, it is very difficult to achieve a good orthodontic result. Often space is created with braces by dragging the teeth further back into the mouth. Plain and simple, if there is not enough space for all the teeth to fit, braces will pull teeth back and squish them into an unstable place. Even with retainers, they will not stay straight into adulthood.
Forward Growth Expanders and Holistic Orthodontics
ALF Palatal Expander
What is Holistic Orthodontics?
Holistic orthodontic therapy focuses on straightening teeth, bite balance and healthy nasal breathing patterns. Expanders help the jaws grow to be the right size a shape, so the teeth will fit into the correct places and so the bite will be balanced. Use of expanders and releasing any tongue and lip ties will stimulate proper jaw and facial development. The tongue is the natural expander, but it cannot expand the palate properly when it is tied down. The goal is to get the jaws to grow to be the right size and shape. After expanders, straightening teeth is a much simpler undertaking.
Orthodontic Expanders are Anterior Facial Growth Appliances
Expanders including the ALF appliance use light and natural forces such as the tongue. The are many different kinds of expanders that work well for kids. The ALF is an example of a palatal expander. If Expansion is initiated at the right time, a child may never need braces. If you notice your child getting crowded teeth, you should see us for a consult immediately. Crowding of the teeth is a major sign of under development. By the time crowding has occurred, the child has a developmental problem that is more difficult to treat.
Dental braces aims at improving your facial profile and smile makeover as well as daily functional demands of chewing and biting food. Crowded, mal-aligned and crooked teeth cause serious functional and cosmetic concerns especially in growing children and adolescents. Loss of self-esteem and confidence due to unsightly appearance of front teeth can seriously damages the personality development and growth of children in their teenage. Baby teeth come erupt in the mouth of infants around an age of 6 months and function up to 6 years of age. The first permanent tooth comes in the mouth around the sixth birthday of your child.
Kids Grow the Fastest in the Mixed Dentition
An age range of 6-12 years is known as the mixed dentition period where baby teeth and permanent teeth both are present in the mouth. This time period is usually characterized by dental development as well as general body growth and development. Majority of orthodontists consider this age ideal for the management of crooked and mal-aligned teeth through dental braces. Some prefer to say an age ranging from 10-14 years to be ideal.
Orthodontics can be done at any age but earlier is better
However, there is no age restriction for dental braces treatment and all age groups can benefit whenever they wish to opt for it. Mixed dentition and teenage is considered best for dental braces treatment as the child is still under growth period and the body copes better with changes in teeth arrangement and bone formation around the new position of teeth reduces the chances of teeth returning to their original position. Growing head and mouth are more conducive to straightening of crooked teeth and stability in the new achieved position and alignment.
Condition of child’s teeth usually guides regarding the decision for starting dental braces treatment. When a child loses baby teeth and grows new permanent teeth, an interceptive orthodontic approach is usually preferred by the dentists. It means using different orthodontic appliances instead of braces at this early age followed by the use of braces once all permanent teeth erupt within the mouth. If Appliances are used at the right time, treatment time for braces will be a lot less or may not even need to be done at all. This approach helps in achieving the best possible results with dental braces in future and the outcome of the child’s smile and facial development.
The Best Treatment to Prevent Dry Socket is Platelet Rich Fibrin Therapy (PRF). The therapy involves simply drawing one small vial of blood from the patient. The blood sample is processed in a centrifuge in minutes while a tooth is extracted. The “processing” involves isolation of the blood fibrin and white blood cells from the patients own blood. After extraction, the extraction socket is thoroughly cleaned to remove any infectious cysts and the tooth periodontal ligament (PDL). The cleaned extraction socket is then treated with ozone and oxygen gas followed by placement of the PRF preparation of Fibrin and White Blood Cells.
Benefits of PRF Treatment in Tooth Extraction Sites:
Faster Bone Healing
Less Pain after Tooth Extractions
Decreased Swelling During Healing
Decreased Chance of Dry Socket and Bone Infection
Increased early blood supply to Tooth Extraction Socket
Tooth removal is necessary when tooth infection becomes untreatable or a tooth cannot be repaired. Removal of diseased teeth can lead to serious post-tooth extraction complications and consequences if not managed properly. Complete evaluation and comprehensive treatment planning is necessary to prevent post-extraction jaw bone or tooth extraction socket infections. An assessment of the pre-extraction infections involving the area surrounding diseased teeth should be carefully performed. In addition to localized infections and conditions, systemic and medical health status must be kept in mind. History taking must involve complete medical history and systemic abnormalities must be taken into consideration.
The most common post-extraction complications are pain, discomfort, swelling and development of Dry socket. Dry socket develops when the blood clot in a healing tooth extraction site dislodges from the tooth extraction socket soon after extraction of teeth. Clot displacement is associated with lysis of fibrin and delayed wound healing. You will feel severe pain and discomfort 2-3 days after tooth removal.
Dentists are in a unique position to do a lot of good for patients who suffer from obstructive sleep apnea. The Vivos and Homeoblock appliances are two examples of sleep apnea mouth guards that can cure sleep apnea and bruxism. The oral appliances slowly increase the size of the mouth and nasal passageways. An increase in space naturally resolves airway obstruction and resistance issues. More space allows for the tongue to fit properly in the mouth rather than being displaced into the throat where it blocks airflow during sleep.
DNA appliance image
Myofunctional Therapy and Breathing Exercises
People will also be asked to perform tongue and breathing exercises to strengthen the muscle tissue in the mouth and throat, so they are strong and do not collapse so easily. This form of physical therapy is called myofunctional therapy. Breathing exercises will increase the strength of the muscles in the throat referred to as the infrahyoid and suprahyoid muscles. Other breathing exercises will focus on restoring proper nasal breathing and preventing mouth breathing during sleep.
Mandibular Advancement Sleep Apnea Mouth Guard
Another sleep apnea oral appliance is referred to as a “mandibular repositioning appliance.” Quite literally the device forces the lower jaw to bite into a more forward bite position and it holds the mouth open. It is a management appliance that needs to be worn every night indefinitely. It does not change the jaw structure, but rather it braces the jaws into a more open and forward position, so the airway is more open. It is kind of like a chin thrust position during CPR, but all night long forever. Some people cannot tolerate this position and over time, teeth can move and the bite can go bad. One advantage of the mandibular oral appliance is that iit can be fitted quickly and does not require any myofunctional exercises.
Dr Adams treats and can improve the lives of people with sleep apnea and TMJ pain. “My goal is to improve the overall health of my patients by optimizing the spaces for airflow through the mouth and assisting people who are living with treatments such as CPAP forever.” Schedule a consultation and I will show you what our treatments can do for you. Treating this problem can literally save years of valuable life.
How Do Sleep Apnea Oral Devices Work?
Dr Adams’ favorite appliance for sleep problems and TMJ is the Vivos DNA Appliance. Other adult growth appliances exist including the Homeoblock and ALF devices. The therapy naturally increases the size of the spaces in the mouth. And improves airflow through the mouth and to the airway. The devices also gets the tongue further away from the throat and airway. Increasing the size of the mouth and improving airflow to the upper airway can create more room for oxygen flow to your lungs during sleep. Additionally with a larger mouth and better airflow to the upper airway, large obstructing structures such as the tongue, tonsils and palatal tissues are less like to fall into the throat and shut down airflow to the airway. Dentists are in a unique position to offer corrective oral appliances where in contrast, many other therapies, such as CPAP, only manage the disease.
Who Can Treat Sleep Apnea?
Dentist do not diagnose sleep apnea. Seeing a dentist for treatment with any oral appliance is not a substitute for being examined and diagnosed by a sleep apnea physician. Many health problems are linked to sleep apnea such as heart, kidney, and thyroid disease. Dentists do not diagnose or treat any of these diseases. Sleep apnea can involve problems with the central nervous system and collapse of the tissues in the airway. Diagnosing sleep apnea involves:
Oximetry. A home test that if failed will lead to more testing.
Polysomnogram. Or an overnight sleep evaluation. This test looks at brain activity, breathing, snoring, oxygen levels, heart rate and muscle activity during sleep.
Electrocardiogram. Tests how the heart is performing while kids are sleeping
Snoring is an alarm and your body sounding off that there is a breathing and airway problem. Whey you are snoring you are literally choking on soft tissue that has collapsed into your airway during sleep. Quite literally what happens is the tongue, tonsils and other tissue settle into your wind pipe or airway and get in the way of you getting enough oxygen while you sleep. It’s almost suffocating to think about. Sadly it is a common phenomenon in roughly 100 million Americans. The truth of the matter is most people who snore have a serious condition called obstructive sleep apnea (OSA).
What is Sleep Apnea Really?
People who have obstructive sleep apnea or OSA stop breathing for 10 seconds or more at a time. For some people this can happen hundreds of times per night. To start breathing again, the individual will usually clench their teeth, causing them to partially awaken, when the obstructions (tongue etc) can be removed. Most people do not realize these things are going on till the problem gets really bad because they are asleep. Once the condition gets really bad, there will usually be complaints about jaw pain, TMJ, headaches and poor sleep. Sadly most of the time this condition escapes diagnosis as it slowly kills you like high blood pressure. OSA is a very insidious disease.
Pediatric Sleep Apnea is Corrected with Expanders
Dr. Adams uses many different expanders for kids to treat OSA, crooked teeth and mouth breathing. Early diagnosis and treatment is critical for kids to prevent growth and developmental problems that last a lifetime. Dr. Adams’ favorite appliances for kids are:
Irregular night time breathing (Gasping, Choking, Reflux)
Restless Sleep
Scalloped Tongue
Small Mouth
Orthodontic Problems
Difficulty Swallowing
Difficulty concentrating
Irritability
Morning Headaches
Dry Mouth and throat
TMJ-TMD Symptoms
Restless Leg Syndrome
How Do Sleep Doctors Diagnose OSA
The best way to diagnose sleep apnea is with an overnight sleep study called a polysomnogram, which is either performed in a sleep clinic or at home. The study will measure a few things such as breathing, quality of sleep, oxygen levels in your blood, heart rate, and body movements. Often people who have airway issues have cracked and missing teeth.
How to Naturally help Sleep Apnea:
Sleep on your side
Strengthen your airway and breathing muscles with exercises such as yoga “fire breathing.”
Lose weight to reduce your BMI
perform some tongue exercises aka myotherapy
quit smoking
regular exercising
avoid caffeine, late meals and becoming over-tired which causes deep sleep.
What Anatomical Structures in the Mouth Obstruct Breathing
Tongue Normally Appears:
Smooth Borders
Wide Range of Tongue motion forward and side-to-side
light red color
Soft smooth and not bumpy
light glossy white coating
Sleep Apnea Tongue
rough scalloped edges
red and inflamed spots on the edges
lumpy, bumpy, rough areas
Scalloped Tongue
Scalloping of the tongue is caused by the tongue being squished up against the teeth. The Scalloping is due to the lower jaw being too small for the tongue to fit. The best way to correct obstructive sleep apnea is to literally correct the obstructions.
High Tongue Position
When there is little space between the teeth, the tongue takes a higher position in the mouth, moving closer to the tonsils and palatal tissues.
A high under-developed palate.
Long Soft Palate
A long soft palate can sag and flop down on the tongue. It’s not too hard to see the obstruction here. Imagine creating more room in the mouth for this tongue to sit down properly. No doubt that would create more room for air to get past the tongue and soft palatal jam here. these are problems a dentist is in a unique position to fix without surgery.
Enlarged Tonsils
When tonsils are large (arrows) they obstruct breathing or the passage of air between the lungs and the mouth and nasal passageways.
Deviated Septum
Large Turbinates
Enlarged turbinates can obstruct air flow during nose breathing.
Undersized Mandible or Retrognathic Lower Jaw:
The smaller and further back your lower jaw is the closer your tongue is to your airway and more likely it is that your tongue will fall back into your throat during sleep.
How Long Will Pain last After Wisdom Teeth Removal?
The healing period after wisdom teeth have been removed could be as few as 1 to 2 days of soreness and bruising with some throbbing, achey pain. The soreness and pain usually dissipates to a little soreness at 3 to 7 days after the surgery. The pain is uaually controlled by ibuprofen and prescription pain medication. Healing patterns are variable depending on adherence to post-operative instructions, patient health status and surgical technique.
When Can You Return to Work After Wisdom Removal
The best plan after wisdom removal is to lay low and rest for 1-3 days after the procedure. Maybe, have your wisdom teeth removed on a Thursday and lay low through the weekend. The best age for wisdom teeth removal is between the ages of 14 and 23. Most people will be able to return to work after a long weekend. In fact some people may have very little pain at all with pain and swelling totally controlled with ibuprofen. Others may have pain and nagging symptoms lasting up to 7-10 days (but this is more unusual). On the average, the worst symptoms are during the first 1-3 days and after that there can be minor soreness for up to a week or so.
Plate Rich Fibrin PRF Speeds Up Wisdom Teeth Healing
The technique uses Platelet Rich Fibrin aka PRF and Ozone. The technique accelerates wisdom teeth healing in surgical sites by preventing infection and stimulating faster bone growth. PRF is very rich in white blood cells and bone morphogenic protein.
PRF and Ozone with Wisdom Teeth Extraction Technique Video
PRF and Ozone Accelerates Healing and Decreases Pain
Platelet Rich Fibrin or PRF decreases the chance of dry socket, pain, swelling and jaw bone infections after oral surgery procedures. Dental PRF is prepared by spinning patient blood in a centrifuge and isolating the PRF. PRF is a thick yellow jello-like blood isolate. During wisdom tooth removal, jaw bone is exposed. Bone has very little blood supply as compared to other tissues in the human body. In areas where there is little blood, the body has less ability to heal quickly and less defense against infection. We place PRF into tooth wisdom tooth extraction sites. In the absence of the PRF, dental extractions sites are left to heal open to the oral cavity and there is a bony hole in the jaw bone. Saliva, bacteria and other contaminants are free to pour down into the jaw bone. When PRF is placed into the extraction site, the PRF protects the site from infection and enriches the area with fibrin, platelets, white blood cells and bone growth factors that accelerate jaw bone healing.
Delaying Wisdom Procedures Will Increase Pain Afterwards
The gum and bone surrounding the teeth get stronger over time, making extraction more difficult. Once the teeth start hurting, you will need to drop everything on your schedule and schedule emergency wisdom teeth extraction surgery. Also, if there is pain and swelling prior to have a surgical procedure, there will likely be more pain after the procedure. If a wisdom tooth gets too infected, it may even be necessary to be on an antibiotic prior to getting the teeth taken out. In some cases the teeth can spread infection to other parts of the body and necessitate a trip to the ER. Wisdom teeth removal is one of the most common oral surgery procedures we perform.
Wisdom Teeth Surgery 1 to 2 Days After:
Some throbbing and aching pain controlled by prescription medications. Minor bleeding of extraction sites after rinsing, eating and drinking. Minor bruising and swelling both inside and outside of the mouth. Notify your Oral Surgeon if there is significant and persistent bleeding or moderate to sever swelling. Notify your doctor if you get severe nausea or any severe swelling of your tongue, throat or rash and hives.
Wisdom Teeth 3 to 4 Days After Extractions:
Throbbing and aching pain will give to soreness. There may be some general jaw inflammation and deep discomfort. Jaw opening may be limited down to 60% of normal opening. Be sure to rinse with warm salt water and keep food particles out of extraction sites. gently dab and brush at the extraction sites with a tooth brush (no tooth paste) in between saltwater rinses. You may see a white or yellow tissue forming in the extraction site that has a fluffy appearance. It may be food particles, plaque or normal collagen formation. Collagen is what the body makes ahead of gum tissue. Light brushing and rinsing should remove plaque and food particles. Do not Force out the Collagen as it is protecting the site. If after rinsing and cleaning, you smell a persistent foul odor, notify your Oral Surgeon.
Wisdom Healing After 5 to 7 Days:
Most Symptoms should subside except limited jaw opening and a minor, occasional ache. It may take 2-4 weeks to reach normal Jaw opening. If any stitches remain, you should return to your dentist to have them removed. During this period you should be able to stop taking the prescription medications. Some patients who bruise easily and who had pain before the extractions ( especially patient who received emergency wisdom tooth removal ) may have more pain for up to 10 days. It is very important to finish all antibiotic medications even if there is not pain.
Wisdom Teeth Recovery Depends on Several Factors:
overall health
age
Was Platelet Rich Fibrin or PRF used?
gum health surrounding the surgical site
the type of surgery needed – full bony horizontal tooth impaction vs partial bony wisdom tooth impaction
difficulty of case
technique- tooth pulling vs root sectioning and elevation
health and care after oral surgery
Wisdom Teeth Should All be Removed at the Same Time
The best course of action, is to remove all your wisdom teeth in one visit. Most of the time, the pain is not much different whether one or all four wisdom teeth are pulled out. Also, who wants to sit through and “enjoy” getting their wisdom teeth removed on more than one occasion. If someone has too much anxiety, they should have sleep sedation dentistry and have all the teeth removed in one day. Unless there is an extreme condition, such as severe swelling or infection of one tooth, you should remove all four wisdom teeth during one visit.
Is Removing Wisdom Teeth Necessary?
Yes, It is definitely medically and dentally necessary to remove impacted wisdom teeth that are Impacted, Infected and damaging adjacent teeth. These same teeth cannot be cleaned, cause gum infections, tooth infection, jaw bone infection and root resorption of adjacent teeth and life threatening bone pathology. See the above picture. If your wisdom teeth are not impacted in soft tissue or bone, they may be able to be kept clean and healthy in the mouth. Not all Wisdom Teeth need to be removed.
Oral Surgery After Care Instructions:
Bite down with firm pressure on cotton gauze or damp cotton pack placed over the extraction socket for at least 30 minutes
Use ice packs for first 24 hours to minimize chances of swelling
Take a mild strength painkiller for reducing pain and discomfort
Avoid spitting, sneezing or coughing
Do not smoke
Avoid sucking on a straw with pressure to avoid clot dislodgment
Eat soft, cold and non-spicy foods
Restrict your physical activities and take complete rest for 24-48 hours
Avoid vigorous rinsing, spitting and repeated touching or licking the area of surgery,
Perform warm water saline rinses 4-5 times a day after 24 hours to flush out food debris for soothing and antibacterial effect,
Minimal post-operative bleeding is a common occurrence. Do not panic. However if persistent bleeding is encountered, bite firmly on a wet tea bag and call your oral surgeon
If any silk sutures were placed in your mouth, visit after 7 days for their removal.
What is Dry Socket?
If Wisdom Teeth Healing does not follow the schedule above, and especially if there is not progress after days 3-4 and the pain even worsens, you should call you Oral Surgeon Immediately because you may have a Dry Socket. Dry Socket requires immediate attention and treatment by the Oral Surgeon.
What are the different kinds of wisdom teeth extractions?
Angular vs Horizontal
Vertical Wisdom Tooth Impactions
Partially erupted vs Complete Bony Wisdom Tooth Impaction
Wisdom Teeth Recovery Tips:
No Strenuous Activity such as running, music classes
Avoid Swishing of Fluid, Spitting, no drinking through straws
Take medications on schedule and take pills ahead of pain and swelling
use ice packs 15 minutes on and 15 minutes off
No Tobacco products and definitely no smoking
Allow 2-3 days to Resume Normal Activity
Often 2-3 days of recovery is needed before returning to regular routines. You may need an additional day or two to regain strength. During the first 24 hours, avoid any strenuous cardiovascular activity that could encourage bleeding from the removal site, or interfere with the blood clot stability in the extraction site. Disruption of the clot in the extraction site can cause a dry socket and delayed healing and pain. Avoid working out, athletic competition, band and choir participation for 3 to 4 days. If you feel tired, have increased pain, swelling, or bleeding, allow an extra day or two of light activity. If you had sedation dentistry, you need to be by another adult for at least 5 hours oral surgery. You cannot be left unattended. You may need assistance standing and going to the bathroom while you are still feeling the effects of the anesthesia. Do not drive, drink alcohol, or operate any kind of machinery for 24 hours after oral or IV Sedation Dentistry. You will receive written prescriptions.
Wisdom Teeth Pain is the Worst the First 1-3 Days
The worst discomfort occurs during the first six hours after local anesthetic has worn off. Take your medication while you are still numb. People do better when they take their medications on time and stay ahead of pain and swelling. It is possible that slight bleeding may reoccur especially after eating and drinking. If significant bleeding occurs, place fresh gauze packs or wadded paper towel over the surgical site that is actively bleeding and bite very firmly for thirty minutes. Avoid spitting or using straws, as they can cause bleeding by creating negative and positive pressure in the mouth. You can minimize swelling by using cold packs for the first 24 hours. This should be used next to the surgical sites 20 minutes on and 20 minutes off. Day one, do not brush, rinse or spit. Day two, brush your teeth with a soft toothbrush. You should also begin gentle rinses with warm salt water 2-3x per day (especially after meal time and before bed). Avoid smoking for at least 3 days and avoid chewing tobacco until the surgical sites are completely healed. Patients who use tobacco experience a longer recovery period and a higher level of complications.
PRF Accelerates Wisdom Teeth Healing,
Platelet Rich Fibrin or PRF decreases the chance of Dry Socket, Pain, Swelling and Jaw Bone infections that can persist after oral surgery. PRF in wisdom teeth removal is prepared by spinning the patients own blood in a centrifuge and isolating the PRF which is a thick yellow jello-like isolate. During Wisdom Tooth Removal Surgery, jaw bone is exposed. In bone there is very little blood supply as compared to other tissues in the human body. In areas where there is little blood, the body has less ability to heal quickly and less defense against infection. We place PRF into tooth wisdom tooth extraction sites. In the absence of the PRF, dental extractions sites are left to heal open to the oral cavity and there is a bony hole in the jaw bone. Saliva, bacteria and other contaminants are free to pour down into the jaw bone. When PRF is placed into the extraction site, the PRF protects the site from infection and enriches the area with Fibrin, Platelets, White Blood Cells and Bone Growth Factors that accelerate jaw bone healing. In Cases of very difficult removals, Natural Bone Grafts with PRF may be necessary. PRF for dental implants is also very helpful in decreasing the healing time after dental implant surgery.
What is a Wisdom Tooth?
The Wisdom tooth is the third and last molar on each side of your upper and lower jaws. These teeth commonly come in the mouth in late teenage or early twenties and are the final teeth to erupt in the mouth. Wisdom teeth are the most common molars which fail to erupt in the mouth due to their far most location and reduced jaw bone growth and space causing physical hindrance. Due to obstruction in their path of eruption in the mouth, tilted and rotated wisdom molars present which often cause infection and swelling of surrounding gum tissues. Infection and swelling occurs especially when food particles cannot be cleaned with daily brushing and becomes accumulated in the spaces between gums and teeth. Severe infection occurs and it becomes necessary to remove tilted, crooked and drifted wisdom teeth by exposing and removing surrounding jaw bone. American Dental Association recommends thorough check up of wisdom teeth around 16-19 years of age and their early removal if necessary to prevent serious side effects in future.
Common Side Effects of Wisdom Teeth Surgery
Pain,
Swelling
Bruising
Limited opening
Bleeding
Tooth Sensitivity
Risks and Complications of Wisdom Teeth Surgery
Sinus exposure during removal of upper wisdom tooth. Chances are small but considerable. Sinus communications normally heal and close on their own without the need for additional procedures
damage to teeth adjacent to the extraction site including broken fillings, crowns, tooth cracks
Damage to nerve in the lower jaw. Usually heals and returns to normal in 1-6 months. Patient will experience temporary numbness or partial numbness during the healing period.
Wisdom Tooth Removal Surgery should be performed with as little trauma and injury as possible. Typical initial wisdom tooth removal surgery usually takes 3-4 days time ranging up to 7-10 days. The estimated length of recovery basically depends upon the degree of severity of tooth impaction, length of surgery time, difficulty of removal and their path of eruption judged by Ct scan and CBCT imaging.
How long will I be in pain after wisdom teeth surgery?
1-3 days of pain where you should lay low.
Should I get an implant to replace my wisdom tooth?
Rarely, but if a full compliment of wisdom teeth are in a health bite, it may be necessary to replace a wisdom tooth with a dental implant to prevent the loss of another wisdom tooth.
(301) 421 1996
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