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There are plenty of hilarious videos of groggy patients coming out of wisdom teeth surgery to keep you occupied for hours. While many of these have turned everyday people into viral video stars, every now and then it really is someone famous. Recently, that someone was Seattle Seahawks quarterback Russell Wilson.

The NFL star underwent oral surgery to remove all four of his third molars (aka wisdom teeth). His wife, performer and supermodel, Ciara, caught him on video as he was wheeled to recovery and later uploaded the clip to Instagram. As post-wisdom teeth videos go, Wilson didn't say anything too embarrassing other than, "My lips hurt."

Funny videos aside, though, removing wisdom teeth is a serious matter. Typically, the third molars are the last permanent teeth to erupt, and commonly arrive late onto a jaw already crowded with other teeth. This increases their chances of erupting out of alignment or not erupting at all, remaining completely or partially submerged within the gums.

This latter condition, impaction, can put pressure on the roots of adjacent teeth, can cause abnormal tooth movement resulting in a poor bite, or can increase the risk of dental disease. For that reason, it has been a common practice to remove wisdom teeth preemptively, even if they aren't showing any obvious signs of disease.

In recent years, though, dentists have become increasingly nuanced in making that decision. Many will now leave wisdom teeth be if they have erupted fully and are in proper alignment, and they don't appear to be diseased or causing problems for other teeth.

The best way to make the right decision is to closely monitor the development of wisdom teeth throughout childhood and adolescence. If signs of any problems begin to emerge, it may become prudent to remove them, usually between the ages of 16 and 25. Because of their location and root system, wisdom teeth are usually removed by an oral surgeon through one of the most common surgeries performed each year.

This underscores the need for children to see a dentist regularly, beginning no later than their first birthday. It's also a good idea for a child to undergo an orthodontic evaluation around age 6. Both of these types of exams can prove helpful in deciding on what to do about the wisdom teeth, depending on the individual case.

After careful monitoring throughout childhood and adolescence, the best decision might be to remove them.  If so, take it from Russell Wilson: It's worth becoming the star of a funny video to protect both current and future dental health.

If you would like more information about wisdom teeth removal, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”

By E. Thomas Elstner Jr., DMD
May 07, 2022
Category: Oral Health
Tags: tmj disorders  

If you've been diagnosed with a temporomandibular joint disorder (TMD), you're likely no stranger to pain and dysfunction. And not just with your jaw joints: In a survey of approximately 1,500 patients, nearly two-thirds of them also reported at least three or more painful conditions like fibromyalgia, chronic fatigue syndrome or rheumatoid arthritis.

Researchers continue to gather evidence of possible connections between TMD and other physical conditions. Hopefully, this research will lead to better treatments for all of them, including TMD. But until then, patients must continue to rely on established methods for reducing TMD's severity.

Although new treatments like Botox injections have been proposed and tried in recent years, the most effective still seem to be long-standing techniques that are conservative and non-invasive in nature. On the other hand, TMD surgical procedures developed in recent years have yet to deliver on their promise: In one survey, only 6% of surgery patients gained significant relief from TMD symptoms, while nearly half reported feeling worse.

It seems the best advice, should you receive a definitive diagnosis of TMD, is to start with the more conservative measures. These treatments tend to be orthopedic in nature, generally treating TMD as a joint problem. Of these, the ones most people have found effective involve thermal therapies like hot or cold compresses against the jaw, or hot baths.

Medications like muscle relaxers or pain relievers can also play a role in reducing TMD discomfort and dysfunction. And, many patients gain benefit from physical therapy massage and exercises that target the jaw muscles. Switching to softer foods with smaller bites can help patients avoid over-stressing the jaw joints while chewing.

It's also important to understand that there is no "one-size-fits-all" treatment protocol: Individual patients and their doctors may need to experiment with different therapies to find the right combination that offers the most relief. Although this can take time, it can be well worth it if the eventual combination brings long-term relief.

From this standpoint, patients should avoid surgical options unless all other methods have been tried and still have not yielded significant relief. For most patients, however, conservative TMD treatment and lifestyle or diet changes will work—with enough time and patience.

If you would like more information on TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”

By E. Thomas Elstner Jr., DMD
April 27, 2022
Category: Oral Health
Tags: dental injury   mouthguards  

Ah, it's spring! As temperatures rise, parents and their "cubs" venture out of their winter dens to enjoy the renewed warmth of the outdoors. April especially marks the height of this activity, especially among children and teenagers participating in sports and other outdoor pursuits. But along with all the fun and enjoyment outdoor activity brings, there's also the risk of injury—including the face and mouth.

April is National Facial Protection Month, a chance to remind everyone about the potential for orofacial injuries that accompany some of our favorite sports and activities. We can also reduce that injury potential with just the right protective equipment.

For mouth or facial protection, two particular pieces of equipment are often essential. One of these is a helmet appropriate to the sport or activity. You might assume a helmet mainly serves to prevent head injury, but it could also play an important role in avoiding injury to the face and mouth. A baseball batting helmet, for example, has guards or cages that prevent a pitched or hit ball from the face or jaw area.

The second piece of essential equipment is an athletic mouthguard. These appliances of pliable plastic worn in the mouth help cushion any blows to the mouth or jaw. It's a must for sports like baseball, basketball or football, as well as outdoor activities like mountain biking.

Although there are a variety of mouthguards, most fall into one of two categories. The first are "boil and bite" mouthguards, which you'll find in generalized sizes online or in retail sporting goods stores. The intended wearer first places the newly acquired guard in hot or boiling water to soften it. They then place the softened guard in their mouth and bite down, which creates a custom fit when it cools (hence the term "boil and bite").

The other category is a custom mouthguard created by a dentist based on the individual wearer's mouth dimensions. Custom guards are more expensive, but they require less material than a retail guard and are usually more comfortable to wear. Because they fit more precisely, they may also offer better protection.

These essential pieces of equipment should be worn whenever the activity calls for it. That includes practice times, scrimmages or "pick-up" games, and not just formal contests. Mouth injuries aren't restricted to regulation games.

So, before your all-star begins their new spring season, be sure their teeth, mouth and jaws are protected with these essential pieces of safety equipment. You don't want a devastating orofacial injury to ruin the fun.

If you would like more information about preventing or treating sports-related dental injuries, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

By E. Thomas Elstner Jr., DMD
April 17, 2022
Category: Dental Procedures

Although dental implants are the nearest artificial teeth we have to the real thing, we should still consider saving a tooth first before replacing it. Real teeth by nature are better for overall dental health and function better than even a life-like implant.

How we save such a tooth will depend largely on what ails it. In most cases, that will be one of two dental diseases: tooth decay or periodontal (gum) disease.

Both diseases begin with dental plaque, a thin biofilm of bacteria and food materials that remain on tooth surfaces. The greater the plaque (often because of poor hygiene), the more these bacteria multiply and, pertaining to tooth decay, the more acid they produce. High acid levels soften and erode tooth enamel, which opens the door to decay.

The degree of decay within a tooth determines the manner of treatment. If it's limited to the enamel and upper dentin layers, we may only need to remove the decayed structure and fill the cavity. Decay reaching the pulp and root canals, however, often requires a more invasive procedure known as root canal therapy.

During a root canal, we drill into the tooth's interior to clear out diseased tissue. We next fill the now empty pulp chamber and root canals to prevent future infection. While general dentists can perform basic root canals, more complex cases often require the services of an endodontist, an interior tooth specialist with the necessary expertise and equipment for just such situations.

Bacteria also causes gum disease, albeit by directly infecting the gum tissues. The disease can quickly spread deeper into the gums, ultimately affecting the roots and underlying bone, and putting the tooth in peril. More teeth, in fact, are lost to gum disease than to tooth decay.

To stop the disease, we must remove any and all dental plaque and tartar (calcified plaque), which feeds the infection. The most effective means for doing this is with hand instruments called scalers and ultrasonic equipment. We may also need to surgically access deeper deposits around the roots to successfully remove them.

As you can see, treating either of these destructive diseases ranges from simple to complex and invasive. But even extensive measures are well worth it for both your tooth and your future dental health.

If you would like more information on dental treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Save a Tooth or Get an Implant?


It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.

While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.

Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.

But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.

One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.

Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.

The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.

Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.

If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”

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