Better Health - July 2023

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Better Health

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Sometimes it’s just necessary to have a tooth extracted.

By C ORI U RBAN Special To The Republican

Whether the tooth is causing pain or decaying or has been injured, a dentist can offer a variety of options for replacing a problem tooth.

“The reasons that teeth need to be extracted include fractured teeth or severe decay that they cannot be restored with a filling or crown,” explained Dr. Alison S. Leecock, a general dentist at Kasperowski Family Dentistry. Or teeth can have bone loss from gum disease resulting in the need for removal.

Other reasons include impacted teeth, overcrowding of space or a dental injury in which the tooth cannot be saved.

The process of an extraction can vary.

“Generally when you come to the office, your medical history is reviewed, your blood pressure is taken, and then we start the procedure by numbing the area” with local anesthetics, she explained.

Once the patient is feeling comfortable, the dentist can loosen the tooth by using instruments called elevators. Occasionally, it may be necessary to make an incision in the patient’s gums and use a drill to help access the tooth or separate it into two roots. “When we feel the tooth is ready, we are able to carefully remove it by using forceps,” she said. “Once removed, we make sure the socket is cleaned out, disinfected, and occasionally the extraction site may require grafting or sutures.”

The time it takes varies depending on the reason for the extraction, which tooth it is and the gum health of the patient. “Sometimes it is a quick in-and-out procedure, other times it can be more complex,” Leecock said.

There is a risk for pain in the procedure, but dentists do their best to minimize that for the patient. “There is a lot of pressure involved which can be uncomfortable, but anesthesia can really quiet the pain,” she noted.

Sedation is an option, and there are many

types of sedation so it is important to check with the dental office to see which types are offered.

Based on the patient and the patient’s health, the decision on what type of sedation is made. Sedation can be achieved with oral sedation, medication taken prior to the appointment; nitrous oxide, which is delivered in office; or IV sedation.

Once the tooth is out, there are options to replace it depending on what end result the patient wants.

“The first option is always to do nothing and leave the space,” Leecock said. “Sometimes

of your mouth.

The dentist explained that there are fixed options that can include an implant or a bridge. Implants consist of three parts: the actual implant, or “screw,” that goes underneath the gum, similar to the root of the tooth. Then, to give it that “tooth-like” appearance, you will need an abutment followed by a crown, or “cap.” The abutment allows the connection between the implant body and the crown that sits on top.

A bridge requires at least two crowns on either side of the space with the third crown in the middle to fill in where the space is.

The number of tooth extractions a year at a practice depends on what the patient population needs, but roughly 175 are completed in Kasperowski Family Dentistry office. Generally, the risks of tooth extraction include swelling, bruising, pain, damage to adjacent teeth and bleeding. There is a risk of post-operative infection, fracture or dislocation of the jaw, damage to the sinuses or damage to the nerves.

But ignoring a tooth that needs to be extracted can result in infection, swelling, pain and systemic disease. “Infection in your teeth relates to your whole body and can become very serious,” she said.

According to the dentist, after a tooth extraction, it is important for the patient to keep biting on the gauze given. Additionally, ice wrapped in a cloth on the cheek near the area of surgery can help keep swelling to a minimum. It is important for the patient to avoid spitting or sucking motions (like using a straw), and smoking for the first 3-4 hours so that the clot that has formed does not become dislodged. The day after the procedure, it is also helpful to use hot compresses on the cheek to reduce swelling and to do salt water rinses.

Any follow-up needed is usually booked about a week out to check the healing process.

The staff of Kasperowski Family Dentistry outside their Westfield Office. (PHOTO COURTESY OF STEVEN E. NANTON)

this is viable if you still have a lot of chewing surfaces and if you are comfortable with how it looks depending on where it is in your mouth.”

One concern with leaving the space is that the teeth around it may shift after extraction, and this can lead to mal-occlusion, which is damage to the way the teeth fit together.

If the patient would like to replace the space, options include fixed or removable. Fixed options mean it is something that does not come in and out of your mouth. Removable means something that comes in and out

“Both of these options should be discussed with your dentist as they have certain pros and cons depending on the situation,” she said.

Removable options can include partial dentures or full dentures depending on the amount of teeth that need replacing. “Removable options are usually less expensive, and they can cover a lot more spaces at the same time which can be a nice option,” Leecock said, adding that the negative side is that it does come in and out of your mouth, and adjusting to it may be difficult.

Partials/dentures have follow-ups as needed for adjustments after they are delivered. Bridges are usually followed-up at every cleaning and exam appointment, and implants are generally followed-up at around four months to ensure that they are osseointegrated prior to restoration placement (i.e abutment and crown). After that, implants and restorations will be evaluated at every cleaning and exam appointment. The healing process itself can take a couple of weeks.

For more information go to drkasperowski.com or mouthhealthy.org/en/ all-topics-a-z/extractions.

D | | SUNDAY, JULY 23, 2023

What to expect at a

Veterinary Dental Cleaning

Oral health is as important for companion animals as it is for their owners. Left unchecked in pets, periodontal disease can lead to pain, trouble eating and other issues.

Pet owners are urged to brush their pets’ teeth to help remove bacteria that can lead to tartar buildup. If oral hygiene is ignored, pets can develop tooth decay and other issues.

People know from experience what to expect when they go to a dentist for a cleaning, but a pet’s oral cleaning may be an unknown and that can induce anxiety. Most cleanings follow a similar pattern and recognition of that pattern can give pet owners an idea of what to expect at a veterinary dental cleaning.

Anesthesia

One of the main differences between a dental cleaning for a person and one for a pet is the use of anesthesia. According to Kulshan Veterinary Hospital, pets do not willingly open their mouths to give veterinary dentists access to perform cleanings. Anesthesia ensures that the animal

will remain still and the vet can remove any plaque and tartar that has built up. If a tooth needs to be extracted, sedation ensures that will go smoothly.

Pre-testing

Since anesthesia will be used, vets often will run lab work and an EKG to determine if a pet is healthy enough to receive anesthesia. Testing ahead of time also helps the vet make the best decisions regarding which types of anesthetics to administer and in what quantities.

Examination and cleaning

The vet will conduct a thorough examination of the pet’s mouth, noting any abnormalities. A dental probe is often used to evaluate bleeding gums and detect pockets in the gums where food can accumulate and potentially lead to decay.

After the examination, VCA Hospitals says tooth scaling will be performed, using both ultrasonic and hand scalers to remove plaque and tartar above and below the gum line. Teeth will then be polished to remove any

microscopic scratches that can snag bacteria and lead to subsequent build-up.

Monitoring

Throughout the procedure, a pet’s vital signs are monitored and IV fluids are administered to keep the animal comfortable and safe. Before the pet is brought out of anesthesia, dental x-rays also may be taken to check for problems not visible to the naked eye. The pet also will be monitored after anesthesia in the recovery room.

At home

When the pet is released to go home, it is important for pet owners to keep up with dental cleanings. Do not use toothpaste designed for humans, as there are special animal-safe products for this purpose. Depending on what was done during the cleaning, the vet may prescribe antibiotics and/or pain medications.

Dental cleanings are an important component of overall pet care. Consult with a vet to learn more about pet dental cleanings.

Common causes of

Toothaches

conditions may cause the enamel on the outside of teeth to wear away. Exposure of the inner layer of the tooth, called dentin, to the air or foods and beverages may result in pain.

avoid a trip to their dentist’s office.

But should a toothache arise, only a dentist can get to the root of the issue.

Toothaches run the gamut from mild to throbbing to unbearably painful. Toothaches may be temporary, but many persist for some time. Here’s a look at nine reasons for toothaches.

Orthodontic appliances

A common cause of discomfort, orthodontic devices can cause toothaches. The pain is most noticeable immediately after an adjustment, but it may ease as the mouth grows accustomed to the wires or pressure.

Tooth sensitivity

Despite being hard, teeth actually are porous. Certain

Sinus congestion

Sometimes teeth aren’t to blame for mouth pain. Pain that persists in the upper teeth only on both sides of the face may occur due to sinusitis. It often is preceded by nasal congestion.

TMJ

Temporomandibular disorders can cause tooth pain. TMJ may result from injury or trauma to the jaw. Tooth grinding, also known as bruxism, can cause tooth pain.

Impacted wisdom teeth

Wisdom teeth are a dental milestone that takes place between the ages of 17 and 21. Wisdom teeth actually are third molars, and are given the name because they come in at a mature age, according to the American Dental Association. If there isn’t enough space for them, wisdom teeth can cause crowding and pain. When molars do not fully

erupt, the result is impacted wisdom teeth, which can be very painful.

Damaged fillings or dental sealants

When fillings or sealants come out, vulnerable parts of the teeth become exposed. This can result in pain.

Tooth damage Dental caries, or cavities, can cause toothache, as can tooth abscesses and tooth fractures.

Gum disease

Gum disease may start with mild inflammation and then become more severe if it is left untreated. The inflammation also may affect the ligament that attaches teeth to the socket in the jaw. This ligament has many nerve fibers. When inflamed, the nerves can get fired up and cause pain.

Food A kernel of popcorn wedged between teeth or a sharp piece of pizza crust that gets lodged behind a molar can cause pain if not addressed.

Toothaches occur for a variety of reasons. Figuring out the cause can lead to effective relief.

Essential Vitamins the body needs

ing blood sugar levels.

Pyridoxine (B6): People rely on B6 to metabolize food energy. It also has a role in proper nerve function and helps in the creation of hemoglobin, which carries oxygen around through red blood cells.

Vitamin

Vitamin A also helps protect against infection. It also is important for vision, as it improves vision in dim light.

Vitamin C:

Vitamin C, also known as ascorbic acid, plays a vital role in immune system function, helping to protect cells from free radicals. Since the body cannot store vitamin C, it needs to be consumed daily.

Vitamin D:

Vitamin D assists in calcium and phosphorous absorption, which helps to keep bones and teeth strong. The body can produce vitamin D naturally by spending time in sunlight. That is why it’s often called Òthe sunshine vitamin.

Vitamin E:

This vitamin maintains muscles and red blood cells. It also protects fatty acids.

Vitamin K:

Vitamin K is necessary for blood to clot and helps to keep bones and other tissues in the body healthy.

Thiamine (B1):

B1 is needed for metabolism and for nerve and heart function.

Riboflavin (B2):

Another important nutrient for metabolizing foods, B2 helps maintain healthy mucus membranes, such as those in the mouth and nose.

Niacin (B3):

This vitamin helps to release energy from food and keeps the nervous system healthy.

Biotin (B7): This is only needed in small amounts to make fatty acids.

Folate (B9): Folate is very important for healthy red blood cells. Folate also helps to prevent birth defects, which is why it is recommended as a prenatal vitamin.

myelin for nerve fibers.

It is preferable to obtain vitamins through healthy foods. If and when foods are inadequate, supplementation might be recommended.

Certain vitamins are fat-soluble, which means they are stored in the body’s fat and used slowly over time, according to WebMD. Others are water-soluble, so they are not stored and need to be replenished frequently. Individuals should speak to their doctors and nutritionists about any vitamin deficiencies they may have and how to combat them safely.

with them.

Though no two individuals are the same, people who develop halitosis tend to be embarrassed by the condition, which Johns Hopkins Medicine notes is an oral health problem marked by foul-smelling breath. The good news for individuals with halitosis is that it’s both preventable and treatable and also quite common. In fact, the Cleveland Clinic estimates that one in four individuals across the globe has halitosis.

Treatment and prevention of halitosis is easier once individuals identify its underlying cause, the following are some common causes.

Food:

Johns Hopkins notes that certain foods can contribute to halitosis. For example, garlic and onions are absorbed into the bloodstream and can affect breath until the food leaves the body. Avoiding such foods or eating them in moderation can prevent or mitigate halitosis.

Poor hygiene: Hygiene should be part of anyone’s healthy routine,

and that includes dental hygiene. But the Cleveland Clinic notes that poor dental hygiene, which can be marked by a lack of brushing and flossing and infrequent dental cleanings, is the most common cause of halitosis. Brushing at least twice per day and flossing everyday can also help individuals reduce the risk for halitosis.

Twice-annual dental cleanings also can help.

Poorly cleaned dentures:

Johns Hopkins notes that improper cleaning of dentures also can contribute to halitosis. When individuals get dentures, they should discuss proper cleaning with their oral health care professional. Poorly cleaned dentures can collect bacteria, fungi and food particles, all of which can contribute to bad breath.

Gum diseases:

Periodontal disease affects the gums by damaging

gum tissue and leading to tooth and bone loss around the teeth. Gingivitis is an inflammation of gums caused by plaque, which is removed with brushing, flossing and routine cleaning. Trench mouth is an advanced gum disease that also can contribute to bad breath.

Tobacco usage: Tobacco causes an array of health problems, including halitosis. Cigarettes and cigars may be most commonly associated with bad breath, but tobacco users also are at elevated risk for gum disease and oral cancer, each of which can contribute to halitosis. Halitosis can be an embarrassing and harmful yet preventable condition. Recognition of the common causes of halitosis can help people overcome it and regain their confidence.