Retained Baby Teeth

As a dental office that specializes in implants and periodontology, we at the practice of Dr. Martin Urban have seen some unusual conditions. Among those are patients who have retained their baby teeth past puberty. This often results in a need for replacement teeth, so we wanted people to know what options are available for their assistance.

Deciduous teeth, or baby teeth, usually fall out when the incoming adult tooth causes the baby tooth’s root to dissolve. This may not happen if the adult tooth never developed or if it is coming in at an unusual angle. Usually, if a patient has both the adult and deciduous versions of the same teeth, it is the lower central incisors or upper canines that are affected. The upper lateral incisors are the teeth that are likeliest to be missing. Either way, a patient’s teeth are will be jumbled, and they may also be overcrowded or misaligned enough to cause bite problems.

Usually, extracting retained baby teeth is a simple process. Once they are out, a patient may be referred for orthodontic therapy to correct their adult teeth’s alignment. If they need prosthetic adult teeth, the orthodontist will make space for them, and we can place implants in the newly opened gaps.

To schedule an appointment with Dr. Martin Urban, call 508-425-9640 or visit us at Martin Urban DDS.

Types of Teeth

Implants and periodontal therapy are our specialties at the dental office of Dr. Martin Urban. But to understand the full range of their treatment options, patients must first understand the basic function of their teeth. Adults normally grow thirty-two in total, and each type can have different issues.

The four teeth in the front of the mouth are called incisors. Their flat shape makes them useful for forming speech and they are the focus of most cosmetic care. In a small number of people, the upper lateral incisors may be missing, or the baby versions of the bottom central incisors may fail to fall out as their adult replacements come in. Framing the incisors are the cuspids, or canine teeth, which are sharp and used for piercing. They occupy the part of the jaw arch with the greatest change in rate of curvature and help to maintain facial stability.

The molars and premolars have multiple cusps and are used for grinding food. The premolars only have a single tooth root, but the lower molars have two and the upper ones have three. Wisdom teeth, the molars furthest in back, are often removed in teenagers because of their difficulty erupting and are generally not replaced. Molars are anchored by strong ligaments and are the only teeth capable of withstanding the pressure of chewing. But even they can crack if subjected to grinding during the patient’s sleep.

To schedule an appointment with Dr. Martin Urban, call 508-425-9640 or visit us at Martin Urban DDS.

Pericoronitis

Extractions and gum disease are of particular interest to us at Dr. Martin Urban’s Waltham dental practice. Sometimes, extractions need to be done to prevent or combat periodontal disease, particularly in cases described as “pericoronitis.” This term describes infection of gum tissue surrounding a dental crown that is impacted.

Impacted teeth are those that are unable to fully erupt. This is a common risk with wisdom teeth, which are the largest teeth and the last to come in. There is often not enough room for them, leaving them stuck only partially erupted. In some cases, a portion of the tooth is still covered by a flap of gum tissue, which is called an operculum. The space between the operculum and the tooth becomes an ideal hiding place for bacteria, causing gum infections that can easily get out of control.

A partially-erupted tooth will likely prove difficult to clean. A patient can swish warm saltwater in their mouth as an anti-bacterial measure and can take oral antibiotics, but in the long term, oral surgery may be necessary. We may cut away an operculum, but the impacted tooth will probably continue to cause misalignment until it, too, is removed. In younger patients, it may be possible for an orthodontist to use braces to guide an impacted tooth into place after some of the gum tissue covering it has been cut away.

To schedule an appointment with Dr. Martin Urban, call 508-425-9640 or visit us at Martin Urban DDS.

 

Wisdom Teeth Removal

At Dr. Martin Urban, DDS we often extract wisdom teeth when they begin to protrude through your gums. In rare cases, wisdom teeth will grow in naturally and are properly aligned.

For most patients, wisdom teeth are misaligned and grow in on an angle, which can cause dental crowding or damage to the jawbone or nerves. If your wisdom teeth only partially erupt through your gums, more bacteria can develop on them. We encourage our patients to have their wisdom teeth removed when this happens otherwise you are at a greater risk of tooth decay, cavities, and gum disease.

Any wisdom teeth that are causing pain or infections need to be removed immediately to prevent your teeth from being damaged. After your wisdom teeth are removed, you will be limited to soft foods for a couple of days until the swelling goes down.

If you have any questions or concerns about your wisdom teeth, please give us a call. To learn more about the treatment provided at the dental practice of Dr. Martin Urban, DDS, visit www.martinurbandds.com for more information. To schedule an appointment with Dr. Martin Urban, DDS in Boston, MA, call 508-425-9640.

Basic Dental Instruments

We provide advanced dental and periodontal restorations at the office of Dr. Martin Urban, but we want our patients to feel fully included in all our decisions. Many people suffering from severe tooth or gum decay feel apprehensive about visiting the dentist. They may feel a sense of helplessness born of an inability to describe what is happening; in which case we think it would be good for them to learn some of the language we use to describe our basic instruments.

When patients go to any kind of dentist, they can expect a hygienist to clean their teeth. The two tools the hygienist uses most are the handheld mirror and the explorer. The explorer, which can also be called a probe, is the wand with metal hooks on either end. The hooks come in different shapes for different tasks. Some are used to inspect the hardness of enamel and the cleanliness of the gum pockets. The explorer is also used to break apart hardened calculus, which is removed with a suction hose called an evacuator. This is the tube hygienists ask patients to close their lips around.

Sometimes, a dental extraction is necessary. Prior to removing a tooth, the patient will be numbed with local anesthetic delivered through a syringe. Inducing full unconsciousness is usually not necessary. A flattened spoon called an elevator will be slid between the tooth and the gum pocket and used to loosen it by rocking it back and forth. It can then be removed with reverse-action forceps.

To schedule an appointment with Dr. Martin Urban, call 508-425-9640 or visit us at Martin Urban DDS.

 

Swelling after Extractions

We’ve provided lots of people with replacement teeth at the office of Dr. Martin Urban, but sometimes teeth need to be extracted before new ones can be put in. When a tooth is severely compromised or causing overcrowding, a patient may be glad to be rid of it. But they will likely have to deal with some swelling after the procedure, so they should know what to expect.

When a tooth is extracted, the empty socket will briefly be exposed before the blood clots and seals it off. The immune system will trigger inflammation at the extraction site to prevent the migration of harmful bacteria and to concentrate while blood cells. Swelling following a simple extraction is usually not as severe as following one in which incisions were made, but the patient should try to minimize it by applying cold packs. A cold pack should be applied for no more than fifteen minutes at a time, with fifteen minutes allowed to pass between applications.

Swelling should peak within three days. A patient should call for advice if it does not. After swelling has peaked, they may try reducing it with heat packs, again using the fifteen-on, fifteen-off rule. The patient should schedule an emergency appointment if they are in pain or the extraction site turns black or white, but in most cases, the swelling completely recedes within a week. Follow-up examinations are common at this point.

To schedule an appointment with Dr. Martin Urban, call 508-425-9640 or visit us at Martin Urban DDS.