Dental health and wisdom teeth

What are potential complications of wisdom tooth removal?

Two of the more important complications after having your wisdom teeth removed include:

• Dry socket. Dry socket is a common complication that occurs when either a blood clot has failed to form in the extracted tooth socket or else the blood clot that did form has been dislodged. Without clot formation, healing will be delayed. When it happens, dry socket typically occurs 3 or 4 days following the extraction and is accompanied by pain, ranging from "dull" to moderate to severe, and a foul mouth odour. Your dentist or oral surgeon will treat the dry socket by placing medication in the socket.
• Paresthesia. Paresthesia means numbness and is a less frequently occurring complication. Wisdom teeth entrapped in the jawbone are often close to nerves. Sometimes these nerves can be bruised or damaged during the tooth removal process. The result is a numbness of the tongue, lip or chin that can last a few days, weeks, months or may even be permanent.

How much does wisdom teeth extraction cost?

The cost of the extraction of a wisdom tooth varies considerably, as it depends on a series of factors like the difficulty of the procedure, whether it’s being carried out in a dental surgery or hospital and whether your dentist is NHS or private. Private prices start from around £179 per tooth and NHS prices are considerably less. It is always recommended that you get a written estimate before starting treatment and, if you have private health care, to check with your provider whether the extraction costs are covered by your plan.

Dental health and wisdom teeth

What happens during wisdom teeth removal?

Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anaesthetic which is the same injection with the same medication you would receive to numb a tooth prior to having a cavity filled. In addition to the local anaesthetic to numb the pain, you and your dentist or oral surgeon may decide that a sedative is desired to control any anxiety. Sedating medications that could be selected include: nitrous oxide (otherwise known as "laughing gas"), an oral sedative, or an intravenous sedative (administered via an injection into your veins). If nitrous oxide is given, you will be able to drive yourself home. If any of the other medications is selected, you will need someone to drive you both to and from the appointment.

What does recovery involve after wisdom teeth are pulled?

After having your wisdom teeth removed, the speed of your recovery depends on the degree of difficulty of the extraction (a simple extraction of a fully erupted tooth versus a tooth impacted into the jawbone). In general, here's what to expect.

During the first 24 hours

• Bleeding may occur for several hours after tooth extraction. To control it, position a piece of clean moist gauze over the empty tooth socket and bite down firmly. Apply constant pressure for about 45 minutes. A moistened tea bag is an effective alternative. The tannic acid in tea helps blood clots to form (blood clots function similarly to a scab over an open wound). Repeat this process if a small degree of bleeding continues; if heavy bleeding continues to occur, contact your dentist or oral surgeon. Avoid rinsing or spitting for 24 hours after tooth extraction, avoid "sucking" actions (for example, don't drink through straws or smoke) and avoid hot liquids such as coffee or tea. These activities can dislodge the clot, causing a dry socket to develop (see below).
• Facial swelling in the area where the tooth was extracted typically occurs. To minimise swelling, place a piece of ice, wrapped in a cloth, on that area of your face on a rotation of 10 minutes on, followed by 20 minutes off. Repeat as necessary during this first 24-hour period.
• Pain medications, such as paracetamol or ibuprofen can be taken for minor pain. Your dentist or oral surgeon may prescribe more potent pain relievers, such as opioid medication, if necessary.
• Antibiotics that may have been prescribed prior to tooth extraction and are being used to treat any active infection around the wisdom tooth to be extracted should continue to be taken until the full course is finished.
• Foods should be restricted to a liquid diet until all the numbness from the anaesthetic has worn off. Eat soft foods for a few days. Also avoid alcohol if you're taking opioid medication.
• Continue to brush your teeth, but avoid the teeth directly neighbouring the extracted tooth during the first 24 hours. On day two, resume the gentle brushing of all your teeth. Do not use commercial mouth rinses as these can irritate the extraction site.

After 24 hours

• Facial swelling in the area of the tooth extraction should be treated with heat after the first 24 hours of ice. Apply a moist warm flannel to the area on a 20 minute on, 20 minute off rotation. Repeat as necessary.
• Rinse your mouth with warm salt water (1/2 teaspoon of salt in a cup of warm water) after meals and before bed. Do not use commercial mouth rinses.
• Stitches, if used and if not of the self-dissolving type, need to be removed by your dentist or oral surgeon in about 1 week. If you do require stitches, ask what type you have been given.
• Watch for signs of dry socket (described below). This condition requires treatment by your dentist.
• Complete healing doesn't occur for a few weeks to a few months following the extraction. However, usually within the first week or two, enough healing has taken place for use of your mouth to be reasonably comfortable in the area of the extraction. Your dentist will explain what to expect in your specific case.

Dental health and wisdom teeth

Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often than not, they are misaligned and require removal.

Wisdom teeth present potential problems when they are misaligned as they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through, or erupt, through the gum. Teeth that remain partially or completely entrapped within the soft tissue or the jawbone are termed "impacted". Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

How do I know if I have wisdom teeth?

Wisdom teeth present potential problems when they are misaligned as they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon (also called an oral and maxillofacial surgeon) for further evaluation.

Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer.

How are wisdom teeth removed?

The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position. Your dentist will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Often, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimise the amount of bone that needs to be removed to get the tooth out.

Tooth extraction

What to tell your dentist before you have a tooth extracted

Although having a tooth out is usually very safe, the procedure can allow harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. If you have a condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction. Before having a tooth removed, let your dentist know your complete medical history, the medications and supplements you take, and if you have one of the following:

damaged or man-made heart valves

a congenital heart defect

an impaired immune system

liver disease (cirrhosis)

an artificial joint, such as a hip replacement

a history of bacterial endocarditis

After you've had a tooth extracted

Following an extraction, your dentist will send you home to recover. Recovery typically takes a few days. The following can help minimise discomfort, reduce the risk of infection and speed recovery.

Take painkillers as prescribed or over the counter products suggested by your dentist - such as ibuprofen, aspirin or paracetamol.

Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads if they become soaked with blood Otherwise, leave the pad in place for three to four hours after the extraction.

Apply an ice bag to the affected area immediately after the procedure to keep down swelling. Apply ice for 10 minutes at a time.

Relax for at least 24 hours after the extraction. Limit activity for the next day or two.

Avoid rinsing or spitting for six hours after the extraction to avoid dislodging the clot that forms in the socket.

After six hours, gently rinse your mouth with a solution made of half a teaspoon of salt in a glass of warm water.

Do not drink from a straw for the first 24 hours.

Do not smoke, as it can inhibit healing.

Eat softer foods (such as soup or yoghurt) the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.

When lying down, prop your head up with pillows. Lying flat may prolong bleeding.

Continue to brush and floss your teeth, and brush your tongue, but avoid the extraction site. Doing so will help prevent infection.

When to call the dentist

It is normal to feel some pain after the anaesthesia wears off. For 24 hours after having a tooth out, you should also expect some swelling and residual bleeding. However, if pain is severe or bleeding continues for more than four hours after the extraction, you should call your dentist. You should also call your dentist if you experience any of the following:

signs of infection, including fever and chills

nausea or vomiting

redness, swelling or excessive discharge from the affected area

cough, shortness of breath or chest pain

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Longer term, however, having a tooth (or teeth) missing can cause the remaining teeth to move, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with an implant, fixed bridge or denture.

Tooth extraction

When you were six, losing a tooth was a rite of passage, perhaps achieved by incessant tooth jiggling, biting into a crisp apple or tying a string around the tooth and giving it a pull. As an adult, tooth loss is hardly cause for celebration, yet having a tooth out is sometimes necessary.

Reasons for extracting teeth

Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. The most common is a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:

A crowded mouth. Sometimes dentists extract teeth to prepare the mouth for orthodontics. The goal of orthodontics is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend extraction.

Infection. If tooth decay or damage extends to the pulp -- the centre of the tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp, leading to infection. If infection is so severe that antibiotics do not cure it, extraction may be needed to prevent the spread of infection.

Risk of infection. If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant) even the risk of infection in a particular tooth may be reason to remove the tooth.

Gum Disease. If periodontal disease -- an infection of the tissues and bones that surround and support the teeth -- have caused loosening of the teeth, it may be necessary to extract the tooth or teeth.

What to expect with tooth extraction

Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before removing the tooth, your dentist will give you an injection of a local anaesthetic to numb the area where the tooth will be removed. If you are having more than one tooth extracted or a tooth is impacted, your dentist may use a general anaesthetic. This will prevent pain throughout your body and make you sleep through the procedure.

If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a tooth that is difficult to remove must be taken out in pieces.

Once the tooth has been extracted, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and get you to bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches -- usually self-dissolving -- to close the gum edges over the extraction site.

Sometimes, the blood clot in the socket breaks loose, exposing the socket -- a painful condition called dry socket. If this happens, your dentist will probably place a sedative dressing over the socket for a few days to protect it as a new clot forms.

Toothache treatment

Self-care at home

For toothaches:

Over-the-counter pain medications such as paracetamol or ibuprofen may be used. Take these as directed on the package while you arrange a dental appointment.

Avoid very cold or hot foods as they may make the pain worse.

Relief may be obtained by biting on some cotton wool soaked in oil of cloves. Oil of cloves is available at most pharmacies.

For jaw pain:

Aspirin may be helpful for problems in the joint of the jaw - the temporomandibular joint (TMJ) - in adults. Paracetamol (not aspirin) should be used for children and teenagers.

If pain occurs every time you open your mouth widely, the TMJ may be the source of the pain. Yawning or taking a large bite of food may intensify the pain. An appointment with your doctor or dentist will help to determine the cause.

Dental health: Teeth and gum care

Tips for eating sensibly

Eat a variety of foods but realise that foods containing sugars and starches produce the most acids and stay longest in the mouth. Hard sweets are especially harmful because of the time they stay in the mouth.

Choose your snacks carefully because most people don't brush after snacks. Starchy food, like crisps, stick to the teeth. Avoid snacking on:

• Sweets, cakes and pies
• Sugary gum
• Crackers, breadsticks and crisps
• Dried fruits and raisins

Dental check-ups

Visit your dentist and hygienist at least once every six months. To maintain healthy teeth and gums, it's important to have regular check-ups and professional cleaning. You should also visit the dentist if you feel pain in your teeth or mouth or if you experience bleeding or swollen gum.

You can also ask your dentist about dental sealants, which are materials used to coat the top, chewing surfaces of the teeth. This coating protects the tooth from decay and usually lasts a long time.

Further Reading:

Gum problem basics: Sore, swollen and bleeding gums

The health perils of gum disease

Dental care: Caring for teeth & gums

Oral Health: Mouth-Body Connection

Oral cancer

Slideshow: Most common problems in your mouth

The health perils of gum disease

Dental health: Teeth and gum care

With proper care, your teeth and gums can stay healthy throughout your life. The healthier your teeth and gums, the less risk you have of tooth decay and gum disease.

How should I care for my teeth and gums?

There are four basic steps to caring for teeth and gums:

1. Brushing
2. Flossing
3. Eating sensibly
4. Visiting the dentist

Tips for brushing

Brush at least twice a day. If you can, brush after every meal. Brushing removes plaque, a film of bacteria that clings to teeth. When bacteria in plaque come into contact with food, they produce acids. These acids lead to cavities. To brush:

• Place a pea-sized dab of fluoride toothpaste on the head of a soft toothbrush.
• Place the toothbrush against the teeth at a 45-degree angle to the gum line.
• Move the brush across the teeth using a small circular motion. Continue with this motion cleaning one tooth at a time. Keep the tips of the bristles against the gum line. Avoid pressing so hard that the bristles lie flat against the teeth and remember that only the tips of the toothbrush do the cleaning. Let the bristles reach into the spaces between teeth.
• Brush across the top of the chewing surfaces of the teeth. Make sure the bristles get into the grooves and crevices.
• Use the same small circular motion to clean the backside of the upper and lower teeth - the side that faces the tongue.
• To clean the inside of the bottom front teeth, angle the head in an up-and-down position towards the bottom inside of the mouth and move the toothbrush in a small circle.
• For the inside of the top front teeth, angle the brush in an up-and-down position with the tip of the head pointing towards the roof of the mouth. Move the toothbrush in a small circle.
• Give your tongue a few gentle brush strokes, brushing from the back of your tongue forwards. Do not scrub. This helps remove bacteria and freshens your breath.
• After brushing your teeth for two to three minutes, rinse your mouth with water.
• Replace your toothbrush every three to four months.

Tips for flossing

Floss once a day. Flossing gets rid of food and plaque between the teeth, where the toothbrush cannot reach. If plaque stays between teeth, it can harden into tartar, which can only be removed by a dentist. To floss:

• Remove about a 45 cm strip of floss from the dispenser.
• Wind the floss around the middle fingers of each hand, leaving a 3 cm section open for flossing. Floss the top teeth first, then the bottom.
• Place the floss in your mouth and use your index fingers to push the floss between the teeth. Be careful not to push too hard and injure the gums.
• Move the floss up and down against the tooth and up and around the gum line. The floss should form a C-shape around the tooth as you floss.
• Floss between each tooth as well as behind the back teeth.
• Use a clean section of floss as needed and take up used floss by winding it around the fingers.

Dental sealants

A sealant is a thin, plastic coating painted on the chewing surfaces of teeth, usually the back teeth (premolars and molars), to prevent tooth decay. The liquid sealant quickly bonds to the depressions and grooves of the teeth forming a protective shield over the enamel of each tooth.

Why use sealants?

Although thorough brushing and flossing can remove food particles and plaque from smooth surfaces of teeth, they cannot always get into all the nooks and crannies of the back teeth to remove the food and plaque. Sealants protect these vulnerable areas from tooth decay by "sealing out" plaque and food.

Who should use sealants?

Because of the likelihood of developing decay in the depressions and grooves of the premolars and molars, children and teenagers are obvious candidates for sealants. However, adults without decay or fillings in their molars can also benefit from sealants.

Typically, children should have sealants on their permanent molars and premolars as soon as these teeth come in. In this way, the dental sealants can protect the teeth through the cavity-prone years of ages six to 14.

In some cases, dental sealants may also be appropriate for baby teeth, such as when a child's baby teeth have deep depressions and grooves. Because baby teeth play such an important role in holding the correct spacing for permanent teeth, it is important to keep these teeth healthy so they are not lost too early.

How are sealants applied?

Applying the sealant is a simple and painless process. It takes only a few minutes for your dentist or hygienist to apply the sealant to seal each tooth. The application steps are as follows:

1. First the teeth that are to be sealed are thoroughly cleaned.
2. Each tooth is then dried and cotton or another absorbent material is put around the tooth to keep it dry.
3. An acid solution is put on the chewing surfaces of the teeth to roughen them up, which helps the sealant bond to the teeth.
4. The teeth are rinsed and dried.
5. Sealant is then painted onto the tooth enamel, where it bonds directly to the tooth and hardens. Sometimes a special curing light is used to help the sealant harden.

How long do sealants last?

Sealants can protect the teeth from decay for up to 10 years, but they need to be checked for chipping or wearing at regular dental check-ups. Your dentist can replace sealants as necessary.

Most NHS dentists can carry out the procedure free of charge, but generally only if they are for your child and there is a clear clinical need.

Will insurance cover the cost of sealants?

If you have private dental care insurance, your insurance plan may cover the cost. It is best to check before embarking on any treatment.

Dental health: Root canals

What should one expect after the root canal?

For the first few days following the completion of treatment, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen. Most patients can return to their normal activities the next day.

Until your root canal procedure is completely finished, that is to say, the permanent filling is in place and/or the crown, it's wise to minimise chewing on the tooth under repair. This step will help avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before the tooth can be fully restored.

As far as oral health care is concerned, brush and floss as you would normally and see your dentist at the usual regular intervals.

How successful are root canals?

Root canal treatment is highly successful; the procedure has more than a 95% success rate. Many teeth fixed with a root canal can last a lifetime.

Also, because the final step of the root canal procedure is application of a restoration such as a crown or a filling, it will not be obvious to onlookers that a root canal was performed.

Complications of a root canal

Despite your dentist's best efforts to clean and seal a tooth, new infections might emerge. Among the likely reasons for this include:

• More than the normally anticipated number of root canals in a tooth (leaving one of them uncleaned).
• An undetected crack in the root of a tooth.
• A defective or inadequate dental restoration that has allowed bacteria to get past the restoration into the inner aspects of the tooth and recontaminate the area.
• A breakdown of the inner sealing material over time, allowing bacteria to recontaminate the inner aspects of the tooth.

Sometimes retreatment can be successful, other times endodontic surgery must be tried in order to save the tooth. The most common endodontic surgical procedure is an apicoectomy or root-end resection. This procedure relieves the inflammation or infection in the bony area around the end of your tooth that continues after endodontic treatment. In this procedure, the gum tissue is opened, the infected tissue is removed, and sometimes the very end of the root is removed. A small filling may be placed to seal the root canal.

Cost of a root canal

The cost varies depending on how severe the problem is and the tooth affected. If you are not covered by the NHS, then speak to your dentist about the cost for your specific case.

Alternatives to a root canal

Saving your natural teeth is the very best option, if possible. Your natural teeth allow you to eat a wide variety of foods necessary to maintain proper nutrition. The root canal procedure is the treatment of choice.

The only alternative to a root canal procedure is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. These alternatives not only are more expensive than a root canal procedure but require more treatment time and additional procedures to adjacent teeth and supporting tissues.

Since some of the reasons why the nerve of a tooth and its pulp become inflamed and infected are due to deep decay, repeated dental procedures on a tooth and/or large fillings, following good oral hygiene practices (brushing twice a day, flossing at least once a day, and booking regular dental visits) may reduce the need for a root canal procedure. Trauma resulting from a sports related injury can be reduced by wearing a mouth guard.

Dental health: Root canals

What happens during the procedure? continued...

The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Your dentist or endodontist will then use local anaesthesia to numb the area near the tooth. Anaesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetise the area to make the patient more relaxed and at ease.

Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth.

An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.

Once the tooth is thoroughly cleaned, it is sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep contaminants out between appointments.

At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.

The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking and restore it to full function. Your dentist will discuss the need for any additional dental work with you.

How painful is the procedure?

Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling done.

Dental health: Root canals

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.

"Root canal" is the term used to describe the natural cavity within the centre of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth's nerve lies within the root canal.

A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory, to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Why does the pulp need to be removed?

When nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:

Swelling that may spread to other areas of the face, neck, or head

Bone loss around the tip of the root

Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.

What damages a tooth's nerve and pulp in the first place?

Nerve and pulp can become irritated, inflamed and infected due to deep decay, repeated dental procedures on a tooth and/or large fillings, a crack or chip in the tooth, or trauma to the face.

What are the signs that a root canal is needed?

Sometimes no symptoms are present; however, signs to look for include:

Severe toothachepain upon chewing or application of pressure

Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)

Discolouration (a darkening) of the tooth

Swelling and tenderness in the nearby gums

A persistent or recurring pimple on the gums

What happens during the procedure?

A root canal requires one or more dentist surgery visits and can be performed by a dentist or endodontist. An endodontist is a dentist who specialises in the causes, diagnosis, prevention and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist's comfort level in working on your tooth. Your dentist will discuss who might be best suited to perform the work in your particular case.

Dental implants

What is involved in getting a dental implant? continued...

Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw. The healing process can take from six to 12 weeks.

Once the implant has bonded to the jawbone, a small connector post, called an abutment, is attached to the post to securely hold the new tooth. To make your new tooth or teeth, your dentist makes impressions of your teeth, and creates a model of your bite (which captures all of your teeth, their type, and arrangement). Your new tooth or teeth are based on this model. A replacement tooth, called a crown, is then attached to the abutment.

Instead of one or more individual crowns, some patients may have attachments placed on the implant that retain and support a removable denture.

Your dentist also will match the colour of your new teeth to your natural teeth. Because the implant is secured within the jawbone, the replacement teeth look, feel, and function just like your own natural teeth.

How painful are dental implants?

Most people who have received dental implants say that there is very little discomfort involved in the procedure. Local anaesthetic can be used during the procedure, and most patients report that implants involve less pain than a tooth extraction.

After the dental implant, mild soreness can be treated with over-the-counter pain medications, such as paracetamol.

How do I care for dental implants?

Dental implants require the same care as real teeth, including brushing, flossing and regular dental check-ups.

Further Reading:

The health perils of gum disease

Glossary of dental health terms

Gingivitis and periodontal disease (gum disease)

Dental health insurance

Treatments for gum disease

Dental health and oral piercings

Gum problem basics: Sore, swollen and bleeding gums

Dental implants

Despite improvements in dental care, millions of people suffer tooth loss, mostly due to tooth decay, gingivitis (gum disease), or injury. For many years, the only treatment options available for people with missing teeth were bridges and dentures, but today, dental implants are available.

What are dental implants?

Dental implants are replacement tooth roots. Implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

What are the advantages of dental implants?

There are many advantages to dental implants, including:

• Improved appearance. Dental implants look and feel like your own teeth, and because they are designed to fuse with bone, they become permanent.
• Improved speech. With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words. Dental implants allow you to speak without the worry that your teeth might slip.
• Improved comfort. Because they become part of you, implants eliminate the discomfort of removable dentures.
• Easier eating. Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favourite foods with confidence and without pain.
• Improved self-esteem. Dental implants can give you back your smile and help you feel better about yourself.
• Improved oral health. Dental implants don't require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving your long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene.
• Durability. Implants are very durable and will last many years. With good care, many implants last a lifetime.
• Convenience. Removable dentures are just that; removable. Dental implants eliminate the embarrasing inconvenience of removing your dentures, as well as the need for messy adhesives to keep your dentures in place.

How successful are dental implants?

Success rates of dental implants vary, depending on where in the jaw the implants are placed but, in general, dental implants have a success rate of up to 98%. With proper care (see below), implants can last a lifetime.

Can anyone get dental implants?

In most cases, anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. Patients should have healthy gums and enough bone to hold the implant. They also must be committed to good oral hygiene and regular dental visits. Heavy smokers, people suffering from uncontrolled chronic disorders, such as diabetes or heart disease, or patients who have had radiation therapy to the head/neck area need to be evaluated on an individual basis. If you are considering implants, talk to your dentist to see if they are suitable for you.

What is involved in getting a dental implant?

The first step in the dental implant process is the development of an individual treatment plan. The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry. This team approach provides coordinated care based on the implant option that is best for you.