As our bodies grow to adulthood, our mouths include a hidden reminder of youth called wisdom teeth. When these teeth finally emerge, usually between the ages of 17-21, they often don’t have the space they need to grow in straight, which can cause serious oral problems and require an extraction. Wisdom tooth extraction requires expert care, such as that given by Mas’ood Cajee DDS MPH in Manteca, CA.

What Are Wisdom Teeth?

Most adults have four wisdom teeth: one in each of the back corners of the mouth. While these molars are actually permanent teeth, by the time they erupt they often get stuck against other teeth because there’s not enough space for them to come through normally. This failure to emerge properly is called an impaction and can cause pain, inflammation and infection.

Some people never develop wisdom teeth. For other lucky individuals, the wisdom teeth grow in normally, just as their other molars did, and cause no problems. However, many, if not most people develop impacted wisdom teeth that erupt only partially or not at all. The wisdom tooth can grow at an angle under the gum line, pressing against healthy teeth and gum tissue. Poor alignment of wisdom teeth can crowd or damage adjacent teeth and even the jawbone itself.

Wisdom teeth are not something that can be dealt with on an at-home basis using straightening kits from internet vendors like SmileDirectClub. These services claim to solve dental and orthodontic problems without the need for medical expertise, but patients should be forewarned. Wisdom teeth require special attention and often an extraction, which of course must be done by a skilled dentist or oral surgeon.

What Is Wisdom Tooth Extraction?

Wisdom tooth extraction is a procedure to remove one or more of the wisdom teeth. When a wisdom tooth causes pain, infection or other dental problems, you’ll likely need to have it extracted. To prevent future problems, some dentists and oral surgeons even recommend preventive extraction even if wisdom teeth aren’t currently causing problems.

The case for pre-emptive wisdom tooth extraction is compelling and worth considering. Even if it’s not already causing pain, an impacted wisdom tooth may grow at odd angles next to adjacent teeth or the back of the mouth. It can stay trapped under the gum line like a ticking time bomb waiting to cause pain and oral damage. In most cases, the tooth will need to be extracted, and for many, sooner is better than later.

Extract Them Now or Wait?

As your wisdom teeth make their way through your gums, your dentist will help you make the best oral care choices. When patients reach the age where wisdom teeth can be problematic, it’s imperative that a dental expert monitor your mouth for signs of potential issues. These include:

Wisdom Teeth That Haven’t Erupted Properly

Poorly erupted wisdom teeth can grow too close to the molars next to them, making it impossible to floss between the two teeth. This puts adjacent teeth at risk for cavities and decay.

Wisdom Teeth That Aren’t in the Right Position for Healthy Eruption

When a wisdom tooth is misaligned as it erupts (a common condition), the emerging tooth can allow food to become trapped. This gives cavity-causing bacteria a place to grow, threatening nearby healthy teeth.

Wisdom Teeth That Have Only Partially Emerged

A wisdom tooth that breaks through the gum but doesn’t grow in further gives bacteria a place to enter the gums and creates conditions for infection. This can lead to pain, swelling and stiffness in the jaw.

Wisdom Teeth That Don’t Have Room to Come Through

By the time people are the age for wisdom teeth to come through, their other teeth are already in place. A wisdom tooth trying to break through can crowd or damage neighboring teeth, affecting chewing function and aesthetics.

An Impacted Wisdom Tooth That Has Formed a Cyst

These fluid-filled sacs can infect the roots of nearby teeth and even damage the bone that supports the teeth. Their potential damage can also spread beyond the teeth into the sinus areas.

How Will I Know When It’s Time to Extract?

It’s difficult to predict future problems with impacted wisdom teeth. Moreover, it’s normal to experience some discomfort when wisdom teeth finally do begin to erupt. However, the signs of an impacted wisdom tooth are unmistakable. Patients will likely need an impacted wisdom tooth extracted when they experience one or more of the following problems:

• Pain from the erupting wisdom tooth
• Food and debris collecting near the eruption
• Gum disease or infection near the wisdom tooth
• Tooth decay in a partially erupted wisdom tooth
• Development of a cyst near the eruption

Most dentists recommend impacted wisdom teeth be removed when the roots are between one to two-thirds formed. X-rays taken by your dentist will reveal the stage of the wisdom teeth and help you formulate a plan for extraction. Waiting too long to take these teeth out makes the extraction more difficult and can increase the risk of complications, such as potential damage to your nerves and sinuses.

Wisdom Teeth and At-Home Cosmetics

Cosmetic dentistry and orthodontic aesthetics have enjoyed increasing popularity in the past several years thanks to new techniques and technologies. These improvements should always be guided by a dental or orthodontic expert rather than attempted as at-home treatments. This caution is particularly true when wisdom teeth may erupt during orthodontic treatments such as braces.

When wisdom teeth finally start to emerge, they can disrupt the alignment of nearby teeth. This can serve to undo the effects of at-home aesthetic treatments that have not taken the individual’s whole oral condition into account. When using an at-home orthodontia kit, there’s no expertise available to identify underlying conditions, such as a wisdom tooth that’s ready to erupt or growing in poorly.

There’s nothing more frustrating than months spent on fixing a smile only to have the work undone by an unforeseen wisdom tooth. In many cases, the at-home kit has to be abandoned until the wisdom tooth or teeth have been extracted, resulting in a waste of time and money as well as frustrated expectations. Expert oral care throughout your orthodontic journey is essential for creating your ideal smile.

What Can I Expect During the Procedure?

Wisdom tooth extraction is done on an outpatient basis at your dentist or oral surgeon’s office. Patients may feel woozy from the procedure or from anesthetics, but they return home right after the extraction. Many dentists and oral surgeons will recommend that family or a friend drive the patient home after the procedure for safety’s sake.

During the procedure to remove one or more wisdom teeth, your dentist or oral surgeon will use one of three types of anesthesia, depending on the complexity of the extraction and your individual comfort level. From simplest to most intensive, these are the three levels of anesthetic:

Local Anesthesia

Your dentist or surgeon will apply a substance to your gums to numb them. Then, one or more pain-blocking injections will be made near the site of each extraction. Patients are awake during the extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain during the procedure.

Sedation Anesthesia

If the extraction will be especially complex, your dentist or oral surgeon may apply sedation anesthesia through an intravenous line in your arm. The patient is not consciousness during the procedure and will have limited memory of it.

General Anesthesia

In especially difficult or complex situations, such as one where multiple wisdom teeth will need to be removed, an oral surgeon may call for general anesthesia. Medication to knock you out is applied through the nose or the arm and the patient is unconsciousness throughout the proceedings.

How Does the Procedure Work?

If the wisdom tooth hasn’t come through the gum, your dentist will make a small incision in the gum to access it. A small piece of any bone covering the tooth may also need to be removed. The tooth may be cut into smaller parts to make it easier to remove through the opening. There’s less need to make an incision if the tooth has broken through the gum.

In most cases, for a single wisdom tooth, the patient is only under local anesthesia. In these cases, you’ll feel some pressure just before the tooth is removed. Often the dentist or oral surgeon needs to widen the tooth socket by rocking the tooth back and forth before taking it out. How long it takes to remove the tooth will vary. Simple procedures can take a few minutes, but it can take longer than 20 minutes if it’s more complicated.

What Is Recovery Like?

Depending on the severity of the case, it can take up to 2 weeks to fully recover after having wisdom teeth removed. During this time, patients may have a swollen mouth and cheeks. This will be worse for the first few days but will gradually improve. A stiff, sore jaw is not uncommon, and these effects will wear off within 7 to 10 days.

Also, depending on the severity of the case, the recovering patient may feel some pain for a few days. This will vary in intensity and length depending on whether the extraction was difficult or complicated. Your dentist or oral surgeon may prescribe pain medication, but in most cases, simple over-the-counter ibuprofen is the best painkiller to take after having wisdom teeth removed.

In broad strokes, the healing process from a wisdom tooth extraction will follow a pattern:

• First 24 hours: Blood clots will form around the extraction point
• 2 to 3 days: Any swelling of the mouth and cheeks will improve
• 7 days: Your dentist will remove any stitches
• 7 to 10 days: Residual jaw stiffness and soreness should go away
• 2 weeks: Any mild bruising on the face that may have occurred will heal

Time to Take Action

When a wisdom tooth becomes impacted, the damage has already been done and must be addressed by your dentist. Regular checkups and X rays will help you and your dentist keep abreast of potential upcoming problems with wisdom teeth. This lets you make plans and minimizes the chance of pain and possible complications.

Wisdom teeth can cause serious oral problems. Even when they seem to be erupting properly, they cannot be aligned by an at-home straightening kit. An expert such as your dentist needs to take thorough X-rays and work with you to formulate a plan for wisdom tooth management. He or she can also advise you on cosmetic straightening treatments that will be more effective than any self-guided methods, such as the ‘straightening of the month clubs.”

Your smile and oral health are too important to be left to amateurs. For expert care on wisdom tooth extraction and cosmetic enhancement of your smile, make an appointment with Mas’ood Cajee DDS MPH, in Manteca, CA today!

Having a missing tooth can affect the way you feel about your smile and your appearance. It can also affect your dental health long-term. If you have a missing tooth and need a replacement, you may have heard of a dental bridge. This is just one of the many dental services we offer here at the office of Mas’ood Cajee DDS MPH in Manteca, CA.

But you may wonder what a dental bridge is and when it is a good idea to get one. We will answer those questions in this article. We will also discuss the different types of bridges, benefits of bridges, and what to expect from the treatment.

A Dental Bridge: What Is It?

If you have space in between your natural teeth where you’re missing your tooth or multiple teeth, then a dental bridge can “bridge” the gap between them. This will allow you to replace it, restoring function and esthetics. A bridge is made up of at least three artificial teeth called crowns that are connected together into one continuous piece. The crown or crowns in the middle replace the missing tooth or teeth.

Parts of a Bridge

Each tooth in a bridge is known as a unit. Bridges typically have up to six teeth, or units, which means they are ideally used to replace a maximum of four teeth except in special cases.

The teeth on either side of the in-between space are called abutments. These teeth are shaped so that the crowns on the end of the bridge can be permanently cemented to them. The replacements for the missing teeth in the gap are called pontics. How many pontics are needed is based on how many teeth are missing.

The abutment crowns and the pontics are all artificial teeth that resemble natural teeth; these form one continuous unit for a natural look.

Types of Dental Bridges

There are several types of bridges, and which one is chosen depends on your personal situation and dental health. These include traditional bridges, cantilever bridges, Maryland bridges, and implant-supported bridges.

Traditional Bridge

The traditional bridge is made of a false tooth or false teeth that are held in place by dental crowns cemented onto the abutment teeth. This is the most popular type of bridge that is used when you have natural teeth on both sides of the gap where the tooth is missing.

Cantilever Bridge

The cantilever bridge is similar to a traditional bridge, but the pontic is held in place by a crown cemented to only one abutment tooth. With this type of bridge, only one natural tooth is needed next to the gap where the tooth is missing.

Maryland Bridge

Like a traditional bridge, the Maryland bridge uses two natural abutment teeth on either side of the gap. However, instead of using abutment crowns, the Maryland bridge uses a metal or porcelain framework that is bonded onto the backs of the abutment teeth.

Implant-Supported Bridge

If you have multiple teeth missing right next to each other and want implants for each individual tooth, you can have an implant-supported bridge on top of them. The implants will hold the bridge in position.

If you can’t have an implant placed for each individual missing tooth, then implants may be used as abutments on either side of a missing tooth. The pontic will be suspended in between the two implant-supported abutment crowns. This is considered the most stable and strongest system, but it does require two surgeries and months of time before the bridge is actually placed.

Materials Used for Bridges

There are many materials that can be used for bridges, including:

• Porcelain
• Porcelain fused to metal
• All-metal
• Gold
• Zirconia

Which material is chosen depends on the area of the mouth, esthetics, the alignment of the teeth, and more. Here at our office, we use BruxZir® Solid Zirconia for our bridges, which is a brand of full-contour Zirconia that is a very strong, highly esthetic material. In fact, it is the most widely used brand for bridges in the dental world, with an excellent record of success.

When Is It a Good Idea to Get a Dental Bridge?

In order to understand when a bridge is a good option, it is good to know how areas of the mouth are classified in the dental world.

The mouth is divided into four quadrants: upper right, upper left, lower right, and lower left. The top jaw and bottom jaw are both called arches, and the front six teeth are anterior while the six back teeth on both sides are posterior. These classifications allow dental professionals to identify tooth numbers and areas of the mouth easily. Knowing the arch, quadrant, and tooth numbers can help them determine if it is a good idea for you to get a bridge.

There are several situations where a dental bridge is a great option. These include missing teeth on the same arch, missing anterior teeth, disqualification for implants, disinterest in implants, and disinterest in partials/flippers.

Missing Teeth on the Same Arch

If you have one or more missing teeth on one side of your mouth with healthy teeth in healthy bone, then a bridge is a great option for you. The dentist can replace up to four missing teeth on one side, creating a bridge with up to six units.

Missing Anterior Teeth

No one wants to have front teeth missing. If you are missing one or more front teeth and want a fixed replacement, you can have a bridge anchored to the teeth on the sides of the missing space as a replacement.

Disqualified for Implants

You may have looked into options for replacement and desired implants only to be informed that you did not qualify as a candidate due to bone loss or other health conditions. If this is the case with you, and you have healthy teeth with good bone on either side of the empty space, then a bridge is an excellent option.

Disinterest in Implants

Even if you qualify for implants, you may not want to have surgery and then have to wait months before you can replace your tooth. In these cases, a bridge is still an excellent option that will provide you with a faster replacement option.

Disinterest in Partials/Flippers

You may not want to invest in a partial or a flipper because it is removable. If you want a fixed solution to missing teeth instead of a removable solution, then it is a great idea to get a bridge.

The Benefits of Dental Bridges

A Fixed Solution

Because a bridge is cemented to the teeth using a permanent cement, you will not have to worry about taking it in and out. This is a great advantage over other tooth replacements like partials or flippers.

Fast Treatment Process

Some processes to replace teeth like implants and partials can take several steps. However, bridges can typically be completed in just two appointments. This allows you to get your tooth replacement in less than a month in most cases.

Improved Tooth Function

As discussed above, having missing teeth can cause a lot of problems in the mouth. By replacing a missing tooth with a bridge, you are restoring the ideal function of the mouth. This will allow the teeth to take on the proper amount of force and perform the functions they are intended to, preventing cracks or breaks.

Better Eating Ability

Losing a tooth or multiple teeth can affect your ability to eat some of your favorite foods, especially tougher foods like steak, chicken, and more. Because the bridge uses teeth on either side of the missing space for support, you can chew on the bridge without worrying about it breaking.

The bridge will also keep you from having to chew with teeth that are not intended to be used for chewing, so you can eat more easily without tooth discomfort or pain. This will allow you to eat more of your favorite foods once again.

Longevity

Studies show that bridges can last anywhere from 10 to 15 years with proper home care. This means that your initial investment will not go to waste, so you can continue to have your missing tooth replaced for years to come.

Esthetics

Missing a tooth can make you feel self-conscious when you talk or smile. It can even affect your desire to have daily conversations with people, especially in the workforce. By replacing your missing tooth or missing teeth with a tooth-colored bridge that is cemented, you won’t have to worry about how your mouth looks while you interact with others. You can have a replacement that looks and feels natural.

The Dental Bridge Process: What to Expect

The Exam

At your initial exam, the dental assistant and dentist will take any x-rays and pictures needed and perform an oral examination to make sure a bridge is a viable option for you. They will also discuss your dental and medical history and answer any questions you may have. If time is available and you are ready to proceed, you may even begin the bridge the same day.

The First Appointment

At the first appointment, Dr. Cajee will numb your teeth if needed. The assistant will take an impression of your teeth as a guide to make your temporary crowns or temporary bridge. A shade will also be selected to provide as close of a match to your natural tooth color as possible.

The teeth on either side of the space will then be shaped as needed with a handpiece and burs to fit a crown on them. The doctor will make an impression and bite record to send to the lab to fabricate your final bridge.

Depending on your situation, temporary crowns or a temporary bridge will be fabricated, fitted to your teeth and your bite, and cemented with temporary cement for you to wear until your final crown is delivered. This typically takes a couple of weeks, so be sure to follow all the precautions and care instructions given for your temporary.

The Second Appointment

At the next appointment, your temporary will be removed and all temporary cement will be cleaned from your teeth. The shade will be compared to your natural teeth to make sure you are satisfied. If you are satisfied with the color, your bridge will then be fitted and adjusted as needed to make sure your bite is correct and you can floss in between the teeth easily.

Once the fit is correct, the doctor will cement the bridge to your teeth using permanent cement and clean all the excess. You will then go over home care instructions and methods and have all your questions answered.

Replacing Your Missing Tooth

We know how much a missing tooth can affect your life. Call us here at the office of Mas’ood Cajee DDS MPH in Manteca, CA so we can provide you with the smile and tooth health that you desire. If you are missing a tooth and would like to know more about bridges, schedule a consult today! We look forward to hearing from you and taking care of your dental needs.

We live in a very fast-paced culture—we want everything quickly and cheaply. Sometimes this is wonderful, but the problem happens when companies offer discount solutions on your health and the health of your mouth. SmileDirectClub is offering such a discount, but it’s important to know all the downsides and risks associated with it and why seeing a legitimate dentist, like Dr. Mas’ood Cajee DDS, MPH in Manteca, CA, is the safest and most effective way to have the smile of your dreams.

What Is SmileDirectClub?

SmileDirectClub offers consumers 3-D printed aligners that claim to straighten the customer’s teeth in as little as six months. Customers have a do-it-yourself dental mold kit sent to their homes. The customer takes a mold of their mouth and sends it back. The company examines the mold so they can, according to their website, “see exactly what’s going on”. They send you a picture of what they think your smile will look like after treatment and, if you like the image, they send you a series of aligners.

They also pair you with a dentist or orthodontist that checks in with you every 90 days, remotely, to monitor your progress. Once they determine your treatment is complete, you can buy a retainer to keep your smile the way they’ve left it. Sounds great, right? Not so fast…

What’s the Downside?

There isn’t just one, there are several.

No Relationship

The profession of dentistry is based on the doctor/patient relationship. The doctor receives all the education and training necessary to address their patients’ needs. SmileDirectClub has created a company/consumer relationship, and that can be dangerous when dealing with your mouth health. When you buy from a company, they play the number. They want to make most people happy and satisfied but understand some just won’t be and aren’t bothered by individual needs.

If you’re one of the consumers that ends up unhappy with their services, it could mean your teeth are damaged, or worse, falling out. That’s a risk they’re willing to take. Because you’re just a customer, there is no relationship to understand your specific needs, your lifestyle or your expectations.

No Recourse

If something goes wrong, if you don’t get the results you want, if something hurts—there’s nobody to see. The dentist they pair you with every 90 days is seeing so many people, impersonally, there no chance for a relationship to form. This leaves you in charge of your dental health without ever having gotten any training.

Are There Risks?

There are many risks in trusting your smile to a DIY program. The minute a computer is more responsible for your smile than a person is, you’re opening yourself up to potential risks.

Your Roots and Bones

Starting at the top is the fact that the mold of your teeth is the only tool being used to determine how to straighten your teeth. The molds they send you are solely based on your teeth they can see, but that’s only half the picture. It’s critical to know what your roots are doing to understand fully how your teeth will respond to treatment and how dynamic that treatment needs to be.

Think of it as a company wanting to fix your foot by looking only at your toes, it neglects a large part of the picture necessary to provide successful treatment. A computer is doing 3-D modeling, so it makes the assumption your bone will grow with your teeth, but that’s not necessarily the case. In fact, as the company makes clear, they’re not practicing medicine.

Doctors Not Practicing Medicine

Another big concern is that a company that employs doctors is making it explicitly clear they are not practicing medicine. When you see a dentist in person, you know you’re being treated by a doctor with years of education and training who uses all the tools at their disposal to make sure you’re cared for and get the best possible results.

Some people will be attracted to this kind of mail-in teeth straightening because it’s cheaper and they may think their teeth don’t need that much work. The issue with that is, without training, none of us is qualified to say how minimal a fix we need. Always keep in mind, as dentists and orthodontists know, when you slightly move one tooth, the whole mouth can shift.

Results using these types of aligners can be really hit and miss because everyone responds differently to a treatment. It’s an impossible task to get consumers to monitor their own dentistry. Making sure you have a good relationship with a dentist will also allow you to express concerns to him and understand what’s normal and what isn’t.

Lack of Progress

Some of the biggest issues for past customers of SmileDirectClub have been the inability to get any answers when concerns pop up, progress isn’t being made, or by the end of “treatment” nothing has changed. Past customers have said they couldn’t get an answer when their new aligner was causing them a lot of pain and the company wouldn’t replace it.

There are the stories of customers who just had very little to no results, even after several attempts at treatment. At the end of the program, they determine, via picture or mold, if your teeth have moved in a way that’s considered successful to them, and if they have, you’re not getting a refund. And then there are the horror stories.

If something is going really wrong in your treatment, how can you know? You can describe your symptoms to the dentist you talk to once a quarter via teleconference, but explaining what’s happening will never be as effective as your dentist being able to see for himself. This company has one tool in their arsenal for progress—a plastic aligner. A dentist has many tools and techniques to get you to your goals.

Serious Complications

More than lost money or poor customer services, some customers have suffered significant injuries from this program.

Losing Teeth

This is when things get scary. Because they send customers a series of aligners they have to wear for a few weeks, then move on to the next one, with no real dentist accountability, serious issues are arising. Customers are supposed to wear these at all times with the exception of eating and brushing their teeth—pretty straight forward, right? Well, we’re human.

Some people have gotten their aligners, worn them a bit but taken them out for much longer than they’re supposed to. To make up for it, they will wear that specific aligner a few days longer than suggested. What’s essentially happening in their mouths is a constant wiggling of their teeth. Wiggled teeth become loose teeth and loose teeth can fall out—in less than the 90 days between dentist teleconferences.

Because they’re not seeing a dentist with whom they have a relationship, there’s no doctor to monitor patient accountability. As patients, we need to take an active role in our tooth health, and that’s something we understand. As customers, we’re just using a company’s product, and that’s an important distinction to be aware of.

Misaligned Bite

After paying the full price of treatment, this company may tell you that your treatment is complete and your smile is fixed. But something doesn’t feel right. This has been well documented with past customers who paid for the aligners and later had to visit a dentist. They ended up having even more treatment than they would have if they had just gone to a dentist off the bat.

One customer ended up with a tooth slightly elevated in a way that prevented his other teeth from coming together. This was not an issue he started with—he just wanted a small amount of straightening. If you go looking, you’ll hear a lot of these stories. People believe and trust that this company has their best interests at heart, and while we don’t think the company is being malicious, they can never replace a relationship with a dentist.

They offer a warranty lasting 30 days. Many customers have issues happening around day 60 or 90. If your treatment gets off track with a set of pre-fab aligners, it may be very difficult or even impossible to get back on track. If one set doesn’t fit and there’s a delay in your next set, by the time they actually arrive your teeth will have already shifted, starting a dangerous cycle.

Other Potential Risks

If you read the agreement a customer has to sign to buy their aligners, the potential risks are severe. These may be risks inherent to anyone undergoing this kind of treatment but because there is no relationship with a dentist, there’s nobody to tell if what’s happening could lead to a severe side effect. If you’re receiving treatment from an in-person dentist, they can head trouble off at the pass.

Here are a few of their self-proclaimed risks associated with their aligners:

• Discomfort
• Periodontal and gum disease
• Cavities
• Shortening of the roots
• Nerve damage
• TMJ
• Possible replacement of previous dental work
• Impacted teeth

Many of these side effects wouldn’t become serious if there were regular appointments with a dentist who can see what’s happening with your individual treatment.

Risk vs Reward

It can be very enticing to think of paying a fraction of the price of traditional teeth straightening, but for every reward, there’s a risk. Not having a relationship with a dentist means there will be details you won’t share with a remote dentist, because you may not feel comfortable and that can cost you in the long run.

We always feel more comfortable talking about real issues with dentists and doctors we have a personal relationship with because we know our dentist wants everything to work out for us. It’s their work they’re standing by, and they’ll do everything they can to ensure they do their job well. A company is just a company.

Price can be prohibitive, but many dentists have financing options for patients, and if you’ve been living with a slightly imperfect smile for a while, you might be better off waiting until you can afford traditional services instead of risking causing more damage and a bigger bill in the long run.

Call for a Consultation

One of the best ways to understand the condition of your smile, what it will cost and what your choices are is to form a relationship with a dentist. Give yourself the benefit of choosing a highly trained and experienced dentist so you know you’re in capable hands.

Call the office of Dr. Mas’ood Cajee, DDS, MPH in Manteca, CA and schedule an examination to understand your options. He and his staff are committed to the health of your smile and will be with you every step of the way.