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Dental Health and Wisdom Teeth

Articles On Wisdom Teeth

Wisdom Teeth

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, they are misaligned and require removal.

When wisdom teeth are misaligned, they may 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 also can be impacted -- they are enclosed within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Partial eruption of the wisdom teeth allows 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 diseas,e because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

How Do I Know if I Have Wisdom Teeth?

Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate for the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral 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 and stage of development. Your oral health care provider 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 minimize the amount of bone that needs to be removed to get the tooth out.

What Happens During Wisdom Teeth Removal?

Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic -- the same type used to numb a tooth prior to having a cavity filled. In addition to the local anesthetic 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 (for example, Valium), 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 healing blood clots to form (blood clots function similarly to 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 beverages through straws or smoke) and avoid hot liquids (such as coffee or soup). These activities can dislodge the clot, causing a dry socket (see below) to develop.
  • Facial swelling in the area where the tooth was extracted typically occurs. To minimize swelling, place a piece of ice, wrapped in a cloth, on that area of your face on a schedule of 10 minutes on, followed by 20 minutes off. Repeat as necessary during this first 24-hour period.
  • Pain medications, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil), can be taken for minor pain. Your dentist or oral surgeon may prescribe more potent pain relievers, if necessary.
  • Antibiotics that may have been prescribed prior to tooth extraction (to treat any active infection around the wisdom tooth to be extracted) should continue to be taken until the full prescription is gone.
  • Foods should be restricted to a liquid diet until all the numbness from anesthesia has worn off. Eat soft foods for a few days. Also avoid alcohol if you're also taking narcotic pain medication.
  • Continue to brush your teeth, but avoid the teeth directly neighboring the extracted tooth during the first 24 hours. On day two, resume the gentle brushing of your teeth. Do not use commercial mouth rinses -- these can irritate the extraction site.

  • 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 towel to the area on a 20-minute on, 20-minute off schedule. 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 oral health care provider 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 oral health care provider.
  • 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.

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 odor. Your dentist or oral surgeon will treat the dry socket by placing medication in the socket.

Paresthesia. Paresthesia is a rarer complication of wisdom teeth extraction. 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 (called a paresthesia) 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?

Simple extraction of a wisdom tooth can cost as little as $99 per tooth. The cost of wisdom teeth that are impacted can cost between $230 and $340 and even more. Because costs vary in different areas of the country, contact your dentist or oral surgeon for their charges. Also, check with both your dental insurance carrier and medical insurance provider. One or the other type of insurance may cover a portion of the cost of wisdom teeth removal.

SOURCE: American Association of Oral and Maxillofacial Surgeons.

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I want to vote absentee

Who can Request an Absentee Ballot?

Any qualified elector (U.S. citizen, 18 years of age, who has resided in the district in which he or she intends to vote for at least 10 days) who registers to vote is eligible to request an absentee ballot. Under Wisconsin law, voters do not need a reason or excuse, such as being out of town on Election Day, to vote absentee. Any voter who prefers to vote by absentee ballot may request one. You have several options for requesting an absentee ballot and casting your vote.

Request an Absentee Ballot by Mail

If you are a registered Wisconsin voter, you can download the Application For Absentee Ballot (EL-121). Just complete the form and mail it to your municipal clerk's office. You can find your clerk at MyVote WI: myvote.wi.gov by searching for your voter record or performing an address search. You can also find your clerk by searching through the list of all Wisconsin municipal clerks. Your application must be received by the clerk no later than 5:00 p.m. on the Thursday before the election in order for an absentee ballot to be SENT to you. You will also need to provide a copy of your acceptable photo ID with your request. If you have not previously provided a copy of photo ID, a copy of your photo ID must accompany your first application by mail. More information about photo ID can be found at www.bringit.wi.gov.

If you are not already registered, you will need to register to vote before an absentee ballot can be sent to you.

Voters who are indefinitely confined, meaning they have a difficult time getting to the polls due to age, illness, infirmity, or disability, may request that a ballot be automatically sent to them for each election. Indefinitely confined voters do not need to provide a photo ID with their absentee ballot request. If you or someone you know are indefinitely confined you will make this designation in box 6 of the Application for Absentee Ballot (EL-121). More information on the exceptions to the photo ID law can be found at: http://bringit.wi.gov/are-there-exceptions-new-law

Military and Overseas voters have additional options for absentee ballot delivery. Click here for Military. Click here for Overseas. Military and permanent overseas voters do not need to provide a photo ID with their request.

Request an Absentee Ballot by E-Mail, Online, or by Fax

Regular Wisconsin voters may also request that a ballot be sent to them by sending an e-mail or fax to their municipal clerk. Registered voters may also use www.myvote.wi.gov to request their absentee ballot by clicking "Vote Absentee." This request must be made no later than 5:00 p.m. on the Thursday before the election in order for an absentee ballot to be SENT to you. If you have not previously provided a copy of photo ID, photo ID must accompany your application. More information about the photo ID requirement can be found at www.bringit.wi.gov.

Instructions for Completing Absentee Ballot

You can find detailed instructions for completing your absentee ballot here: Uniform Instructions for Absentee Voters.

Deadlines for Returning Your Absentee Ballot

Your completed absentee ballot must be delivered no later than 8 p.m. on Election Day. The U.S. Postal Service recommends absentee ballots be mailed one week before Election Day to arrive in time.

In-Person Absentee Voting at your Municipal Clerk's Office (Early Voting)

You can also vote absentee at your local municipal clerk's office. If you apply for an absentee ballot in your municipal clerk's office, or another designated location for in-person absentee voting, you will vote your ballot immediately in the clerk's office, seal your ballot in the proper envelope, and return it to a member of the clerk's staff. No ballots may be taken out of the clerk's office.

You will need to show your acceptable photo ID for voting when voting by in-person absentee ballot. More information about acceptable photo IDs can be found at www.bringit.wi.gov .

When can I Vote an In-Person Absentee Ballot?

Each city, village and town in Wisconsin is responsible for setting the dates and hours of in-person absentee voting for their municipality. To find the dates and hours for in-person absentee voting where you live, contact your municipal clerk.

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Brian Wilson: The Official Website

Brian Wilson: The Official Website

Playback: The Brian Wilson Anthology

Brian's eponymous solo debut for Sire in 1988 launched an extended period of renewal for the iconic Beach Boys composer. Rhino revisits Wilson's solo career with a new 18-song collection that mixes studio and live recordings with two previously unreleased tracks: "Run James Run," a new Brian Wilson wrote and recorded for this collection, and "Some Sweet Day," an unreleased gem he wrote with Andy Paley in the early 1990s for an unfinished recording project.

View The "Brian Wilson Anthology" webisode series:

EPISODE 5: Brian talks about his solo career

EPISODE 3: Brian and Andy Paley talk about "Soul Searchin'"

EPISODE 4: Brian and Andy Paley talk about the previously-unreleased "Some Sweet Day"

EPISODE 1: Brian talks about the release of his new "Anthology" album

EPISODE 2: Brian and Joe Thomas talk about "Run James Run"

Copyright 2018 Brian Wilson Productions. All rights reserved. Website Design and Digital Marketing: Designsite

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The Survival Guide to Getting Your Wisdom Teeth Removed

Stock up on the ice cream and movies, and prepare to reunite with the tooth fairy.

By Stephanie Steinberg, Staff Writer | May 23, 2014, at 3:15 p.m.

Most people have their wisdom teeth removed when they're young because once patients reach their 30s or 40s the procedure can be more difficult with a longer recovery time. (iStockPhoto)

You might be having a routine teeth cleaning when your dentist breaks it to you: "It looks like your wisdom teeth are coming through."

Unfortunately, these teeth won’t bring you bouts of wisdom. (They typically appear between ages 17 and 25, known as an "age of wisdom" – hence the name.)

Not everyone develops the third set of molars, but the American Association of Oral and Maxillofacial Surgeons reports about 90 percent of people have at least one impacted wisdom tooth, meaning there’s not enough space for it to break through the gums. The average person has four wisdom teeth, although it’s possible to have more, says J. David Johnson, an oral surgeon in Oak Ridge, Tennessee. He removes up to 1,500 wisdom teeth a year and once treated a patient with nine.

Regardless the number, "the worst thing the patient can do with their wisdom teeth is ignore them," Johnson says.

Whether you’re guilty of ignoring them (what harm could a few extra teeth do?) or they’re just coming through, Johnson, an American Dental Association spokesman, and Edward Lahey, an attending in oral and maxillofacial surgery at Massachusetts General Hospital and instructor at Harvard School of Dental Medicine, break down what you need to know about wisdom teeth and getting them removed.

Why do people have wisdom teeth?

In prehistoric times, humans had larger, stronger jaws, and wisdom teeth helped with chewing coarse foods such as raw meat and plants. Our ancestors also tended to lose teeth, so a third set of molars (the first develops around age 6 and the second around age 12) had enough room to grow. Fast-forward through evolution, and we have a conundrum: "Modern jaw size and better dental health now make it less likely for wisdom teeth to erupt into a functional position," Johnson says.

How do I know if I have wisdom teeth?

Your dentist can detect if you have an erupted or impacted wisdom tooth. Depending on your dentist’s expertise, he or she may recommend you visit an oral surgeon who specializes in wisdom teeth care.

In some cases, patients may experience symptoms such as swelling in the back of the oral cavity; limited jaw mobility; or pain when chewing. However, the majority of people with wisdom teeth don’t feel any symptoms, which can be just as problematic.

"Just because wisdom teeth are asymptomatic, it doesn’t necessarily mean they’re disease-free," Johnson says. "It’s really important to have someone monitor them because a disease process can occur, and you may not feel it."

Wisdom teeth can lead to infections, lesions, cysts, tumors or damage to adjacent teeth. Johnson says about 25 percent of the population with asymptomatic wisdom teeth develop periodontal disease, also known as gum disease. If ignored, some conditions can escalate and become life-threatening. But if your tooth is disease-free and has room to erupt, then it may be OK to keep. Just make sure to schedule regular checkups, so your dentist can track if the tooth moves or diseases develop, Johnson says.

When’s the best age to remove wisdom teeth?

Wisdom teeth roots typically form during the teenage years. The teeth are easiest to extract and present the least complications up until the roots are two-thirds developed. "Many patients will elect to go ahead and remove their teeth during that time period where the roots are incompletely formed," says Johnson, who adds that it’s important for teens with wisdom teeth to consult with a professional so they "don’t lose that window of opportunity for removal."

As people age, the roots continue to grow. Teeth also reposition, and the difficulty of extraction and related risks – like injuring a nerve – increase as you get older. Once patients reach their 30s or 40s, the recovery can be longer, Lahey says.

When I have the procedure, should I choose laughing gas or anesthesia?

"It’s really the patient’s preference," Lahey says. The question is: Do you want to be awake to see your teeth pulled out or wake up unaware of what happened inside your mouth? In either case, you’ll receive local anesthesia to numb the area – so you won’t feel pain during the procedure – and you’ll need someone to drive you home after.

  • The anesthesia route: You’ll receive a dose of antibiotics to take before the appointment and should not have anything to eat or drink at least six hours prior. During the procedure, you’ll be sedated as the surgeon does his work. When it’s all over, you’ll likely feel sleepy and less alert. Johnson advises that a family member or friend dispense any drugs the first day. "You wouldn’t want a situation where the patient is confused and took the medication inappropriately," he says.
  • The laughing gas route: Remember, it won’t hurt, but you’ll see – and hear – everything. "If their teeth are impacted, the teeth are sometimes sectioned with a surgical drill, so they’re aware of the vibration and the chatter," Lahey says. "And then there’s often brief but sort of intense moments of pressure when (the surgeon) is pushing on the tooth." But inhaling the nitrous oxide should relax you and relieve any anxiety about the drill in your mouth.

Will I be in a lot of pain after?

The level of discomfort depends on the person. Your surgeon can prescribe narcotics such as hydrocodone, oxycodone, Percoset or Vicodin that will alleviate pain.

Patients also don’t have to take narcotics. "You can combine ibuprofen and Tylenol," Johnson suggests. "That’s a very effective way to use less narcotic pain medication and still get extremely effective relief." However, he warns not to take more than 2,400 mg of ibuprofen or more than 3,000 mg of Tylenol in a 24-hour period.

Will my face be puffy?

Sorry, but yes, your cheeks will likely look a chipmunk. In fact, "swelling gets worse before it gets better," Lahey says. Swelling often peaks 48 to 72 hours later and resolves within a week, but keeping your head elevated and applying ice pack compresses will help the swelling go down. Don't be alarmed if you also see bruising or yellowing appear several days later.

When does the bleeding stop?

You might experience intermittent bleeding the first few days. Patients are usually given gauze to bite for 15 to 30 minutes to make it stop. Another trick: Biting on a moist tea bag. "It’s not just a wives’ tale," Johnson says. "That actually has natural constrictors in it that will control the bleeding probably even better than the gauze pad."

If you’re an ice cream fan, here’s some good news: You can eat as much as you want! A liquid diet (yogurt, pudding, smoothies) is recommended the first 24 hours, but do not drink from a straw, since the suction can loosen blood clots. Then it’s a soft foods diet for four to five days: Think mashed potatoes, scrambled eggs and pastas. Avoid anything that requires significant chewing – so no steak! – and opt for colder foods that will feel soothing. And be careful when chewing: "Let the knife and fork do the work for you," Johnson says.

Also minimize smoking and alcohol, especially if you’re taking medication. As for you gum chewers – hold off for a few days. "It’s best just to rest the muscles of mastication," Johnson says.

Should I brush my teeth?

As Lahey puts it, "We like clean mouths." Just don’t brush vigorously or floss around the surgical sites. Also avoid rinsing the first 24 hours. After that, Lahey recommends warm salt water rinses to clean the area.

Maintaining good oral hygiene the following four to six weeks is key to prevent food debris and bacteria from collecting. "Sometimes people will have their teeth removed, and a week later they feel so good they forget to keep it clean, and they get an infection," Johnson says.

When can I return to work?

Many patients schedule the procedure on a Thursday or Friday, and they’re back to work or school by Monday, but it depends on the individual. "If you’re requiring strong pain medication to stay comfortable, that is an indicator you shouldn’t be back at work," Johnson says, adding that you should not drive or operate machinery when taking narcotics.

Patients also shouldn’t do heavy lifting, strenuous workouts or play a wind instrument the first week after the surgery.

Have more questions?

Ask your doctor. Lahey emphasizes that you should feel comfortable with your oral surgeon, who should review potential complications with you before the procedure. "I think people might be dismissive of, ‘Oh I’m getting my wisdom teeth out, everyone does it,’ but there are risks involved," he says. "It’s important to pay attention, and ask questions."

10 Surprising Habits Killing Your Teeth

Your teeth deserve better.

Are you destroying your pearly whites without realizing it? You might be doing permanent damage if you’re a nail biter or using your teeth to rip off the price tag from that new dress. Stop and heed this advice: “Brush your teeth twice daily, floss daily, regularly visit your dentist and have a good, balanced diet. All of those things are going to protect you from damaging your teeth and enamel,” says Ana Paula Ferraz-Dougherty, a dentist in San Antonio and consumer adviser for the American Dental Association. Here are some surprising ways you’re damaging your teeth:

1. Overdoing sugary food and drinks – even cough drops

Forget cookies, cupcakes and candy. Those are obvious cavity-promoting foods. “Astonishingly enough, even things like throat lozenges can be bad,” says Ruchi Sahota, a dentist in Fremont, California, and consumer adviser for the ADA. “But we also want to think about where we might be getting other sources of sugar, like sports drinks and not enough water.” (You need water to wash your teeth of the sugar that creates cavities.) The good news is you can help stave off cavities by using toothpaste recommended by your dentist and keeping the sugary snacks to a minimum.

2. Lack of water

Skip the energy drinks, flavored sports waters and ice teas if you want to dodge cavities. Instead, drink H2O. “Not only is it good to hydrate your body, but it’s good to hydrate your mouth," Sahoto says. "A dry mouth can be an environment where it’s easier for bacteria to cause cavities." Flouride is found in tap water and some bottled water and can ward off tooth decay. “That’s why it’s important to drink as much as possible,” Sahoto says.

3. Nail biting

Get your fingers out of your mouth. When we bite our nails, we put our jaws in a protrusive position, meaning the lower jaw projects out and moves in a repetitive, unnatural way, Sahoto explains. It can cause pain and discomfort in the jaw, plus wear down the enamel on your pearly whites. “It’s also a very common cause for chipped teeth,” Ferraz-Dougherty says. Need to kick the habit? Try using a bitter-tasting nail polish or reducing your stress levels.

4. Heavy brushing

“Brusha, brusha, brusha!” Jan had great intentions in the musical “Grease,” but go easy on your chompers, Sahoto says. “Brushing aggressively can abrade our teeth,” she says. Not only can it strip the teeth of their enamel, promoting cavities and decay, but it can also cause the gums to recede. “That doesn’t look very nice, but it also exposes the roots.” Sahoto says. Think of brushing as a massage for your teeth and gums – gentle strokes will do the trick.

5. Consuming acidic food or drinks

People who have acid reflux or drink lemon water can expect to see damage to their teeth, says Genaro Romo, a dentist in Chicago and consumer adviser for the ADA. “So often, [acidity] is overlooked,” Romo says. Acidic foods can strip the teeth of their natural enamel – the protective coating that blocks cavities and tooth decay. Citric fruits and fruit juices, sparkling water with lemon and even certain salad dressings are so acidic that they can cause the tooth's enamel to erode.

6. Neglecting baby teeth

Kids might lose their baby teeth, but that doesn't mean they're not an important part of their health. In fact, these first teeth help predict how healthy adult teeth will be, Romo says. Baby teeth are meant to fall out, but each tooth has a timeline. If a tooth decays and is pulled out too early, there may be insufficient space available for the adult tooth to grow. Losing a baby tooth prematurely can shift other teeth, forcing a child to need braces later in life.

7. Using your teeth as tools

You had that one friend in college who could pop open a beer with his mouth. Have you seen him since? Using your teeth as tools to open bottles, rip off tags or for any purpose besides chewing food can cause serious fractures. These can worsen over time and become infected, Sahoto says – check for discolored teeth in the days, weeks or months after a trauma.

8. Thumb sucking

It sounds innocent, but thumb sucking is considered a trauma, dentists say. The habit pushes on the upper palate, forcing permanent teeth to move or spread apart. And it's a hard one to break, Sahoto says. “That’s why it’s important kids see the dentist by age 1 or when the first teeth appear,” she adds. Dentists can talk to parents about proper dental care and ways to break the habit, such as using praise when a child doesn't suck his or her thumb rather than criticism when they do, or encouraging the child to limit their thumb sucking to bedtime rather than all day.

This is a given. Smoking has proven health consequences – like increasing the risk for oral cancer and respiratory conditions – and that extends to teeth. “The chemicals found in tobacco can really create some very stubborn stains,” Sahoto says, plus create bad breath. Huffing on cigarettes also increases plaque and bacteria, which can lead to gum disease. That's not good when you consider gum disease is the most common cause for tooth loss, according to Dentalhealth.org. The ADA suggests trying to quit smoking by exercising, chewing gum and staying occupied.

10. Chewing ice

You take a sip of your soda, catch a couple ice cubes in your mouth and what do you do? Chew them, right? Bad move. Don’t do this often – or ever – if you want to prevent a painful injury. “Ice is very hard. It can cause breakage of teeth and fillings," Ferraz-Dougherty says. "It’s a bad habit that people have, and it’s not necessary. It’s not worth the risk of breaking a tooth.” Long-term effects also include jaw pain and tooth sensitivity.

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