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The wisdom teeth are the last of the permanent molars to emerge from the gums. This can occur as early as age 17 or as late as 21. Though some teens and young adults experience a completely normal tooth eruption with ideally aligned molars that pose no health threat, this is not the case for everyone.

According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), wisdom teeth must meet specific criteria to avoid a required extraction. These guidelines include:

• Completely erupted and non-impacted
• Completely functional
• Painless
• Free of decay
• Disease-free
• Capable of being properly cleaned

If one or more of your child’s wisdom teeth do not meet these conditions, we recommend scheduling an appointment with Dr. Dale Scharine and Dr. Mark Pflum; an extraction may be necessary.

Impacted wisdom teeth

One of the most common reasons for extracting a wisdom tooth is due to impaction. An impacted wisdom tooth is one that has not erupted and will not fully erupt from the gums. Usually this occurs because there is not enough room for the tooth to emerge. Impaction can be painful and can also lead to infection if left untreated. According to the AAOMS, roughly 90 percent of the teen and adult population has at least one impacted tooth. Extracting an impacted wisdom tooth early can help prevent future complications, such as periodontal disease, infections, and damage to neighboring teeth.

Extracting fully erupted wisdom teeth

Even if your child’s wisdom teeth are fully erupted, Dr. Dale Scharine and Dr. Mark Pflum and our team at Elite Smiles Dental may recommend removing them as a preventive measure. Fully-erupted third molars often interfere with a healthy bite. This can lead to problems with tooth and jaw alignment and may also contribute to the development of headaches. Your child’s wisdom teeth may also be more prone to tooth decay and gum disease, because their location in the back of the mouth makes them more difficult to reach for brushing and flossing.

To learn more about wisdom teeth, or to schedule an appointment with Dr. Dale Scharine and Dr. Mark Pflum, please give us a call at our convenient Appleton, WI office!

Dentists use advanced procedures to save teeth which would have been lost a few decades ago. But sometimes, when a tooth is severely compromised, it just can’t be saved. In this case, extraction is the best and healthiest option. 

When might Dr. Dale Scharine and Dr. Mark Pflum recommend an extraction? Conditions which call for extraction could include:

• Extensive Decay

When a tooth has experienced mild to moderate decay, the team at Elite Smiles Dental can remove the decayed portion, clean the area, and restore the tooth with a filling or a crown. If the decay is too extensive, there won’t be sufficient healthy tooth structure left for a restoration, and extraction will be necessary.

• Severe Gum Disease

The CDC estimates that almost 50% of those aged 30 and older suffer from some form of gum disease, with the number rising to over 70% of adults aged 65 and older. Serious gum disease, or periodontitis, is the leading cause of tooth loss in adults. 

Periodontitis can cause the gums to pull away from the teeth, creating pockets where bacteria multiply and infection develops. Left untreated, infection destroys the connective tissue and bone which hold the teeth in place. Teeth become loose and eventually fall out. When tooth loss is inevitable, extraction can be a healthier option than waiting for the tooth to fall out.

• Serious Infection

When infection reaches the pulp inside the tooth, immediate treatment is necessary. An infected tooth will never get better on its own, and the infection can spread from the tooth to the surrounding gums and bone, creating a pus-filled abscess. 

When caught early enough, a root canal procedure can save your tooth. If root canal treatment isn’t possible or infection keeps recurring, extraction can be the best option to prevent infection from spreading and destroying gum and bone tissue.

• Extensive Cracks or Fractures

Caught early, cracks in the crown of a tooth or small fractures in a tooth root might be treated with root canal therapy or endodontic surgery. When a crack in the crown of the tooth extends below the gumline, or when a vertical fracture begins in the root of the tooth and spreads upward to the crown, the tooth often cannot be saved. 

• Wisdom Teeth

When wisdom teeth have no room to erupt, they may become completely impacted, lodged in the bone and gum tissue. Or they may begin to break through the gums but aren’t able to erupt completely (partial impaction), making them difficult to clean and vulnerable to infection and decay. When wisdom teeth begin to erupt without sufficient space, they can move horizontally or diagonally, putting destructive pressure on the roots of neighboring molars. 

• Trauma

Often a dislodged tooth can be restored to its place in the mouth when the injury is treated early enough and the damage is limited. When a tooth or its surrounding bone and ligaments are so badly damaged from trauma that the tooth can’t be reimplanted or restored with endodontic or surgical treatment, extraction is the healthiest choice.

When decay, gum disease, injury, or other conditions make it impossible to save a tooth, Dr. Dale Scharine and Dr. Mark Pflum will recommend extraction to protect your oral health. Dentists who are experts in extractions have the skill and experience needed to:

• gently extract the tooth
• provide you with sedation options before the procedure
• provide options for pain management after the procedure
• give you detailed instructions for aftercare 
• suggest follow-up options such as tooth implants, which can restore your smile with a replacement which looks and functions like a natural tooth

Extraction is never your first choice, or your dentist’s! Proactive tooth and gum care help save teeth for a lifetime. But when a tooth can’t be saved, an extraction is the best option for protecting your oral health. Contact Elite Smiles Dental in Appleton, WI for more information today.

Hearing that you need a root canal can be highly intimidating. What is a root canal? It is the removal of the nerve supply from the tooth. Here, Dr. Dale Scharine and Dr. Mark Pflum will describe the parts of a tooth and explain the reasons for a root canal and how it is done when you visit us in our Appleton, WI office.

Your tooth is made up of many layers. The outside layer is called enamel and is made of minerals. The middle layer is dentin, which is also a calcified tissue, but less dense. The center of the tooth is called the pulp, and that hosts the nerves and blood vessels. A root canal is the removal and replacement of this center with a sterile filling.

A root canal is needed when an infection spreads to the center of the tooth. This can be from trauma (recent or previous), a cavity, a severe crack, or other compromise that causes nerve damage. An X-ray and examination are required to see if a root canal is needed. Symptoms may include but are not limited to pain, swelling, change in tooth color, and over-reaction to temperature change or pressure.

When it is time to begin, you’ll receive local anesthesia (via injection) to make you most comfortable. A rubber dam is used to isolate the tooth, while other equipment determines the nerve location and maintains a sterile working environment. All of the infected area is removed including the nerve tissue and blood vessels. Then, medicines are used to sterilize and alleviate any pain. Next is the placement of a filling material in the spot where the nerve used to be.

When your nerve and blood supply are taken away, the tooth is non-vital, or dead, and can become weak and fragile. If your tooth is badly decayed, a large portion of it will have to be removed. It is recommended to place a crown on the tooth to keep the enamel from breaking or falling apart. If you do not get a crown, you could eventually lose the tooth to more decay or infection. The tooth could also break off completely and you would have to have an extraction. The crown fits over the top of the tooth and secures it from breaking down.

A root canal saves the life of a tooth that would otherwise succumb to further infection and eventually extraction. Infection is the cause of most-needed root canals. If you are ever unsure what is happening at your appointment, don’t be afraid to ask questions so you understand the procedure completely.

It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization.

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

Talk to Dr. Dale Scharine and Dr. Mark Pflum at our Appleton, WI office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.